NUR 326 Exam 3 Cardio and Meds Section

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Nursing Fichas sobre NUR 326 Exam 3 Cardio and Meds Section, creado por Brenna Gailinas el 26/03/2020.
Brenna Gailinas
Fichas por Brenna Gailinas, actualizado hace más de 1 año
Brenna Gailinas
Creado por Brenna Gailinas hace más de 4 años
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Pathophysiology of HF heart muscle unable to pump effectively
Expected Findings for Left-Sided HF Dyspnea Displaced apical pulse S3 (gallop) Pulmonary congestion Frothy pink-tinged sputum
Expected Findings for Right-Sided HF Jugular vein distention Ascending edema Ascites Weight gain Liver enlargement
Disease Prevention for HF Exercise program Low-sodium diet Fluid restrictions Smoking cessation Consistent med-schedule
Meds for HF Diuretics After-load reducing agents (ACE/ARB/Ca+ channel blocker) Digoxin Beta blockers
Pathophysiology for Angina Blood flow to heart is compromised causing ischemia
Expected Findings for Angina "Impending doom" feeling Chest pain Dizziness Pallor/clammy skin Tachycardia, tachypnea, heart palpations
Disease Prevention for Angina Regular exercise Check BP & cholesterol checked regularly Low-sodium, low-fat diet Smoking cessation
Meds for Angina Vasodilators Analgesics Beta blockers Thrombolytic agents Antiplatelet agents Anticoagulants Nitro
4 Ways Body Regulates BP 1. Arterial baroreceptor system 2. Regulation of fluid volume 3. RAAS 4. Vascular auto regulation
Expected Findings for Atherosclerosis Cool extremities Prolonged cap. refill Asymmetric pulse strengths Bruit
Treatment for Atherosclerosis Diet Exercise Cholesterol-lowering meds (statins most common)
Expected Findings for Venous PVD Edema Stasis dermatitis Stasis ulcers
Expected Findings for Arterial PVD Intermittent claudication Numbness (at night) Loss of hair on legs Dry, scaly, pale skin Thickened toenails Pain
Meds for PVD Anti-hypertensives Vasodilators Antiplatelet Analgesics Anti-lipidemics
Heart Beat Explanation (P QRS T) P: atrial contraction QRS: contraction of the ventricles T: relaxation of ventricles
Expected Findings for A Fib Fatigue Weakness Shortness of breath Dizziness Anxiety Palpitation Hypotension
Purpose of Meds for A Fib Slow & regulate heart rate NOT to correct rhythm
Meds for A Fib Beta blockers Ca+ channel blockers Digoxin Anticoagulants
Systolic Left-Sided HF Heart cannot contract forcefully enough during systole to eject enough blood into circulation
Diastolic Left-Sided HF Left ventricle cannot not relax enough during diastole (cannot fill properly)
Valvular Stenosis Stiffening/thickening of valve causing narrow opening and obstructing flow
Valvular Regurgitation Backward flow through the valve
Valvular Prolapse Displacement of valve leaflets during systole
Drug Therapy for Valvular Disease Diuretics Beta blockers ACE inhibitors Digoxin O2
Cholesterol Used for insulation Major component in bile Stored in liver
HMG-CoA Reductase Produces LDL and VLDL
MoA of HMG-CoA Reductase Inhibitor Inhibits production of LDL and VLDL
Suffix for HMG-CoA Reductase Inhibitors -statin
Side Effects of HMG-CoA Reductase Inhibitors Myopathy Rhabdomyolysis Hepatotoxicity over time
Rhabdomyolysis Inflammation of the sheath that surrounds the muscle
Nursing Considerations for HMG-CoA Reductase Inhibitors Annual lipid/liver panels Assess for muscle pain Avoid grapefruit juice Teratogenic Take in PM (chol. produced in PM) Contraindicated w/ Ca channel blockers
HMG-CoA Reductase Inhibitor Medication atorvastatin (Lipitor)
MoA of Fibrates Acid Derivatives Reduces production of triglycerides
Side Effects of Fibrates Acid Derivatives GI discomfort Flatulence
Nursing Considerations for Fibrates Acid Derivatives Monitor for GI discomfort Panel annually Notify provider if going to be pregnant
Fibrates Acid Derivation Medication gemfibrozil (Lopid)
MoA for Cholesterol Absorption Inhibitors inhibits absorption of cholesterol in the small intestine
Side Effects of Cholesterol Absorption Inhibitors Cholecystitis (inflammation of gallbladder)
Nursing Considerations for Cholesterol Absorption Inhibitors Teratogenic Used in combination w/diet and exercise
Cholesterol Absorption Inhibitor Medication ezetimibe (Zetia)
MoA for Inotropic Med Slows HR to beat more forcefully; ions shift in the heart to enhance contractility
Side Effects for Inotropic Meds Bradycardia Arrhythmias Toxicity Hypokalemic pt more @ risk for toxicity Weakness
Signs of Digtoxicity Yellow halos Bradycardia Vomiting
Nursing Considerations for Inotropic Meds Apical pulse! Therapeutic lab draw Same time everyday Antidote is Digibind Educate on toxicity
Therapeutic Level in Blood for Digoxin 0.5 - 2.0 ng/dL
Inotropic Med digoxin (Lanoxine)
