NUR 3145 Exam 3 Questions and
Complete Solutions
Thiazide Diuretics ✅i.e. *chlorothiazide*
Side effects: hypokalemia, hyponatremia, hypotension
Adverse effects: syncope, fall when position changing, muscle weakness, blurred vision
Before and After: K levels (hold if low), check apical pulse for a full min, electrolyte
levels
Patient teaching: hypokalemia=weakness, cramping
*normal potassium level: 3.5-5.0
High-Ceiling (Loop) Diuretics ✅i.e. *furosemide*
Side effects: H20, K, Na, and Ca loss in urine, orthostatic hypotension
Adverse: syncope, fall when changing positions, irregular heart rhythms may occur,
*ototoxicity* (elderly), *hyperglycemia*
Before and after: always check electrolyte levels, other ototoxic drugs, give potassium
supplements if ordered, monitor for *hearing loss*
Potassium-Sparing Diuretics ✅i.e. *Spironolactone triamterene*
Heart Failure
Side effects: orthostatic hypotension, hyponatremia
Adverse effects: *hyperkalemia*, development of dysrhythmia
Monitor for hyperkalemia*
Urinary antispasmodics (Drugs for Overactive bladder) ✅i.e. *Oxybutynin tolterodine*
Intended responses: decreased urinary frequency, urgency, and incontinence, ACH
antagonists
Side effects: Dry mouth and eyes*, constipation, headache (parasympathetic system
blocked)
Adverse effects: chest pain, irregular heart rate, dyspnea, edema, weight gain,
confusion/hallucinations, not able to sweat (temp up fast)
Before and after: vitals, assess for edema, history of liver or kidney disease, daily
weights
Drugs for BPH ✅Intended response: decrease in pressure; improve urine flow,
decreased BPH symptoms
Before Admin: rule out cancer, sulfa allergies, monitor for orthostatic hypotension
DHT inhibitors ✅i.e. *finasteride*
Side effects: decreased libido
Adverse effects: adversely affects other hormonal or sexual tissues
*Teratogenic*
, Selective alpha-1 blockers ✅i.e. *tamsulosin*
Side effects: hypotension and decreased libido
Adverse effects: many complex drug interactions
Angiotensin-Converting Enzyme (ACE) Inhibitors ✅i.e. *enalopril* "-pril"
*Given in combination with diuretics
Intended Responses: vasodilation, lower BP, decreased workload of heart
Side effects: hypotension, *hyperkalemia*
*persistent dry cough*- may require patient to ARB drugs
Adverse effects: fever/chills, hoarseness, Angioedema, dyspnea, dysphagia, yellow
eyes or skin (jaundice)
*Class D/X in pregnancy*
Before and after: BP, K levels, *avoid salt substitutes*
Angiotensin II Receptors Blockers ✅i.e. *losartan*
Intended response same as ACE, but slightly different action, *fewer side effects*
*Does not have ACE dry cough*
Side effects: hyperkalemia, diarrhea, hypotension
Adverse effects: rare but include kidney failure and angioedema
Calcium Channel Blockers (general) ✅i.e. *amlodipine, diltiazem, verapamil*
Block Ca from entering muscle cells of heart and arteries; decrease strength in heart
contractions, dilate arteries
Side effects: *constipation* and *edema in legs*, hypotension
Adverse effects: dysrhythmias, *Steven Johnsons syndrome*
Beta Blockers ✅*-"lol"*
Intended responses: block epinephrine (blocks adrenaline to decrease HR), decrease
workload of heart, lowered BP
Side effects: impotence, insomnia, lethargy
Adverse effects: slow HR, chest pain, dyspnea, cyanotic nail beds, seizures
*affects diabetic patients blood glucose levels* (wouldn't know HR is up when on Beta
Blockers)
*Do not discontinue suddenly-may cause heart attack *taper this drug*
*Hold if HR is less than 60*
Alpha Blockers ✅i.e. *Prazosin*
*working on the vasculature instead of the myocardium*
Side effects: same as beta blockers, orthostatic hypotension (first given at night time)
should not be given to patients with *erectile dysfunction*-may result in *profound
hypotension*
Centrally-acting agonists (general) ✅Stimulate alpha-receptors in brain; dilate
peripheral arteries, easing blood flow
Side Effects: drowsiness, dry mouth, nasal congestion
