Unit 1: Oxygenation Pharmacology

Front 1

An agent that blocks parasympathetic nerve impulses by blocking acetylcholine:

Back 1

-Anticholinergic

Front 2

What 5 areas of the body does anticholinergics primarily affect?

Back 2

-heart
-exocrine glands
-stomach
-smooth muscles
-eye

Front 3

Describe s&s of use of Anticholinergic (Atropine):

Back 3

-Blurred vision, Drowsiness, Tachycardia, Dry mouth, Urinary hesitancy, Decreased sweating (can lead to flushing)

Front 4

What is the general use of Atropine?

Back 4

-Given IV to treat bradycardia
-Given IM preoperatively to decrease oral and respiratory secretions
-Inhalant to treat bronchospasm

Front 5

Describe nursing implications for a patient receiving Atropine:

Back 5

-Evaluate frequently for urinary retention, especially in elderly men with prostate problems
-Do NOT administer if client has tachycardia
-Auscultate bowel sounds

Front 6

Describe administration nursing implications when giving a patient Atropine:

Back 6

-Can cause intense face and trunk flushing when given IM (15-20 min post)
-Do not dilute
-Give over 1 min (may be given more rapidly if needed for cardiac resuscitation)

Front 7

Describe patient teaching for a patient receiving Atropine:

Back 7

-Impairs heat regulation (decreases sweating)
-Avoid taking or contact MD before taking other meds/OTC containing anticholinergic properties
-Monitor urinary stream due to possible retention/hesitancy and report any changes

Front 8

This medication prevents sympathetic stimulation of the heart, thereby reducing heart rate and contractility:

Back 8

-Beta-1 adrenergic blockers

Front 9

What suffix do beta-1 adrenergic blockers end with?

Back 9

-olol (think 'blocks')

Front 10

When a patient is taking beta-1 adrenergic blockers, what changes in the heart would you expect (what is its action)?

Back 10

-Decrease heart rate
-Decrease force of contraction
-Decrease rate of AV conduction

Front 11

What is the general use of beta-1 adrenergic blockers?

Back 11

-Treatment of: angina, HTN, and disarrythmias (decreases HR)

Front 12

Describe what route Atropine can be given?

Back 12

-PO, IM, IV, Inhalant

Front 13

Describe what route beta-1 adrenergic blockers can be given?

Back 13

-PO, IV

Front 14

Describe s&s symptoms for patient receiving beta-1 adrenergic blockers:

Back 14

-fatigue
-weakness
-bradycardia
-bronchospasm, bronchoconstriction
-CHF
-ED

Front 15

Describe nursing implications for a patient receiving beta- 1 adrenergic blockers:

Back 15

-Before giving: evaluate the client's BP and pulse (Hold if systolic is <90 mm Hg)
-Before giving: take AP and if < 50 bpm hold med and contact MD; AP limitations may change with hospital policy
-Monitor I & O and daily weights

Front 16

Describe administration nursing implications when giving beta-1 adrenergic blockers:

Back 16

-ALWAYS have another nurse double check math prior to admin (high-alert med)
-Admin undiluted
-Take AP and BP prior to admin (withhold if BP<90 systolic or <50 AP)
-Check medication admin rate prior to admin (IV)
-PO is typically no more than 100 mg/day

Front 17

Describe patient teaching for patient receiving beta-1 adrenergic blockers:

Back 17

-Instruct the client to report any weakness, dizziness, or fainting
-Instruct on proper BP monitoring outside of hosp/clinic

Front 18

This medication affects all adrenergic receptor sites; produces bronchodilation, management of severe allergic reaction, increases cardiac rate & output, and increases blood pressure:

Back 18

-Epinephrine

Front 19

Describe areas of the body in which Epinephrine effects:

Back 19

-Lungs
-Heart
-Bronchi
-Eyes

Front 20

Describe s&s for a patient receiving Epinephrine:

Back 20

-nervousness
-restlessness
-tremor
-angina
-arrhythmias
-HTN
-tachycardia
-hyperglycemia

Front 21

What is the general use for epinephrine?

