Med admin test 2

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everythingshiny
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40027
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Med admin test 2
Updated:
2010-10-06 13:32:09
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IV therapies, Anti-diabetic and CV drugs
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  1. Wh/ diuretics are most often RX as maintenance for HTN?
    • Loop
    • K-sparing
    • Thiazide-like
  2. Wh/ class of diuretics could lead to hyperkalemia?
    • K-sparing diuretics
    • such as:
    • Spironolactone (Aldactone)
    • Triamterene (dyrenium)
    • Amiloride (Midamor)
  3. What is the best time of day for PT to take their diuretics?
    Why?
    • In the A.M.
    • To pervent sleep disturbances
  4. What is the suffix for ACE inhibitors?
    - pril
  5. What are the side effects of ACE inhibitors?
    • Dizziness
    • OH
    • Hyperkalemia
    • Cough
    • H/A
  6. What is the action for ACE inhibitors?
    They decrease peripheral vascular resistance without

    • Increasing cardiac output
    • Increasing cardiac rate
    • Increasing cardiac contractility
  7. What dose ACE stand for?
    • A-angiotensin
    • C-converting
    • E-enzyme
  8. What is the mechanism of action for ACE inhibitors?
    • Blocks the enzyme that converts angiotensin 1 to angiotensin 2
    • They work throught the reini-angiotensin-aldosterone system
  9. When should you notify the MD when administering furisemide?
    If urine output dose not increase in 5-20 min
  10. What could result from pushing furosemide too fast?
    Could result in hearing loss
  11. What is the push rate of IV furosemide?
    10-20 mG/min
  12. What is the expected therapeutic outcome of diuretic therapy?
    • Decrease B/P (diuretics are the 1st line agent HTN)
    • Decrease edema
  13. What is the relationship btwn bld glucose and diuretic?
    • Thiazide and Loop diuretics promote hyperglycemia and hyperlipidemia
    • (monitor bld glucose because exacerbate diabetes)
  14. What are the S/S of K depletion/hypokalamia
    • Muscle weakness
    • ABD distension
    • leg cramps
    • cardiac dysrhythmia
  15. What is angina?
    (chest pain) occurs when the O2 supply demand of the heart is greater than the supply
  16. How are Ca channel blockers effewctive as anti-arrhythmics?
    • They block the Ca channel wh/ causes a slowing of conduction in the artial and AV node
    • They are also used to control ventricular response to atrial fibrillation and flutter
  17. How are beta blockers effective anti-arrhythmics?
    Reduce cardiac stimulation by blocking stimulation of the beta1 receptors wh/ reduces HR and contractility
  18. Wh/ classes of anti-HTN drugs can also be used as anti-arrhythmics?
    • Beat blockers
    • Ca channel blockers
  19. what are the major S/E of nitrates?
    • H/A
    • (Wh/ can be treated w acetaminophen and usu diminishes over time)
    • Reflex tachycardia
    • Hypotension
  20. How do nitrates relieve angina?
    • By producing vasodilation of the venous system wh/ reduces preload and workload of the heart
    • Dilate coronary arteries
  21. Wh/ antihypertnasives are also used for dysrhythmias and angina?
    Ca Channel blockers
  22. What is important teaching on beta blockers?
    • BB can mask the S/S of hypoglycemia
    • Thye can cause activity intolerance and fatigue
    • They blut activity induced heart increases
    • May worsen CHF
  23. What is the fxn of diuretics in managing hypertension?
    Decreasing circulating bld volume
  24. Why is it necessary for clients taking loop diuretics to eat food rich in K/take a k supplement?
    Loop diuretics promote depletion of H2O, K, Na, Ca, Mg
  25. What is the mechanism of action for K-sparing diuretics?
    • Block aldosterone receptors in the distial tubules
    • Interfere w Na/K exchange in the collecting and convoluted tubules
  26. What are the most commonly used diuretics?
    Thiazide
  27. What is the mechanism of action of Thiazide?
    • inhibit reabsorption of Cl and Na in the distial tubules
