NSG 318 REVIEWED EXAM 3
STUDYGUIDE
which antihistamine drug is most likely to cause
significant drowsiness?
diphenhydramine
digoxin drug class
cardiac glycoside
digoxin use
heart failure, atrial fibrillation
digoxin mechanism of action
inhibits sodium-potassium ATPase, promoting increased
force of cardiac contraction, cardiac output, and tissue
perfusion; decreases ventricular rate
digoxin therapeutic serum level
0.5-1 ng/mL (for heart failure)
digoxin physiological effects
increased myocardial contractility, decreases heart rate,
decreases conduction, increases cardiac output
digoxin contraindications
ventricular fibrillation
digoxin cautions
acute MI, AV block, HTN, hypo/hyperthyroidism,
renal/hepatic dysfunction, bradycardia, hypokalemia,
electrolyte imbalance, old age
digoxin side effects
CNS effects, GI distress, blurred or yellow vision
digoxin adverse/LT reactions
bradycardia; LT: cardiac dysrhythmias, thrombocytopenia)
,digoxin signs of toxicity
anorexia, vomiting, diarrhea, blurred vision, green or
yellow halos, bradycardia, abnormal heart rhythms
digoxin antidote
digoxin immune fab
digoxin drug interactions
diuretics and cortisone (increase risk for digitalis/digoxin
toxicity); antacids (decrease digitalis/digoxin absorption)
digoxin cam interactions
increased digoxin levels/effects/risk of toxicity: ginseng,
hawthorn, licorice, aloe, ephedra
decreased absorption of digoxin: st. john's wort, psyllium
digoxin nursing assessment
-obtain a baseline pulse rate for future comparisons
-assess for evidence of digitalis toxicity
-always assess apical pulse prior to administration
digoxin nursing diagnoses
-cardiac output, decreased related to decreased cardiac
pumping ability
-tissue perfusion, ineffective peripheral related to
decreased cardiac pumping ability
digoxin nursing process planning
-patient will check pulse rate daily before taking digoxin
digoxin nursing interventions
-apical pulse prior to administration, do NOT administer if
HR <60bpm
-determine signs of peripheral and pulmonary edema
-monitor serum digoxin level
-monitor serum potassium level and report hypokalemia
-instruct patient tor report side effects
,what nursing intervention is necessary for a patient
taking digoxin and diuretics?
monitor potassium levels
true or false: hypokalemia can increase the incidence
of digoxin toxiciy
true
digoxin immune Fab: mechanism of action
binds to digoxin
calcium channel blockers expected outcome
decrease the afterload and reduce the workload of the
heart
chronotropic drugs
drugs that influence the heart rate
which classes of drugs are used in the treatment of
angina?
beta blockers, nitrates/nitrites, calcium channel blockers
nitrates: mechanism of action
vasodilation
which results would be decreased in a patient taking
hydrochlorothiazide?
chloride, potassium, magnesium
spironolactone may cause hyperkalemia if given with
which drugs?
ACE inhibitors (such as lisinopril)
spironolactone: nursing interventions
assess renal function, daily weight, obtain serum
electrolytes, monitor urinary output
furosemide: patient education
use at least SPF 30 sunscreen, change body positions
slowly, eat foods high in potassium
, what is the reason for discontinuing aspirin 7 days
before surgery?
aspirin has prolonged platelet activity (risk of increased
bleeding)
warfarin antidote
phytonadione (vitamin K)
what is the preferred painkiller for a patient on
anticoagulants?
acetaminophen
which laboratory test is used to monitor warfarin
therapy?
internalized normalized ratio (INR)
which laboratory test is used to monitor heparin
therapy?
activated partial thromboplastin time (aPTT)
acute rhinitis
acute inflammation of the mucous membranes of the nose
allergic rhinitis
caused by pollen or foreign substance
common cold
caused by rhinovirus, affects primarily nasopharyngeal
tract
diphenydramine class
antihistamine (1st generation)
diphenydramine use
treat allergic rhinitis, common cold, cough, sneezing
pruritus, and urticaria, prevent motion sickness, sleep
diphenydramine mode of action
competes with histamine for binding at H1 receptor sites
and antagonizes histamine effects
diphenydramine contraindications
STUDYGUIDE
which antihistamine drug is most likely to cause
significant drowsiness?
