Vasodilator and loop diuretics- use for hyper tension, orthostatic hypotension,
watch for dizziness
Digoxin discharge teaching, what must a client know how to do?
Patient must know how to take their pulse (hold if less than 60 or more than
100)
Therapeutic range is 0.5-2.0
Treat heart failure and heart rhythm problems
If you miss a dose, do not doubt dose. Skip the dose if the next dose is due in
less than 12 hours. If the next dose is due in more than 12 hours, take the
dose as soon as remembered.
Maintain adequate hydration *Symptoms of toxicity
Antacids delay absorption
It is best to take digoxin without food. Peak concentration is reduced if
taken with food. Meals containing increased fiber or foods high in pectin
may decrease absorption.
Maintain adequate potassium in diet
VBAK- Visual, bradycardia, ABD distress, potassium
Toxicity- hallow, bradycardia, GI upset.
How to monitor and interpret labs for potassium wasting diuretics. Normal
potassium ranges. Nursing interventions, potassium rich foods
Normal range: 3.5-5.0
Causes dysrhythmias with too much or too little
Loop diuretics or thiazide also need to monitor weight and report any gain
(greater than 2 lbs in 48 hours or 5 lbs in a week)- pertains to all diuretics
Only prescribe Loop diuretics if HCTZ (hydrochlorothiazide- potassium
wasting diuretic) treatment fails
Thiazide diuretic- (HCTZ) only used in patient who have normal renal
function
Potassium wasting mean you lose more potassium
, Sweet potato, avocado, squash, spinach
Assess response to treatment and prevent adverse events: electrolyte
imbalance and decline in renal function
Potassium low offer- foods like bananas, avocado, squash, and notify
physician.
Actions of ACE inhibitors, think about chronotropic, inotropic etc.
“Pril” medications- prevent angiotensin
ACE inhibitors block angiotensin to cause diuresis by blocking
aldosterone production
Reduce cardiac work, helps with circulation
Vasodilator- opens blood vessels so heart doesn’t have to work hard
to push blood through system
Decreases calcium level
Chronotropic effects changes the heart rate
inotropic effects can be applies to the effect of a transmitter substance
or hormone on its target
Chronotropic: conduction speed
Inotropic: strength of conduction
What meds should not be given with grapefruit juice
Statins
Calcium channel blockers- can cause toxicity and arrhythmias
Calcium channel blockers- edema raises feet up.
Client teaching with use of nitro and other vasodilators- should they continue
to perform a task causing pain?
Teach patient to lie or sit before taking this medication
Nitro can be take X3 with 5 minutes in between each dose but patient cannot
restart strenuous activity after taking it- they need to rest
Sublingual=tingle
Dark, room temp area
How do calcium channel blockers work in the heart, the rest of the body?
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