Podcast
Questions and Answers
A patient with a history of atherosclerosis is prescribed a medication to manage their hyperlipidemia. Which type of lipoprotein poses the greatest risk for exacerbating their condition due to its ability to penetrate the blood vessel walls?
A patient with a history of atherosclerosis is prescribed a medication to manage their hyperlipidemia. Which type of lipoprotein poses the greatest risk for exacerbating their condition due to its ability to penetrate the blood vessel walls?
- Very-low-density lipoproteins (VLDLs) (correct)
- Intermediate-density lipoproteins (IDLs)
- High-density lipoproteins (HDLs)
- Low-density lipoproteins (LDLs)
Following a myocardial infarction, a patient develops a persistent cough, tachypnea, and lower leg edema. Which of the following underlying mechanisms is most likely contributing to these signs and symptoms?
Following a myocardial infarction, a patient develops a persistent cough, tachypnea, and lower leg edema. Which of the following underlying mechanisms is most likely contributing to these signs and symptoms?
- Reduced kidney function and fluid overload (correct)
- Dilation of blood vessels and decreased peripheral vascular resistance
- Compensatory tachycardia and increased cardiac output
- Increased peripheral resistance due to vasoconstriction
A patient is prescribed both digoxin and furosemide for the management of congestive heart failure. Which electrolyte imbalance, frequently caused by furosemide, could potentiate digoxin toxicity, and what monitoring parameter is critical in this scenario?
A patient is prescribed both digoxin and furosemide for the management of congestive heart failure. Which electrolyte imbalance, frequently caused by furosemide, could potentiate digoxin toxicity, and what monitoring parameter is critical in this scenario?
- Hypercalcemia; monitor for shortened QT interval on ECG
- Hypokalemia; observe for greenish-yellow halos around lights (correct)
- Hyponatremia; watch for altered mental status and seizures
- Hypermagnesemia; assess for diminished deep tendon reflexes
A patient with a history of atrial fibrillation is prescribed warfarin. What is the critical rationale for routinely monitoring the patient's INR during warfarin therapy, and what potential consequence is directly associated with a supratherapeutic INR?
A patient with a history of atrial fibrillation is prescribed warfarin. What is the critical rationale for routinely monitoring the patient's INR during warfarin therapy, and what potential consequence is directly associated with a supratherapeutic INR?
A patient experiencing an acute myocardial infarction is administered tissue plasminogen activator (tPA). What is the primary mechanism of action of tPA in this scenario, and what is a critical contraindication for its use?
A patient experiencing an acute myocardial infarction is administered tissue plasminogen activator (tPA). What is the primary mechanism of action of tPA in this scenario, and what is a critical contraindication for its use?
A patient with known hypertension and angina is started on a beta-adrenergic blocker. What are the combined therapeutic effects of beta-blockers in managing these conditions, and what is a crucial consideration when discontinuing this medication?
A patient with known hypertension and angina is started on a beta-adrenergic blocker. What are the combined therapeutic effects of beta-blockers in managing these conditions, and what is a crucial consideration when discontinuing this medication?
A patient is diagnosed with deep vein thrombosis (DVT) and started on heparin therapy. What is the mechanism by which heparin prevents further clot formation, and what laboratory value is used to monitor its therapeutic effect?
A patient is diagnosed with deep vein thrombosis (DVT) and started on heparin therapy. What is the mechanism by which heparin prevents further clot formation, and what laboratory value is used to monitor its therapeutic effect?
A patient with a history of heavy alcohol use is admitted with esophageal varices and significant blood loss. Which antifibrinolytic medication is most appropriate to promote hemostasis in this patient, and what is its primary mechanism of action?
A patient with a history of heavy alcohol use is admitted with esophageal varices and significant blood loss. Which antifibrinolytic medication is most appropriate to promote hemostasis in this patient, and what is its primary mechanism of action?
A patient with iron-deficiency anemia is prescribed ferrous sulfate. What teaching point is most critical to ensure safe and effective administration, considering the common adverse effects and potential interactions?
A patient with iron-deficiency anemia is prescribed ferrous sulfate. What teaching point is most critical to ensure safe and effective administration, considering the common adverse effects and potential interactions?
A patient with Stage 2 hypertension is prescribed hydrochlorothiazide. What is the primary mechanism by which hydrochlorothiazide lowers blood pressure, and what common electrolyte imbalance requires close monitoring?
A patient with Stage 2 hypertension is prescribed hydrochlorothiazide. What is the primary mechanism by which hydrochlorothiazide lowers blood pressure, and what common electrolyte imbalance requires close monitoring?
A patient with a history of myocardial infarction is prescribed clopidogrel. What is the mechanism of action of clopidogrel in preventing thrombotic events, and what specific instruction should be given regarding discontinuation of the drug before a surgical procedure?
A patient with a history of myocardial infarction is prescribed clopidogrel. What is the mechanism of action of clopidogrel in preventing thrombotic events, and what specific instruction should be given regarding discontinuation of the drug before a surgical procedure?
A patient is experiencing anaphylactic shock following a bee sting. What is the immediate treatment of choice, and by what mechanism does this medication reverse the life-threatening symptoms?
