Nursing considerations vaso - dilator
- severe hypotension (take bp to check)
- cyanide poisoning (only nitroprusside) weakness , delirium , drowsy
- monitor pt whose taking sildenafil
Nursing considerations for loop diuretics
-monitor potassium labs (3.5-5)
-increase potassium
-monitor hearing (administer furosemide SLOWLY , rapid administering can cause ototoxicity)
-monitor glucose
-wear sunscreen
-take in morning
-assess lung sounds
Loop diuretic adverse effects
-hyperkalemia : low / slow
-bradycardia
-fatigue
-muscle twitching
Toxicity: tinnitus , dizziness , hearing changes
Hyperglycemia: increase blood sugar labs
-hypotension
-hyponatremia
-dehydration
-photosensitivity (skin , burn changes)
Antidote for heparin
Protamine sulfate
Antidote for warfin
Vitamin k
What is the weakest diuretic?
Potassium sparing diuretic , spironolactone (aldactone)
What is amiodarone used for?
- severe dysthymia’s
- ventricular fibrillation
- ventricular tachycardia
What are nursing considerations for a client on Digoxin?
- check pulse and hold med if less than 60 bpm
- count apical pulse for full minute before administering
- HEART FAILURE
- atrial fibrillation
- atrial flutter
- toxicity: GI upset , fatigue/weakness , vision changes
Nursing considerations for calcium Channel blockers
Risk of reflex tachycardia
Avoid grape fruit juice
Beta blocker nursing considerations
No good for COPD , asthma , respiratory conditions
- lowers HR then BP
When is heparin used
When there’s a risk for clotting.
- Treat stroke , DVT , PE , and other thromboembolic disorders requiring fast anti coagulation
Enoxaprin administration
Subcutaneous
Self administer
7-10 days
Twice a day
Rotate sites
What are nursing considerations for heparin?
- closely monitor aPTT.
- therapeutic aPTT is 1.5-2 times baseline.
- monitor for bleeding ( coffee ground emesis, tarry stools )
What are nursing considerations for Enoxaprin?
Monitor HGB , HCT , and CBC platelets
What are nursing considerations for a client on an ACE inhibitor?
Electrolyte imbalance , angioedema , hyperkalemia
What are nursing considerations for a client on aspirin?
Do not use in patients with peptic ulcer disease or bleeding disorders
- monitor for salicylism ( tinnitus , vomiting/diarrhea , respiratory alkalosis)
- do not give to children w fever , can cause Reye’s syndrome
Abdominal pain
Salicylism
Peptic ulcer
Intestinal blood loss
Reye’s syndrome
Itch rash
Noise (tinnnitus)
Nursing considerations for a client on clopidrogel
Assess for bleeding , monitor EKG and vital signs for -abciximab : bleeding , hypotension , dysrhythmias
Clopidrogel : bleeding , GI upset and rash
Nursing considerations for Anti coagulants
PT , INR , aPTT , vitamin K
Nursing consideration for beta blocker
- bradycardia : less than 60 bpm
- bottom out BP
-bronchorestriction - blood sugars can mask hypoglycemia symptoms
Manifestations for Hypokalemia
-anorexia
-nausea/vomiting
-muscle twitching
-depression
-confusion
-bradycardia
-impaired thought process
-drowsiness
Manifestations for Hyperkalemia
-irritability
-anxiety
-confusion
-muscle cramps
-numbness/tingling
-nausea
-diarrhea
-cardiac arrhythmias
-flaccid paralysis
Nursing considerations for a client on thiazide
Hyperkalemic: low , slow . Fatigue , bradycardia
- chemically similar to sulfamides: watch and ask about allergy
- older the client , risk of toxicity
Nursing considerations for amiodrone
- no grapefruit juice
- hypotension , bradycardia , pulmonary toxicity , liver toxicity , thyroid dysfunction
Nursing considerations for potassium sparing diuretic
-gynecomasia : enlarged breast in men
- menstrual issues
- sexual dysfunction
- weakest
- also done w thiazide
- hyperkalemia: tall T waves , numbing/tingling in extremities, dysthymia’s , increased BP , muscle cramps
