SCF Nursing Level 2 Final Exam Review
Heparin Adverse Effects - Bleeding, thrombocytopenia increased AST, ALT, avoid 2 in of umbilicus,
don't aspirate, preg. C, use soft toothbrush, electric razor, menstruation, ETOH, Recent brain or spinal
cord surgery, antidote: Protamine Sulfate,
Aspirin MOA - Antiplatelet, Inhibits platelet aggregation by binding to an enzyme in platelets,
reduces the risk of recurrent TIA's or strokes, reduce death via MI, prophylaxis, anti-inflammatory,
analgesic, & antipyretic
Aspirin Contraindications - Bleeding, H/A, dizziness, GI distress, tinnitus, Drug/Drug: NSAID's,
Methotrexate, Penicillin, hypoglycemic agents
Warfarin MOA - interferes with the formation of vitamin K, dependent clotting factors in the liver,
maintain a state of anticoagulation when the pt is susceptible to potentially dangerous clot formation.
Treat Afib, Artificial Heart valves, or valvular damage, treat/prevent venous thrombosis after MI, PE, or
stroke. Long Term Treatment
Warfarin Contraindications - Conditions that could be compromised by increased bleeding, ie:
active peptic ulcer, Vitamin K deficiency; diarrhea, Preg: X, Chronic ETOH, Purple toe syndrome, hepatic
dysfunction, GI upset, N/V/D, Keep consistent consumption of foods high in Vit K: liver, cheese, egg yolk,
leafy vegetables, & oils.
Warfarin Monitoring - Narrow therapeutic margin, full effect 1 wk, Prothrombin time (PT): 1.5-2.5,
INR: 2.0-3.0 to a higher 3.0-3.5, Antidote: Vitamin K, or for acute bleed Kcentra IV, fresh or frozen plasma
(FFP), Dark urine, light stools, Hepatitis-swelling of liver
Hypertension Medications - ACE Inhibitors-Lisinopril, ARB's: Losartan, CA+ Channel Blocker:
Nifedipine, Vasodilator: Hydralazine
Anti-hyperlipidemia Medications - Bile Acid Sequestrants: Cholestyramine, HMG-COA Inhibitors:
Atorvastatin, Fibrate/Fibrin Acid: Gemfibrozil
, Anti-Anginal Medications - Beta-Adrenergic blockers: Atenolol, Nitrates: Nitroglycerin, Ca+
Channel Blocker: Diltiazem
Diuretic Medications - Loop: Furosemide, Thiazide: Hydrochlorothiazide (HCTZ), K+ Sparing:
Spironolactone
Lisinopril MOA - Check BP & K+ b4 admin, Tx of HTN, HF, diabetic neuropathy, to improve MI
survival. Blocks ACE from converting to angiotensin I to angiotensin II leading to a decrease in BP, a
decrease in aldosterone production & a small increase in serum potassium levels along with sodium &
fluid loss, Reduces afterload & contractility. Improves survival rate if given w/in 24 h or MI
Heparin MOA - Short term tx, prevents enlargement of existing clots & formation of new ones.
Anticoagulant Natural substance prolongs coagulation time Blocks conversion of prothrombin to
thrombin, thus blocking-conversion of fibrinogen to fibrin, prolongs coagulation
Lisinopril Contraindications - Check BP: ACE: Inhibitor: Angioedema-swelling of lips and tongue,
DRY COUGH, Orthostatic BP, dizziness, Taste disturbances, HF, H/A/N/V/D, Salt/Volume depletion,
Hyperkalemia, Pregnancy, Drug/Drug: NSAID's, WILL NOT EFFECT HR works in the lungs, CO, HR, Cardiac
contractility,
Diltiazem MOA - Check: HR & BP, Tx: HTN, & Prinzmetal Angina, Blocks calcium channel ions
across the membranes of myocardial & arterial muscle cells, altering the action potential, blocking
muscle cell contraction, relaxing arteriolar smooth muscle, reducing cardiac workload, bringing more O2
into the myocardium which slows electrical conduction, decreases contractility & dilates arterioles which
lower BP,
Diltiazem Contraindications - R/T vasodilation; Hypotension, dizziness, H/A peripheral edema,
cardiac arrhythmias, bradycardia, taper off drug, do not give with grapefruit juice, Drug/Drug: Digoxin &
statin (can increase levels). Heart block may be caused by digoxin or beta-adrenergic blockers,
Cholestyramine MOA - Used to reduce elevated lipid levels, treat pruritus (itching) associated with
partial biliary obstruction, Binds (sequesters bile into a ball) with bile acids to form an insoluble mass
which is excreted in feces lowering cholesterol levels, Powder mix in liquids
