Pharmacology Key Concepts

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Questions and Answers

Glipizide primarily works by:

  • Decreasing glucose absorption in the intestines.
  • Increasing the sensitivity of peripheral tissues to insulin.
  • Stimulating the pancreas to release more insulin. (correct)
  • Inhibiting the breakdown of incretin hormones.

NPH insulin typically reaches its peak effect within which timeframe?

  • 4-12 hours (correct)
  • 12-18 hours
  • 18-24 hours
  • 1-3 hours

When mixing rapid-acting and intermediate-acting insulin, what is the MOST important step to perform first?

  • Draw up the intermediate-acting insulin first.
  • Inject air into the intermediate-acting insulin vial.
  • Inject air into the rapid-acting insulin vial. (correct)
  • Draw up the rapid-acting insulin first.

A patient refuses to take their prescribed oral medication. What is the nurse's MOST appropriate initial action?

<p>Assess the reason for the patient's refusal. (B)</p> Signup and view all the answers

Which medication is commonly prescribed to treat hypothyroidism?

<p>Levothyroxine (D)</p> Signup and view all the answers

Lisinopril is effective in managing hypertension by which mechanism?

<p>Inhibiting the conversion of angiotensin I to angiotensin II. (A)</p> Signup and view all the answers

A patient taking digoxin presents with nausea, vomiting, and visual disturbances (halos around lights). These findings are MOST indicative of:

<p>Digoxin toxicity (D)</p> Signup and view all the answers

Which of the following is a common adverse effect associated with digoxin therapy?

<p>Bradycardia (C)</p> Signup and view all the answers

Which electrolyte imbalance MOST significantly increases the risk of digoxin toxicity?

<p>Hypokalemia (B)</p> Signup and view all the answers

A patient taking nitroglycerin complains of a headache. What is the MOST appropriate initial nursing intervention?

<p>Administer acetaminophen. (C)</p> Signup and view all the answers

Before administering digoxin, the nurse should assess which vital sign as a priority?

<p>Heart rate (B)</p> Signup and view all the answers

What is the antidote for warfarin?

<p>Vitamin K (B)</p> Signup and view all the answers

Which of the following medications is MOST likely to be contraindicated in a patient taking warfarin?

<p>Aspirin (C)</p> Signup and view all the answers

When monitoring a patient taking a beta-blocker, which adverse effect requires careful assessment?

<p>Bradycardia (B)</p> Signup and view all the answers

A patient with chronic pain requires increasingly higher doses of a narcotic medication to achieve the same level of pain relief. This phenomenon is BEST described as:

<p>Tolerance (C)</p> Signup and view all the answers

Which of the following is a manifestation of lithium toxicity?

<p>Coarse tremors (A)</p> Signup and view all the answers

Which of the following is a potential adverse effect of metronidazole?

<p>Metallic taste (D)</p> Signup and view all the answers

Which class of medications is MOST likely to increase a patient's risk of falls?

<p>Sedative-hypnotics (D)</p> Signup and view all the answers

A patient taking disulfiram (Antabuse) for alcohol use disorder should be educated to AVOID which of the following?

<p>Alcohol-containing products (B)</p> Signup and view all the answers

A patient taking alprazolam for anxiety should be educated to AVOID what activity?

<p>Driving a car (B)</p> Signup and view all the answers

What is a common side effect/adverse effect of diazepam?

<p>Drowsiness (B)</p> Signup and view all the answers

Which adverse effect of phenytoin would warrant immediate discontinuation of the medication?

<p>Skin rash (B)</p> Signup and view all the answers

What is the antidote for morphine?

<p>Naloxone (A)</p> Signup and view all the answers

A patient overdoses on an opioid analgesic. Which medication should the nurse prepare to administer?

<p>Naloxone (B)</p> Signup and view all the answers

What is the antagonist for benzodiazepines?

<p>Flumazenil (C)</p> Signup and view all the answers

Which manifestation indicates that omeprazole is effective in treating peptic ulcer disease?

<p>Reduction in abdominal pain (D)</p> Signup and view all the answers

Which of the following is a modifiable risk factor for hypertension?

<p>Obesity (B)</p> Signup and view all the answers

What is the primary action of aspirin (Ecotrin) during a heart attack?

<p>Prevent platelet aggregation (A)</p> Signup and view all the answers

Which of the following is a non-modifiable risk factor for stroke?

<p>Age (A)</p> Signup and view all the answers

If a nurse administers the wrong medication to a patient, what is the priority nursing action?