A patient is experiencing anaphylactic shock following a bee sting. What is the immediate treatment of choice, and by what mechanism does this medication reverse the life-threatening symptoms?
A patient with chronic atrial fibrillation is prescribed amiodarone. What is the primary mechanism by which amiodarone controls arrhythmias, and what major organ toxicity requires long-term monitoring?
A patient with chronic atrial fibrillation is prescribed amiodarone. What is the primary mechanism by which amiodarone controls arrhythmias, and what major organ toxicity requires long-term monitoring?
A patient with heart failure is prescribed an ACE inhibitor. What is the primary mechanism by which ACE inhibitors improve cardiac function, and what potentially severe side effect necessitates careful monitoring of kidney function?
A patient with heart failure is prescribed an ACE inhibitor. What is the primary mechanism by which ACE inhibitors improve cardiac function, and what potentially severe side effect necessitates careful monitoring of kidney function?
A patient with hyperlipidemia is prescribed a statin medication. What is the primary mechanism of action of statins in lowering cholesterol, and what specific adverse effect requires immediate reporting to the healthcare provider?
A patient with hyperlipidemia is prescribed a statin medication. What is the primary mechanism of action of statins in lowering cholesterol, and what specific adverse effect requires immediate reporting to the healthcare provider?
A patient is diagnosed with shock due to severe sepsis. What is the initial treatment of choice to support blood pressure and cardiac output, and what potential complication should be monitored closely when administering this treatment?
A patient is diagnosed with shock due to severe sepsis. What is the initial treatment of choice to support blood pressure and cardiac output, and what potential complication should be monitored closely when administering this treatment?
A patient with type 2 diabetes and hypertension is prescribed an angiotensin receptor blocker (ARB). What is the primary mechanism by which ARBs lower blood pressure, and what assessment is crucial when initiating ARB therapy in a patient also taking a potassium-sparing diuretic?
A patient with type 2 diabetes and hypertension is prescribed an angiotensin receptor blocker (ARB). What is the primary mechanism by which ARBs lower blood pressure, and what assessment is crucial when initiating ARB therapy in a patient also taking a potassium-sparing diuretic?
A patient with recurrent ventricular tachycardia is prescribed a Class III antiarrhythmic. What effect do Class III antiarrhythmics have on the cardiac action potential, and what potential ECG change needs to be monitored to prevent a life-threatening complication?
A patient with recurrent ventricular tachycardia is prescribed a Class III antiarrhythmic. What effect do Class III antiarrhythmics have on the cardiac action potential, and what potential ECG change needs to be monitored to prevent a life-threatening complication?
A patient with severe congestive heart failure is receiving digoxin. What is the mechanism by which digoxin improves cardiac output, and what early signs and symptoms may indicate digoxin toxicity?
A patient with severe congestive heart failure is receiving digoxin. What is the mechanism by which digoxin improves cardiac output, and what early signs and symptoms may indicate digoxin toxicity?
A patient with angina pectoris is prescribed sublingual nitroglycerin. What is the key instruction regarding the administration of sublingual nitroglycerin for acute chest pain, and what parameter necessitates immediate medical attention?
A patient with angina pectoris is prescribed sublingual nitroglycerin. What is the key instruction regarding the administration of sublingual nitroglycerin for acute chest pain, and what parameter necessitates immediate medical attention?
A patient with hypertension is prescribed a calcium channel blocker. What is the primary mechanism by which calcium channel blockers lower blood pressure, and what teaching point is most important regarding potential adverse effects?
A patient with hypertension is prescribed a calcium channel blocker. What is the primary mechanism by which calcium channel blockers lower blood pressure, and what teaching point is most important regarding potential adverse effects?
A patient is prescribed warfarin (Coumadin) following a diagnosis of atrial fibrillation. What is the mechanism of action of warfarin, and what dietary consideration is vital to address for this patient?
A patient is prescribed warfarin (Coumadin) following a diagnosis of atrial fibrillation. What is the mechanism of action of warfarin, and what dietary consideration is vital to address for this patient?
A patient is prescribed simvastatin (Zocor) to manage hyperlipidemia. What instruction should be included to minimize a major side effect?
A patient is prescribed simvastatin (Zocor) to manage hyperlipidemia. What instruction should be included to minimize a major side effect?
A patient is prescribed hydrochlorothiazide for hypertension. What side effect would the health professional include in the teaching?
A patient is prescribed hydrochlorothiazide for hypertension. What side effect would the health professional include in the teaching?
A patient is prescribed antiplatelet medication. What statement would the health professional include in the teaching?
A patient is prescribed antiplatelet medication. What statement would the health professional include in the teaching?
You are caring for a patient that has been newly prescribed digoxin, and they are complaining of nausea, vomiting and diarrhea. In addition, they are reporting that they see a greenish halo around lights. What are these symptoms indicative of?
You are caring for a patient that has been newly prescribed digoxin, and they are complaining of nausea, vomiting and diarrhea. In addition, they are reporting that they see a greenish halo around lights. What are these symptoms indicative of?
Which antihypertensive medication classification works by diminishing the amounts of sodium and chloride reabsorbed by the distal tubule of the kidneys?
Which antihypertensive medication classification works by diminishing the amounts of sodium and chloride reabsorbed by the distal tubule of the kidneys?
