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41 Cards in this Set

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Three groups of beta blockers?
beta blockers (nonselective)
beta blockers (selective)
ophthalmic beta blockers
Nine nonselective beta blockers?
carteolol
carvedilol
labetalol
nadolol
penbutolol
pindolol
propranolol
solatol
timolol
Six selective beta blockers?
acebutolol
atenolol
betaxolol
bisoprolol
esmolol
metoprolol
Six ophthalmic beta blockers?
betaxolol
carteoolol
levobetaxolol
levobunolol
metipranolol
timolol
Name 8 uses for beta blockers?
match ghm
angina pectoris
tachyarrhthmias
hypertrophic subaortic
stenosis
migraine headache
(prophylaxis)
MI (prevention)
glaucoma ((ophthalmic use)
CHF (carvedilol and sustained
release metoprolol only)
hyperthyroidism (management
of symptoms)
Beta blockers compete with _______ (________) neurotransmitters (epinephrine and norepinephrine) for adrenergic receptor sites.
adrenergic (sympathetic)
Beta1-adrenergic receptor sites are located chiefly in the ____ where stimulation results in (increased, decreased) heart rate, contractility, and AV conduction.
heart
increased
Beta2-adrenergic receptors are found mainly in ______ and _____ smooth muscle and the uterus.
bronchial
vascular
Stimulation of beta2-adrenergic receptors produces?
(3)
vasodilation
bronchodilation
uterine relaxation
Blockage of beta2-adrenergic receptors ______ the effects of neurotransmitters.
antagonizes
Beta blockers may be relatively SELECTIVE for beta1-adrenergic receptors.
Five beta blockers that do this are?
acebutolol
atenolol
betaxolol
esmolol
metroprolol
Beta blockers may be relatively NONSELECTIVE for blocking both beta1- and beta2-adrenergic receptors. Ten beta blockers that block both are?
carteolol
carvedilol
labetalol
levobunolol
nadolol
penbutolol
pindolol
propranolol
sotalol
timolol

(carvedilol and labetalol have additional alpha-adrenergic blocking properties
Which four agents possess intrinsic sympathomimetic action(ISA) that may result in less bradycardia than other agents?
acebutolol
carvedilol
penbutolol
pindolol
Ophthalmic beta blockers decrease production of ____ ____.
aqueous humor
Name 5 contraindications?
uncompensated CHF (most beta
blockers)
acute bronchospasm
some forms of valvular heart
disease
bradyarrhythmias
heart block
Use cautiously in pregnant and lactating women (may cause fetal _______ and ______).
bradycardia
hypoglycemia
Use cautiously in any form of _____ disease or underlying compensated CHF (most agents).
lung
Use with caution in diabetics and patients with severe ____ disease.
liver
Beta blockers should not be abruptly discontinued in patients with _____ disease.
cardiovascular
May cause additive myocardial depression and ______ when used with other agents having these effects (digoxin and some antiarrhythmics).
bradycardia
May antagonize the therapeutic effects of _____
bronchodilators
May alter the requirements for _____ or hypoglycemic agents in diabetics.
insulin
______ may decrease the metabolism and increase the effects of some beta blockers.
cimetidine
Three major conditions to monitor for when on beta blockers are?
angina (assess frequency and
severity of chest pain)
migraines (assess frequency
and severity of migraines)
CHF
Assessing patient while on beta blockers includes?
monitor blood pressure and
pulse frequently during
dosage adjustment and
periodically throughout
therapy
monitor I & O ratios
monitor daily weight
look for signs and symptoms
of CHF (dyspnea, rales/
crackles, weight gain,
peripheral edema, jugular
venous distention)
What are the signs of CHF?
dyspnea
rales/crackles
weight gain
peripheral edema
jugular
venous distention
List 3 potential nursing diagnoses.
Tissue perfusion, ineffective

Knowledge, deficient, related to disease processes and medication regimen

Noncompliance
IMPLEMENTATION:
Take ____ pulse prior to administering. If heart rate is less than ____ bpm or if _____ occur, hold medication and notify hcp
apical
50
arrhythmias
Many beta blockers are available in ______ products to enhance compliance.
combination
Instruct patient to continue taking medication, even if feeling well. Abrupt withdrawal may cause life-threatening _____, _____, or myocardial _____. Medication controls but does not cure hypertension.
arrhythmias
hypertension
ischemia
Encourage patient to comply with additional interventions for hypertension which include?
weight reduction
low-sodium diet
regular exercise
smoking cessation
moderation of alcohol
consumption
stress management
Instruct patient and family on proper technique for monitoring _____ _____. Advise them to check blood pressure weekly and report significant changes to hcp.
blood pressure
Caution patient to make position changes slowly to minimize ____ ____. Advise patient that exercising or ____ weather may enhance hypotensive effects.
orthostatic hypotension
hot
Advise patient to consult hcp before taking any ____ medications or herbal-alternative therapies, esp ___ remedies.
OTC
cold
Caution patient that these medications may cause ____ sensitivity to cold.
increased
Diabetics should monitor blood glucose closely, esp if which 4 symptoms occur?
weakness
malaise
irritability
fatigue
Advise patient to advise hcp of medication regimen prior to treatment or _____.
surgery
Advise patient to carry id describing disease process and medication regimen at all times.
okay
Emphasize the importance of follow-up exams to monitor progress.
okay
Instruct patient in correct technique for administration of _____ preparations.
ophthalmic
EVALUATION:
Effectiveness of therapy can be demonstrated by?
Decrease in 1_____ ______
Decrease in frequency and
severity of 2_____ ____.
Control of 3______.
Prevention of myocardial 4______, 5 ____ headaches, and tremors.
Lowering of 6______ pressure.
1 blood pressure
2 anginal attacks
3 arrhythmias
4 infarction
5 migraine
6 intraocular