NURSING PHARMACOLOGY TEST
1. Beta Blockers: Category, Action, Use, Side Effects, Nursing Measures -
CORRECT ANSWERS-- 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)
2. Digoxin: Category, Action, Use, Side Effects, Nursing Measures -
CORRECT ANSWERS-- 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)
3. ACE inhibitors: Category, Action, Use, Side Effects, Nursing Measures -
CORRECT ANSWERS-- 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
4. Nitoglycerin: Category, Action, Use, Side Effects, Nursing Measures -
CORRECT ANSWERS-- 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
5. Adrenergics: Category, Action, Use, Side Effects, Nursing Measures -
CORRECT ANSWERS-- 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
6. Verapamil (Veracaps SR): Category, Action, Use, Side Effects, Nursing
Measures - CORRECT ANSWERS-- 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
7. Regular Insulin: Category, Action, Use, Side Effects, Nursing Measures -
CORRECT ANSWERS-- Category: Antidiabetic; Pancreatics
- Action: lower blood glucose by stimulating glucose uptake in skeletal
muscle and fat, inhibiting hepatic glucose production. Inhibition of lipolysis
and proteolysis, enhanced protein synthesis
- Use: control of hyperglycemia in patients with type 1 or type 2 DM
- Side Effects: Hypoglycemia, anaphylaxis, pruritis, erythema
- Nursing Measures: assess for s/s of hypoglycemia and hyperglycemia;
monitor body weight changes; decrease serum phosphate, magnesium,
and potassium; monitor glucose q6h
- Onset: 30 min; Peak 4-8 hour; Duration: 24 hour
- Examples: Humulin 70/30; Novolin 70/30
8. NPH: Category, Action, Use, Side Effects, Nursing Measures - CORRECT
ANSWERS-- Category: Antidiabetic, pancreatics
- Action: Lowers blood glucose by stimulating glucose uptake in skeletal
muscle and fat, inhibiting hepatic glucose production.
- Use: control of hyperglycemia
- Side Effects: hypoglycemia, anaphylaxis, lipodystrophy
- Nursing Measures: assess for s/s of hypoglycemia and hyperglycemia;
monitor body weight periodically; monitor blood glucose q6h
- Onset: 2-4 hr; Peak 4-10 hr; Duration 10-16 hr
- Examples: Humulin N, Novolin ge NPH, Novolin N
9. Long-acting insulin: Category, Action, Use, Side Effects, Nursing Measures -
CORRECT ANSWERS-- Category: antidiabetics, pancreatics
- Action: Lowers blood glucose by stimulating glucose uptake in skeletal
muscle and fat, inhibiting hepatic glucose production.
- Use: control of hyperglycemia
- Side Effects: hypoglycemia, anaphylaxis, lipodystrophy
