MS1: Quiz 17 - Medications used for Cardiovascular Disorders & DM

What do you assess before giving blood pressure medications?

Blood pressure & heart rate

What is the indication of holding blood pressure medication?

Systolic BP <110

or

Heart rate = 60

What are the signs and symptoms of hypotension?

Tachycardia, dizziness, mental confusion, restlessness, cool and clammy skin, pale or cyanotic pallor

What do you monitor for with digoxin?

Serum potassium level

Normal: 3.5 to 5.0 mEq/L

What are the signs and symptoms of digoxin toxicity?

- Lack of appetite (anorexia), nausea, vomiting, or diarrhea

- Headache, confusion, anxiety, or hallucinations

- Restlessness, weakness, or depression

- Blurred vision

- Arrhythmia., tachycardia, dysrhythmia, bradycardia, palpitations

What is the most important vital sign to monitor for in digoxin?

Heart rate (apical pulse)

What are the contraindications for metoprolol?

Severe bradycardia, sick sinus syndrome, heart block (2nd or 3rd degree AV), cardiogenic shock, decompensated heart failure

When does NPH insulin peak?

4-12 hours. Usually starts around lunch so they will need a snack after that to maintain glucose

What are the types of insulin appearance?

Clear: rapid/short/ultra-long acting

&

Cloudy: Intermidiate/long acting

If the short acting insulin looks cloudy, can you administer it?

- No because short acting should always be clear

- If the clear insulin is cloudy, look for clumps, solid white particles, or crystals; discard it

What is the best time to administer insulin?

30 minutes before a meal

How should insulin be stored?

At room temperature because cold insulin can make injection more painful

How long should you wait before eating a snack after taking NPH insulin?

8 Hours

What is a drug that can interact with a diabetes medication?

Prednisone: can make the liver resistant to insulin, elevate blood sugar levels, and lead to steroid-induced diabetes.

What is nifedipine?

- A calcium channel blocker used to treat certain types of angina (chest pain)

- Side effects: dizziness, flushing, lower extremity edema, constipation, headache

What is niacin (vitamin B3)?

- Can boost levels of good cholesterol (HDL), lower triglycerides, and sometimes lowers bad cholesterol (LDL)

- Side effects: liver damage (hepatotoxicity), myopathy (skeletal muscle disorder), severe flushing, dizziness, tachycardia, itching, nausea/vomiting, abdominal pain, diarrhea, gout, diabetes

What is atorvastatin?

- Used together with a proper diet to lower cholesterol and triglyceride levels in the blood.

- Side effects: liver damage (hepatotoxicity), myopathy (skeletal muscle disorder), loss of appetite, jaundice, edema in the lower extremities, constipation, nausea, fatigue, heartburn

Before administering a statin, what laboratory marks should you check first?

Liver function: blood test (AST and ALT levels)

What is the purpose nitroglycerin and how does it work?

- To prevent angina (chest pain) through vasodilation caused by coronary artery disease

What are the side effects of nitroglycerin?

- Allergic reactions (skin rash, itching, hives, swelling of the face, lips, tongue, or throat)

- Headache, fatigue, dyspnea, nausea, vomiting, tachycardia, cyanosis

- Severe headache, blurry vision, hypotension, dizziness, confusion, bradycardia

Who should not take ace inhibitors?

Pregnant women, patients with renal problems, hypersensitivity to drug

What is hypokalemia?

- A serum potassium level less than 3.5 mEq/L

- Causes: excessive alcohol use, chronic kidney disease, diabetic ketoacidosis, diarrhea

- S/sx: muscles feel weak, cramp, twitch, or even paralyzed; dysrhythmia

What is the purpose of aspirin?

- Anti-platelet aggregation (changes the balance between prostacyclin and thromboxane)

- Primary prevention of CVD w/ a decrease risk of myocardial infarction and stroke

What labs do you monitor for warfarin?

- PT/INR: see how well warfarin is working; measures the time it takes for a clot to form in a blood sample

-Prothrombin time is shown as an international normalize ratio

What foods do you not eat while taking warfarin?

Vitamin K rich foods because it can make drug less effective:

- Kale, spinach, brussels sprouts, collard greens, broccoli, asparagus, green tea, seaweed

What can you teach a patient about heparin and what some nursing interventions you can do?

- Instruct patient to report any unusual bleeding or bruising right away

- Encourage the patient to refrain from contact sports or activities

- Advise the use of an electric razor to minimize bleeding

- Teach the patient to use a soft toothbrush to protect the gums from bleeding