Pharmacology Hesi, Pharmacology HESI
Create a high risk of digoxin toxicity if taken long-term and daily - ANS Digoxin and Furosemide
(Lasix)
Dangers associated with Lasix - ANS Hypokalemia leading to digoxin toxicity
Normal Digoxin levels - ANS 0.5 - 2 ng/ml
Normal serum potassium levels - ANS 3.5 to 5 mEq/L
Low potassium or magnesium levels may increase risk for what toxicity? - ANS Digoxin toxicity
Signs and symptoms of digoxin toxicity - ANS Anorexia, bradycardia, headache, dizziness,
confusion, nausea and visual disturbances (blurred vision, yellow vision and/or halo vision)
When should you hold the Labetolol and notify the prescriber? - ANS When the pt's pulse rate
too low
Side effects of Labetolol - ANS Weight gain due to fluid retention
How much weight should the patient be losing when taking Labetolol? - ANS 1kg (2.2 lb.) =
1,000 mL fluid gain or loss in 24 hours.
When should you remove the nitroglycerin transdermal patch? and why? - ANS At night; It can
produce tolerance when worn for 24 hours
How long should be without the nitroglycerin transdermal patch at night? - ANS 8 hours
Why wear gloves when applying nitroglycerin paste or patch? - ANS Because it can cause
severe vasodilation, decrease blood pressure, intense headache to the administrator.
What can you give to a patient who is taken the nitroglycerin paste/patch and is experiencing a
headache? - ANS Acetaminophen
What action should you take when the patient is experiencing angina and is prescribed nitro? -
ANS If the vital signs are okay, leave the nitroglycerin patch and administer the PRN sublingual
nitro.
VS associated with nitro drip - ANS hypotension: decrease drip rate
What is the common ending for calcium channel blockers? - ANS -dipine
,What are the other two names for calcium channel blockers that do not end in -dipine? - ANS
Verapamil (Calan) and Diltiazem (Cardizem)
"Dipines" affect only what? - ANS Vessels (vasodilation)
SE of calcium channel blockers - ANS Dizziness, facial flushing, hypotension and edema.
Verapamil (Calan) and Diltiazem (Cardizem) also affect what? - ANS The heart and vessels
What should you monitor when the patient is taking calcium channel blocker? - ANS Blood
pressure and decrease heart rate.
What is another side effect in Verapamil (Calan) and Diltiazem (Cardizem)? - ANS Constipation
What is a beverage that you should avoid when taking calcium channel blockers? - ANS
Grapefruit juice
Aliskiren (Tekturna) is what kind of medication? - ANS Direct renin inhibitor
What does Aliskiren (Tekturna) treat? - ANS Hypertension
What are some teaching interventions when taking Aliskiren (Tekturna)? - ANS Don't take if
pregnant (stop the drug immediately when the patient is pregnant). Don't take with high fat meal.
What does Aliskiren (Tekturna) increase and what should they avoid? - ANS They increase
potassium levels so don't take medications that increase potassium.
Furosemide (Lasix) is what kind of drug? - ANS Loop diuretic
Is furosemide (Lasix) slow or rapid acting? - ANS Rapid
What is the use for furosemide (Lasix)? - ANS Rapid diuresis in emergencies such as
pulmonary edema.
Furosemide (Lasix) may produce what kind of adverse effect? - ANS Hypokalemia
What should you assess when you suspect patient of hypokalemia? - ANS Muscle cramps and
muscle weakness.
What also should you assess when patient is experiencing some adverse effects of furosemide
(Lasix)? - ANS Hypotension, fluid and electrolyte abnormalities, and dehydration.
,What are the side effects of furosemide (Lasix)? - ANS Dizziness, headache, tinnitus, nausea,
vomiting, diarrhea, low potassium levels, hyperglycemia, ototoxicity with aminoglycosides (drugs
that end in -mycin).
What is biggest side effect concern when patient taking furosemide (Lasix)? - ANS Low
potassium levels
When a patient needs potassium supplements what are some foods a patient can consume that
contain potassium? - ANS Dried fruits, fish, leafy veggies, squash, beans, meats, nuts,
bananas, potatoes, and diary products.
What is another name for IV potassium? - ANS KCl
What should you assess when the patient is on IV potassium? - ANS Overall condition of the
veins.
Which vein should you use when administering IV potassium? - ANS Large vein, like the
antecubital vein.
Why is venous access important when administering IV potassium? - ANS Because it can
irritate the skin.
What should you do when the patient is burning at the site during the IV potassium? - ANS
Notify the nurse immediately
IV Potassium extravasation can cause what? - ANS Necrosis of the tissues
What should you assess and confirm prior to administering IV potassium? - ANS Calculate and
set the rate as ordered, know anticipated duration of therapy and know the restrictions imposed
by patient's history.
Do not give what kind of IV during IV potassium? - ANS IV push
You should infuse the IV potassium rate no greater than what in peripheral IV? - ANS 10
mEq/hr.
You should infuse the IV potassium rate no greater than what in central line? - ANS 20 mEq/hr.
Always use what for IV potassium? - ANS Infusion pump
How often should you assess the IV site when patient is on IV potassium? - ANS Every hour
What is the treatment of hypokalemia adults IV? - ANS 10-20 mEq/dose (maximum 40
mEq/dose) to infuse over 2-3 hours. Maximum infusion rate 40 mEq/hr.
, Antihypertensive effects are more pronounced in which age group? - ANS Elderly
Which antihypertensive will raise potassium? - ANS ACE inhibitors, angiotensin II receptor
blockers (ARBs) and renin inhibitors.
How can you determine the effectiveness of Osmitrol (Mannitol)? - ANS Decrease intracranial
pressure
What is Osmitrol (Mannitol) NOT used for? - ANS Peripheral edema
What does Osmitrol (Mannitol) treat? - ANS Patients with closed head injuries
Spironolactone (Aldactone), amiloride (Midamor), triamterene (Dyrenium) are what kind of
drugs? - ANS Potassium sparing diuretics
What do potassium sparing diuretics cause? - ANS Increase in potassium
What does potassium sparing diuretic block? - ANS Receptors of aldosterone
What does potassium sparing diuretic inhibits? - ANS Sodium and water reabsorption
Why should take potassium sparing diuretic in the morning? - ANS Because you will urinate a
lot
What should avoid when taking potassium sparing diuretics? - ANS Salt substitutes, ACE
inhibitors, ARBs.
Potassium sparing diuretics are often taken with other thiazide diuretics to treat what? - ANS
Edema, hypertension, and heart failure.
Can potassium sparing diuretics be taken with other meds that lower potassium? - ANS Yes
What lab value should you look for in patients taking atorvastatin (Lipitor)? - ANS HDL should
increase and LDL and total cholesterol decrease.
What are some other "statin" drugs? - ANS Rosuvastatin (Crestor), fluvastatin, lovastatin,
simvastatin, pravastatin
What should be routinely checked when taking "statin" drugs? - ANS Liver function tests and
creatinine/kinase.
