For test 2
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| Name the two branches/divisions of the ANS | Sympathetic & Parasympathetic
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| Name 3 physical responses that can occur when the Sympathetic division is activated | Dilation of the eyes & bronchioles, Increased HR, Decreased GI peristalisis (absent/hypoactive bowel sounds), Dryness of the salivary glands (dry mouth, etc.)
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| Beta 2 medications primarily work in the ------ | Lungs
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| Life threatening emergencies to treat anaphylaxis | Epinephrine is a Sympathomimetic, NONSELECTIVE medication used frequently in what type of patien situations
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| Beta 1 medications worprimarily in the ----- | HEART
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| Can Epinephrine be administered orally? | No, common routes are Subcutaneous & IV
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| Why is it important for a patient diagnosed with HTN to avoid OTC cold products? | Many of the OTC are Sympathomimetic & would have the potential to increase B/P & pulse.
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| What is the actiion of Albuterol? | Bronchodilation
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| State 2 Albuterol administration routes | Oral inhalation or nebulizer
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| State the four letters that Beta Blockers end in | -olol
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| Identify the name that helps identify medications/classifications that "mimic" the division activity | Mimetic
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| A medication that is Sympatholytic may also be called ---- | Adrenergic blocker or Adrenergic Antagonist
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| The ANS is a subdivision of the ---- | PNS (Perigeral Nervous SX)
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| The sympathetic division is activated under ---- | Stress (Fight or flight response)
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| State 2 physical findings that occur under Parasympathetic nervous system activation | Increase GI peristalsis (Hyperactive bowel sounds), Eye & bronchial constriction
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| Name the primary NT's of the Sympathetic division | Norepi/Epi
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| Name the four receptors found in the Sympathetic nervous system | Alpha 1 & 2, Beta 1 & 2
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| The parasympathetic division is activated under --- | Peace & Relaxation
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| Describe Glaucoma | Increased intraocular pressure; can occur unilateral/bilateral & across the lifespan
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| Provide 2 diagnoses in which Anticholinergic/Antispasmodic medications may be recommended | Motion sickness, Urinary frequency (over active bladder) / incontinence, Parkinson's Disease
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| The patient diagnosed with Heart failure & is receiving Timolol (Timpotic) is recommended punctual occlusion with medication administration for what reason? | To prevent systemic absorption, thereby having the potential to lower the PT's B/P & pulse
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| Name 4 actions of Anticholinergic/Antispasmodic medications | Head to tow dryness!! Decreased oral mucous secretion, Increased pulse rate, Decreased GI motility (constipation), Increase urinary retention
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| State the primary consideration for the use of Atropine | This is an Anticholinergic/Antispasmodic medication used preoperatively to reduce salivation & dry secretions
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| State the term that is used to identify medications/classifications that "inhibit" the division activity | Olytic
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| Name the primary NT of the Parasympathetic nervous system | Acetycholine
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| A medication that is Sympathomimetic may also be called ---- | "Adrenergic", Adrenomimetic, Adrenergic Agonist
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| Anticholinergics AKA | Antispasmodics
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| Angiotensin II receptor antagonsists/blockers (ARB's) end in | Sartan (Losartan, Valsartan)
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| What is the difference between a Cardioselective & noncardioselective Beta blocker | Cardioselective work only in the heat, NON cardioselective work everywhere in the body
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| State 2 medical conditions in which the classification of Diuretics are commonly used | HTN & Congestive Heart Failure (Peripheral & Pulmonary Edema)
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| The classification of Loop diurectics can also be known as -- | High ceiling
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| Loop diuretics promote potential loss of Na, K+, & --- | Calcium
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| Why is it important for any patient on hypertensive medications to accurately monitor & record their blood pressure readings? | To identify stability or changes in the diagnosis & management
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| What is the name of the diuretic classification that Furosemide (Lasix) is found in? | Loop
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| State four modifiable lifestyle factors that can influence HTN management | Diet, exercise, stress, substance use (alcohol, smoking, etc)
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| The organ of the kidneys help regulate the blood pressure via the Renen Angiotensin Alsosterone system. Renin when stimulated produces Angiotensin II, which is a potent --- | Vasoconstrictor
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| Diuretics that promote K+ excretion are called --- | K+ wasting diuretics
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| If the patient NA level is above 145 mEq/L this is known as --- | Hypernatremia
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| Rapid IV infusion of Furosemide (Lasix) may cause what PT. side effect? | Tinnitus
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| Normal value of Na is --- | 135-145
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| Normal value of K+ is --- | 3.5 - 5.1 mEq/L
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| Urine is made from? | Blood
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| Diuretics that promote K+ retentin are known as? | K+ sparing diuretics
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| HCTZ is in which diuretic classification? | Thiazide
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| Why is HTN known as the "silent killer"? | Many patients are unaware of their B/P readings, pt's may be unaware of their risk factors, pts may have symptoms that they do not think are related to a problem.
