Help
Options
Didn't know it?
click below
click below
Knew it?
click below
click below
Don't Know
Remaining cards (0)
Know
retry
shuffle
restart
0:00
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Phrm Qz 3
ch 25,27,28,29,22
| Question | Answer |
|---|---|
| Heart Failure | The inability of the ventricles to pump enough blood to meet the body’s metabolic demands (weak cardiac muscles) There is no cure for heart failure so treatment is to treat the underlying cause |
| Right side of heart | receives blood from the venous system and sends it to the lungs |
| In the lungs the blood | receives O2 and loses CO2 |
| Blood is returned to the left side of the heart and then goes | to the rest of the body |
| What is preload? | How much fibers stretch for contraction |
| What is afterload | pressure in the aorta that must be overcome so blood can be pumped from the heart to the body |
| Contractility | strength of contraction of the heart |
| Diastolic dysfunction | filling dysfunction |
| Systolic dysfunction | contracting dysfunction |
| Positive inotropic effect | increase strength of muscle contraction |
| Systolic dysfunction | Most common type of heart failure Also known as contracting dysfunction |
| Diastolic dysfunction | Also known as filling dysfunction |
| Left sided heart failure | Left ventricle unable to compensate and blood “backs up” into the lungs Symptoms SOB and cough (esp. when lying down) AKA Congestive Heart Failure |
| Right Sided Heart Failure | If the right side becomes weak the blood “backs up” into the peripheral veins Peripheral edema (feet and ankles) and engorgement of organs such as the liver occurs |
| Cardiac Function | It contracts with a specific force or strength (contractility) It beats at a certain rate (bpm) It conducts electrical impulses at a certain speed |
| Contractility | Changing the force of a contraction can be done with certain medications It is known as a positive inotropic effect |
| Cardiac glycosides | are the class that increases the strength of contraction |
| The faster a heart beats | the harder it works (Doesn’t mean it works better or more efficiently) |
| If HR is slower | it has more time to rest between beats |
| How do we treat heart failure? | Combination of different medications If acute it will be IV therapy |
| ACE Inhibitors (Angiotensin Converting Enzyme Inhibitors) | Lower blood pressure and decrease volume This decreases arterial blood pressure and increases cardiac output Also dilates veins that return blood to the heart- this decreases preload and decreases peripheral edema |
| ACE Inhibitors can cause | HYPERKALEMIA |
| Beta Blockers | Decrease HR, cardiac output, BP Commonly used with ACE inhibitors |
| Digitalis glycosides | oldest treatment for HF used to increase force of contraction of heart. Positive inotropic. slows electro activity in heart. Decreases heart rate. Heart fill/empty more smoothly. Improve circulation-heart size return to normal |
| Digoxin (Lanoxin) | check apical pulse for one full minute; if less than 60 contact physician.Verify the dose carefully. |
| Digoxin (Lanoxin) S.E. | Margin of safety is very narrow Pts need close monitoring Loss of appetite, vomiting and diarrhea HA, drowsiness, confusion and blurred vision Severe bradycardia and abnormal rhythms can occur and be fatal |
| Digoxin immune fab (Digibind) | is given IV to reverse toxic levels of digoxin |
| Digoxin immune fab (Ovine) is given by IV then... | It binds to the digoxin and stops it from reaching the tissues Rapid onset- less than 1 minute after infusion is started |
| Diuretics | Increase urine production which reduces blood volume and cardiac workload Routinely used in pts with fluid overload Decreases blood volume, edema and congestion |
| Naturetic peptide What is BNP (hBNP)? | It is a hormone known as beta-type natriuretic peptide It is made by the ventricles when HF occurs in response to increased stretch of ventricular walls. It causes vasodilation which reduces preload |
| Nesiritide (Natrecor) | is the same molecule as BNP so it reduces preload and afterload.(increases secretion of sodium and water to decrease BP. Only given by IV) |
| Nitrates | IV nitroglycerin Nitroprusside |
| Phosphodiesterase inhibitors | Used for short term control of acute heart failure. These drugs have a short half life They block the enzyme phosphodiesterase in cardiac and smooth muscles.This increases the amount of Ca+ (calcium) available for myocardial contraction.Causes a positive |
| Inamrinone (Inocor) Milrinone (Primacor) | Phosphodiesterase inhibitors |
