ATI PN Pharmacology Proctored Exam
Review QUESTIONS AND ANSWERS NGN
INCLUDED PHARMACOLOGY ATI
PROCTOR EXAM
Receptors - -----ANSWER---->Norepinephrine-Adrenergic (adrenergic comes from the word adrenalin)
Alpha 1-all sympathetic target organs except the heart-constrict the blood vessels and dilation of pupils
Alpha 2-Presynaptic adrenergic nerve terminal-inhibits the release of norepinephrine
Beta 1-Heart and Kidneys (BETA 1-ONE HEART)-increased heart rate and force of contraction, release of
renin
Beta 2-All sympathetic target organs-inhibits smooth muscle (BETA 2-TWO LUNGS)
Beta blockers/olol's - -----ANSWER---->Beta-Adrenergic Blockers
Metoprolol/Lopressor ENDING OLOL
Beta Blockers are use with heart failure, hypertension, angina and with myocardial infarctions.
Action = Blocks Beta-Receptors in the heart causing...
Decreases = HR, force of contraction, Rate of atrioventricular (AV) conduction
SE = Bradycardia, lethargy, GI disturbance, congestive heart failure, decrease BP, depression
The beta blockers stop sympathetic nervous system stimulation of the heart. Does not allow the heart
rate and blood pressure to rise with stress thus lowering the oxygen demand of the heart. It is very heart
protective!
Will slow the heart rate and lower the blood pressure
,Can have beta 2 blockage with larger doses-will constrict the bronchioles-watch for clients with known
COPD, Asthma
Nursing Interventions
Check pulse-needs to be 60 or above
Check blood pressure-if hypotensive do not give (Systolic below 100 is a good rule of thumb I go by)
Monitor for sexual dysfunction-impotence for men-a good reason for non-compliance
Drowsiness/Fatigue-operating heavy machinery, driving could put client at risk
Insomnia-
Contraindicated with Heart Blocks, Bradycardia, Worsening Heart Failure
Increases Hypoglycemic effect of Insulin-monitor blood sugars and for hypoglycemia, may need to lower
insulin dosage
Beta Blockers have to be weaned slowly to prevent rebound hypertension and tachycardia-if a client
wants to stop his beta-blocker they need to contract their physician
CCB,/calcium channel blockers - -----ANSWER---->Nifedipine/Adalat/Procardia/Norvasc-controls blood
vessels
Diltiazem/Cardizem
Verapamil/Calan/Isoptin/Verelan-controls heart rate and blood vessels
Angina/Raynaud's/Vasospastic Angina/Atrial Arrhythmia's
Blocks calcium channels in the myocardial and vascular smooth muscles, decreases the contraction of
smooth muscle-relaxes the arteries-vasodilation. Blocking of calcium channels in the SA and AV node-
Slows conduction through the SA and AV node. Decreases the force of contraction slows heart rate
Grapefruit juice may increase absorption of nifedipine
Side Effects: Relaxes smooth muscle and cardiac muscle-
Headache
,Dizziness-Take lying, sitting and standing B/P, educate client to sit and stand slowly
Peripheral edema-assess for edema, monitor for worsening (diuretic)
Flushing
Reflex tachycardia-monitor for elevated heart rate (may need a BB)
Constipation-increase fibers and fluids (if not restricted) stool softener
Fatigue-Due to low heart rate-monitor EKG, pulse rate and rhythm
Weakness-Monitor B/P and Heart Rate
Impotence and sexual dysfunction-Discuss possibility with client-have client to call and not just to stop
medications
Hepatotoxicity-ALT, AST, ALK PHOS, Bilirubin