<p>Assess the patient for adverse effects. (B)</p> Signup and view all the answers

Where should the nurse auscultate to assess the apical pulse?

<p>Midclavicular line, 5th intercostal space (C)</p> Signup and view all the answers

Which of the following is a modifiable risk factor for heart disease?

<p>High cholesterol (C)</p> Signup and view all the answers

A patient has an elevated INR while taking warfarin. What is the nurse's MOST appropriate action?

<p>Hold the warfarin dose and notify the provider. (D)</p> Signup and view all the answers

Cardiac output is directly influenced by:

<p>Heart rate and stroke volume. (C)</p> Signup and view all the answers

Which neurological function is MOST directly associated with cognition?

<p>Thought processes (C)</p> Signup and view all the answers

The digestion phase of dietary intake primarily involves:

<p>Mechanical and chemical breakdown of food. (B)</p> Signup and view all the answers

Maintenance of stable blood glucose levels MOST directly demonstrates which body function?

<p>Metabolism (C)</p> Signup and view all the answers

Which of the following laboratory values is MOST important to monitor in a patient receiving warfarin?

<p>International Normalized Ratio (INR) (D)</p> Signup and view all the answers

Which of the following actions should a nurse take first when preparing to administer medication?

<p>Verify the medication order and patient identification. (B)</p> Signup and view all the answers

A client exhibits signs of acute digoxin toxicity. Which of the following is the priority nursing intervention?

<p>Administer Digoxin-specific antibody fragments (Digibind). (C)</p> Signup and view all the answers

A patient on lithium reports experiencing increased thirst, frequent urination, and mild hand tremors. The nurse should:

<p>Hold the next dose of lithium and consult the healthcare provider. (C)</p> Signup and view all the answers

A client taking glipizide reports feeling shaky and lightheaded. What is the MOST likely mechanism contributing to these symptoms?

<p>Stimulation of insulin release from the pancreas. (C)</p> Signup and view all the answers

A patient received NPH insulin at 0700. At which time of day is the patient MOST at risk for experiencing hypoglycemia due to the insulin's peak effect?

<p>1200 - 1600 (D)</p> Signup and view all the answers

When mixing rapid-acting insulin (lispro) with intermediate-acting insulin (NPH), what is the rationale behind drawing up the rapid-acting insulin first?

<p>To prevent contamination of the rapid-acting insulin with the longer-acting insulin. (A)</p> Signup and view all the answers

A patient with end-stage renal disease consistently refuses to take an oral medication, stating it makes them feel nauseous. After exploring the reasons and educating the patient about the medication's importance, what is the nurse's NEXT appropriate action?

<p>Document the refusal, notify the provider, and explore alternative medications or routes. (C)</p> Signup and view all the answers

A patient has been newly diagnosed with hypothyroidism. What mechanism of action explains how levothyroxine improves the patient's symptoms?

<p>It provides an exogenous source of thyroid hormone to compensate for deficiency. (B)</p> Signup and view all the answers

How does lisinopril effectively lower blood pressure in hypertensive patients?

<p>By inhibiting the conversion of angiotensin I to angiotensin II, reducing vasoconstriction. (C)</p> Signup and view all the answers

A patient on digoxin exhibits new symptoms of anorexia, blurred vision, and a green tinge to their visual fields. What is the MOST likely underlying cause of these findings?

<p>Accumulation of digoxin leading to toxicity. (A)</p> Signup and view all the answers

Which of the following is a common adverse effect associated with digoxin therapy, necessitating careful monitoring?

<p>Hypokalemia (B)</p> Signup and view all the answers

A patient taking digoxin is also prescribed furosemide. The nurse understands that which electrolyte imbalance poses the GREATEST risk for precipitating digoxin toxicity in this patient?

<p>Hypokalemia (A)</p> Signup and view all the answers

A patient taking sublingual nitroglycerin for angina reports a headache. Assuming the patient's blood pressure is stable, what is the nurse's MOST appropriate initial action?

<p>Explain that headaches are a common side effect and offer acetaminophen. (A)</p> Signup and view all the answers

Prior to administering digoxin, what assessment finding requires careful documentation and possible withholding of the medication?

<p>Apical pulse of 58 beats/min. (D)</p> Signup and view all the answers

A patient is taking warfarin following a pulmonary embolism. What medication should the nurse have readily available in case of a significant overdose?

<p>Vitamin K (B)</p> Signup and view all the answers

Which medication is MOST likely to increase the risk of bleeding in a patient already taking warfarin?