A patient who can be diagnosed and treated within 60 minutes of onset of symptoms of a CVA can be given which treatment?
A patient who can be diagnosed and treated within 60 minutes of onset of symptoms of a CVA can be given which treatment?
A clot in a vessel such as in DVT is known as what?
A clot in a vessel such as in DVT is known as what?
Medications from which classification stimulate the growth of blood cells to treat anemias?
Medications from which classification stimulate the growth of blood cells to treat anemias?
A patient has a pulmonary embolism and needs to be on anticoagulants while in the hospital. Which lab value will the health professional be sure to monitor?
A patient has a pulmonary embolism and needs to be on anticoagulants while in the hospital. Which lab value will the health professional be sure to monitor?
A patient taking an anticoagulant is injured and is bleeding profusely. Which nursing intervention is most appropriate?
A patient taking an anticoagulant is injured and is bleeding profusely. Which nursing intervention is most appropriate?
The health professional is teaching the client about antianginal medications, such as nitroglycerin, and how to use the medication when chest pain begins. How often should the patient repeat the dose?
The health professional is teaching the client about antianginal medications, such as nitroglycerin, and how to use the medication when chest pain begins. How often should the patient repeat the dose?
Which laboratory test is specifically used to evaluate the effectiveness of heparin therapy?
Which laboratory test is specifically used to evaluate the effectiveness of heparin therapy?
A health professional is providing education to a patient newly prescribed cholestyramine. Which instruction is most appropriate regarding the medication's administration?
A health professional is providing education to a patient newly prescribed cholestyramine. Which instruction is most appropriate regarding the medication's administration?
A patient with a history of myocardial infarction is prescribed low dose aspirin. The patient asks why. What is the health professional's best response?
A patient with a history of myocardial infarction is prescribed low dose aspirin. The patient asks why. What is the health professional's best response?
A patient with a history of heavy smoking and hypertension is prescribed a beta-adrenergic blocker. What is the most critical education point to emphasize regarding the potential impact of smoking on the effectiveness of this medication?
A patient with a history of heavy smoking and hypertension is prescribed a beta-adrenergic blocker. What is the most critical education point to emphasize regarding the potential impact of smoking on the effectiveness of this medication?
A patient presenting with symptoms of shock receives a rapid infusion of intravenous fluids. Which assessment finding would be most indicative of fluid overload and the need to slow the infusion rate?
A patient presenting with symptoms of shock receives a rapid infusion of intravenous fluids. Which assessment finding would be most indicative of fluid overload and the need to slow the infusion rate?
A patient is prescribed amiodarone for the management of recurrent ventricular tachycardia. What baseline assessment is most critical to conduct before initiating therapy, considering the drug's known adverse effects?
A patient is prescribed amiodarone for the management of recurrent ventricular tachycardia. What baseline assessment is most critical to conduct before initiating therapy, considering the drug's known adverse effects?
A patient with severe hyperlipidemia is prescribed a statin medication but reports persistent muscle pain and weakness. Which intervention is most appropriate to differentiate between statin-induced myopathy and other potential causes?
A patient with severe hyperlipidemia is prescribed a statin medication but reports persistent muscle pain and weakness. Which intervention is most appropriate to differentiate between statin-induced myopathy and other potential causes?
A patient with a history of atrial fibrillation is started on warfarin therapy. They also take several herbal supplements, including St. John's Wort, for mood regulation. What potential interaction should the healthcare provider be most concerned about?
A patient with a history of atrial fibrillation is started on warfarin therapy. They also take several herbal supplements, including St. John's Wort, for mood regulation. What potential interaction should the healthcare provider be most concerned about?
A patient admitted with an acute myocardial infarction is receiving thrombolytic therapy. Which assessment finding would be most concerning and warrant immediate cessation of the thrombolytic infusion?
A patient admitted with an acute myocardial infarction is receiving thrombolytic therapy. Which assessment finding would be most concerning and warrant immediate cessation of the thrombolytic infusion?
A patient with a history of heart failure is prescribed digoxin and furosemide. The patient reports muscle weakness and cramping. Which electrolyte imbalance is most likely contributing to these symptoms, and what intervention is most appropriate?
A patient with a history of heart failure is prescribed digoxin and furosemide. The patient reports muscle weakness and cramping. Which electrolyte imbalance is most likely contributing to these symptoms, and what intervention is most appropriate?
A patient is receiving heparin therapy for deep vein thrombosis (DVT). The aPTT result is subtherapeutic. What is the most appropriate nursing action based on this lab value?
A patient is receiving heparin therapy for deep vein thrombosis (DVT). The aPTT result is subtherapeutic. What is the most appropriate nursing action based on this lab value?
A healthcare provider is initiating thrombolytic therapy for a patient experiencing an acute ischemic stroke. Which factor is most critical when determining a patient's eligibility for thrombolytic therapy?
A healthcare provider is initiating thrombolytic therapy for a patient experiencing an acute ischemic stroke. Which factor is most critical when determining a patient's eligibility for thrombolytic therapy?
A patient with a history of angina is prescribed sublingual nitroglycerin. After administering one dose for chest pain, the patient reports persistent pain and develops significant hypotension (systolic BP <90 mmHg). What is the most appropriate next step?
