NSG 251 Exam 5 Blueprint

.docx

School

University of Florida *

*We aren’t endorsed by this school

Course

FLO765

Subject

Chemistry

Date

May 24, 2024

Type

docx

Pages

Uploaded by DeaconGorillaMaster1166

NSG 251: Pharmacology and Dosage with Lab Exam 5: Test Blueprint FALL 2022 Exam 5 40 questions worth 2 points each Testing Date Exam 5 is scheduled for Week 11. See Communication Course Calendar Module 7 Outcomes: Drugs Acting on the Cardiovascular System After completing this module, you will be able to: Antihypertensive Drugs  Describe the mechanism of action, therapeutic purpose, cautions, contraindications, common adverse and toxic effects, and significant drug interactions for patients receiving antihypertensive medications: o alpha 2 agonists o beta blockers o ACE/ARBs o calcium channel blockers o vasodilators  hydralazine Diuretic Drugs  Describe the mechanism of action, therapeutic purpose, cautions, contraindications, common adverse and toxic effects, and significant drug interactions for patients receiving diuretic medications: o loop o thiazide o potassium sparing  Develop a nursing plan of care using nursing process for patients receiving diuretic therapy. Drugs to Treat Angina  Describe the mechanism of action, therapeutic purpose, cautions, contraindications, common adverse and toxic effects, and significant drug interactions for patients receiving anti-anginal medications: o nitrates o beta blockers o calcium channel blockers  Develop a nursing plan of care using nursing process for patients receiving anti-anginal medication therapy. 1

Drugs to Treat Heart Failure  Describe the mechanism of action, therapeutic purpose, cautions, contraindications, common adverse and toxic effects, and significant drug interactions for patients receiving heart failure medications: o ACE/ARB o beta blockers o cardiac glycosides  digoxin  Develop a nursing plan of care using nursing process for patients receiving medication therapy for heart failure. Drugs that Affect Coagulation  Describe the mechanism of action, therapeutic purpose, cautions, contraindications, common adverse and toxic effects, and significant drug interactions for patients receiving anticoagulant medications: o anticoagulants  heparin  warfarin o thrombolytics  alteplase o antifibrinolytic  aminocaproic acid  Develop a nursing plan of care using nursing process for patients receiving anticoagulant medication therapy. Antilipemic Drugs  Describe the mechanism of action, therapeutic purpose, cautions, contraindications, common adverse and toxic effects, and significant drug interactions for patients receiving antilipemic medications: o statins o fibric acid derivative  gemfibrozil  Develop a nursing plan of care using nursing process for patients receiving medication therapy for elevated cholesterol. Antidysrhythmic medications  Describe the mechanism of action, therapeutic purpose, cautions, contraindications, common adverse and toxic effects, and significant drug interactions for patients receiving antidysrhythmic medications: o Class III: potassium channel blocker 2

 amiodarone o adenosine  Develop a nursing plan of care using nursing process for patients receiving medication therapy for cardiac dysrhythmias. DO YOU KNOW THIS?  What is the difference between a cardio selective and a nonselective beta blocker? What happens when a beta 1 receptor is blocked? What happens when a beta 2 receptor is blocked? Cardio selective Beta 1 blockers block beta 1 receptors in the heart (ex. atenolol (Tenormin)) •  Slows automaticity of the SA node resulting in a slower heart rate (a negative • chronotropic effect) • Decreased heart rate prolongs diastole allowing more coronary artery • perfusion, reducing ischemia •  Decreases contractility and oxygen demand (a negative inotropic effect) •  slower signal conduction through the AV node (a negative dromotropic effect) •  inhibit release of renin-angiotensin-aldosterone (decrease preload and • afterload) •  some beta-blockers have vasodilatory effects Nonselective: beta 1/beta 2 blocker (ex. propranolol (Inderal))   Beta 1 blocker effects   Block beta 2 receptors located in smooth muscles of the bronchioles and  blood vessels  Causes bronchoconstriction of the airways  Block glycogenolysis leading to hypoglycemia  Blunt symptoms of hypoglycemia: tachycardia, tremor, nervousness  EXCEPT sweating  Block secretion of insulin leading to hyperglycemia  Release of free fatty acids elevating triglyceride levels and decreasing HDL (good cholesterol)  What are the therapeutic uses for beta blockers? What box warning has been issued for beta blockers? What significant adverse effects may occur? What assessments must be made prior to administration? What patient education must be completed? Therapeutic Purpose/Indications   Management of hypertension   Treatment of angina   Cardioprotective blockade of norepinephrine and epinephrine  post myocardial infarction   Acute treatment of supraventricular tachycardia   Treatment of heart failure   prevention of migraine headaches and some essential tremors 3