<p>Aspirin (C)</p> Signup and view all the answers

A diabetic patient is prescribed a beta-blocker for hypertension. What adverse effect requires careful assessment due to its potential to mask symptoms of hypoglycemia?

<p>Tremors (A)</p> Signup and view all the answers

A patient with chronic back pain has been taking opioid medication for several months. They now require higher doses to achieve the same level of pain relief. What can explain this?

<p>Tolerance (A)</p> Signup and view all the answers

A patient on lithium therapy presents with coarse hand tremors, confusion, and persistent gastrointestinal upset. What condition is MOST likely indicated by these assessment findings?

<p>Lithium toxicity (D)</p> Signup and view all the answers

A patient taking metronidazole reports experiencing a metallic taste in their mouth, nausea, and abdominal cramping. What is the best course of action?

<p>Explain that these are common side effects and advise the patient to continue the medication. (B)</p> Signup and view all the answers

What class of medications can significantly increase a patient's risk of falls due to sedative effects and orthostatic hypotension?

<p>Antidepressants (C)</p> Signup and view all the answers

A patient prescribed disulfiram (Antabuse) for alcohol use disorder should be instructed to STRICTLY avoid which of the following?

<p>Products containing alcohol (D)</p> Signup and view all the answers

A patient taking alprazolam (Xanax) for anxiety should be educated to avoid what activity due to the medication's potential side effects?

<p>Operating heavy machinery (B)</p> Signup and view all the answers

Which of the following adverse effects is MOST commonly associated with diazepam (Valium)?

<p>Confusion (C)</p> Signup and view all the answers

Which adverse effect of phenytoin requires immediate discontinuation of the medication?

<p>Skin rash (A)</p> Signup and view all the answers

A patient receiving IV morphine demonstrates respiratory depression. Which medication should the nurse prepare to administer?

<p>Naloxone (B)</p> Signup and view all the answers

What medication reverses the effects of a benzodiazepine overdose?

<p>Flumazenil (B)</p> Signup and view all the answers

A patient is taking omeprazole for peptic ulcer disease. Which of the following indicates that the medication is having the desired therapeutic effect?

<p>Decreased abdominal pain (D)</p> Signup and view all the answers

What lifestyle factor can a patient modify to help manage hypertension?

<p>Dietary sodium intake (C)</p> Signup and view all the answers

During a heart attack, aspirin (Ecotrin) is given to inhibit:

<p>The formation of blood clots. (A)</p> Signup and view all the answers

Which of the following is considered a non-modifiable risk factor for stroke?

<p>Advanced age (D)</p> Signup and view all the answers

A nurse accidentally administers twice the prescribed dose of an intravenous antibiotic. After ensuring the patient's immediate safety, what is the nurse's NEXT priority action?

<p>Immediately notify the prescribing physician or healthcare provider. (A)</p> Signup and view all the answers

To accurately assess the apical pulse, the nurse should place the stethoscope at which location?

<p>Midclavicular line, fifth intercostal space (D)</p> Signup and view all the answers

Which of the following is a modifiable risk factor that individuals can change to reduce their risk of heart disease?

<p>Elevated LDL cholesterol. (D)</p> Signup and view all the answers

A patient taking warfarin has an INR of 5.5. What is the nurse's MOST appropriate action based on this laboratory value?

<p>Hold the next dose of warfarin and notify the physician. (D)</p> Signup and view all the answers

Which of the following physiological factors directly influence cardiac output?

<p>Heart rate and stroke volume. (B)</p> Signup and view all the answers

Which neurological function is MOST directly associated with the ability to process information, learn, and remember?

<p>Cognition (A)</p> Signup and view all the answers

The breaking down of dietary intake into smaller molecules primarily occurs during which phase of the digestive process?

<p>Digestion (A)</p> Signup and view all the answers

The body using insulin to facilitate the movement of glucose from the bloodstream into cells to provide energy BEST demonstrates which body function?

<p>Regulation and metabolism (C)</p> Signup and view all the answers

Which laboratory value is MOST important for the nurse to monitor in a patient receiving warfarin?

<p>Prothrombin time (PT) and international normalized ratio (INR) (C)</p> Signup and view all the answers

Before administering any medication, what is the FIRST action a nurse should take to ensure safe medication administration?

<p>Verify the medication order and the patient's identification. (D)</p> Signup and view all the answers

A patient exhibits signs of acute digoxin toxicity. Which nursing intervention is the priority?

