Pharmacology in Nursing (Exit Exam
WCU)
Reproductive system meds: Medications for postpartum client: Rho(D) Immune Globulin
(RhoGAM) - ✔️✔️suppresses the stimulation of active immunity by Rh-positive foreign
red blood cells that enter the maternal circulation at the time of delivery
Reproductive system meds: Medications for postpartum client: Rho(D) Immune Globulin
(RhoGAM): Precaution - ✔️✔️- confirm that mother is Rh-negative, - never administer
the IGIM full-dose or micro dose products IV, - never administer neonate
Reproductive system meds: Medications for postpartum client: Rho(D) Immune Globulin
(RhoGAM): Nursing interventions - ✔️✔️- RhoGAM is administered as an injection
after any event where fetal cells can mix with maternal blood
Cardio: Antihypertensives: ACE inhibitors and ARBs precautions and side effects -
✔️✔️- Precaution: use with caution if diuretic therapy is in place, monitor potassium
level
- Sides: persistent non-productive cough with ACE, angioedema (swelling under skin),
hypotension, should not be used in 2nd or 3rd trimester if pregnant
Cardio: Antihypertensives: ACE inhibitors and ARBs nursing interventions - ✔️✔️-
captopril should be taken 1 hour before meals, - monitor blood pressure, - monitor for
angioedema and administer epinephrine if needed
Cardio: Antihypertensives: Calcium Channel Blockers - ✔️✔️Nifedipine, verapamil,
diltiazem, amlodipine
Cardio: Antihypertensives: Channel Blockers precautions and side effects - ✔️✔️-
Precaution: use cautiously in clients taking digoxin and beta blockers, contraindicated
for clients w/ heart failure/block, do not consume grapefruit juice (toxic effects)
- Sides: Constipation, reflex tachycardia, peripheral edema, toxicity
Cardio: Antihypertensives - ✔️✔️Nursing interventions: Assess weight, vital signs, and
hydration status. Assess blood pressure in supine, sitting, and standing. Assess labs:
renal and coagulation. Teach to take meds at the same time everyday. Clients should
avoid hot tubs and saunas. Do not discontinue abruptly. Prevent orthostatic
hypertension.
Cardio: Antihypertensives: ACE inhibitors and ARBs - ✔️✔️ACE: Captopril, enalapril,
enalaprilat, fosinopril, lisinopril
,ARBs: Losartan, valsartan, irbesartan
Cardio:Antihypertensives:Calcium Channel Blockers nursing interventions - ✔️✔️- do
not crush or chew sustained release tablets, - administer IV over 2-3 minutes, - slowly
taper dose if discontinuing, - monitor HR and BP
Cardio:Antihypertensives:Alpha adrenergic blockers (sympatholytics) - ✔️✔️Prazosin
and doxazosin
Cardio:Antihypertensives:Alpha adrenergic blockers: precautions and side effects -
✔️✔️Precautions: increased risk of hypotension and syncope if given with other
antihypertensives, beta blockers, or diuretics. NSAIDS may decrease the effect of
prazosin
Sides: dizziness, fainting
Cardio:Antihypertensives:Alpha adrenergic blockers: nursing interventions - ✔️✔️-
monitor HR and BP, - take medication at bedtime to minimize effects of hypotension, -
advise to notify prescriber immediately for adverse reactions, - consult prescriber before
taking any OTC medications
Cardio:Antihypertensives:Centrally acting alpha agonist - ✔️✔️Clonidine, guanfacine,
methyldopa
Cardio:Antihypertensives:Centrally acting alpha agonist: precautions and side effects -
✔️✔️Precautions: - contraindicated with anticoagulant therapy, hepatic failure, - do not
administer to clients taking MAOIs, - Do not administer IV with barbiturates or
sulfonamides, - Use cautiously in CVA, MI, diabetes mellitus, major depression, or renal
failure
Side effects: - dry mouth, - drowsiness and sedation, - rebound hypertension, - black or
sore tongue, - leukopenia
Cardio:Antihypertensives:Centrally acting alpha agonist: nursing interventions -
✔️✔️monitor for adverse CNS effects, monitor CBC, HR, and BP, - assess for weight
gain or edema, - monitor for rebound HTN 48 hrs after discontinuations, - never skip a
dose, take at bedtime to reduce hypotension, - notify of any involuntary jerky
movements, prolonged dizziness, rash, yellowing of skin
Cardio:Antihypertensives:Beta adrenergic blockers (sympatholytics) - ✔️✔️Selective:
Metoprolol, Atenolol, Metoprolol succinate
Non selective: Propanolol, Nadolol, Labetalol
, Cardio:Antihypertensives:Beta adrenergic blockers (sympatholytics): Precautions and
