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NURS 319
Class Preparation Activity
Pharmacologic Management of Cardiovascular Dysfunction
Written Assignment/Case Study
Type or write your responses to the case study questions and submit to iLearn by the date
indicated in the course calendar. The grading rubric is found in Appendix D of the syllabus.
A.M., a 67-year-old women with a medical history of hypercholesterolemia, osteoarthritis,
osteopenia and hypertension, presents via her own vehicle to the Emergency Room reporting a
sudden onset of chest pain and dyspnea.
Medication Allergies: NKDA
Home Medications: atenolol (Tenormin) 50 mg PO once daily
lisinopril (Prinivil) 10 mg PO once daily
hydrochlorothiazide (HCT) 12.5 mg PO once daily
ibuprofen (Motrin) 600 mg Q 6 hours PO PRN pain
Calcium 600+ with Vitamin D 3 One tablet PO daily
Ginkgo biloba One tablet PO daily
simvastatin (Zocor) 20 mg once daily
Height: 165 cm 5 feet 5 inches
Admission Weight: kg 176.5 pounds
80.23
Vital Signs: 0900 T: 36.4 ˚C P: 102 R: 20 BP: 142/68mmHg 94% RA
Pain Report 7/10, mid-sternal chest pressure, non-radiating
1. Review A.M.’s home medications. For each drug listed in the table below, select the drug’s
Classification, Purpose and Common Side/Adverse Effects. Note that options may be used more than
once.
Home Medication Classification Purpose Common Side/Adverse Effects
atenolol (Tenormin) Beta-Adrenergic Management of Postural Hypotension
Blocker hypertension
Lisinopril (Prinivil) ACE Inhibitor Management of Angioedema
hypertension
Hydrochlorothiazide (HCT) Thiazide diuretic Management of hypokalemia
hypertension
ibuprofen (Motrin) Non-steroidal anti- Pain management GI bleed, Nausea/Vomiting
inflammatory drug
(NSAID)
Calcium 600+ with Vitamin D 3 Supplement Increase blood Nausea/Vomiting
calcium levels
Ginkgo biloba Supplement Reduce inflammation Nausea/Vomiting, Interacts with
, 2
ibuprofen: bleeding/bruising
simvastatin (Zocor) HMG-CoA Reduction of LDL Rhabdomyolysis
Reductase Inhibitor cholesterol
(Statin)
Options for Classification Options for Purpose Options for Common Side/Adverse Effects
Thiazide diuretic Increase blood calcium levels Nausea/Vomiting
HMG-CoA Reductase Inhibitor (Statin) Reduction of LDL cholesterol Rhabdomyolysis
Beta-Adrenergic Blocker Management of hypertension Postural Hypotension
Non-steroidal anti-inflammatory drug (NSAID) Pain management Angioedema
ACE Inhibitor Reduce inflammation Interacts with ibuprofen: bleeding/bruising
Supplement GI bleed
Hypokalemia
A.M. is evaluated by the provider in the Emergency Department and the following orders are received:
Physician Orders
nitroglycerin (Nitrostat) 0.4 mg SL every 5 minutes x 3 PRN chest pain
aspirin (Ecotrin) 325 mg chewable tablets PO x 1 STAT
oxygen via nasal cannula 2-4 liters to maintain SPO2 greater than 94%
2. What does the nurse need to consider prior to administering these medications? (Select all that apply)
A. Current blood pressure
B. Lung sounds
C. No considerations as it is an emergency situation
D. Current pulse
E. Skin turgor
F. Increased risk of bleeding with aspirin and Ginkgo biloba
G. Current pulse ox
H. Placing the client on continuous cardiac monitoring
I. Current chest pain report of 7/10
The nurse administers the nitroglycerin to A.M. and documents the following assessment findings:
Nitroglycerin Administration Results:
0905 0910 0915
Chest Pain Report: 7/10 Chest Pain Report: 5/10 Chest Pain Report: 3/10
Based on A.M.’s response, the nurse receives the following new orders:
Physician Orders:
Nitroglycerin continuous infusion. Start infusion at 5 mcg/min and increase by 5 mcg/min at 5
minute intervals if chest pain persists and systolic blood pressure remains above 100 mmHg.
