GoConqr has a new look! Let us know what you think.

Sign up free

Flashcards

Med/Surg

sam boney English 65 cards

Cards in this deck (65)

  1. 1Coumarin exampleswarfarin (Coumadin)
  2. 2Coumarin Nursing Implications• Monitor INR regularly
    • Monitor for bleeding
    Teach patient to report bleeding.
    • Acetaminophen (Tylenol) for analgesia used instead of aspirin during therapy
    • Antidote: Vitamin K.
  3. 3Direct Thrombin Inhibitors example• dabigatran (Pradaxa)
  4. 4Direct Thrombin Inhibitors Nursing Implications• Monitor for bleeding.
  5. 5Heparin functionBinds to antithrombin III, which then inhibits fibrin formation.
  6. 6Heparin exampleheparin sodium
  7. 7Heparin nursing implications• Do not give intramuscularly as can cause pain and hematoma.
    • Monitor heparin antifactor Xa or partial thromboplastin time: 1.5 to 2 times control.
    • Monitor platelet count for decrease.
    • Monitor for bleeding.
    • Teach: Report bleeding.
    • Antidote: Protamine sulfate.
  8. 8Factor Xa Inhibitors functionBind with antithrombin III, inhibiting making of factor Xa and the formation of thrombin.
  9. 9Examples of Factor Xa Inhibitors• apixaban (Eliquis)
    • dalteparin sodium (Fragmin)
    • enoxaparin (Lovenox)
    • fondaparinux (Arixtra)
    • rivaroxaban (Xarelto)
    • edoxaban (Savaysa)
  10. 10Factor Xa Inhibitors Nursing Implications• Bleeding rare
    • Contraindicated with kidney disease due to increased bleeding risk.
    • Compliance is key for efficacy.
    • Teach: Give injection subcutaneously (with a prefilled syringe; the air bubble is not to be removed).
  11. 11What is the function of Thrombolytics?Promote fibrinolysis to break down fibrin in blood clot.
  12. 12Examples of Thrombolytics• reteplase; rPA (Retavase)
    • tenecteplase; TNK (TNKase)
    • tissue plasminogen activator; tPA (Alteplase)
  13. 13Thrombolytics nursing implications• Minimize blood draws for 24 hours.
    • Monitor for bleeding.
    • Avoid acetylsalicylic acid, nonsteroidal anti-inflammatory drugs.
  14. 14What is the function of Statins?First-line drugs to reduce low-density lipoprotein (LDL) by reducing cholesterol synthesis.
  15. 15Examples of Statinsatorvastatin (Lipitor)
    fluvastatin (Lescol XL)
    lovastatin (Mevacor)
    pravastatin (Pravachol)
    rosuvastatin (Crestor)
    simvastatin (Zocor)
  16. 16Statins Nursing Implications• Monitor liver function studies.
    • Monitor for rhabdomyolysis (lethal breakdown of skeletal muscle).
    •Teach: Take medication in evening when cholesterol synthesis is highest.
    • Report muscle pain to health care provider.
  17. 17FibratesReduce triglycerides.
  18. 18Examples of Fibrates• clofibrate (Atromid-S)
    • fenofibrate (TriCor)
    • gemfibrozil (Lopid)
  19. 19Fibrates Nursing ImplicationsTeach: Take 30 minutes before morning and evening meal.
    May increase the effects of anticoagulants and hypoglycemia.
  20. 20Bile Acid SequestrantsLower cholesterol by binding bile acids, so stored cholesterol is used to make more bile acids.
  21. 21Examples of Bile Acid Sequestrants• cholestyramine (Questran)
    •colesevelam hydrochloride (Welchol, Sankyo) • colestipol (Colestid)
  22. 22Bile Acid Sequestrants Nursing Implications• Teach: Add fruits and vegetables high in fiber to diet to reduce constipation and other gastrointestinal associated effects.
    • Can interfere with absorption of digoxin, thiazides, and beta blockers.
  23. 23Niacin• Prevents conversion of fats into very low LDLs.
    • Rarely used because of flushing.
