SCF Nursing Lvl 2 exam 2- cardiac Questions and Answers 100% Verified

Nifedipine nursing considerations - -H&P -Allergy -Liver/Kidney function -Pregnancy & lactation -BP & HR (does not require HR every time) -Gums DAILY **Might not be first drug of choice for PT w/ unresolved cardiac issues** What are some concerns with antihypertensives in pregnancy? - -ACEs / ARBs cat C&D depending on trimester What are some concerns with antihypertensives in older adults? - -Older adults- Drug Drug interactions; decreasing liver and kidney function; increased risk of falls ACE Inhibitors mechanism of action? - -Blocks the conversion of angiotensin I to angiotensin II -Angiotensin II receptor blocker: blocks effects of angiotensin on blood vessels Beta-Blocker mechanism of action? - -leads to a decrease in HR & strength of contraction as well as vasodilation Calcium Channel Blocker mechanism of action? - -Relaxes (smooth) muscle contraction Vasodilator mechanism of action? - -Act directly on vascular smooth muscle to cause muscle relaxation, leading to vasodilation and drop in BP ACE Inhibitor generic drug? - LisinoprilLisinopril Actions - ACE inhibitor -Blocks ACE from converting angiotensin I to angiotensin II -Decreasing peripheral vascular resistance -Leads to a decrease in BP -Decrease in aldosterone production -Small increase in serum K+ levels along with Na+ and fluid loss **doesn't affect HR** Lisinopril Indications / Pharmacokinetics - -Treatment of HTN, heart failure, diabetic nephropathy, to improve MI survival -Not metabolized, excreted primarily in urine Lisinopril Contraindications / Cautions - -Allergies -Impaired renal functions (hyperkalemia) -Pregnancy and lactation -Salt/ volume depletion -NSAIDS decrease effectiveness Lisinopril adverse effects - -R/T the effects of vasodilation: orthostatic BP, dizziness, Headache -Renal insufficiency -N/V/D -DRY COUGH!!! -Hyperkalemia -ANGIOEDEMA (blood vessel swelling usually face and tongue) Lisinopril Nursing considerations - -H&P -Allergies -Impaired renal function, pregnancy, lactation-Salt/volume depletion and heart failure -Baseline status before beginning therapy; including VS, Lung sounds, ECG, CBC, Electrolytes Angiotensin II Receptor Blockers (ARBs) Generic Med - Losartan Losartan Action - -Selectively bind w/ the angiotensin II receptors in vascular smooth muscle & in the adrenal cortex to block vasoconstriction & the release of aldosterone (Receptors bind w/ something else so there is no room left for angiotensin II) Losartan Pharmacokinetics - -Well absorbed and metabolized in the liver by the cytochrome P450 system -Excreted in feces and urine Losartan contraindications / cautions - -Allergies -Pregnancy & Lactation -Hepatic or renal dysfunction -Hypovolemia Losartan adverse effects - -Headaches, dizziness, fatigue -Diarrhea, hyperkalemia -URI -Angioedema Losartan Drug-Drug Interactions - -May increase lithium levels -NSAIDS (less effective) Lostartan Nursing Considerations - **Must check BP prior to admin** -H&P -Allergies-Impaired renal and hepatic function -Pregnancy, lactation -Hypovolemia -Baseline status before beginning therapy; including VS, Lung sounds, renal and liver function tests, ECG, CBC, Electrolytes ***GRAPEFRUIT JUICE*** - May decrease effectiveness Calcium Channel Blockers Generic Med - Nifedipine Nifedipine Mechanism of Action - -Inhibits movement of calcium ions across cell membranes of myocardial & vascular smooth muscle cells including those in arteries, which lowers BP and decreases myocardial oxygen consumption. -Allows arteries to open up more and decrease vascular resistance to lower BP (heart doesnt have to push as hard so can also treat angina) Nifedipine Indications - -Treatment of HTN and Angina What are some concerns with antihypertensives in children? - -ACEs / ARBs not studied in children <6 yrs. -Also treat cardiac arrhythmias if it works on the heart (Calcium Channel Blockers not Nifedipine) Nifedipine pharmacokinetics - -Well absorbed, metabolized in liver, excreted in urine Nifedipine contraindications and cautions - -Allergies -Unstable Angina -Acute MI -Renal or hepatic dysfunction -Pregnancy & Lactation -GI obstructionNifedipine adverse effects - -R/T vasodilation: Headache, dizziness, peripheral edema, hypotension,