A patient with a history of angina is prescribed sublingual nitroglycerin. After administering one dose for chest pain, the patient reports persistent pain and develops significant hypotension (systolic BP <90 mmHg). What is the most appropriate next step?
A patient with chronic hypertension is prescribed a calcium channel blocker. The patient reports persistent constipation. What dietary recommendation would be most appropriate to manage this side effect?
A patient with chronic hypertension is prescribed a calcium channel blocker. The patient reports persistent constipation. What dietary recommendation would be most appropriate to manage this side effect?
A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin for long-term anticoagulation. What instruction is most critical to include in the patient's education regarding potential interactions with food and medications?
A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin for long-term anticoagulation. What instruction is most critical to include in the patient's education regarding potential interactions with food and medications?
A patient who is post-MI is prescribed clopidogrel (Plavix) for secondary prevention. Which statement indicates the patient needs further education regarding this medication?
A patient who is post-MI is prescribed clopidogrel (Plavix) for secondary prevention. Which statement indicates the patient needs further education regarding this medication?
A patient experiencing anaphylactic shock is administered epinephrine via intramuscular injection. Following the injection, what assessment finding indicates the medication's effectiveness?
A patient experiencing anaphylactic shock is administered epinephrine via intramuscular injection. Following the injection, what assessment finding indicates the medication's effectiveness?
A patient with heart failure is prescribed an ACE inhibitor. What assessment is most critical for the nurse to monitor during the initial phase of therapy?
A patient with heart failure is prescribed an ACE inhibitor. What assessment is most critical for the nurse to monitor during the initial phase of therapy?
A patient with hyperlipidemia is prescribed a statin medication. To minimize the risk of rhabdomyolysis, what specific advice should the healthcare provider give to the patient?
A patient with hyperlipidemia is prescribed a statin medication. To minimize the risk of rhabdomyolysis, what specific advice should the healthcare provider give to the patient?
A patient in septic shock is receiving vasopressors to maintain blood pressure. Which assessment finding would indicate that the vasopressor dosage may be too high and causing excessive vasoconstriction?
A patient in septic shock is receiving vasopressors to maintain blood pressure. Which assessment finding would indicate that the vasopressor dosage may be too high and causing excessive vasoconstriction?
A patient with type 2 diabetes and hypertension is prescribed an angiotensin receptor blocker (ARB). What is the most critical assessment to perform before initiating ARB therapy, especially if the patient is also taking a potassium-sparing diuretic?
A patient with type 2 diabetes and hypertension is prescribed an angiotensin receptor blocker (ARB). What is the most critical assessment to perform before initiating ARB therapy, especially if the patient is also taking a potassium-sparing diuretic?
A patient with recurrent ventricular tachycardia is prescribed a Class III antiarrhythmic. Which electrolyte imbalance requires careful monitoring to prevent potentially life-threatening complications?
A patient with recurrent ventricular tachycardia is prescribed a Class III antiarrhythmic. Which electrolyte imbalance requires careful monitoring to prevent potentially life-threatening complications?
A patient with severe congestive heart failure is receiving digoxin. What are the early signs and symptoms indicative of digoxin toxicity that the patient should report to their healthcare provider?
A patient with severe congestive heart failure is receiving digoxin. What are the early signs and symptoms indicative of digoxin toxicity that the patient should report to their healthcare provider?
A patient with angina pectoris is prescribed sublingual nitroglycerin. What parameter necessitates immediate medical attention after administering nitroglycerin?
A patient with angina pectoris is prescribed sublingual nitroglycerin. What parameter necessitates immediate medical attention after administering nitroglycerin?
A patient with hypertension is prescribed a calcium channel blocker. What teaching point is most important regarding potential adverse effects of this medication?
A patient with hypertension is prescribed a calcium channel blocker. What teaching point is most important regarding potential adverse effects of this medication?
A patient is prescribed warfarin (Coumadin) following a diagnosis of atrial fibrillation. What dietary consideration is vital for this patient?
A patient is prescribed warfarin (Coumadin) following a diagnosis of atrial fibrillation. What dietary consideration is vital for this patient?
A patient is prescribed simvastatin (Zocor) to manage hyperlipidemia. Which instruction would the health professional include to minimize a major side effect?
A patient is prescribed simvastatin (Zocor) to manage hyperlipidemia. Which instruction would the health professional include to minimize a major side effect?
A patient is prescribed hydrochlorothiazide for hypertension. What information regarding the medication should the healthcare professional include in the teaching?
A patient is prescribed hydrochlorothiazide for hypertension. What information regarding the medication should the healthcare professional include in the teaching?
A patient is prescribed antiplatelet therapy. What instructions should the healthcare professional include in the teaching?
A patient is prescribed antiplatelet therapy. What instructions should the healthcare professional include in the teaching?
The client is prescribed an IV thrombolytic medication in the ED after arriving within the appropriate time frame for treatment of a CVA. What potential risk must the health professional closely observe for?
The client is prescribed an IV thrombolytic medication in the ED after arriving within the appropriate time frame for treatment of a CVA. What potential risk must the health professional closely observe for?
