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*Medication Aide Chapters 18-23
*Lipids
*Lipids are fats
*Hyperlipidemia
*Cholesterol
*Triglycerides
*Anti-lipemics
*Used to reduce the LDL and triglycerides in blood, reducing risk of hardening of arteries and prevention of heart attacks
*Common side affects
* Headaches
* Runny nose
* Upset stomach
* Nausea, vomiting
* Diarrhea
* Muscular aching
* Joint pain
*Nursing precautions
* Observe for changes in bowel habits, stomach cramps, joint pain,
* Some of “statin” medications should be given with food, others at bedtime
*cont
*Questran give with meals to decrease LDL’s
*Mix with juice(do not give other meds 1 hr. before or 4 hrs. after other meds)
*Enc. High fluid intake & a diet high in fiber
*Niacin give @ night lowers cholesterol & triglycerides-used with statins
*Side effects; flushing, itching, nausea, headache, fatigue, muscle aches & weakness
*Statins
*Reduce risk of MI & stroke
*Do not give with grapefruit juice
*Lipitor
*Mevacor
*Crestor
*Zocor
*Side effects
*Fatigue, anorexia, nausea
*Muscle aches & weakness
*Fibric acids
*Lowers triglycerides & LDL’s
*Lopid
*Tricor
Side effects
nausea & diarrhea
flatulence & abd. Discomfort
fatigue, anorexia, nausea
muscle aches
* Common Conditions of the circulatory system
*Anemia
*Arrhythmias
*CHF (congestive heart failure)
*CVA (Cerebral Vascular accident)
*Hyperlipidemia
*Hypertension
*MI (Myocardial Infarct)
*Peripheral Vascular Disease
*Shock
*Thrombus
*Hypertension
*High blood pressure
*Systolic greater than 140
*Diastolic greater than 90
*Narrow blood vessels are the common cause
*Anti-hypertensives
* Used to restore blood pressure to within normal range
* Common side affects
* Dizziness
* Low blood pressure
* Irregular pulse
* Edema
* Confusion
* Breathing difficulties
* Headache
* Heartburn & indigestion
* Nursing precautions
* Take blood pressure regularly
* Observe for unsteady walking and mobility
* Monitor dietary salt intake and weight loss/gain
*examples
* Diuretics (Lasix, Bumex, Dyazide) increases urine output-lowers edema
* Beta-adrenergic blockers (Inderal, Lopressor, Corgard)
* Lowers heart rate & cardiac output, thus lowers BP
* Must reduce dosages slowly
* Angiotensin converting enzyme inhibitors (Altace, Zestril, Lotensin)Ace Inhibitors
* Less vasoconsrtiction & less sodium & water retention
* Usually combined with diuretic for more effectiveness
* Antiotensin II receptor blockers –ARB’s(Avapro, Cozaar, Micardis, Benicar)
* Less vasoconstriction & less sodium & water retention
* Calcium ion antagonists (Cardizem, Procardia, Calan)
* Calcium Channel Blockers
* Relaxes smooth muscle(vaso-dilation)
* Remind to change positions slowly
* Monitor wt. dly.(may cause edema)
*Cont.
*Alpha-1Adrenergic Blocking agents(Minipress, Cardura, Hytrin)
*Causes vaso-dilation
*Relaxes smooth muscle of the bladder & prostate
Alpha-2 Agonist(Catapress, Aldomet)
Used with other anti-hypertensive agents
Lowers ht. rate & peripheral vascular resistance
If a transdermal patch becomes loose, secure with a piece of adhesive
*Peripheral-acting adrenergic
antagonists
*Lowers peripheral vascular resistance(lowers BP)
*Lowers venous blood return(may cause increase of edema)
*Hyorel
*Ismelin
*Serpasil
*Direct vaso-dilators
*Reduces peripheral vascular resistance, thus it lowers the BP(relaxes smooth muscle)
*Apresoline-Increases cardiac output & sodium retention
*Loniten-same response(does cause increased body hair)
*Both are used with diuretics
*Combination drugs
*A combination of a anti-hypertensive drug & a diuretic
*Usually very expensive as not on the generic lists @ this time
*Hyzaar
*Lopressor HCT
*Corzide
*Aldoril
*Dysrhythmias
*Lack or correlation between diastole and systole
*Can be related the electrical system of the heart.
*cont
* Electrical cardiograms are what maps the electrical activity of the heart
* They can help to diagnose different arrhythmias(heart rhythm)
* You won’t be expected to read or interpret them; however you need to know that if when you’re taking a pulse, & it is irregular, you need to let you nurse know, so that she can check it out to see if there’s a problem
*Check with your facility to see if can take apical pulses
* Frequently are given with the same guidelines as digoxin(don’t give if pulse is below 60 or greater then 100)
* Dr. will have written guidelines if in force)
*Beta Blockers
*Are frequently used for dysrhythmias
*Lowers ht. rate, cardiac output & BP
*Lopressor
*Toperal
*Indural
*Other Meds
*Used to restore rhythms(affects the electrical impulses)
*Always monitor for changes in the rhythm of the heart
*Norpace
*Tambocor(may cause the dysrhythmias to worsen)
*Procanbid
*Quinidine
*Cordarone
* Medications affecting circulatory system
*Anti-anginal
* Used to relieve chest pain
* Common side affects
* Weakness
* Dizziness
* Rapid lowering of blood pressure
* Nursing precautions
* Monitor blood pressure during course of administering the medication
* Stay with patient during report of chest pain
* If chest pain unrelieved, call supervisor immediately
* Examples
* Nitroglycerin products: Nitrostat, Nitro-bid
* isosorbide dinitrate
* Calcium channel blockers (Cardizem, Procardia, verapamil)
*Angina
* The coronary arteries are in the heart.