| Why aren’t Phosphodiesterase inhibitors used much? | Both are given IV (mcg/kg/min) Short term use Side effects- biggest one is ventricular dysrhythmia Pt needs to be on telemetry during infusion |
| The Kidneys | Regulate fluid balance Regulate electrolyte composition Regulate the acid-base balance of body fluids Secrete renin and erythropoieten Produces calcitriol |
| The Urinary System contains the following: | 2 kidneys 2 ureters The bladder The urethra |
| Blood flow through the nephron: | Enters the nephron, filtered through Bowman’s Capsule, through the proximal tubule, through the loop of Henle and then to the distal tubule, then to the common collecting ducts and larger collecting structures |
| Pharmacokinetics | The effect of re-absorption and secretion are critical to PK Some drugs are reabsorbed and others are secreted into the filtrate |
| If excretion is limited | the drugs will accumulate to high concentrations in the blood and tissues and may result in toxicity |
| Most drugs are excreted | by the kidneys |
| Glomerular filtration rate (GFR) | It is calculated based on age, race, sex and creatinine GFR = 186.3 x SerumCr-1.154 * age-0.203 * 1.212 (if patient is black) * 0.742 (if female) |
| Acute Renal Failure (ARF) | Most common cause is lack of sufficient blood flow through the kidney Requires immediate treatment The cause needs to be quickly identified and treated CVVH (Continuous veno-venous hemofiltration) or CVVHD (Continuous veno-venous hemo-diafiltration |
| Chronic Renal Failure (CRF, ESRD) | Occurs over months or years Most common causes of CRF are HTN and DM |
| Treatment for ESRD includes | hemodialysis, peritoneal dialysis (PD) or transplant |
| ESRD has a higher impact on | minority populations |
| The kidney secretes | erythropoietin This hormone causes an increase in RBC production |
| Synthetic erythropoietin | Epoetin alfa (Procrit, Epogen) Darbepoetin alfa (Aranesp) |
| How diuretics work | Most work by blocking sodium reabsorption in the neprhon which sends more sodium into the urine Water likes to go where sodium goes so this increases diuresis |
| Loop diuretics | AKA high ceiling diuretics These are the most effective diuretics Work on the Loop of Henle |
| Loop Diuretics inhibit the body’s ability to reabsorb sodium at the ascending Loop of Henle which leads to increased water in the urine. Potassium is also "lost" into the urine. | Can cause hypokalemia. |
| Example of Loop diuretics | Furosemide (Lasix) Torsemide (Demadex) Bumetanide (Bumex) |
| Side effects of loop diuretics | Dehydration Thirst, dry mouth, HA, weight loss HYPOKALEMIA Electrolyte imbalance Hypotension Dizziness Fainting Ototoxicity |
| Thiazide Diuretics | Most commonly prescribed class of diuretics Act on the distal tubule to block sodium reabsorption and increase water excretion Less effective than loop diuretics and are INEFFECTIVE in pts with severe renal disease |
| Common thiazides | Hydrochlorothiazide (HCTZ) short acting Chlorthalidone (Hygroton) Long acting, thiazide like |
| Side effects of thiazides | Dehydration Hypotension Need to check electrolytes for: HYPOKALEMIA |
| Potassium sparing diuretics | LESS effective than loop diuretics Do NOT cause hypokalemia Causes mild diuresis Sodium and potassium are exchanged in the distal tubule Potassium sparing diuretics block this exchange |
| EX: of Potassium sparing diuretics | Amiloride HCL (Midamor) Spironolactone (Aldactone) Triamterene (Dyrenium) |
| Potassium sparing diuretics S.E. | Dehydration Dizziness HYPERKALEMIA |
| Methylxanthines | Used for the cardiorenal disease Also used as bronchodilators |
| Methylxanthines EX: | Aminophylline Theophylline (TheoDur) |
| Carbonic anhydrase inhibitors | Carbonic anhydrase is an enzyme that affects acid-base balance by its ability to form carbonic acid from water and carbon dioxide |
| Carbonic anhydrase inhibitors EX: | Acetazolamide (Diamox) Diclorphenamide (Daramide) Methazolamide (Neptazane) |
| Hyperkalemia | May be caused by high consumption of potassium rich foods or supplements Can be caused by ACE inhibitors In mild cases dietary restriction may work or dose of current meds may be changed or D/C In severe cases medication is given |
| Sodium polystyrene sulfate (Kayaxelate) | A resin that removes potassium ions by exchanging them for sodium ions in the large intestine When the drug is excreted through the feces potassium is eliminated Available in oral and enema formulations |
| Glucose and insulin are administered together | This causes potassium to leave the extracellular fluid and enter the cells |
| Hypokalemia | Fairly common side effect of loop diuretics Also can be caused by strenuous muscular activity and severe vomiting and diarrhea |