Back 21

-Bronchodilation in clients with acute asthma
-Treatment of: HTN, anaphylactic rxn, cardiac arrest
-Produces mydriasis (abnormal dilation of the pupils)

Front 22

Describe nursing implications for a patient receiving epinephrine:

Back 22

-Monitor lung sounds, RR, pulse, and BP

Front 23

Describe administration nursing implications for administrating Epinephrine:

Back 23

-ALWAYS double check math calculations with another nurse
-Can cause irritation to tissues so rotate (IM and SC) injections sites

Front 24

Describe patient teaching for a patient receiving Epinephrine:

Back 24

-Instruct to contact MD if shortness of breath is not relieved or is accompanied by diaphoresis, dizziness, palpitations, or chest pain
-Advise to quit smoking
-Contact MD before taking OTC meds
-Inhalants: wait 1-5 min in between doses; wash mouth piece between uses; if using with other meds, wait 5 min before admin other inhalants; rinse mouth after

Front 25

Describes routes Epinephrine can be given:

Back 25

-IV, SC, Inhalant, PO, IM

Front 26

This medication suppresses the inflammatory and immune systems by inhibiting synthesis of chemical mediators (prostaglandins, leukotrienes, and histamine); acts by decreasing inflammation, which then reduces swelling, warmth, redness, and pain:

Back 26

-Corticosteroids

Front 27

What is the general use of corticosteroids?

Back 27

-Addison's dz (autoimmune), hormone replacement, cancer therapy
-To decrease inflammation: RA, IBD, lupus, allergic conditions, asthma, COPD, respiratory distress syndrome in infants
-To suppress graft rejection

Front 28

Describe s&s for a patient receiving corticosteroids:

Back 28

-Peptic ulcers, GI bleeding, edema
-Hyperglycemia, delayed wound healing
-F & E disturbance, Cushing's syndrome

Front 29

Describe nursing implications for a patient receiving corticosteroids:

Back 29

-During periods of stress, dose may need to increase
-Check fluid balance, K, and BG levels
-Assess for signs of Cushing's
-Check stools for occult blood

Front 30

Describe administration nursing implications for giving corticosteroids:

Back 30

-Check fluid balance, K, and BG
-Dose may need to increase at time of increases stress or sx
-If dose is ordered as SID or EOD, be sure to give in the am to coincide with normal cortisol secretions
-Admin with meals to minimize GI irritation

Front 31

Describe patient teaching for patient receiving corticosteroids:

Back 31

-Tablets can be broken, crushed, or chewed
-Best to take with meals
-Can cause increase appetite, H2O consumption, and swelling
-Do not sudden stop taking med, it needs to be slowly weened

Front 32

Any of a class of agents affecting the force of muscle contraction, particularly a drug affecting the force of cardiac contraction:

Back 32

-Inotropics

-Positive inotropic agents increase, and negative inotropic agents decrease the force of cardiac muscle contraction.

Front 33

Are drugs used in the treatment of congestive heart failure and cardiac arrhythmia by increasing cardiac output by increasing cardiac contraction:

Back 33

-Cardiac glycosides (Digoxin)

Front 34

What is the trade name for Metoprolol?

Back 34

-Lopressor

Front 35

What is the trade name for Atenolol?

Back 35

-Tenormin

Front 36

What is the Trade name for digoxin?

Back 36

-Lanoxin

Front 37

This medication affects the mechanical and electrical actions of the heart, which increases myocardial contractility; alters the electrical activity in noncontractile tissue and ventricular muscle; prolongs refractory period of the AV node:

Back 37

-Digitalis (Digoxin)

Front 38

What is the general use of Digoxin?

Back 38

-Heart failure- improves cardiac output and slows heart rate
-Atrial fibrillation and flutter

Front 39

Describe s&s for a patient receiving Digoxin:

Back 39

-Fatigue
-Bradycardia
-anorexia
-N & V

Front 40

Describe nursing implications for a patient receiving Digoxin:

Back 40

-ALWAYS: assess AP for 1 min, withhold if <60 bpm
-Monitor digoxin serum level (2ng/ml is toxic)
-Do not double up with missed doses
-Monitor I & O, daily weights, lung sounds

Front 41

Describe administration nursing implications for giving Digoxin:

Back 41

-AP for 1 min, if <60 bpm withhold
-Admin IV for at least 5 min
-Before giving, have another nurse double check math
-Monitor therapeutic levels

Front 42

Describe patient teaching for Digoxin:

Back 42

-Take as directed at same time each day
-Teach pt to take own pulse
-Teach client to recognize signs of hypokalemia (muscle weakness) and digatalis toxicity (N & V, diarrhea, blurred or yellow visual disturbance), and notify HCP

Front 43

This medication relaxes vascular (arterial and venous) with more prominent effects on veins, which decreases preload; arterial relaxation reduces systemic vascular resistance, which decreases afterload; decreases left ventricular end-diastolic pressure and left ventricular end-diastolic volume (preload); reduces myocardial O2 consumption:

Back 43

-Nitroglycerin

Front 44

What is the general use of Nitroglycerin?

