Cardiac, Respiratory, and Hematologic Medications: Key Concepts, Nursing Considerations, and Monitoring Guide Rationales Graded A+

Cardiac, Respiratory, and Hematologic Medications: Key Concepts, Nursing Considerations, and Monitoring Guide Rationales Graded A+ Beta Blockers e.g., Metoprolol, Atenolol, Propranolol; ↓ Heart rate, ↓ BP, ↓ myocardial workload Beta Blockers - Position Change Change positions slowly (orthostatic hypotension) Beta Blockers - Stopping Medication Do not stop abruptly (rebound hypertension/tachycardia) Beta Blockers - Monitoring Monitor HR & BP before taking Beta Blockers - Adverse Effects Adverse: Bradycardia, fatigue, bronchospasm (avoid in asthma/COPD) ACE Inhibitors e.g., Lisinopril, Enalapril, Captopril; Blocks angiotensin I → II → vasodilation, ↓ BP ACE Inhibitors - Cough Report persistent dry cough ACE Inhibitors - Monitoring Monitor BP and potassium ACE Inhibitors - Potassium Avoid potassium supplements and salt substitutes ACE Inhibitors - Adverse Effects Adverse: Hyperkalemia, angioedema, hypotension Calcium Channel Blockers e.g., Amlodipine, Diltiazem, Verapamil; Relaxes vessels, slows HR, ↓ BP/workload Calcium Channel Blockers - Monitoring Monitor HR & BP, avoid grapefruit juice Calcium Channel Blockers - Adverse Effects Adverse: Bradycardia, hypotension, edema Nitroglycerin - Sublingual 1-3 min onset (30-60 min duration) Nitroglycerin - Translingual Spray 2 min onset Nitroglycerin - Topical 15-60 min onset Nitroglycerin - Transdermal 40-60 min onset (24 hr duration) Nitroglycerin - IV Immediate onset Diuretics - Hydrochlorothiazide Potassium loss, take in AM, eat K-rich foods Diuretics - Spironolactone Potassium-sparing, avoid salt substitutes, monitor K & renal labs Digoxin ↑ contractility, ↓ HR Digoxin - Pulse Check Hold if apical pulse 60 bpm Digoxin - Toxicity Toxicity: N/V, halos, confusion Digoxin - Monitoring Monitor dig level (0.5-2 ng/mL), potassium Antiplatelet - Clopidogrel Prevents clots post-MI/stent, report bleeding Antiplatelet - Aspirin Antiplatelet post-MI/stroke, take with food, GI bleed risk Anticoagulant - Warfarin Antidote Vitamin K, monitor INR (2-3), steady diet K Anticoagulant - Heparin Antidote Protamine sulfate, monitor aPTT (60-80 sec) Epoetin Alfa Stimulates RBC production for CKD/chemo anemia Epoetin Alfa - Monitoring Monitor BP, may cause hypertension Asthma Meds - Albuterol Rescue medication Asthma Meds - Salmeterol Maintenance medication Asthma Meds - Cromolyn Preventive (weeks for effect) Asthma Meds - Inhaled Steroids Budesonide, Fluticasone; rinse mouth after use Asthma Meds - Theophylline Narrow range (10-20 mcg/mL), toxicity = seizures/tachycardia COPD Management Assess O2, teach pursed-lip breathing Antibiotics - Penicillin Allergy Avoid cephalosporins (cross-sensitivity) Antibiotics - Rifampin Orange fluids, ↓ contraceptive effectiveness Antibiotics - Strep Throat Treat with penicillin/amoxicillin; replace toothbrush after 24 hr Antibiotics - Influenza Antivirals Start ≤48 hr onset Antibiotics - Oral Candidiasis Nystatin swish & swallow Iron Supplement - Ferrous Sulfate Dark stools, take with vitamin C, empty stomach