NURS 319
Class Preparation Activity
Pharmacologic Management of Cardiovascular Dysfunction
Written Assignment/Case Study
Type or write your responses to the case study questions and submit to iLearn by the date
indicated in the course calendar. The grading rubric is found in Appendix D of the syllabus.
A.M., a 67-year-old women with a medical history of hypercholesterolemia, osteoarthritis,
osteopenia and hypertension, presents via her own vehicle to the Emergency Room reporting a
sudden onset of chest pain and dyspnea.
Medication Allergies: NKDA
Home Medications: atenolol (Tenormin) 50 mg PO once daily
lisinopril (Prinivil) 10 mg PO once daily
hydrochlorothiazide (HCT) 12.5 mg PO once daily
ibuprofen (Motrin) 600 mg Q 6 hours PO PRN pain
Calcium 600+ with Vitamin D 3 One tablet PO daily
Ginkgo biloba One tablet PO daily
simvastatin (Zocor) 20 mg once daily
Height: 165 cm 5 feet 5 inches
Admission Weight: kg 176.5 pounds
80.23
Vital Signs: 0900 T: 36.4 ˚C P: 102 R: 20 BP: 142/68mmHg 94% RA
Pain Report 7/10, mid-sternal chest pressure, non-radiating
1. Review A.M.’s home medications. For each drug listed in the table below, select the drug’s
Classification, Purpose and Common Side/Adverse Effects. Note that options may be used more than
once.
Home Medication Classification Purpose Common Side/Adverse Effects
atenolol (Tenormin) Beta-Adrenergic Management of Postural Hypotension
Blocker hypertension
Lisinopril (Prinivil) ACE Inhibitor Management of Angioedema
hypertension
Hydrochlorothiazide (HCT) Thiazide diuretic Management of hypokalemia
hypertension
ibuprofen (Motrin) Non-steroidal anti- Pain management GI bleed, Nausea/Vomiting
inflammatory drug
(NSAID)
Calcium 600+ with Vitamin D 3 Supplement Increase blood Nausea/Vomiting
calcium levels
Ginkgo biloba Supplement Reduce inflammation Nausea/Vomiting, Interacts with
, 2
ibuprofen: bleeding/bruising
simvastatin (Zocor) HMG-CoA Reduction of LDL Rhabdomyolysis
Reductase Inhibitor cholesterol
(Statin)
Options for Classification Options for Purpose Options for Common Side/Adverse Effects
Thiazide diuretic Increase blood calcium levels Nausea/Vomiting
HMG-CoA Reductase Inhibitor (Statin) Reduction of LDL cholesterol Rhabdomyolysis
Beta-Adrenergic Blocker Management of hypertension Postural Hypotension
Non-steroidal anti-inflammatory drug (NSAID) Pain management Angioedema
ACE Inhibitor Reduce inflammation Interacts with ibuprofen: bleeding/bruising
Supplement GI bleed
Hypokalemia
A.M. is evaluated by the provider in the Emergency Department and the following orders are received:
Physician Orders
nitroglycerin (Nitrostat) 0.4 mg SL every 5 minutes x 3 PRN chest pain
aspirin (Ecotrin) 325 mg chewable tablets PO x 1 STAT
oxygen via nasal cannula 2-4 liters to maintain SPO2 greater than 94%
2. What does the nurse need to consider prior to administering these medications? (Select all that apply)
A. Current blood pressure
B. Lung sounds
C. No considerations as it is an emergency situation
D. Current pulse
E. Skin turgor
F. Increased risk of bleeding with aspirin and Ginkgo biloba
G. Current pulse ox
H. Placing the client on continuous cardiac monitoring
I. Current chest pain report of 7/10
The nurse administers the nitroglycerin to A.M. and documents the following assessment findings:
Nitroglycerin Administration Results:
0905 0910 0915
Chest Pain Report: 7/10 Chest Pain Report: 5/10 Chest Pain Report: 3/10
Based on A.M.’s response, the nurse receives the following new orders:
Physician Orders:
Nitroglycerin continuous infusion. Start infusion at 5 mcg/min and increase by 5 mcg/min at 5
minute intervals if chest pain persists and systolic blood pressure remains above 100 mmHg.