The patient has diagnoses that include unstable angina and is prescribed nitroglycerin. Which instruction should the health professional include in the teaching regarding administration?
The patient has diagnoses that include unstable angina and is prescribed nitroglycerin. Which instruction should the health professional include in the teaching regarding administration?
A health professional is providing education to a patient newly prescribed cholestyramine. Which instruction is most appropriate regarding the medication's administration to minimize gastrointestinal side effects and potential drug interactions?
A health professional is providing education to a patient newly prescribed cholestyramine. Which instruction is most appropriate regarding the medication's administration to minimize gastrointestinal side effects and potential drug interactions?
The health professional is caring for a client who has been newly prescribed digoxin. What electrolyte level is most important to monitor because it can increase the risk of digoxin toxicity if it’s not within normal limits?
The health professional is caring for a client who has been newly prescribed digoxin. What electrolyte level is most important to monitor because it can increase the risk of digoxin toxicity if it’s not within normal limits?
Which patient statement indicates an understanding of why blood laboratory values must be checked regularly while receiving anticoagulant therapy?
Which patient statement indicates an understanding of why blood laboratory values must be checked regularly while receiving anticoagulant therapy?
A client is being treated with alteplase (tPA) for an acute myocardial infarction (MI) and begins to show signs of angioedema. What is the priority intervention?
A client is being treated with alteplase (tPA) for an acute myocardial infarction (MI) and begins to show signs of angioedema. What is the priority intervention?
A client is prescribed warfarin for long-term anticoagulation due to atrial fibrillation. Besides the INR level, what other lab test should be monitored to assess the risk of a major adverse effect associated with warfarin?
A client is prescribed warfarin for long-term anticoagulation due to atrial fibrillation. Besides the INR level, what other lab test should be monitored to assess the risk of a major adverse effect associated with warfarin?
A client is being discharged home on enoxaparin (Lovenox) injections due to a deep vein thrombosis (DVT). Which of the following instructions is most important to include in the discharge teaching?
A client is being discharged home on enoxaparin (Lovenox) injections due to a deep vein thrombosis (DVT). Which of the following instructions is most important to include in the discharge teaching?
An older adult client is being prescribed a thiazide diuretic for hypertension. What is the most critical consideration related specifically to the older adult population?
An older adult client is being prescribed a thiazide diuretic for hypertension. What is the most critical consideration related specifically to the older adult population?
A patient with a history of heart failure is prescribed both furosemide and digoxin. Which statement BEST illustrates the physiological rationale for closely monitoring potassium levels in this patient?
A patient with a history of heart failure is prescribed both furosemide and digoxin. Which statement BEST illustrates the physiological rationale for closely monitoring potassium levels in this patient?
A patient presents with a suspected myocardial infarction. After initial stabilization, the physician considers initiating thrombolytic therapy. Which factor poses the most significant risk that MUST be carefully evaluated before administering thrombolytics?
A patient presents with a suspected myocardial infarction. After initial stabilization, the physician considers initiating thrombolytic therapy. Which factor poses the most significant risk that MUST be carefully evaluated before administering thrombolytics?
A patient with chronic atrial fibrillation is managed with warfarin. The patient's INR has been stable, but during a routine checkup, it is found to be subtherapeutic. What is the MOST LIKELY reason for this change?
A patient with chronic atrial fibrillation is managed with warfarin. The patient's INR has been stable, but during a routine checkup, it is found to be subtherapeutic. What is the MOST LIKELY reason for this change?
A patient with heart failure is prescribed an ACE inhibitor. The patient develops a persistent, dry cough. What is the MOST appropriate action?
A patient with heart failure is prescribed an ACE inhibitor. The patient develops a persistent, dry cough. What is the MOST appropriate action?
A patient with hyperlipidemia is prescribed a statin. The patient reports muscle pain and weakness. What should be the healthcare provider's NEXT action?
A patient with hyperlipidemia is prescribed a statin. The patient reports muscle pain and weakness. What should be the healthcare provider's NEXT action?
A patient in septic shock is receiving vasopressors to maintain blood pressure. Which assessment BEST indicates that the vasopressor dosage may be excessively high and causing harm?
A patient in septic shock is receiving vasopressors to maintain blood pressure. Which assessment BEST indicates that the vasopressor dosage may be excessively high and causing harm?
A patient with type 2 diabetes and hypertension has been prescribed an angiotensin receptor blocker (ARB). What assessment finding is MOST critical before initiating ARB therapy, especially if the patient is also taking a potassium-sparing diuretic?
A patient with type 2 diabetes and hypertension has been prescribed an angiotensin receptor blocker (ARB). What assessment finding is MOST critical before initiating ARB therapy, especially if the patient is also taking a potassium-sparing diuretic?
A patient with recurrent ventricular tachycardia is prescribed a Class III antiarrhythmic. Which electrolyte imbalance requires MOST careful monitoring to prevent life-threatening complications?
A patient with recurrent ventricular tachycardia is prescribed a Class III antiarrhythmic. Which electrolyte imbalance requires MOST careful monitoring to prevent life-threatening complications?
Before administering digoxin, what assessment is MOST important?
Before administering digoxin, what assessment is MOST important?