MoA of Nitrates Dilates coronary arteries (smaller vessels) to increase blood supply
Side Effects of Nitrates Headaches Orthostatic hypotension Reflexive tachycardia Dizziness
Nursing Considerations for Nitrates Fall risk Need rest for 30 mins after admin Change positions slowly Assess pain Avoid w/ erectile dys meds Educate pt not to carry in pocket
Nitrate Medication nitroglycerin (Nitrostat)
MoA for ACE Inhibitors ACE blocks the conversion of angiotensin I to angiotensin II which helps to decrease BP, decrease blood volume, and decrease uptake of Na+
Suffix for ACE Inhibitors -pril
Side Effects of ACE Inhibitors Hypotension Cough
Nursing Considerations for ACE Inhibitors Monitor BP Change positions slowly Fall risk Angioedema Monitor for cough Teratogenic
ACE Inhibitor Medication captopril, lisinopril
MoA of ARB Inhibitor Blocks angiotensin II receptor from binging to the smooth muscles which decreases BP, decreases BV, and decreases uptake of Na+
Suffix of ARB Inhibitors -sartan
Side Effects of ARB Inhibitors Hypotension Angioedema
Nursing Considerations for ARB Inhibitors Monitor BP Change positions slowly Don't give to pt w/hypokalemia Teratogenic
ARB Inhibitor Medication losartan (Cozaar)
MoA for Calcium Channel Blockers Blocks calcium from binding to channels in smooth muscle of blood vessels, decreasing BP
Side Effects of Calcium Channel Blockers Hypotension Peripheral edema
Nursing Considerations for Calcium Channel Blockers Monitor BP & HR Change positions slowly Edema: monitor weight & I/O, sock lines Avoid grapefruit juice Photosensitivity
Calcium Channel Blocker Medication nifedipine (Adatta, Procardia)
Purpose of Alpha in Body Contraction of smooth muscle
MoA for Alpha I Blockers Vasodilates smooth muscle of SMALLER vessels; helps decreases BP & benign prostatic hyperplasia (BPH)
Side Effects of Alpha I Blockers Dizziness Hypotension Headaches
Nursing Considerations for Alpha I Blockers Monitor BP Report headaches Change positions slowly Take @ bedtime
Alpha I Blocker Medication doxazosin (Cardura)
MoA of Beta Blockers Blocks beta receptors in the heart to decrease HR and blocks epinephrine
Suffix for Beta Blockers -olol
Side Effects for Beta Blockers Hyperglycemia Bradycardia Hypotension Erectile dysfunction Fatigue
Nursing Considerations for Beta Blockers Monitor HP & BP Change positions slowly Monitor glucose levels
Beta Blocker Medications metoprolol (Lopressor) atenolol (Tenormin)
MoA of Centrally-Acting Alpha Antagonists Activates Alpha receptors in the CNS to reduce BP & HR; Long-term use med
Side Effects of Centrally-Acting Alpha Antagonist Reflexive tachycardia Drowsiness Dry mouth Weight gain Hypotension
Nursing Considerations for Centrally-Acting Alpha Antagonists Avoid alcohol Avoid other CNS depressants Taper off slowly Avoid machinery Slows metabolism
Centrally-Acting Alpha Antagonist Medication clonidine (Catapres)
MoA of Arterial Vasodilators Vasodilators arterioles for restrictive blood flow
Side Effects of Arterial Vasodilators Hypotension Reflex tachycardia Headaches
Nursing Considerations for Arterial Vasodilators Monitor BP & HR Change positions slowly
Arterial Vasodilator Medication hydralazine (Apresoline)
Pathophysiology of Aortic Regurgitation Aortic valve cannot close properly so blood flows back into left ventricle
Disease Prevention for Aortic Regurgitation Diet low in sodium Control chronic illnesses Regular exercise
Expected Findings for Aortic Regurgitation Increased pulmonary artery pressure LV hypertrophy Orthopnea Fatigue Palpitations
Medications for Aortic Regurgitation Diuretics Afterload-reducing agents (ACE/ARB/Ca+ Channel blockers) Inotropic agents (digoxin)
Infective Endocarditis Microbial infection of the endocardium (most common microbe is S.aureus or S.viridians)
Expected Findings for Infective Endocarditis Fever: chills, night sweats, fatigue Anorexia/weight loss New cardiac murmur Development of HF Petechiae Systemic embolization
Examples of Primary Hypertension Family hx of HTN African-American Hyperlipidemia Smoking > 60yo or postmenopausal Excessive sodium/caffeine intake Overweight/Obesity Physical inactivity
Examples of Secondary Hypertension Kidney disease Primary aldosteronism Cushing's Disease Brain tumors Encephalitis Pregnancy Drugs
Aneurysm Permanent localized dilation of an artery; arterial wall is weakened by congenital or acquired problems
Common Anatomic Sites of Arterial Aneurysms
Stasis Dermatitis Reddish-brown discoloration along the ankles extending up the calf
What Symptoms Activate the RAAS? (4) 1. Decreased BP 2. Decreased Na+ 3. Decreased O2 4. Decreased fluid volume
Ways BP Medications Affects Organs (3) 1. Decreases glomerular filtration 2. Vasoconstriction 3. Adrenal cortex releases aldosterone
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