CORRECT SPRING FALL-2022 LATEST GUARANTEED GRADE A+
Digoxin discharge teaching, what must a client know how to do? TAKE THEIR PULSE,
0.5-2.0 NORMAL THERAPEUTIC DOSE, HOLD MEDS IF PULSE IS UNDER 60, IF
LEVEL IS NOT THERAPUETIC ADJUST THE DOSE.
What is main thing you need to ‘assess’ while on digoxin? PULSE^^^
How to monitor and interpret labs for potassium wasting diuretics (HCTZ).
Know Normal potassium ranges. 3.5-5.0 IS NORMAL
Nursing interventions-should you give potassium wasting diuretic if K+ is out of
range? NO! BECAUSE IT CAN CAUSE DISRHYTHMIAS OR
HYPERKALEMIA. IF ITS TOO LOW IT CAN CAUSE DISRHYMIAS, TOO
HIGH CAN CAUSE LETHAL DISRHYTHMIAS
What are potassium rich foods? SPINACH, BANANAS, POTATOES, APRICOTS,
WHITE BEANS
CAUTION IF PATIENT GAINS 2 LBS IN 24 HOURS OR 5 LBS IN A WEEK.
THIS INDICATES MEANS HEART FAILURE (EDEMA).
HYDROCHLOROTHIAZIDE IS A POTASSIUM WASTING DIURETIC- MEANS
YOUR LOSING MORE POTATSSIUM WHEN YOU’RE TAKING IT. IF
POTASSSIUM IS LOW DON’T GIVE MEDS BECAUSE IT WILL MAKE IT
LOWER.
Actions of ACE inhibitors, think about chronotropic, inotropic etc.
Why is it given and what are it’s effects on the heart? –(reduces workload by
decreasing fluid volume) ACE INHIBITIOR IS A VASODILATOR. REDUCES
WORK LOAD AND DECREASES FLUID VOLUME. OPENS BLOOD VESSELS
SO BLOOD DOESNT HAVE TO WORK SO HARD TO PUSH THROUGH
SYSTEM
IT BLOCKS ANGIOTENSIN 2 AND CAUSES DIURESIS BECASUE IT BLOCKS
ELDOSTERONE. IT DECREASESS FLUID VOLUME.
what meds should you not take with grapefruit juice-
, calcium channel blockers should not be taken
Client teaching with use of nitro and other vasodilators- IT’S NOT GIVEN SO THEY CAN
CONTINUE TO DO THE ACTIVITY THEY RAE DOING. TYPICALLY GIVING FOR
ANGINAL PAIN WHICH IS USUALY CAUSED BY ACTIVITY. DON’T HAVE PATIENT
CONTINUE ACTIVTY, HAVE THEM REST. GIVE WHEN PATIENT IS SITTING AND
HAVE THEM REST AFTER.
GIVEN IN 3 DOSES BUT HAVE TO BE TAKEN 5 MINUTES APART, OTHERWISE
BLOOD PRESSURE WILL DROP TOO DRAMATICALLY IF NOT 5 MINUTES APART
(WANT BP TO DROP BUT NOT RAPIDLY). HAVE PATIENT SIT AND REST
AFTERWORDS
should they continue to perform a task causing pain?
How much time should be between each dose of nitro?
How do calcium channel blockers work in the heart, the rest of the body?
What is it used for? And how does it work on the heart? (vasodilator- what does that
mean?)
by blocking the entry of calcium, calcium channel blockers reduce electrical conduction
within the heart, decrease the force of contraction (work) of the muscle cells, and dilate
arteries. Dilation of the arteries reduces blood pressure and thereby the effort the heart
must exert to pump blood.
When to hold beta blockers-what do they impact?
HOLD ON PULSE UNDER 60, DON’T GIVE IF SYSTOLIC IS UNDER 100. THEY
WORK BY LOWERING THE BLOOD PRESSURE BY BLOCKING EPINEPHRINE.
HR, BP, should be checked before given what are the parameters to hold?
Minipress for HTN teaching-
what should patient do after taking it since it can cause lightheadedness CHANGE
POSITIONS SLOWLY. WHEN GETTING UP, SIT UP BEFORE THEY STAND UP.