NR 293 FINAL EXAM EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED)

NR 293 FINAL EXAM EXAM QUESTIONS WITH CORRECT VERIFIED ANSWERS | 100% PASS (A+ CERTIFIED) 1. Adrenergic drugscentrally and peripherally acting adrenergic neuron blockers -centrally acting alpha2 receptor agonists -peripherally acting alpha1 receptor blockers -peripherally acting beta receptor blockers -peripherally acting dual alpha1 and beta receptor blockers 2. centrally acting alpha2 receptor agonistsstimulate alpha2 adrenergic receptors in the brain -decrease sympathetic outflow from CNS -decrease norepinephrine production -stimulate renin activity in the kidneys -decrease blood pressure Ex: clonidine (catapres), methyldopa (aldomet) 3. Clonidine: useful in management of withdrawal symptoms in opioid-dependent person 4. Peripherally acting alpha1 receptor agonists: "azosin" -block alpha1-adrenergic receptors -management of severe HF when used with glycosides and diuretics -some used to relieve symptoms of BPH (flomax) 5. "azosin" adverse effects: hypotension (first dose) syncope diziness 6. beta blockers "olol": Reduce BP by reducing heart rate -cause reduced secretion of renin -long term use causes peripheral vascular resistance -improve survival after MI Ex: nebivolol, propanolol, atenolol 7. Dual action alpha1 and beta receptor blockers: reduce HR (beta1) cause vasodilation (alpha 1) result in decreased BP -Carvediolol, labetalol 8. adrenergic adverse effects: high incidence of orthostatic hypotension bradycardia w/reflex tachycardia sexual dysfunction dry mouth drowsiness, sedation constipation depression edema 9. less common adrenergic adverse effects: headache sleep disturbances nausea rash cardiac disturbances (palpitations) 10. ACE inhibitors "pril": inhibit angiotensin-converting enzyme preventing angiotensin 1 from being converted to angiotensin 2 -decreased systemic vascular resistance (afterload) -vasodilation -decreased blood pressure 11. angiotensin 2: potent vasoconstrictor causes aldosterone secretion from the adrenal glands 12. indications for ACE inhibitorsfirst line drugs for HF and HTN -slow progression of left ventricular hypertrophy after MI -renal protective effects in patients with diabetes 13. captopril and lisinopril: ACE inhibitors -can be used if patient has liver dysfunction -not prodrugs 14. prodrugs: inactive in administered form and must be metabolized in the liver to an active form to be effective 15. "pril" adverse effects: hyperkalemia angioedema dry, nonproductive cough (reverses when therapy is stopped) 16. angiotensin II receptor blockers "sartan"block receptors that receive angiotensin II -block vasoconstriction and release of aldosterone -well tolerated, do not cause cough Ex: losartan, valsartan 17. indications for ARB: HTN adjunctive drugs for the treatment of HF 18. "sartan" ARB adverse effects: URI Headache occasional dizziness inability to sleep diarrhea dyspnea hearburn nasal congestion back pain fatigue 19. calcium channel blockers: cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing smooth muscle contraction 20. indications for calcium channel blockers: HTN Angina dysrhythmias migraine headaches raynaud's disease 21. diuretics: decrease plasma and extracellular fluid volumes -decreased workload of the heart and decreased BP 22. thiazide diuretics: first-line antihypertensives 23. vasodilators: directly relax arteriolar and/or other venous smooth tissue -decrease systemic vascular response -decrease afterload -peripheral vasodilation 24. indications for vasodilators: sodium nitroprusside and IV diazoxide are reserved for the management of hypertensive emergencies 25. examples of vasodilatorsdiazoxide -hydralazine HCl -minoxidil -sodium nitroprusside 26. antihypertensive NIoral forms should be given with food -take as prescribed -never double up on dose -should not be stopped abruptly (rebound HTN) -change position slowly -impotence in male patients is expected effect 27. when administering alpha-adrenergiv drug for hypertension, it is most important for the nurse to assess the patient for the development of what?: hypotension 28. ACE inhibitors and kidneys: reduce glomerular filtration pressure -have protective effect on kidneys -drug of choice for diabetic patients 29. common adverse effect of angiotensin receptor blockers: cough 30. drugs for angina: nitrates/nitritis beta blockers calcium channel blockers 31. nitroglycerin: protypical nitrate -large first pass with oral forms -used for treatment of angina 32. IV nitroglycerin: BP control in perioperative HTN treatment of HF ischemic pain pulmonary edema associated with acute MI hypertensive emergencies 33. adverse effects of nitrates: headaches (usually diminish with continued use) reflex tachycardia postural hypotension tolerance may develop 34. preventing tolerance of nitrates: remove transdermal patch at bedtime for 8 hours, then apply new patch in the morning 35. sublingual nitroglycerin: burning sensation indicated drug is still potent -potency is lost about 3 months after bottle is opened -store in airtight, dark glass bottle with metal cap and no cotton filler -lie down after taking to prevent/decrease dizziness and fainting 36. topical nitrates: rotate site remove old medication remove at bedtime 37. indications for beta blockers "olol": angina antihypertensive cardiac dysrhythmias cardioprotective effects (esp. after MI) migraine headaches, essential tremors, stage fright Ex: atenolol, metoprolol, propanolol, nadolol 38. adverse effects of beta blockers "olol": bradycardia hypotension atrioventricular block hyperglycemia and/or hypoglycemia hyperlipidemia dizziness fatigue depression lethargy impotence wheezing dyspnea 39. beta blockers NImonitor pulse rate daily and report 60bpm -never d/c abruptly -long term prevention of angina, not immediate relief 40. calcium channel blockers MOA: cause coronary artery and peripheral arterial vasodilation decreasing systemic vascular resistance -reduce workload of the hear -decrease myocardial oxygen demand 41. examples of calcium channel blockers: verapamil diltiazem amlodipine 42. adverse effects of calcium channel blockers: constipation peripheral edema hypotension 43. if anginal pain occurs:: stop activity and sit down take sublingual tablet if no relief in 5 minutes call 911 and take second tablet if no relief in 5 minutes, take third tablet do not drive to hospital 44. IV administration of antianginal: frequent VS IV nitroglycerin must be given in non-PVC tubing and bags -discard parenteral solution that is blue, green, or dark red 45. cholesterol and coronary heart disease: risk for CHD in patients with cholesterol levels of 300