<p>Prepare to administer digoxin immune Fab (Digibind). (D)</p> Signup and view all the answers

A patient on lithium therapy reports increased thirst, frequent urination, and mild hand tremors. What action should the nurse take?

<p>Hold the next dose of lithium and notify the healthcare provider of potential toxicity. (A)</p> Signup and view all the answers

Flashcards

Glipizide action

Glipizide stimulates the pancreas to release insulin, lowering blood glucose levels.

NPH insulin peak

NPH insulin typically peaks between 4-12 hours after administration.

Patient refusal of medication

Patients have the right to refuse medication. The nurse should assess the reason, educate about the medication, and notify the provider.

Hypothyroidism medication

Levothyroxine is used to treat hypothyroidism by replacing or supplementing thyroid hormone.

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Lisinopril mechanism & effectiveness

Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I to angiotensin II, leading to vasodilation. Effectiveness is indicated by reduced blood pressure.

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Digoxin toxicity manifestations

Manifestations include nausea, vomiting, vision changes (halos), and dysrhythmias.

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Digoxin adverse effects

Adverse effects of digoxin include bradycardia, anorexia, nausea, and visual disturbances.

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Electrolyte monitoring with digoxin

Monitor potassium levels. Hypokalemia can increase the risk of digoxin toxicity.

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Nitroglycerin adverse effects

Adverse effects include headache, hypotension, and dizziness. For a headache, the nurse should administer analgesic as prescribed, it is expected.

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Pre-administration digoxin assessment

Assess apical pulse for one full minute. Hold if heart rate is less than 60 bpm and document.

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Warfarin antidote

Vitamin K is the antidote for warfarin.

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Warfarin contraindications

Medications that increase bleeding risk, such as NSAIDs and aspirin, are contraindicated.

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Beta-blocker adverse effects

Beta-blockers can cause bradycardia and hypotension.

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Narcotic tolerance

Tolerance means the patient requires more medication to achieve the same effect.

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Lithium toxicity manifestations

Manifestations include tremors, confusion, nausea, vomiting, and muscle weakness.

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Metronidazole adverse effects

Adverse effects include nausea, metallic taste, and dark urine.

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Medication class increasing fall risk

Sedative-hypnotics increase the risk of falls due to sedation and impaired coordination.

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Disulfiram patient education

Patients should be educated to avoid alcohol while taking disulfiram.

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Alprazolam patient education

Avoid alcohol due to increased sedation and CNS depression.

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Diazepam side effects

Diazepam can cause sedation and respiratory depression.

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Phenytoin adverse effects

Gingival hyperplasia (gum overgrowth) requires immediate discontinuation.

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Morphine antidote

Naloxone is antidote/antagonist for morphine.

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Medication for opioid overdose

Naloxone.

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Benzodiazepine antagonist

Flumazenil is an antagonist for benzodiazepines.

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Omeprazole therapeutic effects

A decrease in heartburn and abdominal pain indicates effectiveness.

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Hypertension risk factors & interventions

Modifiable risk factors include diet, exercise, and smoking. Interventions include weight loss, low-sodium diet, and regular exercise.

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Aspirin action in MI

Aspirin inhibits platelet aggregation, preventing further clot formation.

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Non-modifiable stroke risk factors

Age, race, and family are non-modifiable risk factors.

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Priority action for medication error

Assess the patient, notify the provider, and implement any necessary interventions.

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Apical pulse location

The apical pulse is assessed at the 5th intercostal space, midclavicular line.

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Modifiable heart disease risk factors

Modifiable risk factors include smoking, high cholesterol, high blood pressure, obesity, physical inactivity, and diabetes.

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Elevated INR action

Administer vitamin K or fresh frozen plasma as prescribed.

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Warfarin elevated INR intervention

If a patient has an elevated INR while taking warfarin, the nurse should administer Vitamin K per physician's orders.

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BP decrease - Lifestyle changes

Lifestyle changes to decrease blood pressure include decreased sodium intake, regular exercise, smoking cessation, and moderating alcohol consumption.

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Cardiac Output & Tissue Perfusion

Cardiac output and tissue perfusion involve adequate blood flow to deliver oxygen and nutrients to the body's tissues.

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Cognition and Sensation Defined

Cognition and sensation relate to the ability to think, understand, and perceive stimuli through the senses.

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Digestion & Elimination Overview

Ingestion, digestion, absorption, and elimination are the processes by which the body takes in, breaks down, absorbs, and removes nutrients and waste.