MI-Monitor for chest pain, dyspnea, increases fatigue, weakness
CHF-Monitor for chest pain, dyspnea, edema, increasing weight, decreasing output, increasing HR and
B/P
Angioedema-edema in face, throat, trouble swallowing, trouble breathing, thickened tongue
Grapefruit juice may increase absorption of nifedipine
Acute Toxicity
With an overdose or overmedicated
Gastric lavage
Monitor EKG-bradycardia-widening QRS, hypotension
Norepinephrine to treat hypotension and decreased cardiac contractility
Atropine or Isoproterenol-Bradycardia and Cardiac Blocks
Verapamil (Calan, Covera, Isoptin Verelan)
Class IV antidysrhythmic
Calcium channel blocker
Inhi
Pril/ace inhibitors - -----ANSWER---->Enalapril/Vasotec
, PRIL-is the ending for ace's
Reduces Angiotensin 2 and aldosterone levels
Prevents Angiotensin 1 from converting to Angiotensin 2 in the lungs-leaves the Angiotensin 1 hanging in
the lungs-creates irritation-cough
Vasodilation-mostly arteriole (decreases afterload)
Excretion of sodium and water-retention of K (decreases preload)
Treats hypertension and heart failure
Do not take 2nd and 3rd Trimester of pregnancy
SE = Angioedema-allergic reaction-swelling of tongue, throat-stop taking and notify md
Hyperkalemia-monitor for widening and slowing of pulse/qrs, weakness, fatigue, avoid high K foods,
AVOID SALT SUBSTITUTES-usually very high in K, avoid potassium sparing diuretics, sport drinks are high
in K also
Orthostatic Hypotension-teach client to sit and stand slowly, enact fall precautions
Neutropenia/Agranulocytosis-monitor CBC-WBC count, reoccurring infections
Renal Insufficiency-Monitor weight, edema, I/O, BUN, Cr, and GFR
Hepatic Insufficiency-Monitor AST, ALT, ALK PHOS, Bilirubin
Cough-Cough lozenges, hard candy, increase fluid intake, sleep with HOB elevated, antihistamines
ACE Inhibitors
Discussed these medications with hypertension
Arb's-Angiotensin receptor blockers, sartan's
No Cough, same effects and side effects as Ace's-just not as potent
Sartan's/angiotension blockers/arb's - -----ANSWER---->...
Arb's-Angiotensin receptor blockers, sartan's
No Cough, same effects and side effects as Ace's-just not as potent
Review QUESTIONS AND ANSWERS NGN
INCLUDED PHARMACOLOGY ATI
PROCTOR EXAM
Receptors - -----ANSWER---->Norepinephrine-Adrenergic (adrenergic comes from the word adrenalin)
Alpha 1-all sympathetic target organs except the heart-constrict the blood vessels and dilation of pupils
Alpha 2-Presynaptic adrenergic nerve terminal-inhibits the release of norepinephrine
Beta 1-Heart and Kidneys (BETA 1-ONE HEART)-increased heart rate and force of contraction, release of
renin
Beta 2-All sympathetic target organs-inhibits smooth muscle (BETA 2-TWO LUNGS)
Beta blockers/olol's - -----ANSWER---->Beta-Adrenergic Blockers
Metoprolol/Lopressor ENDING OLOL
Beta Blockers are use with heart failure, hypertension, angina and with myocardial infarctions.
Action = Blocks Beta-Receptors in the heart causing...
Decreases = HR, force of contraction, Rate of atrioventricular (AV) conduction
SE = Bradycardia, lethargy, GI disturbance, congestive heart failure, decrease BP, depression
The beta blockers stop sympathetic nervous system stimulation of the heart. Does not allow the heart
rate and blood pressure to rise with stress thus lowering the oxygen demand of the heart. It is very heart
protective!
