NUR 2047 Pharmacology Final Exam Study Guide 1 _ 2020 | NUR2047 Pharmacology Final Study Guide 1 Updated
NUR 2047 Pharmacology Final Study Guide 1 Updated Final Exam Study Guide Digoxin discharge teaching, what must a client know how to do? TAKE THEIR PULSE, 0.5-2.0 NORMAL THERAPEUTIC DOSE, HOLD MEDS IF PULSE IS UNDER 60, IF LEVEL IS NOT THERAPUETIC ADJUST THE DOSE. What is main thing you need to ‘assess’ while on digoxin? PULSE^^^ How to monitor and interpret labs for potassium wasting diuretics (HCTZ). Know Normal potassium ranges. 3.5-5.0 IS NORMAL Nursing interventions-should you give potassium wasting diuretic if K+ is out of range? NO! BECAUSE IT CAN CAUSE DISRHYTHMIAS OR HYPERKALEMIA. IF ITS TOO LOW IT CAN CAUSE DISRHYMIAS, TOO HIGH CAN CAUSE LETHAL DISRHYTHMIAS What are potassium rich foods? SPINACH, BANANAS, POTATOES, APRICOTS, WHITE BEANS CAUTION IF PATIENT GAINS 2 LBS IN 24 HOURS OR 5 LBS IN A WEEK. THIS INDICATES MEANS HEART FAILURE (EDEMA). HYDROCHLOROTHIAZIDE IS A POTASSIUM WASTING DIURETIC- MEANS YOUR LOSING MORE POTATSSIUM WHEN YOU’RE TAKING IT. IF POTASSSIUM IS LOW DON’T GIVE MEDS BECAUSE IT WILL MAKE IT LOWER. Actions of ACE inhibitors, think about chronotropic, inotropic etc. Why is it given and what are it’s effects on the heart? –(reduces workload by decreasing fluid volume) ACE INHIBITIOR IS A VASODILATOR. REDUCES WORK LOAD AND DECREASES FLUID VOLUME. OPENS BLOOD VESSELS SO BLOOD DOESNT HAVE TO WORK SO HARD TO PUSH THROUGH SYSTEM IT BLOCKS ANGIOTENSIN 2 AND CAUSES DIURESIS BECASUE IT BLOCKS ELDOSTERONE. IT DECREASESS FLUID VOLUME. what meds should you not take with grapefruit juice- calcium channel blockers should not be taken Client teaching with use of nitro and other vasodilators- IT’S NOT GIVEN SO THEY CAN CONTINUE TO DO THE ACTIVITY THEY RAE DOING. TYPICALLY GIVING FOR ANGINAL PAIN WHICH IS USUALY CAUSED BY ACTIVITY. DON’T HAVE PATIENT CONTINUE ACTIVTY, HAVE THEM REST. GIVE WHEN PATIENT IS SITTING AND HAVE THEM REST AFTER. GIVEN IN 3 DOSES BUT HAVE TO BE TAKEN 5 MINUTES APART, OTHERWISE BLOOD PRESSURE WILL DROP TOO DRAMATICALLY IF NOT 5 MINUTES APART (WANT BP TO DROP BUT NOT RAPIDLY). HAVE PATIENT SIT AND REST AFTERWORDS should they continue to perform a task causing pain? How much time should be between each dose of nitro? How do calcium channel blockers work in the heart, the rest of the body? What is it used for? And how does it work on the heart? (vasodilator- what does that mean?) by blocking the entry of calcium, calcium channel blockers reduce electrical conduction within the heart, decrease the force of contraction (work) of the muscle cells, and dilate arteries. Dilation of the arteries reduces blood pressure and thereby the effort the heart must exert to pump blood. When to hold beta blockers-what do they impact? HOLD ON PULSE UNDER 60, DON’T GIVE IF SYSTOLIC IS UNDER 100. THEY WORK BY LOWERING THE BLOOD PRESSURE BY BLOCKING EPINEPHRINE. -- - -
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