NR 324 AH Exam 2

1. Pacemaker safety-MRI, battery life, etc. a. MRI is contraindicated for patients with implanted metallic devices such as pacemakers 2. Delegation to UAP and LVN 3. Diet choices- a. Iron i. Egg & whole grain b. Folate c. B12 d. low sodium i. Milk and yogurt naturally contain a significant amount of sodium e. low fat i. 4. Medications: a. ACE Inhibitors (pril) i. ACE inhibitors cause retention of potassium by the kidney, so hyperkalemia is a possible adverse effect. ii. ACE inhibitor therapy is currently recommended to prevent the development of heart failure in patients who have had a myocardial infarction and as a first-line therapy for patients with chronic heart failure. iii. Captopril can cause hypotension b. Beta Blockers (olol) i. Patients who have been taking -adrenergic blockers can develop intense and frequent angina if the medication is suddenly discontinued c. Diuretics (Lasix) i. Hypokalemia is a frequent adverse effect of the loop diuretics and can cause life-threatening dysrhythmias. ii. Diuretics should be taken earlier in the day to avoid nocturia and sleep disturbance. d. Heparin/Coumadin (PTT (partial thromboplastin time) and PT/INR (international normalized ratio) associated) i. Heparin prevents the development of new clots in the coronary arteries ii. IM injections are avoided in patients receiving anticoagulation iii. Vitamin K is used to reverse warfarin iv. (INR) value indicates that the warfarin has reached a therapeutic level v. Patients taking warfarin are taught to follow a consistent diet with regard to foods that are high in vitamin K, such as green, leafy vegetables e. Digoxin (know levels and mechanism of action) i. Nausea is an indication of digoxin toxicity and should be reported so that the provider can assess the patient for toxicity and adjust the digoxin dose ii. Low potassium level increases the risk for digoxin toxicity and potentially fatal dysrhythmias iii. hyperkalemic, which makes the patient more prone to digoxin toxicity iv. If the pulse is less than 60, to call their provider before taking the digoxin