Nursing Pharmacology Final Exam 2023.

Nursing Pharmacology Final Exam 2023.Beta Blockers: Category, Action, Use, Side Effects, Nursing Measures - ANSWER - Category: Cardiovascular/Antiarrhythmics; Antihypertensives; Antianginals - Action: blocks stimulation of beta1-adrenergic receptors - Use: decreased BP & heart rate, decreased attacks of angina - Side Effects: bradycardia, fatigue, weakness, HF, pulmonary edema, erectile dysfunction - Nursing Measures: monitor BP/ECG/Pulse; Monitor q5-15 min after parenteral administration; I/O; Daily weights; S/s of HF (dyspnea, rales/crackles, weight gain, peripheral edema, jugular vein distention); increase in BUN/lipoprotein/potassium/triglycerides/uric acid - Examples: metoprolol (Lopressor); atenolol (Tenormin) Digoxin: Category, Action, Use, Side Effects, Nursing Measures - ANSWER - Category: Cardiovascular; Antiarrhythmics; Inotropics - Action: Increases the force of myocardial contraction, prolongs refractory period of the AV node, decreases conduction through the SA and AV nodes; increased cardiac output and slowing of the HR - Use: HF, Afib, Atrial flutter, paroxysmal atrial tachycardia - Side Effects: fatigue, arrhythmias, bradycardia, anorexia, nausea, vomiting - Nursing Measures: therapeutic range (0.5-2 ng/ml); Monitor apical pulse for 1 min (withhold less than 60 bpm); monitor BP; monitor ECG throughout IV admin and 6 hr after each dose; observe for infiltration; falls risk in geriatric; electrolyte levels (potassium, magnesium, calcium); s/s toxicity (ab pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, arrhythmias) ACE inhibitors: Category, Action, Use, Side Effects, Nursing Measures - ANSWER - Category: Cardiovascular; Antihypertensives - Action: block the conversion of angiotensin I to the vasoconstrictor angiotensin II. Prevent the degradation of bradykinin and other vasodilatory prostaglandins. Increase plasma renin levels and decrease aldosterone levels. Results in systematic vasodilation - Use: HTN, symptomatic HF, Slowed progression of asymptomatic left ventricular dysfunction to overt HF - Side Effects: cough, hypotension, proteinuria, hyperkalemia, angioedema - Nursing Measures: Administer over 5 minutes; Monitor BP and pulse; assess for s/s of angioedema (swelling of face, extremities, eyes, lips, or tongue; difficulty swallowing or breathing); monitor renal function (increased in BUN & Creatinine); monitor CBC (decrease Hbg & Hct) - Examples: enalapril (Vasotec), lisinopril Nitoglycerin: Category, Action, Use, Side Effects, Nursing Measures - ANSWER - Category: Cardiovascular; Antianginals; Nitrates - Action: increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic regions. Produces vasodilation (venous arterial); decreases left ventricular end-diastolic pressure and left ventricular end-diastolic volume (preload); reduces myocardial oxygen consumption; increased cardiac output; reduction of BP - Use: management of angina pectoris; production of controlled hypotension during surgical procedures; treatment of HF associated with acute MI - Side Effects: dizziness, headache, hypotension, tachycardia, contact dermatitis - Nursing Measures: administer 1 h before or 2 h after meals with a full glass of water; do not break; monitor BP and pulse before and after administration; urine catecholamine; false increase serum cholesterol levels Adrenergics: Category, Action, Use, Side Effects, Nursing Measures - ANSWER - Category: Cardiovascular; Inotropics, Vasopressors - Action: small doses (0.5-3 mcg) stimulate dopaminergic receptors producing renal vasodilation; larger doses (2-10 mcg) stimulate dopaminergic and beta1-adrenergic receptors producing cardiac stimulation and renal vasodilatior; doses greater than 10 mcg stimulate alpha-adrenergic receptors and may cause renal vasoconstriction; increased cardiac output, increased BP, improved renal blood flow - Use: Improve BP, cardiac output, urine output in tx of shock unresponsive to fluid replacement; increase renal perfusion - Side Effects: arrhythmias, hypotension, irritation at IV site, ECG change, vasoconstriction - Nursing Measures: extravasation may cause severe irritation, necrosis, and sloughing tissue; dilute 200-800 mg of dopamine in 250-500 ml of NS, D5W, D5/LR, D5 0.45 % NaCl, D5NS, or LR; Monitor BP, HR, Pulse pressure, ECG, pulmonary capillary wedge pressure, cardiac output, CVP & urinary output; Palpate peripheral pulses and assess appearance of extremities - Examples: dopamine infusion (Intropin); albuterol, epinephrine Verapamil (Veracaps SR): Category, Action, Use, Side Effects, Nursing Measures - ANSWER - Category: Calcium Channel Blocker, Antianginals, Antiarrhythmics (Class IV), Antihypertensives, Vascular headache suppressants - Action: inhibits the transport of calcium into myocardial and vascular smooth muscle cells, resulting in inhibition of excitation-contraction coupling and subsequent contraction; Decreases SA and AV conduction and prolongs AV node refractory period in conduction tissue; Systemic vasodilation resulting in decreased BP; Coronary vasodilation resulting in decreased angina; Reduction of ventricular rate during afib or flutter - Use: Management of HTN, angina pectoris, and/or vasospastic angina; Management of supraventricular arrhythmias and rapid ventricular rates in atrial flutter or fibrillation - Side Effects: arrhythmias, HF, stevens-johnson syndrome, extrapyramidal reactions, epistaxis, cough, SOB, bradycardia, syncope, palpitations - Nursing Measures: Administer with meals or milk to minimize gastric irritation; Do not crush; Monitor BP & pulse; Monitor ECG (may cause prolonged PR interval); S/s of HF; Assess for rash (Stevens-Johnson Syndrome); Monitor serum potassium, renal and hepatic functions