Summary NURS 3000 Module 5-7 Review

BLUEPRINT NURS 3000
EXAM 2
Note: When studying drugs, you need to know the classification and
prototype, therapeutic action/indication, therapeutic levels and half-
life (if I indicated them in class), contraindications/cautions, and
adverse effects (group them) pay attention to toxic/severe AE.
ADDITIONALLY, Nursing Interventions if indicated in class.

Module 5A (18 questions)
hypertension
 ACE inhibitors (captopril)
 therapeutic action: BLOCKS ace from converting angiotensin I to angiotensin
II thus decreasing BP and aldosterone production and small increase in
potassium. (Lowers BP)

 indication: hypertension, heart failure, diabetic nephropathy, left
ventricular dysfunction after MI. (reducing blood volume and
cardiac workload)
 caution: hx of allergic reaction, impaired renal function, Acute heart
failure, salt/volume depletion.
 adverse effects: cough (dry), hyperkalemia, angioedema
 drug to drug: NSAIDS, K+ supplements, K+ sparing diuretics

 Angiotensin 2 receptor blocker ARB’s (losartan)
 therapeutic action: blocks the binding of angiotensin II in vascular smooth
muscle, and adrenal gland. Blocks of vasoconstriction and aldosterone
 indication: hypertension, diabetic neuropathy with elevated creatine and
proteinuria in type two diabetes and hypertension, heart failure
 caution: history of allergic reaction, impaired renal function, hepatic
dysfunction, hypovolemia
 adverse effects: Angioedema
 drug to drug: NSAIDS, K+ supplements, K+ sparing diuretics

 Renin inhibitors (aliskiren)
 therapeutic action: directly inhibits Renin which inhibits the conversion of
angiotensinogen to angiotensin one.
 indication: hypertension, diabetic neuropathy with elevated creatine and
proteinuria in type two diabetes and hypertension, heart failure
 caution: pregnancy and lactation
 adverse effects: risk factors of hyperkalemia, Angioedema with respiratory
involvement, renal impairment
 drug to drug: ACE inhibitors, ARBs

,  Calcium channel blockers (diltiazem)
 therapeutic action: inhibits movement of Ca2+ across cardiac and arterial
muscle cells, slows AP which delaying repolarization, Decreases myocardial
contractility and dilation of arterioles.
 indication: hypertension, angina, cardiac dysrhythmias, tachyarrhythmias
 caution: heart block, sick, sinus syndrome, heart failure, acute myocardial
infarction
 adverse effects: peripheral edema, bradycardia, AV block, hypotension
 drug to drug: avoid grapefruit juice
 Interventions: lifestyle, changes, monitor renal status, monitor fluid status
and electrolytes, monitor pulse rate daily for bradycardia and blood pressure,
report dizziness or a fainting, never stopped abruptly, monitor glucose

 Vasodilators (nitroprusside)
 therapeutic action: acts directly on vascular smooth muscles to cause
vasodilation and drop blood pressure.
 indication: severe hypertension, acute heart failure
 caution: conditions, worsened by sudden blood pressure drops, PVD, CAD,
heart failure, tachycardia.
 adverse effects: retrosternal pressure, palpitations, cyanide toxicity.
 how to take the medication: IV
 half-life: 2 minutes
 nursing interventions: lifestyle, changes, monitor renal status, monitor fluid
status and electrolytes, monitor blood pressure, report dizziness or fainting,
never stop abruptly, and monitor glucose

heart failure.
 Cardiac glycosides (digoxin)
 therapeutic action: increases intracellular Ca2+ to enter myocardial cell
during depolarization. causes a positive inotropic effect.
 indication: heart failure, arterial fibrillation
 caution: V tach or V fib, heart block, sic, sinus syndrome, acute myocardial
infarction, electrolyte abnormalities
 adverse effects: Visual disturbances (green halos), arrhythmias
 therapeutic levels: 0.5-2 ng/mL
 Nursing interventions: must check apical heart rate for one minute before
administering every time hold for anything less than 60 while awake (chart:
apical pulse times one minute and goes 75 BPM located in the fifth intercostal
space midclavicular). Notify the provider for any signs of toxicity. Administer
IV slowly over at least five minutes. Toxicity must be treated with digiband
therapy, treat the hyperkalemia, treat the dysrhythmias, overdose is a life
threatening. Must monitor drug life, monitor, potassium levels due to the
increasing digoxin’s toxicity.

 Phosphodiesterase inhibitor (milrinone)