Exam 1 Blueprint

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  1. Rationalize the pharmacological uses for epinephrine.
    Cardiac Arrest, Bradycardia, Bronchospasms, Superficial Bleeding, Anaphylactic Shock, Nasal Congestion
  2. Describe the pharmacological action of epinephrine.
    Binds to Adrenergic receptors Alpha1, to cause vasoconstriction, and beta1 and 2 to cause a faster SA to AV node transmission resulting in increased HR; it also increases the contraction force; it will also cause bronchodilation.
  3. Explain which drugs are appropriately used in combination with ACE inhibitors and ARBs.
    These drugs are usually combined with diuretics such as hydroclorothiazide.
  4. Assess the importance of nursing interventions when administering dopamine intravenously.
    Monitor BP, HR, ECG, Assess IV site to assure patency because it might cause necrosis (tissue will die if medication is leaked). Ensure that IV pump is available and working to set correct rate. Titrate medication according to protocol based on patients vital signs.
  5. Analyze the importance of assessment before administering beta-adrenergic blocking agents.
    BP, Ensure HR is over 60, ECG to rule out AV block, HX of asthma or COPD (Propanolol), and monitor glucose for your diabetics (Propanolol)
  6. Summarize the overall action of blocking the Alpha1 receptor sites.
    Blocks Alpha1 receptor sites which causes a decrease in vascular tone to cause vasodilation and it also relaxes the bladder neck and prostate capsule. (Vasodilation decreases you preload which will cause a decreased afterload and CO, resulting in a lower BP)
  7. Review expected patient outcomes when the patient is prescribed medication for hypertension.
    Expected outcome is that BP is within normal limits, verbalize the understanding of the side effects and action of the medication.
  8. Review the actions of the following receptor sites: Alpha1, Beta1, Beta2, Dopamine.
    • Alpha1-it cause vasoconstriction and closure of bladder sphincter.
    • Beta1-it increases transmission from the SA to AV node, it increases HR, it increases contraction force.
    • Beta2-Bronchodilation
    • Dopamine-Dilation of the renal arteries which increases renal perfusion;and same beta1 effects.
  9. Assess the investigational uses for centrally acting Alpha2 agonists.
    Alcohol, tobacco and opiate withdrawls, ADHD, severe cancer pain, migraines, and tourettes.
  10. Describe the differences associated with ARBs:
    ARBs-it works at the receptor site to prevent the binding of angiotensin 2 and having its effect. There is no side effect for cough and hyperkalemia.
  11. Describe the differences associated with ACE inhibitors:
    ACE inhibitors: they block the conversion of angiotensin 1 to angiotensin 2 by inhiiting ACE. Hyperkalemia and dry cough.
  12. Describe the differences associated with Beta blockers:
    Beta blockers: they do not cause vasodilation.
  13. Describe the differences associated with calcium channel blockers:
    Calcium channel blockers: They cause vasodilation by blocking calcium channels in the coronary arteries and peripheral vessels. Cause constipation.
  14. Describe the differences associated with Antilipemics/Statins:
    Antilipemics/Statins: work in the liver to block HMB CoA reductase to prevent further synthesis of cholesterol. Hepatotoxic and Prego Category X.
  15. Describe the differences associated with Antilipemics/Fibrates:
    Antilipemics/Fibrates: Inhibits the breakdown of lipids in the vessels and decreases formation of triglycerides.
  16. Describe the differences associated with Antilipemics/Cholesterol Absorption Inhibitors:
    Antilipemics/Cholesterol Absorption Inhibitors: Inhibits the uptake of cholesterol from the small intestine into the liver.
  17. Describe the differences associated with Antilipemics/Bile Acid Sequestrant:
    Antilipemics/Bile Acid Sequestrant: it makes your bile acids into complex compounds to be excreted by your feces.
  18. Review digoxin toxicity
    Main S/S anorexia, green/yellow halos, weakness-hypokalemia puts you at risk for dig toxicity, 0.5-2.0 ng/ml.
  19. Summarize the correct pharmacological action of medications used for hypertensive crisis.
    It directly causes vasodilation to decrease preload, which decreases afterload and cardiac output resulting in decreased BP. Dilates coronary vessels to supply the heart with more oxygen.
  20. Assess the uses for organic nitrates.
    Angina, prevention and treatment of MI.
  21. Review the pharmacological uses of cardiac glycosides.
    HF, Atrial Fibrillation, Atrial Tachycardia.
  22. Explain in your own words the expected pharmacological action of centrally acting Alpha2 agonists, such as Clonidine (Catapres).
    Binds to Alpha2 receptors in the CNS to decrease sympathetic outflow causing vasodilation in the peripheral vessels.
  23. Explain the rationale for evaluation of the patient's potassium level when administering ACE inhibitors.
    Inhibits the formation of angiotensin II which ingibits the release of aldosterone which cause the kidneys to excrete sodium and water but retain potassium.
  24. Be able to list at least four therapeutic nursing interventions when administering adrenergic agonists with rationales for each.
    • 1. monitor IV site every 2 hours to prevent necrosis on extravasation.
    • 2.offer support and encouragement to deal with the drug regimen.
    • 3. teaching the patient about the side effects.
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