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NR 293 Exam 3 Study Guide final latest – Chamberlain college of nursing | NR293 Exam 3 Study Guide final latest

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NR 293 Exam 3 Study Guide final latest – Chamberlain college of nursing Study Guide for NR 293 Exam 3 • Alpha2-adrenergic receptor stimulators (agonists)/clonidine o Stimulate alpha2-adrenerg... ic receptors in the brain o Decrease sympathetic outflow from the CNS, decrease norepinephrine production o Stimulates alpha2-adrenergi receptors, thus reducing renin o Examples: Clonidine (Catapres), Methyldopa (aldomet): used for pregnant women w/htn • Alpha1-blockers/”azosin,” o Block alpha1-adrenergic receptors o Management of severe heart failure (HF) when used with cardiac glycosides and diuretics o Some used to relieve symptoms of BPH- increase urinary flow rate o Example: “ Azosin” (doxazosin (Cardura) o Adverse Effects: ♣ Serious: hypotension (first dose) syncope ♣ Common: dizziness o Nursing implications: instruct pt. to lie down after taking first dose because they may become dizzy • Beta-blockers “olol”: First-line treatment for heart failure & HTN o Reduce BP by reducing heart rate through beta1 blockade (block receptors for norepinhrine) o Cause reduced secretion of renin o Long-term use causes reduced peripheral vascular resistance o Adverse Effects: orthostatic hypotension, bradycardia w/ reflex tachycardia, sexual dysfunction in men, possible hypoglycemia or hyperglycemia • Angiotensin-converting enzyme inhibitor, “pril” Captopril o Mechanism of Action: ♣ Inhibit angiotensin-converting enzyme, which is responsible for converting angiotensin I (through the action of renin) to angiotensin II ♣ Angiotensin II is a potent vasoconstrictor and causes aldosterone secretion from the adrenal glands ♣ Result in decreased systemic vascular resistance (afterload), vasodilation, and therefore decreased blood pressure o Indications: ♣ First-line treatment for heart failure & HTN ♣ HF (either alone or in combination with diuretics or other drugs) ♣ Slow progression of left ventricular hypertrophy after MI (cardio protective) ♣ Renal protective effects in patients with diabetes ♣ Captopril and lisinopril can be used if a patient has liver dysfunction, unlike other ACE inhibitors that are pro-drugs • *Pro-drugs are inactive in their administered form and must be metabolized in the liver to an active form so as to be effective o Adverse Effects: hyperkalemia & dry, nonproductive cough o Serious drug interaction: NSAIDs • Angiotensin II receptor blocker “sartan” losartan (Dovan) o Mechanism of Action: ♣ Allow angiotensin I to be converted to angiotensin II, but block the receptors that receive angiotensin II ♣ Block vasoconstriction and release of aldosterone ♣ Well tolerated, do not cause a dry cough ♣ Indications: first-line treatment for heart failure & HTN o Adverse Effects: URI, headache ♣ May cause occasional dizziness, inability to sleep, diarrhea • Calcium channel blockers: Amlodipine “dipine” verapamil (calan), diltiazem (cardizem) o Mechanism of Action: cause smooth muscle relaxation by blocking the binding of calcium to its receptors, preventing muscle contraction o Adverse effect: constipation ♣ High-fiber diet with plenty of fluids will help prevent constipation o Indications: hypertension ♣ Angina- ch. 23 • Ischemia: o Ischemic heart disease: Poor blood supply to the heart muscle (Atherosclerosis, Coronary artery disease) o Myocardial infarction (MI): Necrosis, or death, of cardiac tissue, disabling or fatal • Therapeutic Objectives o Minimize the frequency of attacks and decrease the duration and intensity of anginal pain o Improve the patient’s functional capacity o Prevent or delay the worst possible outcome: MI - - - - - - - - - - - - - - - - - - Chapter 52 • Anticholinergics : Scopolamine (Transderm-Scōp) o Mechanism of action: bind to and block acetylcholine (ACh) receptors in the inner ear labyrinth o Nursing implications: change patch every 3 days   • Antihistamines : Meclizine (Antivert), Benadryl o Mechanism of action: Inhibit ACh by binding to H1 receptors, prevent cholinergic stimulation in vestibular and reticular areas, o Indications: used for motion sickness, allergy symptoms, sedation o Nursing implications: avoid driving because of possible dizziness • Antidopaminergics : prochlorperazine (Compazine) o Mechanism of action: block dopamine receptors in the CTZ o Indications: used for psychotic disorders, intractable hiccups o Examples: promethazine (Phenergan) ♣ Give IV push, be careful can make blood vessel constrict and block the circulation. Dilute 20cc of saline for 15 min. Do not want to end up with necrosis. Start very slow!! Stop if burning or hurting!! ♣ Droperidol: use is controversial because of associated cardiac dysrhythmia • Prokinetic: metoclopramide (Reglan) o Mechanism of action: block dopamine receptors in the CTZ, CTZ to be desensitized to impulses it receives from the GI tract o Also stimulate peristalsis in GI tract, enhancing emptying of stomach contents o Indications: used for gastroesophageal reflux disease (GERD), delayed gastric emptying ♣ Long-term use may cause irreversible tardive dyskinesia o Contraindications: hypersensitivity to procaine • Serotonin blockers: “setron” ondansetron (Zofran)/ Granisetron (Hytril) o Block serotonin receptors in the GI tract, CTZ, and VC o Used for nausea and vomiting in patients receiving chemotherapy and for postoperative nausea and vomiting o Adverse effects: diarrhea • Nursing Implication: o Many of these drugs cause severe drowsiness; warn patients about driving or performing any hazardous tasks o Taking antiemetics with alcohol may cause severe CNS depression o Teach patients to change positions slowly to avoid hypotensive effects o For chemotherapy, antiemetics are often given 30 to 60 minutes before chemotherapy begins [Show More]

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