Simple Nursing Pharmacology NCLEX

Simple Nursing Pharmacology NCLEX 10 studiers today Leave the first rating Students also studied Terms in this set (68) Save Nursing Pharmacology (Drugs) 150 terms Sarah_ShanerPreview 140 Must Know NCLEX Meds 141 terms eyoung389Preview Pharmacology NCLEX Questions 49 terms notnursingPreview NCLEX 110 term kan ACE Inhibitors (-pril) ARBs (-sartan)

(Antihypertensives: lower BP)

Act to lower BP (not HR!)

S/E: Orthostatic Hypotension = SLOW position changes

Do we give ACE and ARBs if the HR < 60>

Key notes:

• Avoid giving to pregnant patients
• ACE can cause angioedema, cough, elevates potassium (increased K+ > 5.0)
• ARBs used to decrease dry cough and they spare Potassium

Avoid food high in Potassium with ACE inhibitors (-prils)

such as:

• Green leafy vegetables
• Oranges
• Bananas
• Avocado
• Melon
• Dried apricot
• Kidney beans

Also salt substitutes and LIVER Potassium > 5.0 EKG changesPeaked T waves, ST elevation (muscle spasms)

**Any Potassium level high or low, fist action by the nurse is: CARDIAC MONITOR

Beta Blockers: Lowers HR & BP

(-lol) (Lowers HR & BP) What are the three negative tropics for Beta Blockers?

• Negative chronotropic (lower rate)
• Negative Inotropic (less force)
• Negative dromotropic (less beats)

The above tropics mean:

• Decreases resistance
• Decreases workload
• Decreases cardiac output

DO NOT GIVE to COPD or ASTHMA pt's ----> causes bronchospasm

Most dangerous side effects of Beta blockers: 1. Bradycardia

---> HR < 60>

(HOLD DRUG)

• Breathing problems (wheezing)

---> HOLD for COPD and Asthma pt's

• BAD for Heart failures pt's!

---> can worsen heart failure **---> New edema, worsening crackles in the lungs, rapid weight gain, new JVD** All indicate worsening HR = PRIORITY report to HCP

• Can mask/hide the signs and symptoms of Hypoglycemia (Low blood sugar)

---> Monitor blood sugar closely < 70>

Calcium Channel blockers: Calms the heart!

Nifedipine (only decreases BP) Cardizem (decreases BP and HR Verapamil (decreases BP and HR)

Key nursing considerations:

- ALWAYS before giving the drug --> Assess HR and BP, HOLD drug if:

If BP systolic <100>

• Change positions slowly
• Bad headaches - normal S/E

NCLEX: If on CCB drip, if the HR has a BIG drop like < 50>

Digoxin = Increases heart contractions = more forceful contractions and decreases the HR (has no effect on BP) No orthostatic hypotension, so no slow position changes

TOXICITY:

• Check the apical pulse for a full 60 seconds*

(if HR < 60>

• Digoxin level > 2.0 = BAD

--> NOTIFY HCP ASAP --> Vision changes (fuzziness, difficulty reading, haziness, color changes), N/V, anorexia, dizziness or lightheadedness

Big Test Tip:

• Older patients with decreased kidney function are at HIGHER risk for digoxin

toxicity

• Monitor BUN and Creatinine (Cr is #1)
• Cr > 1.3 = huge risk for toxicity

**Low Potassium increases risk for Digoxin toxicity!! K+ < 3>

• Pt on potassium wasting diuretics (furosemide or thiazide)
• Kidney failure (Cr > 1.3)

Vasodialtors --> Nitroglycerin (Lowers preload and afterload) (lowers BP)

• Nitroglycerin
• Nitroprusside
• Hydralazine
• Isosorbide (don't confuse with diuretic)
• Minoxidil

Decreases blood pressure by dilating the blood vessels and decreases vascular resistance/constriction

KILLER PRECAUTIONS:

• No viagra = No Sildenafil (-afil)
• STOP is systolic BP < 90>
• STOP if confusion, irritability, lack of coordination, cold, pale, clammy, pallor,

diaphoresis

NORMAL S/E:

• Headaches
• Hypotension
• Hot flushing or facial redness

Teach:

• Slow position changes
• Always check BP before giving drug

Diruetics (drains fluid from heart/body)#1 drug used for acute or worsening HF D - decrease BP by diuresing the fluid

Potassium wasting: Block reabsorption of sodium in the kidneys (K+ must be 3.5-

5.0)

• Furosemide
• Hydrochlorothiazide
• 1st line treatment --> worsening crackles, new edema in the legs, rapid weight

gain

• AVOID LICORICE ROOT (Lowers K+) licorice lowers potassium

**(NOT Isosorbride!! That is for chest pain, vasOdilator)

Potassium Sparing:

• Spironolactone
• Teach pt's to avoid potassium rich food and salt substitutes (Avocados, bananas,

oranges, melons, liver, green leafy vegetables, kidney beans)

• Risk for peaked T waves & ST elevation in severe Hyperkalemia

Potassium HIGH YIELDNormal: 3.5 - 5.0

If high or low, key S/S will be:

Muscle spasms, muscle cramps, muscle weakness, paresthesia)

First nursing action:

• Put pt on cardiac monitoring!

High Potassium > 5 = Peak T waves, ST elevation Low Potassium < 3>

Before giving diuretics, always check:2. Check the blood pressure

--> HOLD if BP < 100>

• Check BUN and Cr
• Check for potassium balances, always put patient on cardiac monitor