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NURSING 330 EXAM 1 Study Guide (MEDSURG II).
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NURSING 330 EXAM 1 Study Guide (MEDSURG II).
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NURSING 330 EXAM 1 Study Guide(MEDSURG II)
BNP (brain natriuretic peptide)
Normal <100 pg/mL. Used to diagnose Heart Failure.
100-299 mild
300-599 moderate
600-899 severe
>900 emergency
PAWP (pulmonary artery wedge pressure)
Normal 4-12 mmHg
> 12mmHg seen with excess fluid( overload)
<4mmHg seen in fluid deficit( dehydration).
Albumin
Normal 3.5 -5.0g
protein in blood; maintains the proper amount of water in the blood.
Given to patient with poor Nutrition Status, Burns, Shock. Also given in Edema patient to
mobilize the fluid into vascular space.
Creatinine
0.6-1.2 mg/dL*. Removed entirely by the kidneys.
High in the blood indicates kidney failure. Can be seen with Dehydration or low perfusion to
the kidneys.
BUN
Normal value 7-20mg
High level indicates kidneys failures.
Heart failure, dehydration, or a diet high in protein can also make your BUN level higher.
Liver disease or damage can lower your BUN level.
,Furosemide (Lasix)
Loop Diuretic. Inhibits Na 2Cl- K+ Co-transporter in the thick ascending loop of the LOH.
Also increases Ca2+ secretion in LOP. Can be given oral ( 40mg) as maintenance dose, IV (
20-120mg) in emergency or in Hospital settings, and Last 6- 8 hours
Uses to treat Edema, Acute CHF, and Acute Pulmonary edema.
SE: Hypokalemia, nephrotoxicity, ototoxicty.
Precaution: place patient in Falls risk and add oral supplement of potassium
Hydrochlorothiazide
promotes sodium, chloride, and water excretion (diuresis). Only Given orally ( 12.5mg
-25mg)
Used for HTN and peripheral edema
does not treat immediate emergency diuresis
FIRST DRUG OF CHOICE FOR PERIPHERAL EDEMA
SE: hypercalcemia, hyperglycemia, and Hypokalemia
ONLY USE IN PATIENTS WITH NORMAL RENAL FUNCTION
***monitor for leg cramps, causes hypokalemia***
Spironolactone (Aldactone)
Potassium sparing diuretic. Blocks aldosterone at the late DCT and collecting duct.
Given orally (25-100mg) as maintenance.
Use for CHF, HTN, ACNE, PCOS, and Hyperaldosteronism.
SE: hyperkalemia, gynecomastia (due non-specific blockage of the androgen receptors).
Digoxin (Lanoxin)
cardiac glycoside, slows and strengthens the heart muscle( increase contractility).
Uses to treat CHF, atrial dysrhythmias and cardiogenic shock. Normal TI 0.5-2
, SE: Bradycardia, Ototoxicity, vision changes( yellow halos around eyes).
Precaution: Hold the meds if Heart rate less than 50.
lisionpril (Prinivil, Zestril)
Prevent formation of Angiotensin II by inhibiting ACE. Given PO only ( 2.5 - 40mg).
Use to treat HTN and CHF post MI patient.
Side Effects: Dry cough( does not go aways), Hypotension, and decreases Heart rate.
Precaution: Monintor the kidneys function( increased BUN and creatinine stop the meds
because it 100% excreted by the kidneys. Regular lab.
Metropolol (Lopressor)
selective B1 adrenergic receptor antagonist
Can be given PO or IV( 12.5 - 50mg)
Uses for Angina, acute MI and HF.
Side effects: bradycardia, Hypotension
Assess patient before move out the bed( orthostatic Hypotension and for falls).
Notes: shown to reduce mortality in heart failure patients. Widely used for Stage I/II HTN
Carvedilol
beta-blocker with alpha-blocking activity
Can be given PO (3.125 - 25mg)
Uses for Angina, acute MI and HF.
Side effects: bradycardia, Hypotension
Assess patient before move out the bed( orthostatic Hypotension and for falls).
Notes: shown to reduce mortality in heart failure patients. Widely used for Stage I/II HTN
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