NUR 1141 EXAM 2 BLUEPRINT
QUESTIONS WITH CORRECT
ANSWERS.
Cardiac Glycosides (Digoxin) - ANSWER- inhibit the sodium-potassium pump,
increasing intracellular sodium and leads to an influx in calcium; allowing the heart to
contract more efficiently
Positive inotropic action (digoxin) - ANSWER- increases myocardial contraction stroke
volume
Negative chronotropic action (digoxin) - ANSWER- decreases heart rate
Negative dromotropic action (digoxin) - ANSWER- decreases conduction of heart cells
Hypokalemia, Hypomagnesemia, Hypercalcemia - ANSWER- can increase digoxin
toxicity
Diuretics and digoxin - ANSWER- promote the loss of potassium resulting in
hypokalemia, increasing the effects of digoxin
Cortisone and digoxin - ANSWER- promote sodium retention and potassium excretion
resulting in hypokalemia, increasing the effects of digoxin
Antacids and digoxin - ANSWER- decrease digitalis absorption if taken at the same time
calcium and digoxin - ANSWER- calcium enhances the effect on digoxin. An elevated
serum calcium level can cause digitalis toxicity.
Signs and Symptoms of digoxin toxicity - ANSWER- Anorexia
Diarrhea
Nausea Vomiting
Bradycardia (less than 60 BPM)
Premature Ventricular Contractions
Cardiac Dysrhythmias
Headaches
Malaise
Blurred Vision
Visual Illusions (white, green, yellow halo)
Confusion Delirium
, Calcium channel blocker use in angina - ANSWER- Calcium activates myocardial
contraction, increasing the workload of the heart and the need for oxygen. CCB relaxes
angina by decreasing cardiac oxygen demand.
how do calcium channel blockers relax variant and stable angina? - ANSWER-
decreasing oxygen demand, contractility, afterload, peripheral resistance
how do calcium channel blockers achieve their effect? - ANSWER- in controlling variant
angina by relaxing the coronary arteries and control stale angina by decreasing oxygen
demand
nitro patient education - ANSWER- 1. Administer sublingual nitroglycerin tablet if chest
pain occurs. If pain ha not subdued/worsens in 5 minutes, call 911.
2. Advise patient not to ingest alcohol while taking nitroglycerin to avoid hypotension,
weakness, and faintness.
3. Advise patients to notify a health care provider if chest pain is not completely
alleviated. Tolerance to nitroglycerin can occur.
4. Inform patients not to discontinue beta blockers and calcium blockers without a health
care providers approval. Withdrawal symptoms (reflex tachycardia and pain) may be
severe.
5. Side Effects and Adverse Reactions: Hypotension, Dizziness, Flushing,
Weakness/Faintness, Ointment or Transdermal patch should be tapered. Orthostatic
hypotension, Chest Pain, Dyspnea, Tachycardia, Paradoxical bradycardia (severe/life-
threatening), Palpitations, Methemoglobinemia (abnormal amount of methemoglobin in
blood)
Possible electrolyte imbalance with loop diuretics - ANSWER- Hypokalemia
(Potassium), Hypomagnesemia (Magnesium), Hyponatremia (Sodium), Hypocalcemia
(Calcium), Hypochloremia (Chloride) - all lost from the body
Potassium sparing diuretics - ANSWER- Are weaker than thiazides and loop diuretics -
used as mild diuretics
Interfere with the sodium - potassium pump
Spironolactone, Amiloride, Triamterene, Eplerenone
Potassium sparing diuretics drug names - ANSWER- Spironolactone, Amiloride,
Triamterene, Eplerenone
Spironolactone (Potassium sparing diuretic) - ANSWER- blocks the action of
aldosterone (mineralocorticoid hormone that promotes sodium retention and potassium
excretion) and inhibits sodium-potassium pump; prescribed by cardiologist for cardiac
disorders
Amiloride (Potassium sparing diuretic) - ANSWER- antihypertensive agent
QUESTIONS WITH CORRECT
ANSWERS.
