NRSG 220 Final (1-21 : week 9 hyperlipidemics > 22- : week
9 ACEI, ARBS< ARNIS > : week 9 HTN > :week 10
Antianginals, HF, & Antiarrhythmics :week 11: seizure
medication : week 11: anticoagulants : week 11: Anemia,
hematopoietic growth factors : week 13: bipolar disorder
and psych drugs) Questions With Complete Solutions
5 reasons not to give blood thinners/anticoagulants Correct
Answers -hemmorhagic stroke
-gi bleed
-trauma (potential internal bleeding)
-surgery (24hr pre and post op)
-hemophilia (bleeding disorder)
ANYTHING TO DO WITH THE PT ALREADY BLEEDING
A client is started on a non-selective beta blocker for conversion
of a fib. Which of the following finding requires immediate
nursing action
-complaining of SOB
-complaints of irregular HR
-Complaints of headache (could be a stroke- could be nothin)
-increased BG levels Correct Answers -complaining of SOB
ACE inhibitor: Overview Correct Answers -First-line agents in
treatment of HTN and heart failure
-ACE inhibitor drugs block conversion of angiotensin I to
angiotensin II - Key: occurs in the lung = pot. for cough
-Results in decrease in BP and PR
-Decrease in aldosterone secretion reduces blood volume.
-ACEI inhibit breaks down bradykinin (similar to histamine)
,-Accumulation of bradykinin causes several of the adverse
effects of ACE inhibitor.
ACE inhibitors : Overview Correct Answers -cause
vasodilation by reducing angiotensin II
-decreases aldosterone effects (increases effectiveness of
diuretics and protect kidneys)
-common agents: enalapril, lisinopril, captopril
-ae: persistent cough, postural hypotension, hyperkalemia,
angioedema
ACE Inhibitors: indications Correct Answers -Slow
progression of heart failure
-Lower mortality of recent acute MI
-Prophylaxis for adverse cardiac events
-Prevent or delay progression of renal disease and retinopathy of
diabetics
Adenosine diphosphate (ADP) receptor blockers (P2Y12):
overview Correct Answers -decreases bloods ability to clot
-irreversibly inhibits plately ADP receptors: inhibits
aggregation.
Adrenergic antagonists : overview Correct Answers -alpha and
beta blockers
-block adrenergic receptors in sympathetic nervous system
-lowers bp, blocks beta 1, alpha 1 and 2, and peripheral
adrenergic neurons
Adverse effects of Antipsychotics Correct Answers -
extrapyramidal side effects (EPS):postural and automatic
,movements (dystonia, akathisia, parkinsonism, tardive
dyskinesia)
-neuroleptic malignant syndrome (NMS): potentially fatal. s/s
muscle rigidity, fever, diaphoresis tachycardia. can deteriorate to
stupor or coma. (TX: antipyretics, electrolytes, muscle relaxants)
-adverse effects on reproductive system: sexual, menstrual and
breast dysfunction (leads to non adherence)
Alpha 1-adrenergic antagonists Correct Answers -Prazosin
(minipress), tamsulosin (flomax)
-effective at reducing bp
-htn related cv events when used alone
alpha 2 adrenergic agonists: Clonidine Correct Answers -
intractable cancer pain, many off label uses: dysmenorrhea,
migraine, smoking cessation
-decreases arterial pressure
-sedative and anxiolytic actions
-reinforces morphine and general anesthetics
Alpha 2 adrenergic agonists: Methyldopa Correct Answers -
indications: Resistant HTN , HTN during pregnancy.
-AE: drowsiness, depression, headache, orthostatic hypotension,
peripheral edema, positive coombs test.
alpha 2 adrenergic agonists: overview Correct Answers -
activate central alpha 2 receptors (decreases sympathetic nerve
impulses)
-decrease HR and conduction velocity, dilates arterioles
-AE: sedation, dizziness, orthostatic hypotension
-usualy reserved for resistant htn
, -methyldopa, clonidine
Angiotensin II Receptor Blockers: ARBS overview Correct
Answers - used for htn and hf
-block angiotensin II from activating their target receptors in
smooth muscle.
-blocking causes vasodilation, reduces PR, an decreases BP
-prevents aldosterone secretion
-promote excretion o Na and water by kidneys
Angiotensin receptor- neprilysin inhibitor: ARNIs Correct
Answers indications: HF CV disease.
-Combination of an angiotensin II receptor blocker, and a
neprilysin inhibitor
-ARB: lowers BP by preventing blood vessels from constricting
-neprilysin inhib: increases vasodilatory peptides which help the
body get rid of more sodium and open blood vessels wider.
Anticoagulant antidote Correct Answers Protamine sulfate-
vitamin K
take 6-8 hr to kick in
Antidepressants for bipolar Correct Answers -treat depressed
stage of bipolar
-can cause hypomania/mania
-administered with mood stabilizer
-SSRIs, SNRIs, Wellbutrin
Antifibrinolytics (hemostatics): overview Correct Answers -
action: occupies binding site on plasminogen and plasmin,
prevents digestion of fibrin clot by plasmin, stabilizes clot.