| Mild hypokalemia | is usually treated with diet |
| More severe hypokalemia | More severe hypokalemia |
| Hyperlipidemia | High level of lipids in the blood |
| Hypercholesterolemia | is elevated cholesterol |
| Dyslipidemia | is an abnormality with one or more of the blood fats |
| Cholesterol | Contributes to the fatty plaque that narrows arteries This contributes to angina, MI, CVA |
| Eating saturated fats | raises the cholesterol levels in the blood |
| Dietary cholesterol comes from | animal food products |
| Three classes of lipids | Triglycerides Steroids Phospholipids |
| Triglycerides | Most common lipids AKA neutral fats |
| Steroids | Second class of lipids- all have a steroid nucleus Cholesterol is the best known of the steroids |
| Phospholipids | This class is essential to building cellular membranes Best known phospholipids are lecithins which are found in egg yolks and soybeans |
| Lipoprotein levels are predictors of cardiovascular disease | Cholesterol is not soluble in blood so very little is in the blood in a free form |
| Lipoproteins | are water soluble and can be transported throughout the blood |
| There are 5 different types of lipoproteins- named for their weight density | Low-density lipoprotein (LDL) High density lipoprotein (HDL) Very-low-density lipoprotein (VLDL) Intermediate-density lipoprotein (IDL) Chylomicrons |
| LDL | Almost 50% of LDL is cholesterol The body makes enough cholesterol on its own if we eat too much food that is high in cholesterol we alter the normal function of the body |
| HDL | This is the good cholesterol It takes cholesterol from the blood and other tissues and returns it to the liver Once the cholesterol is in the liver it is used to make bile |
| VLDL | Is the primary carrier of triglycerides in the blood High levels of VLDL are associated with pancreatits |
| Risk factors for high cholesterol | Age Family history of CHD HTN Smoking |
| Statins | First drug of choice to reduce blood lipid levels.Statin is a class of antihyperlipidemics.Can produce a 20-40% reduction in LDL cholesterol Can also lower triglyceride and VLDL levels Also can raise HDL levels |
| Cholesterol is made in | the liver |
| Statins inhibit | HMG-CoA reductase - hydroxymethlygluraryl-Coenzyme A reductase |
| statins can also be called | HMG-CoA reducase inhibitors |
| statins are all | oral meds Some may be given in the evening because cholesterol biosynthesis is higher at night |
| Common statins (HMG-CoA reducatase inhibitors) | Atorvastatin (Lipitor) Simvastatin (Zocor) Rosuvastatin (Crestor) |
| Statin SE- | GI disturbances- indigestion, flatulence, cramping and constipation Muscle injury is possible- weakness, soreness and pain |
| Muscle injury | can progress to rhabdomyolysis |
| Bile Acid-binding agents | These bind to bile acids and increase the excretion of cholesterol These can produce a 20% decrease in LDL cholesterol |
| Bile Acid-binding agents SE- | Side effects are generally GI Constipation, bloating, nausea, gas or indigestion |
| Common bile acid-binding agents EX: | Cholestyramine (Questran) Colesvelam (Welchol) Colestipol (Colestid) |
| Nicotinic acid | Can reduce triglyceride and LDL levels Nicotinic acid is niacin (B complex vitamin) Taken in very high doses 2-3 grams per day Normal dose as a supplement is 25 mg |
| Niacin- high doses | Causes hot flashes and flushing in almost every pt Also causes nausea, gas, and diarrhea Liver toxicity and gout are also possible |
| Fibric acid agents | At one time were widely used Now used in combo with statins Reduces triglyceride (VLDL) levels Also elevates good cholesterol (HDL) Little effect on LDL levels |
| Fibric acid agents SE | Rashes and GI complaints are most common Increases risk for gall stones Some pts have muscle pain and weakness |
| Fibric Acid agents EX: | Fenofibrate (Tricor) Gemfibrozil (Lopid) |
| Ezetemibe (Zetia) | Acts on the small intestine to block the absorption of dietary cholesterol LDL and triglycerides are reduced Slightly increases HDL When used by itself it can decrease cholesterol 20% |
| Omacor | Combination of two omega-3 fatty acids: Eicosapentaenoic acid (EPA) Docosahexaenoic acid (DHA) |
| Vytorin | is a combo of ezetamibe (Zetia) and simvastatin (Zocor) |
| Caduet | is a combo of simvastatin (Lipitor) and amlodipine (Norvasc) |
| Advantages of combo therapy | One less pill to take for pts May increase compliance Available in multiple dose combinations |
| Common side effects of niacin include? | Nausea, diarrhea and flatulence |
| Why are diuretics usually not administered after midafternoon? | To prevent nocturia |