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Regulation and Metabolism Defined

Regulation and metabolism are the processes by which the body maintains homeostasis through hormonal and enzymatic actions.

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Study Notes

  • Glipizide stimulates the pancreas to release insulin, lowering blood glucose levels.
  • NPH insulin typically peaks between 4-12 hours after administration.
  • Insulin syringes can hold a maximum of 100 units.
  • Patients have the right to refuse medication, based on the 10 Rights of Medication Administration.
  • If a patient refuses medication:
    • Explore the reasons for refusal.
    • Educate the patient about the medication's importance.
    • Notify the provider.
    • Document the refusal and actions taken.
  • Levothyroxine treats hypothyroidism.
  • Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I to angiotensin II, leading to vasodilation and decreased blood pressure.
  • Indications of effective Lisinopril:
    • Decreased blood pressure
    • Reduced heart failure symptoms

Digoxin

  • Manifestations of digoxin toxicity:
    • Nausea, vomiting, and anorexia
    • Visual disturbances (blurred vision, yellow or green halos)
    • Bradycardia and dysrhythmias
  • Adverse effects of digoxin:
    • Fatigue and muscle weakness
    • Bradycardia
    • Anorexia
  • Potassium (K+) is the electrolyte to monitor for patients on digoxin.
  • Hypokalemia can increase the risk of digoxin toxicity.

Nitroglycerin

  • Adverse effects of nitroglycerin:
    • Headache
    • Hypotension
    • Dizziness
  • For a headache caused by nitroglycerin:
    • Administer a mild analgesic.
    • Reassure the patient that this is a common side effect.
  • Expected adverse effects of nitroglycerin include hypotension and headache.
  • Before administering digoxin:
    • Assess apical pulse for one full minute, if less than 60 bpm, withhold the medication and notify the provider.
    • Review digoxin and potassium levels.
    • Assess for signs and symptoms of digoxin toxicity.
  • Findings requiring documentation include:
    • Apical pulse rate
    • Digoxin level
    • Potassium level
    • Any signs of digoxin toxicity
  • Vitamin K is the antidote for warfarin.
  • Medications contraindicated with warfarin:
    • NSAIDs
    • Aspirin
    • Other anticoagulants

Beta-Blockers

  • An adverse effect to monitor for when taking beta-blockers is bradycardia.
  • Tolerance to a narcotic medication means the patient requires more of the medication to achieve the same analgesic effect, thus requiring more of the medication.
  • Manifestations of lithium toxicity:
    • Tremors
    • Confusion
    • Nausea and vomiting
    • Muscle weakness
    • Incoordination
  • Manifestations/adverse effects of metronidazole:
    • Nausea
    • Headache
    • Metallic taste
    • Darkened urine

Fall Risk

  • Sedative-hypnotics can increase a patient's risk of falls.
  • Disulfiram patient education:
    • Avoid all forms of alcohol.
  • Alprazolam patient education:
    • Avoid alcohol
    • Avoid driving
    • Avoid operating heavy machinery
  • A side effect/adverse effect of diazepam is respiratory depression.
  • A common adverse effect of phenytoin that requires immediate discontinuation is Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN).
  • The antidote/antagonist for morphine is naloxone.
  • If a patient overdoses on an opioid analgesic, administer naloxone.
  • Flumazenil is an antagonist for Benzodiazepines.
  • Manifestations that omeprazole is effective:
    • Decrease in heart burn
    • Decrease in abdominal pain

Hypertension

  • Modifiable risk factors for hypertension:
    • Obesity
    • High sodium intake
    • Smoking
    • Excessive alcohol consumption
    • Physical inactivity
  • Interventions to decrease blood pressure:
    • Dietary changes (lower sodium, DASH diet)
    • Increase physical activity
    • Weight loss
    • Smoking cessation
    • Limit alcohol consumption
  • Aspirin inhibits platelet aggregation, preventing further clot formation in a patient having a heart attack.
  • Non-modifiable risk factors for stroke:
    • Age
    • Race
    • Family history
    • Genetics
  • Priority nursing action for a medication error:
    • Assess the patient for adverse effects.
    • Notify the provider.
  • Apical pulse assessment:
    • Located at the fifth intercostal space at the midclavicular line.
  • Modifiable risk factors for heart disease:
    • High cholesterol
    • Hypertension
    • Smoking
    • Obesity
    • Physical inactivity
    • Uncontrolled diabetes
  • If a patient has an elevated INR:
    • Notify the provider.
    • Prepare to administer vitamin K.
    • Monitor for signs of bleeding.

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