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| The pressure of blood against the artery when the heart is relaxing is what number of the blood pressure reading? | diastolic (bottom #)
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| Patients using Sprinolactone (Aldactone) should avoid over consumption or supplements of --- | Potassium (K+)
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| The pressure when the blood against the aretery when the heart is contracting is what number of the B/P? | Systolic (Top)
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| Aldosterone is an adrenral hormone caused by release of Angiotensin II. The aldosterone causes retention of two things. What are they? | H2O & NA (making the B/P go up)
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| Why is it important for a patient taking any hypertensive medication, to not discontinue the medication abruptly? | Blood pressure has been managed by the medication, could result in a RAPID increase of blood pressure.
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| Name the desired action and most common side effect and disired action of ALL Antihypertensive medications | Hypotension
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| Name four NONmodifiable lifestyle factors | Age, gender, family HX, race
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| Name three medical complications when HTN is not managed appropriately | Arteriosclerosis, heart attack, stroke, diabetes mellitus, cardiomegaly, blindness
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| What type of HTN is the most common? | Primary (cause not 100% known) associated with risk factors
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| What medication classification is often times prescribed as a first line agent in the management of HTN? | Diuretics
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| What is the action of Beta blockers on the heart rate? | Slows the rate
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| Calcium channel blockers slow the movement of what ion into the cells of the heart? | Calcium
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| Name three signs and symptoms of hyponatremis/Kalemia | Muscle cramping &/or weakness, N/V, Heart irregularities
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| The pt K+ level os 3.2 represents low K+, this is called --- | Hypokalemia
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| name two respiratory conditions in which a NONcardioselective beta blocker would be used with caution | Asthma & COPD
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| Alpha blockers such as Terazosin (Hytrin) are contraindicated in a male pt using Sildenafil (Viagra) due to what severe side effect? | Hypotension
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| Identify the medication classification of Atenolol (Tenorim) & Furosemide (Lasix) | Atenolol = Beta blocker, Lasix (Loop diuretic)
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| Identify the desired actions of Atenolol & Lasix | Atenolol (slows the heart rate Lasix (rid the body of fluids)
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| Identify five patient assessments prior to administration of a beta blocker & diuretic | Vital signs, weight, heart sounds, lung sounds, other meds, & lab results
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| Angiotensin converting enzymes (ACE) end in "PRIL" & are known for their common side effect of --- | Cough
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| Why would you not administer a hypertensive medication, if the patient blood pressure was low? | The action of any hypertensive medication is to lower the blood pressure. This could result in the patient becoming extremely hypotensive!
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| What is a hypertensive crisis? | Sudden, dangerous, life threatening blood pressure
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| Why is NA awareness important ofr any patient with a DX of HTN? | NA causes retention of body fluids, patients should be aware of dietary NA intake
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| Name a common direct vasodilator | Nitroglycerin
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| Beta blockers medication names end in --- | OLOL (Atenolol, Metoprolol)
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| Both the Angiotension conbberting enzymes (ACE) & Angiotensin II receptor antagonists/Blockers (ARB's) can cause a rare condition causing swelling of the eyes, lips, & tongue known as ---- | ANGIOedema
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| What heart rate in an adult is considered bradycardia? | <60 BPM
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| Name the medication classification that Nitroglycerin is found | Vasodilator
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| Name the type of Angina that is worrisome for an impending MI | Unstable
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| State the maintenance dose of Digoxin | 0.125 - 0.5 mg
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| Name the antidote and the route for a patient with Dig toxicity | Digoxin Immune Fab (Digibind) IV
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| Identify one of the three compensation mechanisms in heart failure | Hypoxia stimulates the SNS, Rening angiotensin System is activated, Hypertrophy
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| State the most common side effect of Nitroglycerin/Nitrate therapy | Headache
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| Define heart failure | Chronic condition, in which the heart muscle weakens and enlarges losing its ability to pump blood through the heart and body
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| Name the only cure for heart failure (HF) | Heart transplant
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| Medication examples of K-Dur, SLow K are examples of what medication? | Potassium supplements
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| What necessary PPE is required with the route of administration of Nitro paste/oint/patch | Gloves; because the medication can be absorb through the skin
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| What is the action & side effect of Dig | Bradycardia
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| There are four stages of HF, identify what happens in teh first stage | Risk for heart failure, no symptoms or structural heart problems
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| Identify four signs & symptoms of left sided heart failure | Fatigue, weakness, Angina, Tachycardia, hacking cough worse @ night, Abnormal lung and heart sounds
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| Identify the normal Dig level | 0.8 - 2.0 ng/ml
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| Name one priority nursing intervention prior to the administration of Dig | In an adult, check the apical pulse (one full minute) <60 BPM, HOLD medication
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| Identify two signs & symptoms of right sided heart failure | Dependent edema (lelgs, sacrum, hands, fingers), weight gain
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| Define Angina | Any form of "chest pain" causing lack of O2 (oxygen) to the heart. There are three types.