Cardiac Glycosides (Digoxin) - ANSWER- inhibit the sodium-potassium pump,
increasing intracellular sodium and leads to an influx in calcium; allowing the heart to
contract more efficiently
Positive inotropic action (digoxin) - ANSWER- increases myocardial contraction stroke
volume
Negative chronotropic action (digoxin) - ANSWER- decreases heart rate
Negative dromotropic action (digoxin) - ANSWER- decreases conduction of heart cells
Hypokalemia, Hypomagnesemia, Hypercalcemia - ANSWER- can increase digoxin
toxicity
Diuretics and digoxin - ANSWER- promote the loss of potassium resulting in
hypokalemia, increasing the effects of digoxin
Cortisone and digoxin - ANSWER- promote sodium retention and potassium excretion
resulting in hypokalemia, increasing the effects of digoxin
Antacids and digoxin - ANSWER- decrease digitalis absorption if taken at the same time
calcium and digoxin - ANSWER- calcium enhances the effect on digoxin. An elevated
serum calcium level can cause digitalis toxicity.
Signs and Symptoms of digoxin toxicity - ANSWER- Anorexia
Diarrhea
Nausea Vomiting
Bradycardia (less than 60 BPM)
Premature Ventricular Contractions
Cardiac Dysrhythmias
Headaches
Malaise
Blurred Vision
Visual Illusions (white, green, yellow halo)
Confusion Delirium
, Calcium channel blocker use in angina - ANSWER- Calcium activates myocardial
contraction, increasing the workload of the heart and the need for oxygen. CCB relaxes
angina by decreasing cardiac oxygen demand.
how do calcium channel blockers relax variant and stable angina? - ANSWER-
decreasing oxygen demand, contractility, afterload, peripheral resistance
how do calcium channel blockers achieve their effect? - ANSWER- in controlling variant
angina by relaxing the coronary arteries and control stale angina by decreasing oxygen
demand
nitro patient education - ANSWER- 1. Administer sublingual nitroglycerin tablet if chest
pain occurs. If pain ha not subdued/worsens in 5 minutes, call 911.
2. Advise patient not to ingest alcohol while taking nitroglycerin to avoid hypotension,
weakness, and faintness.
3. Advise patients to notify a health care provider if chest pain is not completely
alleviated. Tolerance to nitroglycerin can occur.
4. Inform patients not to discontinue beta blockers and calcium blockers without a health
care providers approval. Withdrawal symptoms (reflex tachycardia and pain) may be
severe.
5. Side Effects and Adverse Reactions: Hypotension, Dizziness, Flushing,
Weakness/Faintness, Ointment or Transdermal patch should be tapered. Orthostatic
hypotension, Chest Pain, Dyspnea, Tachycardia, Paradoxical bradycardia (severe/life-
threatening), Palpitations, Methemoglobinemia (abnormal amount of methemoglobin in
blood)
Possible electrolyte imbalance with loop diuretics - ANSWER- Hypokalemia
(Potassium), Hypomagnesemia (Magnesium), Hyponatremia (Sodium), Hypocalcemia
(Calcium), Hypochloremia (Chloride) - all lost from the body
Potassium sparing diuretics - ANSWER- Are weaker than thiazides and loop diuretics -
used as mild diuretics
Interfere with the sodium - potassium pump
Spironolactone, Amiloride, Triamterene, Eplerenone
Potassium sparing diuretics drug names - ANSWER- Spironolactone, Amiloride,
Triamterene, Eplerenone
Spironolactone (Potassium sparing diuretic) - ANSWER- blocks the action of
aldosterone (mineralocorticoid hormone that promotes sodium retention and potassium
excretion) and inhibits sodium-potassium pump; prescribed by cardiologist for cardiac
disorders
Amiloride (Potassium sparing diuretic) - ANSWER- antihypertensive agent