| Omega-3 fatty acids are often referred to as: | Fish oils |
| Angina Pectoris | Characterized by acute chest pain on physical exertion or emotional stress |
| Plaque | Takes a long time to form enough to make symptoms If it accumulates in a coronary artery the myocardium receives less O2 than it needs This leads to myocardial ischemia |
| Angina- what symptoms does the pt have? | Sharp pain the chest- often moves to the Left side of the neck and jaw and down the Left arm Usually preceded by physical exertion or emotional excitement |
| Stable Angina | Pain usually subsides within 15 minutes of rest Attacks that are predictable in frequency and duration |
| Unstable Angina | If attacks become more frequent or severe or occur during rest |
| What is variant angina? | Variant angina occurs while the pt is at rest Has specific ECG changes Caused by a vasospasm of a coronary artery |
| Other causes of chest pain | Diabetes Peptic ulcer GERD HTN Mitral stenosis |
| CABG might see written as CABG X4 | coronary artery bypass graft |
| PTCA | Percutaneous transluminal coronary angioplasty |
| There are 7 classes of drugs used to treat angina | Nitrates Beta Blockers Calcium Channel Blockers ACE Inhibitors Statins Platelet-active agents Fatty oxidase enzyme inhibitor |
| Stable angina is treated with | fast acting nitrates |
| If Angina more frequent or severe- | oral nitrates, B-blockers, or CCB’s are used |
| Therapeutic Action of Nitrates | Relaxes arterial and venous smooth muscles Venodilation decreases the amount of blood returning to the heart (preload) Less blood to eject leads to decreased cardiac output (afterload) This reduces the work of the heart and lowers myocardial ox demand |
| Short acting nitrates | work on an acute anginal attack in progress (sublingual) |
| Long acting nitrates | are taken orally or through a patch to decrease frequency and severity of anginal episodes |
| Short acting nitrates examples | Amyl nitrate (Vaporole) - inhalation Nirtoglycerin (Nitrostat, Nitrobid, Nitro-Dur, and more) - SL tab or spray, oral, IV, transdermal, topical, transmucosal forms are available also extended release |
| Long Acting Nitrates examples | Isosorbide dinitrate (Isordil, Sorbitrate) Isosorbide mononitrate (Imdur, Ismo, Monoket) |
| What about tolerance? of nitrates | Commonly occurs with long-acting nitrates when taken for extended periods Depends on the dose and frequency of administration Frequently pts are instructed to remove patch for 8-12 hours/day usually at night to delay the onset of tolerance |
| Beta Blockers for Angina | Reduce myocardial oxygen demand Used to: reduce the number of attacks reduce nitro use improve exercise tolerance minimize side effects All beta blockers are effective in treating angina |
| CCBs for Angina | Decrease myocardial oxygen demand and increase myocardial blood supply Need to use with extreme caution with pts who may be developing heart failure |
| Angiotensin Converting Enzyme Inhibitors (ACE Inhibitors)for angina | Used promote vasodilatation and minimize platelet cell aggregation Reduce the incidence of MI Used as routine secondary prevention for pts with CAD |
| Fatty Oxidase Enzyme Inhibitor | Exact mechanism is unknown but it decreases the demand for oxygen which reduces myocardial ischemia and symptoms of angina |
| Ranolazine (Ranexa) | Used in combination with CCBs, beta blockers, and/or nitrates It doesn’t effect BP or HR It can prolong the QT interval and should only be used to treat angina in pts who the other meds aren’t working |
| Ranolazine (Ranexa) Side effects: | Dizziness HA Constipation Nausea |
| Hemostasis | The stopping of blood flow Involves multiple steps (cascade) and clotting factors |
| Coagulation Cascade | Prothrombin activator (prothrombinase) converts prothrombin to thrombin Thrombin converts fibrinogen to fibrin Fibrin forms a web over the injured area to stop blood loss Normal clotting takes about 6 minutes |
| The Liver | Thromboplastin and fibrinogen are proteins made by the liver It requires vitamin K to make four of the clotting factors |
| If a patient has a serious liver disorder | they may have abnormal coagulation |
| Fibrinolysis | is the process of clot removal |
| When the fibrin clot is formed | the blood vessel cells secrete tissue plasminogen activator (tPA) |
| tPA converts | plasminogen to plasmin |
| Plasmin | digests the fibrin strands to remove the clot |
| Anticoagulants | Prevent formation of clots |
| Antiplatelets | Diminish clotting action of platelets |
| Thrombolytics | Dissolve life threatening clots |
| Hemostatics | Inhibit the normal removal of fibrin |
| Protamine sulfate | will reverse heparin |
