GN 200-Pharm Exam 3 Study Guide

GN 200-Pharm Exam 3 Study Guide Pharm Exam 3 Study Guide – PLEASE STUDY HARD!!!!!!! Cardiac 1. Digoxin – client teaching, side/adverse effects, normal Digoxin levels and s/s of Digoxin toxicity *****Digoxin slows and strengthens the heart***** Client teaching: Report headaches, visual disturbances, seeing Halos around things. Educate patient how to take pulse and too hold medication if pulse is less than 60. Side/adverse effects: nausea, vomiting, loss of appetite, GI symptoms, malaise. S/S of Dig toxicity: visual illusions white/green halos around objects, cardiac dysrhythmias, PVC’s, blurred vision, confusion, and delirium. Normal Dig level ****narrow therapeutic window**** 0.5 – 2.0 ng/ml ****Antidote for Digoxin toxicity is digoxin immune Fab (Digibond)** 2. Potassium levels, considerations and precautions related to levels, and when taking with HCTZ or potassium supplements Normal K+ levels: 3.5 – 5.2 mEq/L Considerations and precautions related to levels: Hold medication is level is too low. Hypokalemia s/s: cardiac dysrhythmias, twitching, fatigue, paresthesia, dyspnea, cramping, diarrhea. Hyperkalemia s/s: muscle weakness, lethargy, anorexia, dysrhythmias. Have K+ levels monitored with taking HCTZ and K+ supplements. HCTZ is a thiazide diuretic and K+ loss is the main concern. Patient needs to increase K+ intake to prevent hypokalemia and cardiac arrhythmias. Eat foods such as strawberries, bananas, dried apricots and prunes, tomatoes, beets, orange juice, grapefruit juice and fresh meats, potassium based salt substitutes. *****if patient is hypokalemic HOLD dose and call MD****** 3. ACE Inhibitor: (Lisinopril (Zestril) – client teaching Client teaching: monitor BP following first dose. Dry, non-productive cough is a common side effect but report if continues for long period, report metallic or decreased taste of foods along with decreased intake and weight loss. Report sore throat or other infections to MD. Report angioedema (swelling of the mouth, throat), rash, caution patient to get up slowly due to orthostatic hypotension. Do not use alcohol. 4. Calcium channel blockers (nifedipine) – client teaching Client teaching: educate patient on how to properly take pulse. Notify MD is pulse is less than 50. AVIOD grapefruit juice and grapefruit while on this medication. Change position slowly, Maintain good oral hygiene to prevent gingival hyperplasia, Report any angina!! Wear sunscreen when outside, 5. Nitroglycerin – client teaching, side/adverse effects, contraindications Client teaching: change positions slowly, Do not drink alcohol while taking this med, advise patient that a headache is a normal side effect, notify MD of dry mouth or blurred vision. **** take 1 tablet under tongue every 5 minutes up to 3 tabs, keep pills in original glass container, avoid exposure to air or moisture. ******* Side/adverse effects: dizziness, headache, hypotension, tachycardia,