    • Promote Ca reabsorption
    • Promote hyperglycemia
  28. What are loop diuretics more potent?
    Because they block Cl
  29. What is the mechanism of action for loop diuretics?
    • Block absorption of sodium from the loop of henle
    • They block Na and Cl reabsorption in the ascending loop of henle
  30. What is the goals of HTN therapy?
    • Reduce pump action
    • Vasodilation
    • Reduce volume
  31. What is the suffix for Alpha-1 adrenergic blockers?
    -sartan
  32. What is the suffix for beta blockers?
    • -olol
    • propranolol
    • atenolol
  33. What class of anti-HTN drugs are associated w 1st pass phenomenon?
    Alpha-1 Adrenergic blockers
  34. What is the 1st dose phenomenon?
    PT suffers from syncope and dizziness and are instructed to take medications a bedtime
  35. Which anti-HTN drug has cough and hyperkalemia as a common S/E?
    ACE inhibitors
  36. What is the peak of long acting insulins?
    NO PEAK
  37. What is the onset of long acting insulins?
    2-3 hours
  38. What is the duration of long acting insulins?
    20-24 hours
  39. What is the peak of short acting insulins?
    2-4 hours
  40. What is the duration of short acting insulins?
    5-7 hours
  41. What is the onest of short acting insulins
    30-60min
  42. Wh/ insilins are used for meal time coverage?
    • Short acting
    • regular insulin (novolin R and Humulin R)
  43. Wh/ insulins are used for basal coverage?
    • intermediate acting insulins
    • (NPH, Isophane insulin suspension)
  44. What should a PT do if they miss a dose of digixon?
    • Take missed dose w in 12 hours of scheduled dose or do not take it at all
    • DO NOT double doses
    • Contact MD if 2 days of doses are missed
  45. What is a sign that anti-arrhythmics are acheiving their therapeutic effect?
    • Increase in cardiac output (positive intropic effect)
    • Slowing of the heart rate (negative chronotropic effect)
  46. What are the common S/E of digixon?
    • Fatigue
    • H/A
    • Vision disturbances (yellow, green, blurry)
    • Arrhythmias
    • Bradycardia
    • anorexia
    • N/V
    • electrolyte imbalances
  47. What is the effects of diurectis on digixion levels?
    • may cause hypokalemia
    • (increase risk of toxicity)
  48. What are some things that should be monitored w the PT on digitalis?
    • K
    • MG
    • CA
    • hepatic and renal functioning
  49. What are the effects of low K levels in the PT on digitalis?
    Hypokalemia may make the PT more susceptible to digitalis toxicity
  50. Wha are the expected outcomes of the PT on digixon?
    • They have both a positive inotropic effect (increased cardiac output)
    • Negative chronotropic effect (slowing of the heart rate)
  51. What is dromotrophic effect?
    • Effect the conduction of current
    • Negative= decrease in conduction activity of a current
    • Positive= increase in conduction activity current
  52. What is chronotropic effect?
    • Affecting the rhythm of the movements of the heart (heartbeat)
    • Positive= increasing the HR
    • Negative=decreasing the HR
  53. What is an intropic effect?
    • Affects the contraction of the muscles (especially the heart)
    • Increases the myocardial contractility therefore affecting the force of muscle contractions
  54. What is the antidote for digoxin?
    Digoxin immune fab (Digibind) IV diluted in 50 mL of NS over 30 min
  55. What is the therapeutic range for digixon?
    • 0.5-2.0
    • serum digixon levels sould me monitored closely
  56. What are the S/S of digixon toxicity?
    • Anorexia
    • diarrhea
    • N/V
    • Bradycardia (<60BPM)
    • Premature ventricular contractions
    • confusion
    • visual disurbances
  57. How are BB helpful for MI
    They block the stimulatioin of Beta 1 receptors wh/ results in reduced HR, conduction, and contractility
  58. How do Beta adrenergic blockers relieve angina?
    • BB decrease workload of the heart wh/ decreases the O2 need
    • They also reduce angina by recucing contractility and arterial B/P wh/ reduces after load

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