diphenhydramine
digoxin drug class
cardiac glycoside
digoxin use
heart failure, atrial fibrillation
digoxin mechanism of action
inhibits sodium-potassium ATPase, promoting increased
force of cardiac contraction, cardiac output, and tissue
perfusion; decreases ventricular rate
digoxin therapeutic serum level
0.5-1 ng/mL (for heart failure)
digoxin physiological effects
increased myocardial contractility, decreases heart rate,
decreases conduction, increases cardiac output
digoxin contraindications
ventricular fibrillation
digoxin cautions
acute MI, AV block, HTN, hypo/hyperthyroidism,
renal/hepatic dysfunction, bradycardia, hypokalemia,
electrolyte imbalance, old age
digoxin side effects
CNS effects, GI distress, blurred or yellow vision
digoxin adverse/LT reactions
bradycardia; LT: cardiac dysrhythmias, thrombocytopenia)
,digoxin signs of toxicity
anorexia, vomiting, diarrhea, blurred vision, green or
yellow halos, bradycardia, abnormal heart rhythms
digoxin antidote
digoxin immune fab
digoxin drug interactions
diuretics and cortisone (increase risk for digitalis/digoxin
toxicity); antacids (decrease digitalis/digoxin absorption)
digoxin cam interactions
increased digoxin levels/effects/risk of toxicity: ginseng,
hawthorn, licorice, aloe, ephedra
decreased absorption of digoxin: st. john's wort, psyllium
digoxin nursing assessment
-obtain a baseline pulse rate for future comparisons
-assess for evidence of digitalis toxicity
-always assess apical pulse prior to administration
digoxin nursing diagnoses
-cardiac output, decreased related to decreased cardiac
pumping ability
-tissue perfusion, ineffective peripheral related to
decreased cardiac pumping ability
digoxin nursing process planning
-patient will check pulse rate daily before taking digoxin
digoxin nursing interventions
-apical pulse prior to administration, do NOT administer if
HR <60bpm
-determine signs of peripheral and pulmonary edema
-monitor serum digoxin level
-monitor serum potassium level and report hypokalemia
-instruct patient tor report side effects
,what nursing intervention is necessary for a patient
taking digoxin and diuretics?
monitor potassium levels
true or false: hypokalemia can increase the incidence
of digoxin toxiciy
true
digoxin immune Fab: mechanism of action
binds to digoxin
calcium channel blockers expected outcome
decrease the afterload and reduce the workload of the
heart
chronotropic drugs
drugs that influence the heart rate
which classes of drugs are used in the treatment of
angina?
beta blockers, nitrates/nitrites, calcium channel blockers
nitrates: mechanism of action
vasodilation
which results would be decreased in a patient taking
hydrochlorothiazide?
chloride, potassium, magnesium
spironolactone may cause hyperkalemia if given with
which drugs?
ACE inhibitors (such as lisinopril)
spironolactone: nursing interventions
assess renal function, daily weight, obtain serum
electrolytes, monitor urinary output
furosemide: patient education
use at least SPF 30 sunscreen, change body positions
slowly, eat foods high in potassium
, what is the reason for discontinuing aspirin 7 days
before surgery?
aspirin has prolonged platelet activity (risk of increased
bleeding)
warfarin antidote
phytonadione (vitamin K)
what is the preferred painkiller for a patient on
anticoagulants?
acetaminophen
which laboratory test is used to monitor warfarin
therapy?
internalized normalized ratio (INR)
which laboratory test is used to monitor heparin
therapy?
activated partial thromboplastin time (aPTT)
acute rhinitis
acute inflammation of the mucous membranes of the nose
allergic rhinitis
caused by pollen or foreign substance
common cold
caused by rhinovirus, affects primarily nasopharyngeal
tract
diphenydramine class
antihistamine (1st generation)
diphenydramine use
treat allergic rhinitis, common cold, cough, sneezing
pruritus, and urticaria, prevent motion sickness, sleep
diphenydramine mode of action
competes with histamine for binding at H1 receptor sites
and antagonizes histamine effects
diphenydramine contraindications