| Vitamin K | will reverse coumadin |
| Most commonly used anticoagulants | Heparin- IV, SQ Coumadin (warfarin)- oral Enoxaparin (Lovenox)- SQ Low molecular weight heparin |
| Sometimes Heparin and Coumadin are overlapped because | it can take several weeks to see the effects of coumadin |
| Aspirin (ASA) | Available OTC Daily dose for cardioprophylaxis is 81 mg Acts by inhibiting thromboxane2- this effect decreases platelet aggregation |
| A single dose of ASA can have an anticoagulant effect | for a week! |
| Should not take ASA with other anticoagulants unless | MD order |
| ADP Receptor blockers | Interfere with the plasma membrane of platelets, preventing them from aggregating |
| Common ADP receptor blockers | Ticlopidine (Ticlid) Clopidogrel (Plavix) Used to prevent thrombi formation in pts with recent thromboembolic event (MI or CVA) |
| Glycoprotein IIb/IIIa | is an enzyme necessary for platelet aggregation Inhibiting this enzyme prevents thrombus formation in pts with MI, CVA, or percutaneous transluminal coronary angioplasty (PCTA) |
| is an enzyme necessary for platelet aggregation Inhibiting this enzyme prevents thrombus formation in pts with MI, CVA, or percutaneous transluminal coronary angioplasty (PCTA) | Alteplase recombinant (Activase) Works by dissolving existing clots in the body. Narrow margin of safety between dissolving normal and abnormal clots Reteplase recombinant (Retavase) Streptokinase (Streptase)- this was the first thrombolytic |
| Hemostatics AKA antifibrinolytics | Slow blood flow and are used to prevent excessive bleeding after surgery Prevents fibrin from dissolving, enhancing the stability of the clot |
| Common hemostatic | Aminocaproic Acid (Amicar) |
| A patient is beginning cholestyramine therapy. The nurse instructs the patient to observe for and report bleeding gums, bruising, or dark tarry stools that can be caused by which potential effect of cholestyramine? | Deficiency of vitamin K |
| A lipid profile, liver function tests, uric acid, and blood glucose levels must be assessed before a patient is started on which type of antilipemic therapy? | Niacin |
| Which question must be answered before a 40-year-old woman can begin statin therapy? | “Are you pregnant?” |
| Which instruction does the nurse give to a patient beginning lovastatin (Mevacor) therapy? | Do not drink grapefruit juice. |
| A patient taking a statin reports muscle aches and soreness. What about this symptom concerns the nurse? | Muscle aches and soreness may be early signs of myopathy. |
| A patient is taking warfarin (Coumadin) and cholestyramine. How does the nurse instruct this patient to take the medications? | Take warfarin 1 hour before or 4 hours after taking cholestyramine. When cholestyramine and warfarin are taken at the same time, cholestryamine binds with the warfarin, which reduces its absorption. Taking warfarin 1 hour before or 4 hours after taking ch |
| What supplemental vitamins may be required for patients taking bile acid–sequestering resins? | Fat-soluble vitamins.Absorption of fat-soluble vitamins may be decreased in long-term therapy with bile acid–sequestering resins. Therefore, patients taking this medication may need supplemental vitamins. |
| Which instruction does the nurse include when teaching a patient with hyperlipidemia about how to take the powdered form of cholestyramine? | Mix the powder with 2 to 6 ounces of water or juice. The powdered form of cholestyramine must be mixed with 2 to 6 ounces of water, juice, soup, applesauce, or crushed pineapple, and should be allowed to stand for a few minutes to allow absorption and di |
| What does a patient taking colesevelam do to relieve constipation and bloating? | Increases fluid and fiber intake |
| Which medication has the greatest effect on increasing high-density lipoprotein (HDL) levels? | Niacin. Niacin increases HDL levels by 15% to 30% |
| Which pharmacologic agent is the most effective in raising high-density lipoprotein (HDL)? | Fibric acid |
| A patient has been prescribed ezetimibe (Zetia) for management of hyperlipidemia. The nurse instructs the patient to monitor for which adverse effect? | Abdominal pain,Diarrhea, not constipation, is a common adverse effect of ezetimibe. |
| For which condition does the nurse assess a patient before beginning treatment with the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec)? | Persistent cough |
| A patient taking a calcium ion antagonist asks how the drug works to help his angina. The basis for the nurse’s reply is that calcium ion antagonists do what? | Dilate coronary arteries and peripheral blood vessels, thereby increasing myocardial blood flow and decreasing workload |