A patient with angina pectoris is prescribed sublingual nitroglycerin. After administering one dose for acute chest pain, the patient reports persistent pain and develops significant hypotension (systolic BP <90 mmHg). What is the MOST appropriate next step?
A patient with angina pectoris is prescribed sublingual nitroglycerin. After administering one dose for acute chest pain, the patient reports persistent pain and develops significant hypotension (systolic BP <90 mmHg). What is the MOST appropriate next step?
A patient with chronic hypertension is prescribed a calcium channel blocker. The patient reports persistent constipation. What dietary recommendation is MOST appropriate to manage this side effect?
A patient with chronic hypertension is prescribed a calcium channel blocker. The patient reports persistent constipation. What dietary recommendation is MOST appropriate to manage this side effect?
A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin for long-term anticoagulation. What is the MOST critical instruction regarding potential interactions with FOODS and medications?
A patient with a history of deep vein thrombosis (DVT) is prescribed warfarin for long-term anticoagulation. What is the MOST critical instruction regarding potential interactions with FOODS and medications?
A patient who is post-MI is prescribed clopidogrel (Plavix) for secondary prevention. Which statement indicates the patient needs further education?
A patient who is post-MI is prescribed clopidogrel (Plavix) for secondary prevention. Which statement indicates the patient needs further education?
A patient with heart failure is prescribed an ACE inhibitor. What monitoring assessment is MOST critical for the nurse to perform during the initial phase of therapy?
A patient with heart failure is prescribed an ACE inhibitor. What monitoring assessment is MOST critical for the nurse to perform during the initial phase of therapy?
A patient with hyperlipidemia is prescribed a statin medication. To minimize the risk of rhabdomyolysis, what specific advice should the health professional give to the patient?
A patient with hyperlipidemia is prescribed a statin medication. To minimize the risk of rhabdomyolysis, what specific advice should the health professional give to the patient?
A client is being treated with alteplase (tPA) for an acute myocardial infarction. What is the priority intervention if the client suddenly shows signs of angioedema?
A client is being treated with alteplase (tPA) for an acute myocardial infarction. What is the priority intervention if the client suddenly shows signs of angioedema?
A client is prescribed warfarin for long-term anticoagulation. Besides the INR level, what other lab test should be monitored regularly to assess for a major adverse effect associated with warfarin?
A client is prescribed warfarin for long-term anticoagulation. Besides the INR level, what other lab test should be monitored regularly to assess for a major adverse effect associated with warfarin?
An older adult is being prescribed a thiazide diuretic for hypertension. What is the MOST critical consideration related specifically to managing the older adult patient?
An older adult is being prescribed a thiazide diuretic for hypertension. What is the MOST critical consideration related specifically to managing the older adult patient?
Flashcards
Anticoagulants
Anticoagulants
Drugs that interrupt the clotting process, ensuring smooth blood flow.
Angina Pectoris
Angina Pectoris
Chest pain caused by lack of oxygen and nutrients in heart tissue.
Antiplatelet
Antiplatelet
Medications preventing platelets from clumping together to form clots
Anoxia
Anoxia
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Atherosclerosis
Atherosclerosis
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Antifibrinolytics
Antifibrinolytics
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Thrombolytics
Thrombolytics
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Cyanosis
Cyanosis
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Cerebrovascular Accident (CVA)
Cerebrovascular Accident (CVA)
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Contractility
Contractility
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Hematopoietic Stimulants
Hematopoietic Stimulants
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Congestive Heart Failure (CHF)
Congestive Heart Failure (CHF)
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Embolus
Embolus
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High-Density Lipoproteins (HDLs)
High-Density Lipoproteins (HDLs)
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Hemostasis
Hemostasis
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Hyperlipidemia
Hyperlipidemia
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Hypertension
Hypertension
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Hypoxia
Hypoxia
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Infarction
Infarction
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Ischemia
Ischemia
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Low-Density Lipoproteins (LDLs)
Low-Density Lipoproteins (LDLs)
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Myocardial Infarction (MI)
Myocardial Infarction (MI)
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Pulmonary Circulation
Pulmonary Circulation
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Shock
Shock
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Thrombus
Thrombus
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Antihypertensives
Antihypertensives
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Very-Low-Density Lipoproteins (VLDLs)
Very-Low-Density Lipoproteins (VLDLs)
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Deep Vein Thrombosis (DVT)
Deep Vein Thrombosis (DVT)
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Antianginal Medications
Antianginal Medications
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Dysrhythmias
Dysrhythmias
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Cardiac Glycosides
Cardiac Glycosides
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High-Density Lipoproteins
High-Density Lipoproteins
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Very-Low-Density Lipoproteins
Very-Low-Density Lipoproteins
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angiotensin receptor blockers
angiotensin receptor blockers
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HMG-CoA reductase inhibitors
HMG-CoA reductase inhibitors
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Study Notes
Key Terms in Cardiovascular Health
- ACE inhibitors block the conversion of angiotensin I to angiotensin II, lowering blood pressure.
- Angina pectoris is chest pain resulting from a lack of oxygen and nutrients in the heart tissue.
- Angiotensin receptor blockers (ARBs) prevent angiotensin from attaching to receptors, thus lowering blood pressure.
- Anoxia refers to a total lack of oxygen.