9 ACEI, ARBS< ARNIS > : week 9 HTN > :week 10
Antianginals, HF, & Antiarrhythmics :week 11: seizure
medication : week 11: anticoagulants : week 11: Anemia,
hematopoietic growth factors : week 13: bipolar disorder
and psych drugs) Questions With Complete Solutions
5 reasons not to give blood thinners/anticoagulants Correct
Answers -hemmorhagic stroke
-gi bleed
-trauma (potential internal bleeding)
-surgery (24hr pre and post op)
-hemophilia (bleeding disorder)
ANYTHING TO DO WITH THE PT ALREADY BLEEDING
A client is started on a non-selective beta blocker for conversion
of a fib. Which of the following finding requires immediate
nursing action
-complaining of SOB
-complaints of irregular HR
-Complaints of headache (could be a stroke- could be nothin)
-increased BG levels Correct Answers -complaining of SOB
ACE inhibitor: Overview Correct Answers -First-line agents in
treatment of HTN and heart failure
-ACE inhibitor drugs block conversion of angiotensin I to
angiotensin II - Key: occurs in the lung = pot. for cough
-Results in decrease in BP and PR
-Decrease in aldosterone secretion reduces blood volume.
-ACEI inhibit breaks down bradykinin (similar to histamine)
,-Accumulation of bradykinin causes several of the adverse
effects of ACE inhibitor.
ACE inhibitors : Overview Correct Answers -cause
vasodilation by reducing angiotensin II
-decreases aldosterone effects (increases effectiveness of
diuretics and protect kidneys)
-common agents: enalapril, lisinopril, captopril
-ae: persistent cough, postural hypotension, hyperkalemia,
angioedema
ACE Inhibitors: indications Correct Answers -Slow
progression of heart failure
-Lower mortality of recent acute MI
-Prophylaxis for adverse cardiac events
-Prevent or delay progression of renal disease and retinopathy of
diabetics
Adenosine diphosphate (ADP) receptor blockers (P2Y12):
overview Correct Answers -decreases bloods ability to clot
-irreversibly inhibits plately ADP receptors: inhibits
aggregation.
Adrenergic antagonists : overview Correct Answers -alpha and
beta blockers
-block adrenergic receptors in sympathetic nervous system
-lowers bp, blocks beta 1, alpha 1 and 2, and peripheral
adrenergic neurons
Adverse effects of Antipsychotics Correct Answers -
extrapyramidal side effects (EPS):postural and automatic
,movements (dystonia, akathisia, parkinsonism, tardive
dyskinesia)
-neuroleptic malignant syndrome (NMS): potentially fatal. s/s
muscle rigidity, fever, diaphoresis tachycardia. can deteriorate to
stupor or coma. (TX: antipyretics, electrolytes, muscle relaxants)
-adverse effects on reproductive system: sexual, menstrual and
breast dysfunction (leads to non adherence)
Alpha 1-adrenergic antagonists Correct Answers -Prazosin
(minipress), tamsulosin (flomax)
-effective at reducing bp
-htn related cv events when used alone
alpha 2 adrenergic agonists: Clonidine Correct Answers -
intractable cancer pain, many off label uses: dysmenorrhea,
migraine, smoking cessation
-decreases arterial pressure
-sedative and anxiolytic actions
-reinforces morphine and general anesthetics
Alpha 2 adrenergic agonists: Methyldopa Correct Answers -
indications: Resistant HTN , HTN during pregnancy.
-AE: drowsiness, depression, headache, orthostatic hypotension,
peripheral edema, positive coombs test.
alpha 2 adrenergic agonists: overview Correct Answers -
activate central alpha 2 receptors (decreases sympathetic nerve
impulses)
-decrease HR and conduction velocity, dilates arterioles
-AE: sedation, dizziness, orthostatic hypotension
-usualy reserved for resistant htn
, -methyldopa, clonidine
Angiotensin II Receptor Blockers: ARBS overview Correct
Answers - used for htn and hf
-block angiotensin II from activating their target receptors in
smooth muscle.
-blocking causes vasodilation, reduces PR, an decreases BP
-prevents aldosterone secretion
-promote excretion o Na and water by kidneys
Angiotensin receptor- neprilysin inhibitor: ARNIs Correct
Answers indications: HF CV disease.
-Combination of an angiotensin II receptor blocker, and a
neprilysin inhibitor
-ARB: lowers BP by preventing blood vessels from constricting
-neprilysin inhib: increases vasodilatory peptides which help the
body get rid of more sodium and open blood vessels wider.
Anticoagulant antidote Correct Answers Protamine sulfate-
vitamin K
take 6-8 hr to kick in
Antidepressants for bipolar Correct Answers -treat depressed
stage of bipolar
-can cause hypomania/mania
-administered with mood stabilizer
-SSRIs, SNRIs, Wellbutrin
Antifibrinolytics (hemostatics): overview Correct Answers -
action: occupies binding site on plasminogen and plasmin,
prevents digestion of fibrin clot by plasmin, stabilizes clot.
