FINAL EXAM STUDY GUIDE

1. What are you going to teach a patient that is on an ACE inhibitor? a. Dry, non-productive, consistent cough is a side effect; drugs end in -pril; if can’t stand the cough, switch to ARB (end in -sartans); take BP before giving med; does not affect pulse rate, only BP; change positions slowly 2. What are some potassium sparing diuretics? a. Aldactone, spirolactone 3. What are you going to teach patient when sending them home on potassium sparing diuretics? a. Avoid salt substitutes; heart palpitations; signs and symptoms of hyperkalemia; take in the morning; take weight daily; monitor urine output, expect it to increase; take with food 4. Nursing interventions for nitroglycerines? a. No Viagra; wait 5 minutes in between; for patient having chest pain: give 1 dose, if still having pain call 911 and give second dose 5 minutes apart, if still not going away and ambulance hasn’t come, give 3 rd dose 5 minutes apart from 2 nd dose; no alcohol; no other meds that end in -ephil 5. Side effects of albuterol a. Restlessness; adrenergic effects; tachycardia; jittery, dizziness, chest pain, insomnia, anxiety, increased heart rate, palpitations, tremors (if albuterol is abused) 6. Beclomethasone a. Steroid: end in -sone b. Patient education: rinse mouth (can cause oral thrush), slow onset, always taken last (albuterol 1 st , ipratropium 2 nd , steroid 3 rd ) 7. What teaching would you give to patients taking ARBs? a. Monitor for angioedema; don’t take if pregnant; no salt or salt substitutes (contain potassium); check BP; monitor daily weight; put on fall precautions/orthostatic precautions b. Ends in-sartan 8. Nitroglycerine teaching? a. Can you swallow it? NO; it is sublingual; 5 minutes apart b. What’s expected when patients take this? Headaches c. Teaching? No swallowing (sublingual or IV) 9. Meds used to treat A-Fib? a. Digoxin; coumadin; calcium channel blocker; warfarin 10. When a patient arrives at ED in status asthmaticus, what would we do? a. Albuterol administered every 20 minutes, in nebulizer until status asthmaticus has resolved (less wheezing, O2 sat improve); prednisone IV to help reduce some swelling 11. What drug do we use to treat V-tach? a. Amiodarone 12. When would you hold a beta blocker? a. Systolic BP 90-100; diastolic at or over 60; heart rate above 60

13. What are you going to teach a patient that you’re sending home on digoxin? a. Check pulse (radial) for one full minute, needs to be over 60, if not hold the medicine; toxic side effects: yellowing, nausea, vomiting, vision disturbances (green, yellow, or white “Hallows”), blurred vision, anorexia. Normal blood levels: 0.8-2.0 14. What are some major side effects to patients that are taking antiemetic drugs (-statin drugs) (cholesterol)? a. Muscle pains; monitor liver enzymes (AST, ALT) 15. Side effects to xanthine’s? a. Theopelin, amiopelin b. Tachycardia; jittery 16. Sucralfate? a. Take one hour before meals; take before bedtime; can cause constipation; cannot take with any other meds; provides coating/barrier for the lining of the stomach and ulcers that are there; given for stomach/peptic ulcers 17. Liver biopsy, what medication would you expect to give them pre-procedure? a. Vitamin K; hemorrhaging is very likely, this clots blood; antidote to warfarin 18. Why do we encourage bulk laxatives, like MiraLAX (polyethylene glycol) or benfiber, over milk of magnesia? a. Doesn’t affect magnesium levels, too much magnesium can cause heart issue 19. Why do we give leukotriene blockers at night? a. To avoid bronchospasms/asthma attacks; its long acting 20. What are the side effects of promethazine? a. Tremors; muscle rigidity; bradycardia; slapping of the tongue; arching of the back b. Promethazine is a neuroleptic 21. Prazosin, what is it used to treat? a. High BP; antihypertensive b. Teaching? Change positions slowly; monitor BP 22. If we have a patient on spironolactone, are we going to see hyper- or hypokalemia? a. Hyperkalemia 23. Metoclopramide, how does it work? a. Suppresses nausea response in the brain; empties the gut 24. What patients can we not administer diphenoxylate with atropine to? a. Glaucoma; patients with urinary retention or bowel obstructions 25. What’s the antidote to heparin? a. Protamine sulfate 26. What is the therapeutic PTT level for heparin? a. 46-70; if over 70, get protamine sulfate 27. What do we use in a congestive heart failure patient to treat edema and increase in urine output? a. Loop diuretic (end in -ide), furosemide, bumetanide