  24. 24Examples of Niacinniacin (Nicotinic acid)
    extended-release niacin (Niaspan)
  25. 25Niacin Nursing Implications• Teach: Take aspirin 30 minutes before taking medication to reduce flushing.
  26. 26Cholesterol Absorption Inhibitor• Inhibits the absorption of cholesterol.
    • Decreases LDLs and increases HDLs
  27. 27Examples of Cholesterol Absorption Inhibitorezetimibe (Zetia)
  28. 28Cholesterol Absorption Inhibitor Nursing Implications• Teach: Take with liquids and meals.
    • Take other medications 1 hour before or 4 hours after.
  29. 29Examples of Combination AgentVytorin = ezetimibe (Zetia) + simvastatin (Zocor)
  30. 30AntiplateletsInhibit platelet activation, adhesion, or procoagulant activity.
  31. 31Examples of Antiplatelets• aspirin
    • clopidogrel (Plavix)
    • ticagrelor (Brilinta)
  32. 32Antiplatelets Nursing Implications• Enteric-coated aspirin beneficial for daily use.
    • Monitor for bleeding.
  33. 33Nitrates• Vasodilate to reduce preload and afterload. • Reduce oxygen consumption of myocardium.
  34. 34Examples of Nitrates• nitroglycerin (Nitrostat, NitroQuick) •nitroglycerin sublingual spray (Nitrolingual Pumpspray)
    • isosorbide dinitrate (Isordil)
    • isosorbide mononitrate (Imdur, ISMO)
  35. 35Nitrates Nursing Implications• Document onset, type, radiation, location, and duration of chest pain.
    • Take AP and BP pre- and postadministration.
    • Place sublingual (SL) tablet in buccal pouch to lessen burning sensation under tongue.
    • Do not shake aerosol canister before administration of lingual spray.
    • Remove patch before magnetic resonance imaging or defibrillation.
    • Teach: Explain need to rise slowly, especially with SL spray.
    • If chest pain is not relieved, call 911.
    •Tablets should be replaced every 3 to 6 months.
    • Keep tablets in original bottle as they become inactive when exposed to light, air, heat, and moisture.
    • Burning or tingling sensation may be felt under the tongue with SL nitroglycerin.
    • Use of erectile dysfunction medications is contraindicated because they can cause a drop in blood pressure.
    • Avoid alcohol.
  36. 36nitroglycerin (Transderm Nitro, Nitro-Bid) nitroglycerin patch (Nitro-Dur, Nitrek)• Teach: Remove old transdermal patch before applying new patch.
    • Rotate application sites.
    • Apply patch to clean, dry, hairless area. •Remove at bedtime so tolerance does not develop.
  37. 37Angiotensin-Converting Enzyme (ACE) Inhibitors• Block production of angiotensin II, a potent vasoconstrictor.
    • Vasodilate and improve cardiac output and exercise tolerance.
  38. 38Examples of Angiotensin-Converting Enzyme (ACE) Inhibitors• Captopril (Capoten)
    • enalapril (VasoteC)
    • lisinopril (Prinivil, Zestril)
    • ramipril (AltaCe)
  39. 39Angiotensin-Converting Enzyme (ACE) Inhibitors Nursing Implications• If pulse is < 60 beats per minute (bpm) or systolic BP < 90 mm Hg, notify health care provider (HCP) before administering medication.
    • Give 1 hour before meals.
    • Give captopril on empty stomach.
    • Teach: Take first dose at night to adjust to lower BP.
    • Rise slowly.
    • Check BP weekly.
    • Report development of dry cough or other side effects.
  40. 40Calcium Channel Blockers• Dilate peripheral arteries
    • decrease myocardial contractility
    • depress conduction system
    • decrease workload of the heart.
    • In variant angina, reduce coronary artery spasm.
  41. 41Examples of Calcium Channel Blockers• amlodipine (NorvasC)
    • diltiazem (Cardizem, DilaCor XR)
    • felodipine (Plendil)