| The nurse is teaching a patient about the correct use of nitroglycerin paste. Which statement by the patient indicates a need for further teaching? | “I will choose a convenient site for application and use it consistently.” |
| A patient states that he frequently gets a headache when he changes his nitroglycerin patch. How does the nurse respond? | “Nitrate-induced headaches may be treated with acetaminophen.” |
| When sildenafil (Viagra) and nitrates are taken together, what may a patient experience? | A significant drop in blood pressure |
| When applying nitroglycerin ointment, what does the nurse instruct a patient to do? | Use an applicator to measure the correct dose of ointment. |
| Which term describes a feeling of chest discomfort arising from the heart because of lack of oxygen to heart cells? | Angina pectoris. |
| The nurse is teaching a patient about the use of transdermal nitroglycerin. Which statement by the patient indicates a correct understanding of the nurse's instructions? | "If the disk becomes dislodged, I will replace it with a new disk." |
| Which principle does the nurse follow when preparing to administer nitroglycerin to a patient intravenously? | Use an infusion pump to administer nitroglycerin. |
| A patient is prescribed ranolazine (Ranexa) for treatment of chronic stable angina. The nurse contacts the prescriber after discovering that the patient is also taking which medication? | Erythromycin (E-mycin) |
| Which statements about nitrates are true? | Nitroglycerin is currently the drug of choice for treating angina pectoris. |
| When teaching a patient with angina how to use nitroglycerin translingual spray, which instructions does the nurse give? (Select all that apply.) | Do not swallow the spray.” “Do not shake the container.” |
| Which symptoms are most suggestive of the need to adjust warfarin (Coumadin) dosage? | Nosebleeds, petechiae, menorrhagia |
| What is the expected action of heparin when used to treat deep vein thrombosis (DVT)? | Prevent clot formation. |
| Which instruction does the nurse give to a patient who is ordered aspirin 325 mg PO bid for the prevention of thrombi? | Take the aspirin with breakfast and supper. |
| Which is a priority assessment when caring for a patient being treated with urokinase (Abbokinase)? | Intracranial bleeding |
| A patient comes to the clinic reporting unexplained bruising and bloody-appearing urine. It is most important for the nurse to determine if the patient is taking which type of medication? | Anticoagulants |
| For which condition does the nurse assess a patient before beginning treatment with the angiotensin-converting enzyme (ACE) inhibitor enalapril (Vasotec)? | Persistent cough |
| A patient taking a calcium ion antagonist asks how the drug works to help his angina. The basis for the nurse’s reply is that calcium ion antagonists do what? | Dilate coronary arteries and peripheral blood vessels, thereby increasing myocardial blood flow and decreasing workload |
| The nurse is teaching a patient about the correct use of nitroglycerin paste. Which statement by the patient indicates a need for further teaching? | “I will choose a convenient site for application and use it consistently.” |
| A patient states that he frequently gets a headache when he changes his nitroglycerin patch. How does the nurse respond? | “Nitrate-induced headaches may be treated with acetaminophen.” |
| When sildenafil (Viagra) and nitrates are taken together, what may a patient experience? | A significant drop in blood pressure |
| When applying nitroglycerin ointment, what does the nurse instruct a patient to do? | Use an applicator to measure the correct dose of ointment |
| Which term describes a feeling of chest discomfort arising from the heart because of lack of oxygen to heart cells? | Angina pectoris |
| The nurse is teaching a patient about the use of transdermal nitroglycerin. Which statement by the patient indicates a correct understanding of the nurse's instructions? | "If the disk becomes dislodged, I will replace it with a new disk." |
| Which principle does the nurse follow when preparing to administer nitroglycerin to a patient intravenously? | Use an infusion pump to administer nitroglycerin. |
| A patient is prescribed ranolazine (Ranexa) for treatment of chronic stable angina. The nurse contacts the prescriber after discovering that the patient is also taking which medication? | Erythromycin (E-mycin) |
| Which statements about nitrates are true? | Nitroglycerin is currently the drug of choice for treating angina pectoris. |
Created by:
1700840073