Back 44

-Relief from anginal pain
-In conjunction with beta blockers or Ca channel blockers to suppress tachycardia
-Reduces BP and increases CO

Front 45

Describe s&s for a patient taking Nitroglycerin:

Back 45

-Orthostatic hypotension
-Headaches
-Tachycardia
-Dry mouth
-Blurred vision

Front 46

Describe nursing implications for a patient receiving Nitroglycerin:

Back 46

-Monitor BP and pulse before and after admin

Front 47

Describe administering nursing implementations for a patient receiving Nitroglycerin:

Back 47

-Rotate transdermal patches and remove after 12-14 hours to have a "patch free" interval of 10-12 hours daily
-Admin 1 hr before meals or 2 hrs after meals with a full glass of water

Front 48

Describe patient teaching for a patient on Nitroglycerin:

Back 48

-Clients with angina should carry at all times
-Teach proper storage for freshness
-Call 9-1-1 if pain is not relieved after 3 doses of medication
-Protect from sunlight

Front 49

Describe routes that Nitroglycerin can be given:

Back 49

-PO
-SL
-SB
-Transdermal
-IV

Front 50

What does "ACE" in ACE-inhibitors stand for?

Back 50

-Angiotensin Converting Enzyme

Front 51

This medication suppresses formation of angiotensin II (vasoconstrictor) from the renin-angiotensin-aldosterone system, reduces peripheral resistance, and improve CO:

Back 51

-ACE Inhibitors

Front 52

What is the general use of ACE Inhibitors?

Back 52

-Treatment of: HTN and HF

Front 53

What is the effect of ACE Inhibitors?

Back 53

-Decreases peripheral vascular resistance (avoids constriction) without increasing output, cardiac rate, and cardiac contractility

Front 54

Describe s&s for a patient taking ACE Inhibitors:

Back 54

-Headache
-Dizziness
-Orthostatic hypotension
-Angioedema
-Altered sense of taste
-Nagging, nonproductive cough
-GI distress

Front 55

Describe nursing implications for a patient receiving ACE Inhibitors:

Back 55

-Monitor BP and pulse
-Assess hx of renal impairment
-Monitor daily weights

Front 56

Describe administration nursing implementation for giving ACE Inhibitors:

Back 56

-Verify the correct med and dose VERY carefully with another nurse
-Admin on an empty stomach for best absorption

Front 57

Describe patient teaching for a patient receiving ACE Inhibitors:

Back 57

-Teach client to rise slowly from a lying to a sitting position
-Teach to contact HCP if cough develops
-Teach to avoid K supplements or K containing salt substitutes
-Taste disturbances should resolve 8-12 wks
-Contact HCP if facial swelling, mouth sores, fever, irregular heart beat, chest pain, or dry cough occur

Front 58

Blocks vasoconstrictor and aldosterone-producing effects of angiotensin II at receptor sites, including vascular smooth and the adrenal glands (lowering BP):

Back 58

-Angiotensin II blockers

Front 59

What is the general use of Valsartan (angiotensin II blockers)?

Back 59

-Lowers BP

Front 60

Describe s&s for a patient receiving Valsartan:

Back 60

-Dizziness
-Hypotension
-Angioedema
-Headache

Front 61

Describe nursing implications for a patient receiving Angiotensin II blockers (Valsartan):

Back 61

-Assess BP
-Assess signs of angioedema
-May be admin without regard of meals

Front 62

Describe patient teaching for a patient receiving Valsartan (Angiotensin II blockers):

Back 62

-Take as directed at the same time each day
-Avoid taking salt substitutes with containing K or K additives
-Teach to rise slowly and avoid sudden movement changes
-Teach to contact HCP if facial swelling occurs
-Teach about BP lowering diets and lifestyles

Front 63

Inhibit Na and Cl reabsorption through direct action primarily in the ascending loop of Henle but also in the proximal and distal tubules:

Back 63

-Loop Diuretics (K-wasting)

Front 64

What is the general use of loop diuretics?