Will slow the heart rate and lower the blood pressure
,Can have beta 2 blockage with larger doses-will constrict the bronchioles-watch for clients with known
COPD, Asthma
Nursing Interventions
Check pulse-needs to be 60 or above
Check blood pressure-if hypotensive do not give (Systolic below 100 is a good rule of thumb I go by)
Monitor for sexual dysfunction-impotence for men-a good reason for non-compliance
Drowsiness/Fatigue-operating heavy machinery, driving could put client at risk
Insomnia-
Contraindicated with Heart Blocks, Bradycardia, Worsening Heart Failure
Increases Hypoglycemic effect of Insulin-monitor blood sugars and for hypoglycemia, may need to lower
insulin dosage
Beta Blockers have to be weaned slowly to prevent rebound hypertension and tachycardia-if a client
wants to stop his beta-blocker they need to contract their physician
CCB,/calcium channel blockers - -----ANSWER---->Nifedipine/Adalat/Procardia/Norvasc-controls blood
vessels
Diltiazem/Cardizem
Verapamil/Calan/Isoptin/Verelan-controls heart rate and blood vessels
Angina/Raynaud's/Vasospastic Angina/Atrial Arrhythmia's
Blocks calcium channels in the myocardial and vascular smooth muscles, decreases the contraction of
smooth muscle-relaxes the arteries-vasodilation. Blocking of calcium channels in the SA and AV node-
Slows conduction through the SA and AV node. Decreases the force of contraction slows heart rate
Grapefruit juice may increase absorption of nifedipine
Side Effects: Relaxes smooth muscle and cardiac muscle-
Headache
,Dizziness-Take lying, sitting and standing B/P, educate client to sit and stand slowly
Peripheral edema-assess for edema, monitor for worsening (diuretic)
Flushing
Reflex tachycardia-monitor for elevated heart rate (may need a BB)
Constipation-increase fibers and fluids (if not restricted) stool softener
Fatigue-Due to low heart rate-monitor EKG, pulse rate and rhythm
Weakness-Monitor B/P and Heart Rate
Impotence and sexual dysfunction-Discuss possibility with client-have client to call and not just to stop
medications
Hepatotoxicity-ALT, AST, ALK PHOS, Bilirubin
MI-Monitor for chest pain, dyspnea, increases fatigue, weakness
CHF-Monitor for chest pain, dyspnea, edema, increasing weight, decreasing output, increasing HR and
B/P
Angioedema-edema in face, throat, trouble swallowing, trouble breathing, thickened tongue
Grapefruit juice may increase absorption of nifedipine
Acute Toxicity
With an overdose or overmedicated
Gastric lavage
Monitor EKG-bradycardia-widening QRS, hypotension
Norepinephrine to treat hypotension and decreased cardiac contractility
Atropine or Isoproterenol-Bradycardia and Cardiac Blocks
Verapamil (Calan, Covera, Isoptin Verelan)
Class IV antidysrhythmic
Calcium channel blocker
Inhi
Pril/ace inhibitors - -----ANSWER---->Enalapril/Vasotec
, PRIL-is the ending for ace's
Reduces Angiotensin 2 and aldosterone levels
Prevents Angiotensin 1 from converting to Angiotensin 2 in the lungs-leaves the Angiotensin 1 hanging in
the lungs-creates irritation-cough
Vasodilation-mostly arteriole (decreases afterload)
Excretion of sodium and water-retention of K (decreases preload)
Treats hypertension and heart failure
Do not take 2nd and 3rd Trimester of pregnancy
SE = Angioedema-allergic reaction-swelling of tongue, throat-stop taking and notify md
Hyperkalemia-monitor for widening and slowing of pulse/qrs, weakness, fatigue, avoid high K foods,
AVOID SALT SUBSTITUTES-usually very high in K, avoid potassium sparing diuretics, sport drinks are high
in K also
Orthostatic Hypotension-teach client to sit and stand slowly, enact fall precautions
Neutropenia/Agranulocytosis-monitor CBC-WBC count, reoccurring infections
Renal Insufficiency-Monitor weight, edema, I/O, BUN, Cr, and GFR
Hepatic Insufficiency-Monitor AST, ALT, ALK PHOS, Bilirubin
Cough-Cough lozenges, hard candy, increase fluid intake, sleep with HOB elevated, antihistamines
ACE Inhibitors
Discussed these medications with hypertension
Arb's-Angiotensin receptor blockers, sartan's
No Cough, same effects and side effects as Ace's-just not as potent
Sartan's/angiotension blockers/arb's - -----ANSWER---->...
Arb's-Angiotensin receptor blockers, sartan's
No Cough, same effects and side effects as Ace's-just not as potent