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| What is the action of Antihypertensive medication classifications in teh management of heart failure? | Lower the blood pressure, thus reducing the workload of the heart
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| Identify the action of Digoxin | SLOWS & STRENGTHENS the heart beat
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| State the action of Antihyperlipidemic medications | Medications used to decrease the amount of lipids (fats) or cholesterol in the blood
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| Identify three health complications of poorly managed lipid levels | Angina, Heart attack, Stroke
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| State four risk factors for development of hyperlipidemia | Lifestyle factors (Smoking, Alcohol intake, Diet, Sedentary lifestyle) Hx of hypertension (HTN), DM &/or heart disease
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| Identify the total cholesterol & triglyceride level for an adult | 200 mg/dl
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| identify the name of "good" cholesterol, that is considered cardioprotective | HDL (high density lipids)
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| Statin (HMG CoA reductase inhibitors help lower lipid levels by slowing the production of cholesterol & increasing the ability of what body organ to remove cholesterol from the blood | Liver
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| Atrovastatin (Lipitor) & Simvastatin (Zocor) both have side effects of Rhabodomyolosis. What is this? | Muscle pain (Can be severe & life threatening!!)
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| Bile Acid Sequestrants (Ex Cholestyramine (Questran) or Colestipol (Colestid)) bind with cholesterol in the intestine, preventing fats from being absorbed in the body by eliminating the cholesterol through which body function | Bowel elimination/movements
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| Cholesterol Absorption inhibitors (Ezetimibe(Zetia) control blood cholesterol levels & are commonly used ofr patients that cannot take which Antihyperlipidemic class? | Statins!! (Usually due to s/e)
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| Fibrates (Gemfibrozil (Lopid) decrease what lipid? | Triglycerides!!
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| State the common side effect of Nicotinic Acid (Niacin) | Flushing
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| What medication OTC can reduce flushing with Niacin use | Asprin (ASA) or NSAID's (nonsteroidal sntiinflammotory) 30 min priop to dose administration
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| Can lipid levels be elevated without experiencing side effects or symptoms? | Yes, Lipid Panel is the best way to identify serum lipid levels!
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| Medications used to reduce clot formation or to prevent an already existing clot from becoming larger are known as... | Anticoagulants
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| Medications that are used when a clot is already there, used to dissolve it are known as... | Thrombolytics (AKA:Clot busters)
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| Name three patients conditions in which an Anticoagulant, Antiplatelet or Thrombolytic medication may be used to manage the condition: | Patients with a heart rhythm problem, Hx of clot conditions, Risk of clot conditions (bedrest)
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| Identify the route in which Heparin is most commonly administered: | Subcutaneous
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| State the antidote used for Heparin: | Protamine Sulfate
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| Medications used to prevent clumping of platelets to form a clot are known as... | Antiplatelets
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| Is Lovenox a low molecular weight Heparin that does not need any lab/serum monitoring? | Yes
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| Identify the common location of Heparin & Lovenox administration | Abdomen
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| Name the priority assessment that any patient using Heparin or Coumandin Must be monitored for... | Bleeding (concealed or obvious)
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| Identify the route of Warfarin (Coumadin) administration | Oral
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| State the lab work that is necessary for Warfarin (Coumadin) management | INR (International ratio) & Prothrombin time (PT)
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| State the antidote for Warfarin (Coumadin) | Vitamin K (Aquamephyton)
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| Why is over consumption of Vitamin K foods/supplements NOT recommended for a patient using Warfarin (Coumadin)? | Could make the patient form a clot! Vitamin K is the antidote for too much Warfarin (Coumadin)!
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| Is Heparin &/or Warfarin (Coumadin) actual "blood thinners"? | No, these medications DO NOT thin the blood, they work on the clotting factors of the blood!
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| ASA is AKA? | Aspirin
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| Name four patient s/e of ASA (aspirin) use; | Bleeding, GI upset (N/V, heart burn), Ulcers, Dark or bloody bowel movements, Tinnitus
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| State the name of the medical condition that can result if a Pediatric patient is administered ASA with hx of a fever | Reye's Syndrome!
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| State the facility in which a patient requiring Thrombolytic medication administration is needed | Hospital! Usually critical care area!
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| Identify the priority patient assessment that is necessary to evaluate PRIOR to administration of any Thrombolytic medication is administered | Evaluation of any current hx of bleeding!
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| Does Colony Stimulating Factors improve the ability of the blood to clot? | Yes
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| State the action of Epoetin alfa (Procrit) | Increases red blood cell (RBC) levels
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| State the action of Oprelvekin (Neumega) | Increase platelet (PLT) levels
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| Why is ASA (aspirin) or ASA like products contraindicated with Heparin/Warfarin (Coumadin) use? | Bleeding!
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