* They supply the heart with blood.
*Coronary artery disease (CAD) causes the arteries to become narrow therefore the heart gets less oxygen and blood.
*Angina means chest pain related to lack of blood and oxygen.
* tightness
* Pressure
* Squeezing
* Burning
* SOB
* Radiating pain
*Cont…
*Things that cause angina are avoided.
*Over-exertion
*Heavy meals
*Emotional stress
Some individuals need medication
If rx is in disk form & it becomes loose, remove & apply a new disk
*Peripheral Vascular Disease
*Involves the blood vessels in the arms and legs
*Deep vein thrombosis
*Blood clots
*Arteriosclerosis obliterans
*Hardening of the arteries
*Raynaud’s disease
*Blood vessel spasms (vaso-spasms)
*Hemorrheologic agent
*Prevents red blood cells & platelets from clumping
*Monitor for SOB or chest pain or indigestion
*Monitor for poor tolerance to caffeine products
*Trental
*Heart failure
*Or also called congestive heart failure (CHF)
*Occurs when the heart is weakened and cannot pump normally.
*Blood backs up
*Tissue congestion occurs
*Left-side failure causes pulmonary congestion
*Right-side failure causes peripheral congestion
*Cardiotonics
*Used to help cardiac muscle to beat more slowly & stronger
*Common side affects
* Accumulative affect may become toxic
* Nausea, vomiting
* Headache
* Blurred vision
* Dizziness
* Irregular pulse
* Loss of appetite
* Weakness
* confusion
*Nursing precautions
* Take pulse before each dose, if under 60 or over 100 hold medication and report to supervisor
* Examples
* Digoxin
* Crystodigin
*diuretics
* Used to promote formation, excretion of urine
* Common side affects
* Weakness
* Leg cramps
* Thirst
* Jaundice
* GI stress
* Nursing precautions
* Measure, record I&O
* Weigh as directed
* Monitor BP as directed
* Do not switch to salt substitute without checking with physician
* Dietary restrictions of low salt intake apply
* Examples
* Lasix (furosemide)
* Bumex (bumetanide)
* Diuril (chlorothiazide)
* Hydrodiuril (hydrocholorothiazide)
* Enduron (methylclothiazide)
* Lozol (indapamide)
* Edecrin (ethacrynic acid)
* Demadex (torsemide)
* Midamor Iamiloride)
* Aldactone Ispironolactone)
* Diazide (hydrocholorthiazide)
*Diuresis
* Means the increased formation and excretion of urine
* Lab values of K*, Na*, & frequently Ca* are monitored q 3 mo.
* Very often on a K* supplement
* Encourage to eat foods high in K* such as bananas, tomatoes, potatoes, orange juice etc.
* Dyazide & Aldactazide are considered to be K* sparing
* Diuretics are used to treat several disorders
* Ascites
* Hypertension
* Heart failure
* Cerebral edema
* Liver disease
*Thrombo-embolic diseases
*Thrombosis
*Is the process of clot formation
*Thrombus
*Blood clot
*Embolus
*Clot that travels through the blood vessels
* Ischemia – decreased blood supply
* Infarction- local area of tissue death
*Cont.
*Major causes
* Immobility
*Surgery
*Leg trauma
*Vaso-spasm
*Cancer
*Pregnancy
*Contraceptive agents
*Heredity
*Diseases caused by clotting within blood vessels
*anticoagulants
* Used to thin the blood and reduce clot formation
* Common side affects
* Bleeding
* Nausea, vomiting
* Prolonged bleeding time
* Bruises
* Black tarry stools
* Brownish colored urine
* Nursing precautions
* Monitor patients for bleeding & bruises during ADL cares (report immediately)
* Prevent prolonged sitting and tissue damage by careful positioning and turning
* Prevent falls, skin tears, injury
* Examples
* Coumadin
* Heparin (Warfarin)
* Platelet Inhibitors
* ASA
* Persantine (dipyridamole)
* Plavix (clopidogrel)
* Ticlid (ticlopidine)
*Coagulants
*Used to help blood form clots
*Common side affects
*Vertigo
* Flushing
*Rash
*Headache
* Leg pain/swelling
*Nursing precautions
*Monitor for leg tenderness, redness, swelling, cramping, pain
*Observe dietary intake potential interactions
*Report any chest pain or shortness of breath immediately
*Examples
*Vitamin K
*Added Treatments
*Leg exercises
*Elevating the legs
*Early ambulation
*Teds or Compression hose
*Placing of stents to reopen a artery
*Bypass grafts
*Angioplasty(balloon surgery)