Back 64

-Treatment of edema (pulmonary also) resulting from disorders of the heart, liver, or kidney
-HTN

Front 65

Describe s&s for a patient receiving loop diuretics (K-wasting):

Back 65

-Dehydration, hyponatremia, hypochloremia, hypokalemia
-Unusual tiredness, weakness, dizziness
-Irregular heart beat, weak pulse, orthostatic hypotension
-Tinnitus, hyperglycemia, hyperuricemia, hearing loss (Lasix)

Front 66

Describe nursing implications for a patient receiving loop diuretics (K-wasting):

Back 66

-Monitor I&O and K levels
-Monitor daily weights and VS
-Monitor for signs of hearing loss, which may last from 1-24 hours
-Monitor lung sounds
-Monitor BP and pulse

Front 67

Describe routes loop diuretics can be given:

Back 67

-PO
-IV (preferred over IM)
-IM

Front 68

What is the general use for K-sparing diuretics?

Back 68

-Have a weak diuretic and antihypertensive properties and are used mainly to conserve K in patients receiving thiazide or loop diuretics

Front 69

Prevention and treatment of deficiencies or excesses of electrolytes and maintenance of optimal acid/base balance for homeostasis:

Back 69

-Electrolyte supplements

Front 70

True or False:
Do not administer Potassium-Chloride undiluted.

Back 70

-True

Front 71

Blocks Ca access to the cells, causing decreased heart contractility and conductivity and leading to a decreased demand for O2:

Back 71

-Ca-Channel Blockers

Front 72

What are the general uses of Ca-Channel blockers?

Back 72

-Angina
-HTN
-Dysrhythmias

Front 73

Describe s&s for a patient receiving Ca Channel Blockers:

Back 73

-Edema of the extremities
-Dysrrhythmias
-Decreased BP
-Headache
-Constipation
-Nausea,
-Skin flushing

Front 74

Describe nursing implications for a patient receiving Ca Channel blockers:

Back 74

-Do not crush or allow client to chew sustained-release med preparations
-Monitor VS and BP
-Daily weights and assess for edema
-Monitor I & O

Front 75

Describe patient teaching for a patient receiving Ca Channel blockers:

Back 75

-Teach about orthostatic hypotension
-Teach client to avoid grapefruit
-Teach client that constipation can be minimized by increasing dietary fiber and fluid

Front 76

Inhibit platelet aggregation, prolongs bleeding time, and are used to prevent MI or CVA:

Back 76

-Antiplatelet Agents

Front 77

What is the general use of antiplatelet agent?

Back 77

-Treatment and prevention of thromboembolic events such as CVA and MI

Front 78

Describe s&s for a patient receiving antiplatelet agents:

Back 78

-Abdominal pain
-Dyspepsia
-Diarrhea
-Rash

Front 79

Describe nursing implications for a patient receiving antiplatelet agents:

Back 79

-Administer with food to diminish GI upset
-Monitor INR times

Front 80

Describe patient teaching for a patient receiving antiplatelet agents:

Back 80

-Teach client to report an unusual bleeding or bruising
-Teach client that if Sx is scheduled, med may be held 3-7 days before Sx

Front 81

Used to prevent clot extension and formation; does not dissolve clots:

Back 81

-Anticoagulants

Front 82

What is the general use of anticoagulants?

Back 82

-Prevention and treatment of thromboembolic disorders inlcuding DVT, pulmonary embolism, and atrial fibrillation with embolization

Front 83

Describe s&s for a patient receiving anticoagulants:

Back 83

-can change urine into an amber-orange tint

Front 84

Describe nursing implications for a patient receiving anticoagulants:

Back 84

-Check INR time
-Assess for signs of bleeding (bruising, occult blood, bleeding gums)
-Venipunctures require prolonged pressure

Front 85

Describe patient teaching for a patient receiving anticoagulants:

Back 85

-Caution patient to avoid activities that may lead to injury
-Do NOT take aspirin, NSAIDs, or alcohol (limit garlic and foods with Vit K)