Side effects - ✔️✔️Precaution: contraindicated in clients who have AV block and sinus
bradycardia, - do not administer nonselective beta blockers to clients who have asthma,
bronchospasm, or heart failure. - Propranolol may mask effects of hypoglycemia in
client with DM
Side effects: Bradycardia, nasal stuffiness, AV block, rebound myocardium excitation if
stopped suddenly, bronchospasm
Cardio:Antihypertensives:Beta adrenergic blockers (sympatholytics): Nursing
interventions - ✔️✔️administer 1-2 times daily as prescribed, do not discontinue
without consulting provider, do not crush or chew extended release tabs, hold
medication and notify provider if systolic BP < 100 mmHg or pule <60/min
Cardio: Antihypertensives: Vasodilators - ✔️✔️Nitroglycerin: enalaprilat, nitroprusside,
hydralazine
Cardio: Antihypertensives: Vasodilators: Precautions and side effects -
✔️✔️Precaution: Clients who have hepatic or renal disease, older adults, electrolyte
imbalances
Side effects: dizziness, headache, profound hypotension, cyanide toxicity, thiocyanate
poisoning
Cardio: Antihypertensives: Vasodilators: Nursing intervention - ✔️✔️Nitroprusside may
not be mixed with any other medication, - apply protective cover to container, - discard
unused fluid after 24 hour, - provide continuous ECG and BP monitoring
Cardio: Cardiac glycosides - ✔️✔️Digoxin
Cardio: Cardiac glycosides: Precautions and Side effects - ✔️✔️thiazide or loop
diuretics increase risk or hypokalemia and precipitate digoxin toxicity, - ACE and ARBs
increase risk of hyperkalemia, - Verapamil increases risk of toxicity
Cardio: Cardiac glycosides: nursing interventions - ✔️✔️assess apical pulse for 1 min
prior to administration, - notify provider if HR less than 60 (adult) less than 70 (child) or
less than 90 (infant), - monitor for signs of digoxin toxicity, hypokalemia and
hypomagnesemia, - notify provider of any sudden increase in pulse rate , - maintain
therapeutic digoxin level
Cardio: antianginal meds - ✔️✔️nitrostat, nitrolingual, nitro-bid, nitro-dur
Cardio: abtianginal meds: Precaution and side effects - ✔️✔️Precaution:
contraindicated in clients with head injury, - hypotensive risk with antihypertensive
medications, - erectile dysfunction meds can cause life-threatening hypotension
Side effects: Headache, - orthostatic hypotension, - reflex tachycardia, - tolerance
WCU)
Reproductive system meds: Medications for postpartum client: Rho(D) Immune Globulin
(RhoGAM) - ✔️✔️suppresses the stimulation of active immunity by Rh-positive foreign
red blood cells that enter the maternal circulation at the time of delivery
Reproductive system meds: Medications for postpartum client: Rho(D) Immune Globulin
(RhoGAM): Precaution - ✔️✔️- confirm that mother is Rh-negative, - never administer
the IGIM full-dose or micro dose products IV, - never administer neonate
Reproductive system meds: Medications for postpartum client: Rho(D) Immune Globulin
(RhoGAM): Nursing interventions - ✔️✔️- RhoGAM is administered as an injection
after any event where fetal cells can mix with maternal blood
Cardio: Antihypertensives: ACE inhibitors and ARBs precautions and side effects -
✔️✔️- Precaution: use with caution if diuretic therapy is in place, monitor potassium
level
- Sides: persistent non-productive cough with ACE, angioedema (swelling under skin),
hypotension, should not be used in 2nd or 3rd trimester if pregnant
Cardio: Antihypertensives: ACE inhibitors and ARBs nursing interventions - ✔️✔️-
captopril should be taken 1 hour before meals, - monitor blood pressure, - monitor for
angioedema and administer epinephrine if needed
Cardio: Antihypertensives: Calcium Channel Blockers - ✔️✔️Nifedipine, verapamil,
diltiazem, amlodipine
Cardio: Antihypertensives: Channel Blockers precautions and side effects - ✔️✔️-
Precaution: use cautiously in clients taking digoxin and beta blockers, contraindicated
for clients w/ heart failure/block, do not consume grapefruit juice (toxic effects)
- Sides: Constipation, reflex tachycardia, peripheral edema, toxicity
Cardio: Antihypertensives - ✔️✔️Nursing interventions: Assess weight, vital signs, and
hydration status. Assess blood pressure in supine, sitting, and standing. Assess labs:
renal and coagulation. Teach to take meds at the same time everyday. Clients should
avoid hot tubs and saunas. Do not discontinue abruptly. Prevent orthostatic
hypertension.