    • niCardipine (Cardene)
  42. 42Calcium Channel Blockers Nursing Implications• If pulse < 60 bpm or systolic BP < 90 mm Hg, notify HCP before administering medication.
  43. 43Beta Blockers• Decrease pulse, BP, and cardiac output
    • Suppress renin activity.
    • Decrease the risk of sudden death.
  44. 44Examples of Beta Blockers• atenolol (Tenormin)
    • metoprolol (Lopressor, Toprol XL)
  45. 45Beta Blockers Nursing Implications• Beta blockers contraindicated in asthma, heart block, and bronchoconstriction.
    • If pulse < 60 bpm or systolic BP < 90 mm Hg, notify HCP before administering medication. •Teach: Explain need to rise slowly.
    •Abrupt withdrawal may result in diaphoresis, palpitations, headache, and tremors.
  46. 46Anti-Ischemic AgentAntianginal agent used as combination therapy for those not responding to other antianginal medication.
  47. 47Examples of Anti-Ischemic Agent• ranolazine (Ranexa)
  48. 48Anti-Ischemic Agent Nursing Implications• May not be as effective in women.
    • Prolongs QT interval on electrocardiogram.
  49. 49Analgesics• Opioid relieves pain.
    • Reduce preload and afterload.
    • Decrease anxiety.
  50. 50Examples of Analgesics• morphine sulfate
  51. 51Analgesics Nursing Implications• Monitor vital signs and sedation level before and after administration.
  52. 52Low Molecular Weight Heparin (LMWH) Antithrombotic.Prophylaxis of ischemic complications in unstable angina or non-ST-elevation myocardial infarction with aspirin therapy.
  53. 53Examples of (LMWH)• dalteparin (Fragmin)
    • enoxaparin (Lovenox)
    • fondaparinux (Arixtra)
  54. 54LMWH Nursing Implications• Do not remove prefilled syringe air bubble. • Give deep subcutaneously: Hold fold of skin while giving injection.
    • Rotate sites.
    Teach: Monitor for bleeding.
  55. 55AntiarrhythmicsInhibit ventricular arrhythmias.
  56. 56Examples of Antiarrhythmics• amiodarone (Cordarone, Pacerone)
  57. 57Antiarrhythmics Nursing Implications• Contraindicated in atrioventricular block or pregnancy.
    • Obtain baseline vital signs and electrocardiogram (ECG).
    • Monitor for lung toxicity.
    • Teach: Avoid grapefruit juice with oral form.
  58. 58Antiplatelets• Inhibit platelet activation, adhesion, or procoagulant activity.
  59. 59Examples of Antiplatelets• aspirin clopidogrel (Plavix)
    • prasugrel (Effient)
    • ticagrelor (Brilinta)
    • vorapaxar (Zontivity)
  60. 60Antiplatelets Nursing Implications• Teach: Chew aspirin when acute coronary syndrome (ACS) or myocardial infarction (MI) suspected.
    • Report bleeding or bruising.
  61. 61Glycoprotein IIb/IIIa InhibitorsInhibit platelet aggregation.
  62. 62Examples of Glycoprotein IIb/IIIa Inhibitors• abciximab (ReoPro)
    • bivalirudin (Angiomax)
    • eptifibatide (Integrilin)
    • tirofiban (Aggrastat)
  63. 63Glycoprotein IIb/IIIa Inhibitors Nursing Implications• Given via intravenous route only during percutaneous coronary intervention.
    • Prevent injury for bleeding risk.
    • Monitor vital signs and ECG.
    • Teach: Report bleeding or bruising.
  64. 64Examples Additional Medications as NeededAntiemetics
    Anxiolytics
    Antacids
    stool softeners
  65. 65Additional Medications as Needed Nursing Implications• Control:
    nausea
    vomiting
    anxiety
    gastric upset
    straining/constipation.

Information

Description
Flashcards on Med/Surg, created by sam boney on 26/01/2020.
Created by
sam boney
Views
9
Tags
ms
Rating

Feedback

What is it about?

What do you think of the new look?

How do you like it?