- Atherosclerosis is the buildup of fatty plaques in the arteries.
- Cerebrovascular accident (CVA), or stroke, occurs when the brain is deprived of oxygen and blood flow.
- Congestive heart failure (CHF) is a condition where the heart muscle weakens, leading to fluid buildup.
- Contractility is the ability of the heart to contract.
- Cyanosis is a bluish tint to the skin, indicating low oxygen levels.
- Deep vein thrombosis (DVT) is the formation of a blood clot in a deep vein, often in the lower extremities.
- Dysrhythmias are irregularities in heart rhythm.
- Embolus is a clot that breaks loose and travels through the bloodstream.
- Hemostasis is the process of stopping bleeding.
- High-density lipoproteins (HDLs) help clear out blood vessels.
- Hyperlipidemia is the presence of excessive amounts of lipids (fats) in the blood.
- Hypertension is high blood pressure.
- Hypoxia is a state of significantly reduced oxygen.
- Infarction is tissue death due to lack of oxygen.
- Ischemia is tissue injury due to insufficient oxygen supply.
- Low-density lipoproteins (LDLs) deposit fat in the blood vessels.
- Myocardial infarction (MI) is a heart attack caused by ischemia of the heart muscle.
- Pulmonary circulation is the sequence where blood goes to the lungs to obtain oxygen and then returns to the heart.
- Shock is the collapse of the cardiovascular system.
- Thrombus is a blood clot that forms in a blood vessel.
- Very-low-density lipoproteins (VLDLs) wedge themselves inside blood vessel walls and are difficult to clear.
The Cardiovascular System
- Consists of the heart and blood vessels.
- Delivers oxygen, hormones, immune factors, and clotting factors to the body.
- Removes waste products like carbon dioxide from the cells.
- The heart has four chambers: left and right atria and left and right ventricles.
- Pulmonary circulation involves the heart pumping blood to the lungs for oxygenation, then back to the heart.
- Oxygenated blood is sent to the body via the aorta, which branches into arteries.
- Deoxygenated blood returns to the heart through veins to be pumped to the lungs.
Myocardial Infarction (MI), Stroke, and Clotting
- MI, stroke, and clots are caused by impeded blood flow to the chest, brain, or lungs.
- Chest pain can indicate anoxia (total lack of oxygen) or hypoxia (reduced oxygen) in the heart muscle.
- Anoxia/hypoxia can lead to ischemia or infarction.
- MI symptoms include chest pain, sweating, pale skin, and cyanosis.
- Stroke (CVA) occurs when the brain is deprived of oxygen and blood flow.
- Medications preventing ischemia can be prescribed to prevent both stroke and MI.
Cardiovascular Medications
- Function by increasing or slowing the heart rate.
- Can improve heart efficiency or make the heart less irritable.
- Diuretics like furosemide (Lasix) reduce fluid volume, decreasing the heart's workload.
Antianginal Medications
- Angina pectoris results from a lack of oxygen and nutrients in the heart tissue.
- Antianginal drugs dilate arteries and veins to decrease angina pectoris.
- Nitroglycerin can be administered sublingually, buccally, as a spray, or intravenously.
- A transdermal patch (nitroglycerin topical) can be used daily for angina pectoris prevention.
- NSAIDs may be effective if chest pain is due to skeletal muscle issues.
- Non-pharmacological treatments for angina include lifestyle changes like diet and exercise.
Anticoagulants, Antiplatelet, and Thrombolytic Medications
- Anticoagulants interrupt the clotting process for smooth blood flow.
- Antiplatelet medications prevent platelet clumping to form clots.
- Thrombolytics dissolve existing clots.
- Aggressive treatment of thrombolytic stroke can improve survival.
- Thrombolytics prevent CVA and MI.
Anticoagulants and Antiplatelet Medications
- Anticoagulants disrupt the production of clotting cofactors.
- Warfarin (Coumadin) decreases vitamin K levels to reduce clot formation.
- Heparin blocks thrombin and fibrin from forming clots.
- Enoxaparin (Lovenox) neutralizes the effectiveness of clotting cofactors.
- Heparin and Lovenox are given to prevent deep vein thrombosis (DVT).
- DVT risk factors include bedrest, fractures, obesity, recent surgery, and family history.
- Anti-embolic stockings compress veins and aid blood return to the heart.
- Blood must be monitored to ensure appropriate clotting ability when taking anticoagulants.
- Antiplatelet medications like aspirin, ticlopidine (Ticlid), and clopidogrel (Plavix) prevent platelet clumping.
Thrombolytic Medications
- Thrombolytics dissolve clots if other medications fail.
- A clot in a vessel is a thrombus; a clot that breaks loose is an embolus.
- Pulmonary embolus is a blood clot in the lung.
- Tissue plasminogen activator (tPA) is a thrombolytic for acute stroke.
- Thrombolytics can clear IV catheters blocked with blood but must be used cautiously.
- Frequent testing is necessary to ensure therapeutic doses of anticoagulants, antiplatelets, or thrombolytics.
- Common tests include prothrombin time (PT), activated partial thromboplastin time (aPTT), and international normalized ratio (INR).