Cardio: Antihypertensives: ACE inhibitors and ARBs - ✔️✔️ACE: Captopril, enalapril,
enalaprilat, fosinopril, lisinopril
,ARBs: Losartan, valsartan, irbesartan
Cardio:Antihypertensives:Calcium Channel Blockers nursing interventions - ✔️✔️- do
not crush or chew sustained release tablets, - administer IV over 2-3 minutes, - slowly
taper dose if discontinuing, - monitor HR and BP
Cardio:Antihypertensives:Alpha adrenergic blockers (sympatholytics) - ✔️✔️Prazosin
and doxazosin
Cardio:Antihypertensives:Alpha adrenergic blockers: precautions and side effects -
✔️✔️Precautions: increased risk of hypotension and syncope if given with other
antihypertensives, beta blockers, or diuretics. NSAIDS may decrease the effect of
prazosin
Sides: dizziness, fainting
Cardio:Antihypertensives:Alpha adrenergic blockers: nursing interventions - ✔️✔️-
monitor HR and BP, - take medication at bedtime to minimize effects of hypotension, -
advise to notify prescriber immediately for adverse reactions, - consult prescriber before
taking any OTC medications
Cardio:Antihypertensives:Centrally acting alpha agonist - ✔️✔️Clonidine, guanfacine,
methyldopa
Cardio:Antihypertensives:Centrally acting alpha agonist: precautions and side effects -
✔️✔️Precautions: - contraindicated with anticoagulant therapy, hepatic failure, - do not
administer to clients taking MAOIs, - Do not administer IV with barbiturates or
sulfonamides, - Use cautiously in CVA, MI, diabetes mellitus, major depression, or renal
failure
Side effects: - dry mouth, - drowsiness and sedation, - rebound hypertension, - black or
sore tongue, - leukopenia
Cardio:Antihypertensives:Centrally acting alpha agonist: nursing interventions -
✔️✔️monitor for adverse CNS effects, monitor CBC, HR, and BP, - assess for weight
gain or edema, - monitor for rebound HTN 48 hrs after discontinuations, - never skip a
dose, take at bedtime to reduce hypotension, - notify of any involuntary jerky
movements, prolonged dizziness, rash, yellowing of skin
Cardio:Antihypertensives:Beta adrenergic blockers (sympatholytics) - ✔️✔️Selective:
Metoprolol, Atenolol, Metoprolol succinate
Non selective: Propanolol, Nadolol, Labetalol
, Cardio:Antihypertensives:Beta adrenergic blockers (sympatholytics): Precautions and
Side effects - ✔️✔️Precaution: contraindicated in clients who have AV block and sinus
bradycardia, - do not administer nonselective beta blockers to clients who have asthma,
bronchospasm, or heart failure. - Propranolol may mask effects of hypoglycemia in
client with DM
Side effects: Bradycardia, nasal stuffiness, AV block, rebound myocardium excitation if
stopped suddenly, bronchospasm
Cardio:Antihypertensives:Beta adrenergic blockers (sympatholytics): Nursing
interventions - ✔️✔️administer 1-2 times daily as prescribed, do not discontinue
without consulting provider, do not crush or chew extended release tabs, hold
medication and notify provider if systolic BP < 100 mmHg or pule <60/min
Cardio: Antihypertensives: Vasodilators - ✔️✔️Nitroglycerin: enalaprilat, nitroprusside,
hydralazine
Cardio: Antihypertensives: Vasodilators: Precautions and side effects -
✔️✔️Precaution: Clients who have hepatic or renal disease, older adults, electrolyte
imbalances
Side effects: dizziness, headache, profound hypotension, cyanide toxicity, thiocyanate
poisoning
Cardio: Antihypertensives: Vasodilators: Nursing intervention - ✔️✔️Nitroprusside may
not be mixed with any other medication, - apply protective cover to container, - discard
unused fluid after 24 hour, - provide continuous ECG and BP monitoring
Cardio: Cardiac glycosides - ✔️✔️Digoxin
Cardio: Cardiac glycosides: Precautions and Side effects - ✔️✔️thiazide or loop
diuretics increase risk or hypokalemia and precipitate digoxin toxicity, - ACE and ARBs
increase risk of hyperkalemia, - Verapamil increases risk of toxicity
Cardio: Cardiac glycosides: nursing interventions - ✔️✔️assess apical pulse for 1 min
prior to administration, - notify provider if HR less than 60 (adult) less than 70 (child) or
less than 90 (infant), - monitor for signs of digoxin toxicity, hypokalemia and
hypomagnesemia, - notify provider of any sudden increase in pulse rate , - maintain
therapeutic digoxin level
Cardio: antianginal meds - ✔️✔️nitrostat, nitrolingual, nitro-bid, nitro-dur
Cardio: abtianginal meds: Precaution and side effects - ✔️✔️Precaution:
contraindicated in clients with head injury, - hypotensive risk with antihypertensive
medications, - erectile dysfunction meds can cause life-threatening hypotension
Side effects: Headache, - orthostatic hypotension, - reflex tachycardia, - tolerance
