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Exam (elaborations)

NUR 138 Exam 3- Answered

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NUR 138 Exam 3- Answered

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NUR 138 Exam 3- Answered




ACE: - ANSWER--pril

Calcium channel blockers: - ANSWER--dipine, -pamil, zem;

Benzodiazepine: - ANSWER--pam, -lam;

Antilipidemic: - ANSWER--statin

Beta blocker: - ANSWER--olol

Antiviral: - ANSWER--vir

Anticoagulant: - ANSWER--arin

ARB inhibitor: - ANSWER--artan

Teaching points for new prescription of an adrenergic drug for hypertension -
ANSWER-(Stimulate alpha 2 -adrenergic receptors in the brain that reduce renin
activity which decreases BP
because it slows down the work of the kidneys)
● Adverse effects: bradycardia with reflex tachycardia, postural and postexercise
hypotension, dry mouth, drowsiness, dizziness, depression, edema, constipation,
and
sexual dysfunction. Other effects include: headache, sleep disturbances, nausea,
rash, and
palpitations.
● Change positions slowly: high incidence of orthostatic hypotension in pts taking
alpha
blockers
● Don't stop abruptly: abrupt discontinuation of the centrally acting alpha2
receptor
agonists can result in rebound hypertension, which is characterized by a sudden
and very
high elevation of blood pressure
● any change in the dosing regimen should be undertaken gradually and with
appropriate pt
monitoring and follow-up
● Some meds can cause disruptions in blood count as well as in serum electrolyte
levels
and renal function. Periodic monitoring of WBC, serum potassium, sodium, and

, creatinine levels is necessary
● Can cause additive CNS depression when taking with alcohol, benzodiazepines,
and
opioids
● monitor BP during therapy; instruct pts to keep a journal of regular BP checks
● Men taking these drugs may not be aware that importance is an expected effect.
This may
influence compliance with drug therapy
● Never double dose up on doses if a dose is missed
● ALWAYS stay by the bedside to assess the patient for big side effects on NEW
DRUG
ex. huge decrease in BP.
● Usually used after other drugs have failed because of adverse effects
● Clonidine is useful in the management of withdrawal symptoms in opioid-
dependent persons, alcohol withdrawal
● number 1 side effect is orthostatic hypotension

Why do we use Captopril for patients with liver disease? - ANSWER-Captopril has
the shortest half-life. It may be best to start with a drug that has a short half-life in
a pt who is critically ill, so if problems arise they will be short-lived. Captopril and
lisinopril are the only two ACE inhibitors that are not prodrugs. A prodrug is a drug
that is inactive in its administered form and must be metabolized to its active form
in the body, generally by the liver, to be inactive. This characteristic of captopril
and lisinopril is an important advantage in treating
pt with liver dysfunction; all other ACE inhibitors are prodrugs, and their
transformation to
active form is dependent upon liver function to reveal the active drug

Why do men decide not to take their anti-hypertensives? - ANSWER-Sexual
dysfunction is a common adverse effect

How long do people stay on antihypertensives? - ANSWER-Lifelong therapy is
usually required

Why do diabetics take ACE inhibitors? - ANSWER-ACE inhibitors have been shown
to have a protective effect on the kidneys because
they reduce glomerular filtration pressure. This property makes them the
cardiovascular
drug of choice for diabetic patients.
-It is also approved for treatment of diabetic nephropathy, in which the renal artery
is being
damaged by diabetes. It is thought that decreased in stimulation of angiotensin
receptors in the
kidney will slow down the damage in the renal artery

What does Digoxin toxicity look like and what should you do? - ANSWER-Toxicity:
Bradycardia, dizziness, loss of consciousness, colder extremity, nausea, vomiting,
people report seeing color yellow, headache, diaphoresis,

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