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NUR 2060_ Week 7. Part 1 of Cardio Lecture, _Cardiovascular Agents_ (1)
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NUR 2060_ Week 7. Part 1 of Cardio Lecture, _Cardiovascular Agents_ (1)
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NUR 2060: Week 7. Part 1 of Cardio Lecture,"Cardiovascular Agents"
what is hypertension (HTN) defined as? - ANS-systolic BP of 140mm hG or higher OR a
diastolic BP of 90mm hG or higher
this is based on the avg of two or more accurate readings taken 1 - 4 weeks apart.
what are some benefits of lowering BP? (if pt has HTN) - ANS-reduces incidence of stroke,
heart attack, and heart failure.
what are the JNC 8 guidelines in regards to HTN? - ANS-ways in which HTN is treated in adults.
"group of doctors meeting to figure out what are the best meds to give for HTN"
slide 8: meds for HTN - ANS-good slide for summary review
what is the function of the kidney nephron? - ANS-carefully control body fluid composition to
remain constant
what is the difference in drugs that affect the different parts of the nephron? - ANS-different
drugs work in different parts of the nephron for different effects.
what is the action of diuretics, and where would their effects be seen? - ANS-1. incr urination
and decr fluid volume
2. mobilize fluid so they treat HTN, as well as other water retention problems (ex: HF, nephrotic
syndrome, liver cirrhosis)
they produce diuresis by DECREASING reabsorption of sodium and water in the kidney tubules
and they will both be excreted.
they may affect one or more tubule areas (diff amounts of diuresis):
-proximal loop
-loop of henle
-distal loop
dieretics may have some side effects that include electrolyte imbalances. what electrolytes are
we most concerned about losing? - ANS-Potassium, Sodium, and Magnesium
what is the action of loop diuretics? - ANS-inhibit sodium reabsorption in the loop of henle
(sodium and water become excreted)
, work best in pts with very low urine outputs
VERY strong, used for RAPID DIURESIS.
what are the uses for loop diuretics? - ANS-heart failure. (best applies to this cardio lecture)
also used for: hepatic disease, renal disease, pulmonary edema, HTN refractory to thiazides
(HTN that refuses to be treated with thiazides), ascites (swelling in abdominal area), oliguria
(low urine output).
what are some possible ADRs for loop diuretics? - ANS--fluid and electrolyte imbalance
-hearing loss/deafness can occur with rapid IV or IV push administration.
-antibiotic interactions (gentamyacin) can cause hearing loss
what class is furosemide (Lasix) part of? - ANS-loop diuretics
what are some nursing implications/patient teaching points for loop diuretics? - ANS--deliver IV
pushes of Lasix NO FASTER THAN 20-40mg/min.
-take in AM, look for s/sx of hypokalemia (low potassium)
-dangerous for pregnant women
-caution in elderly
what are some s/sx of hypokalemia? (low potassium levels) - ANS-slow bowel, dysrhythmia,
muscle weakness, dizziness, thirst, mental confusion
what are some s/sx of hyperkalemia? (high potassium) - ANS-weakness, paralysis,
VENTRICULAR FIBRILLATION, DEATH.
what can occur if potassium is IV pushed? - ANS-DEATH. excess potassium can be removed
with insulin and glucose infusion in emergency
what is the action of thiazide diuretics? - ANS-increase excretion of sodium chloride, water, and
potassium.
act on DISTAL TUBULE - inhibits Na reabsorption
antihypertensive = decr blood volume and EVENTUALLY Peripheral vascular resistance.
what are the uses for thiazide diuretics? - ANS-HTN, heart failure.
NOTE: takes one month to see full effect. INCR EFFECTIVENESS OF OTHER HTN MEDS!
also used for: edema of EARLY renal disease, cirrhosis, works best in pts who have moderate
urine output
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