Test Your Medication Management Skills

Important Medication Management Considerations for Nurses

• Nurses administering Beta-Adrenergic Blockers must check patients’ heart rate and blood pressure and hold medication if vital signs are low. Beta Blockers are contraindicated for Asthma Patients.
• The effectiveness of diuretic therapy can be monitored by measuring changes in urine output and daily weights.
• Digoxin serum levels must be monitored while a patient is taking the therapy as levels greater than 1.8 ng/dl can lead to toxicity. Signs of Digoxin Toxicity include nausea, anorexia, visual disturbances, fatigue, and vomiting.
• ACE inhibitors are the first choice of therapy for Heart Failure, Hypertension, diabetic neuropathy, and post-MI to improve outcomes.
• Hypokalemia can increase the likelihood of Digoxin toxicity, and potassium levels must be monitored and intervened upon if less than 3.5 for a patient taking Digoxin.
• Administering Nitrates in conjunction with Viagra can cause a dangerous drop in blood pressure.
• Digoxin's effectiveness can be measured by observing if a heart failure patient is able to perform ADL’s and walk better than without the medication.
• Black Tarry stools are an abnormal finding for patients taking Coumadin and may indicate bleeding. Patients taking Coumadin should have PT and INR drawn to measure levels and adjust dose.
• Transdermal Nitroglycerin can build tolerance, and the patch should be removed for at least 6-8 hours. Headache is a common side effect for patients using Nitrates.
• Calcium channel blockers and grapefruit juice can lead to dangerous drug interactions.
• Lasix can cause Hypokalemia, Hypotension, Hyperuricemia, Hyperglycemia, and Ototoxicity if the medication is IV pushed too fast.
• Statins can cause muscle pain, tenderness, and weakness, indicating a type of myopathy known as rhabdomyolysis. Patients with diabetes and hypertension will likely be ordered Ace Inhibitors, which can lead to hyperkalemia.

Bonus:

• B1 agonist drugs activate B1 receptors in the heart, indicating that the drug is working.
• Verapamil, a calcium channel blocker, can be used to control supraventricular tachyarrhythmias and acts as a coronary vasodilator and antianginal agent. Hypotension is a major adverse effect, and blood pressure and pulse must be monitored before and during parenteral administration.
• Nurses educating hypertensive patients should emphasize positive lifestyle changes such as restricting sodium intake, increasing activity, and eliminating tobacco products.