  open-angle glaucoma  FDA: BOX WARNING: do NOT abruptly stop, taper off over a period of 1-2 weeks Adverse effects   Bradycardia, Depression, Impotence, Nausea, vomiting, Constipation, Fatigue, Delay recovery from hypoglycemia (type 1 diabetic), Heart failure, Dizziness, Low WBCs and platelets, Hyperlipidemia, Alopecia, Wheezing, Dry mouth Administration/Teaching  Assess blood pressure and heart rate prior to administration (Count apical heart rate for one full minute)  Assess weight, intake and output, breath sounds, and blood glucose levels  Assess for sexual dysfunction issues  Assess adherence to therapy  Teach not to abruptly stop, drug MUST be weaned  Take exactly as directed, do not skip doses, do not double doses   May be taken with or without food  No caffeine/alcohol  Increase fiber in diet, and increase fluids  What are the therapeutic purposes of calcium channel blockers? What adverse effects can occur? What assessments must be made prior to administration? What patient education must be completed? Therapeutic purpose/Indications  Treatment of angina, hypertension, atrial fibrillation/flutter with controlled ventricular response, paroxysmal supraventricular tachycardia (PSVT)  Treatment of coronary artery spasm and Raynaud’s disease INTERACTION: grapefruit juice: increased effect; decreased heart rate with beta blockers, amiodarone; toxicity with statins, antifungals, antivirals, and erythromycin Adverse effects  Potent effect, Hypotension  Palpitations, variable heart rate  Constipation/nausea  Dyspnea, edema, rash Administration/teaching   Do not crush, puncture, or open sustained-release tablets or capsules   Teach to avoid grapefruit   Do not abruptly stop, withdraw slowly 4

  Monitor breath sounds, assess for dyspnea, edema   Change positions slowly to prevent falls, implement safety plan for  inpatient care   Assess bowel habits, last BM, increase fiber (and fluids as allowed),  monitor for constipation   Monitor for manifestations of heart failure   Take BP and heart rate prior to administration  How is an ACE inhibitor different than an angiotensin receptor blocker (ARB)?  ACE inhibitor: what the therapeutic purposes? What box warning has been issued? Who would not benefit from an ACE inhibitor? What adverse effects may occur? What lab work should be monitored? What teaching should be completed? Ex. of ACE inhibitor: captopril (All ACE inhibitors end in “pril”) Therapeutic Purpose/Indications  Management of hypertension  Management of heart failure  Prevention of left ventricular hypertrophy following MI  Renal protective: reduced glomerular filtration pressure  Prevent proteinuria and progression of diabetic  Nephropathy  FDA: BOX WARNING: fetal toxicity  Persons of Black race do NOT respond to ACE inhibitors for BP management  INTERACTIONS: NSAIDS: decrease BP effect, risk of renal failure; risk of lithium toxicity; risk of hyperkalemia with potassium supplements  Assess/teach manifestations of hyperkalemia  Monitor electrolytes, especially potassium  Avoid potassium supplements and salt substitutes made from potassium  chloride Adverse Effect  Fatigue  Dizziness, mood changes, headaches  Dry nonproductive cough (reversible with discontinuation  of therapy)  Hyperkalemia  Angioedema  May cause acute renal failure in patients with severe  heart failure  ARBs: what the therapeutic purposes? What box warning has been issued? What adverse effects may occur? What lab work should be monitored? What teaching should be completed? Example of ARB: losartan (Cozaar) - All ARBs end in “sartan” 5

Therapeutic Purpose/Indications  Treatment of hypertension  Associated with a lower mortality after MI compared to ACE inhibitors  as effective in treating heart failure compared to ACE inhibitors  as renal protective in diabetics as ACE inhibitors  FDA: BOX WARNING: fetal toxicity  Caution: older adults  Caution: renal impairment  INTERACTIONS: NSAIDs and rifampi Adverse Effect  Chest pain, Fatigue, Weakness, Hypoglycemia, Diarrhea, Urinary tract infection, Cough (less likely than ACE inhibitors), and Hyperkalemia (less likely than ACE inhibitors) Teaching/Administration  Take with meals  Report dizziness, dyspnea, or excessive fatigue to HCP  Take BP and apical heart rate prior to administering  Monitor potassium levels, monitor for manifestations of hyperkalemia  What lifestyle changes should be made to reduce high blood pressure?  Smoking cessation  Reduce alcohol intake  Dietary changes o Reduce salt intake o Reduce cholesterol and fat intake o Increase intake of vegetables, fruits nuts, legumes, fish, and whole grains  Physical activity o 150 minutes/week of moderate exercise  Stress management  What general teaching should be done for any patient receiving antihypertensives?   Teach patient about hypertension and potential chronic complications   Treatment for primary hypertension is lifelong   Teach about prescribed medication   Teach to not skip doses, do not double doses and to take exactly as directed   Lack of adherence to therapy causes REBOUND HYPERTENSION and is the primary cause of malignant hypertension and end target organ damage   Teach patient to monitor BP at home   Teach lifestyle measures to reduce hypertension 6

Your preview ends here

Eager to read complete document? Join bartleby learn and gain access to the full version