Antifibrinolytic Medications
- Antifibrinolytic medications help form clots when a patient is hemorrhaging, thereby providing hemostasis.
- Prevent the destruction of fibrin.
- Examples include aminocaproic acid (Amicar) and tranexamic acid (Cyklokapron).
- Blood loss can also be treated with hemostatic drugs like vitamin K, protamine sulfate, and desmopressin acetate (DDAVP).
Medications That Promote Blood Cell Development (Hematopoietic Stimulants)
- Stimulate the growth of blood cells to treat anemias.
- Used to treat sickle cell and pernicious anemia.
- Used for patients with low blood iron levels.
- Ferrous sulfate (Feosol, Fer-in-Sol, Ferra-TD) treats iron-deficiency anemia.
- Cyanocobalamin (vitamin B12) is used for patients who cannot absorb vitamin B12 in the GI tract.
- Filgrastim (Neupogen), pegfilgrastim (Neulasta), and sargramostim (Leukine) stimulate blood cell development.
Medications That Decrease Blood Pressure
- Blood pressure is influenced by cardiac output, peripheral resistance, and blood volume.
- Cardiac output is the product of heart rate and stroke volume.
- Peripheral resistance is determined by the size and flexibility of arteries.
- The kidneys regulate circulating fluid volume.
- Hypertension can be caused by poor heart action, atherosclerosis, kidney failure, narrowed blood vessels, and chronic stress.
- Antihypertensives include ACE inhibitors, autonomic nervous system agents, diuretics, and calcium channel blockers.
- ACE inhibitors block the renin-angiotensin pathway.
- Angiotensin receptor blockers (ARBs) block the action of angiotensin.
- Autonomic nervous system agents (adrenergic blockers) relax the fight-or-flight stress response.
- Beta-adrenergic blockers manage hypertension, angina pectoris, slow the heart rate, prevent MI, reduce congestion associated with heart failure, and treat glaucoma.
- Diuretics clear excess fluid and regulate blood pressure.
Diuretics
- Thiazide diuretics diminish sodium and chloride reabsorption in the distal tubule.
- Potassium-sparing diuretics interrupt the sodium-potassium exchange in the distal tubule.
- Loop diuretics inhibit sodium and chloride reabsorption in the loop of Henle.
- Potassium supplements may be needed when taking thiazide and loop diuretics to prevent imbalances.
- Calcium channel blockers block calcium from passing into the heart muscle and blood vessel walls.
- Non-medication methods include losing weight, ceasing tobacco use, decreasing salt intake, limiting alcohol, reducing stress, and exercising.
Medications for Heart Failure
- Congestive heart failure (CHF) occurs when the heart muscle weakens.
- Drugs for heart failure include vasodilators and cardiac glycosides.
- ACE inhibitors, ARBs, beta blockers, and diuretics treat CHF.
- Signs and symptoms of CHF are anxiety, cyanosis, tachycardia, lower leg edema, tachypnea, persistent cough.
- Non-medication approaches include smoking cessation, exercising, reducing weight, decreasing salt consumption, and minimizing stress.
Vasodilators
- Vasodilators decrease oxygen demand on the heart and vascular resistance.
- Phosphodiesterase inhibitors cause vasodilation and increase contraction force.
Cardiac Glycosides
- Cardiac glycosides strengthen heart contractility.
- Increase the strength of heart contractions, whereas other drugs relax the resistance in the peripheral vessels (reduce afterload).
- Digoxin comes from plants like purple and white foxglove.
Drugs for Abnormal Heart Rhythms
- Dysrhythmias can be caused by increased blood pressure, cardiac valve disease, coronary artery disease, decreased or increased potassium consumption, heart failure, diabetes mellitus, stroke, MI, and certain medications.
- Drugs for dysrhythmias are classified by how they act to improve heart rhythm.
- Sodium channel blockers (Class I antiarrhythmics)
- Beta-adrenergic blockers (Class II antiarrhythmics)
- Potassium channel blockers (Class III antiarrhythmics)
- Calcium channel blockers (Class IV antiarrhythmics)
- Sodium channel blockers slow electrical conduction by inhibiting sodium.
- Beta-adrenergic blockers slow electrical conduction and decrease oxygen demands.
- Potassium channel blockers affect potassium levels, which are needed for cardiac muscle contraction.
- Calcium channel blockers block calcium ions, dilate heart vessels, and decrease workload.
Medications for Shock
- Shock is the collapse of the cardiovascular system.
- Shock can be cardiogenic, hypovolemic, neurogenic, or septic.
- Drug therapy includes vasopressors, inotropic drugs, IV antibiotics, and plasma expanders.
- Anaphylactic shock is treated with epinephrine (EpiPen).
Medications for Lipid Disorders
- Excess fat can cause hyperlipidemia, leading to atherosclerosis, hypertension, and CHF.
- High-density lipoproteins (HDLs) clean out blood vessels.
- Low-density lipoproteins (LDLs) deposit fat.
- Very-low-density lipoproteins (VLDLs) wedge inside blood vessel walls.
- HMG-CoA reductase inhibitors (statins) decrease blood levels of lipids.
- Bile acid sequestrants lower LDL levels.
- Fibric acid derivatives lower triglyceride levels by inhibiting the liver from producing VLDLs.
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