Pharm Cardio/Hem Meds

Cardiovascular and Hematologic Medications

Heather Miller, RN, BSN

Objectives

• Explain the expected therapeutic effects of cardiovascular and hematologic medications.

• Summarize the pharmacological action of cardiovascular and hematologic medications.

• Monitor for common adverse effects of cardiovascular and hematologic medications.

• Apply the concept of safe medication administration and dosage calculation when administering cardiovascular and hematologic medications.

• Reinforce client education regarding cardiovascular and hematologic medications.

• Determine if the cardiovascular and hematologic medications are appropriate for the client.

• Monitor for potential interactions that can cause adverse or life-threatening effects when administering cardiovascular and hematologic medications.  

Cardiovascular System

Cardiac Disorders

• Hypertension

• Congestive heart failure (CHF)

• Coronary artery disease (CAD)

• Myocardial infarct (MI)

• Dysrhythmias

Dropdown

Medications that cause vasoconstriction cause ​

Select answer

pressure, while medications that cause vasodilation cause ​

Select answer

pressure.

Hypertension

Multiple Choice

The best description of how an antihypertensive works is that they:

• promote workload of the heart

• vasodilate vessels to reduce pressure

• increase angiotensin produciton

• increase reabsorption of sodium in the nephron

Antihypertensives

• ACE inhibitors (-pril)

• Beta blockers (-olol)

• Ca⁺ Channel blockers

Poll

To avoid symptoms associated with orthostatic hypotension, the nurse advises the client to ____________.

• sleep in a side-lying position

• avoid sitting for prolonged periods.

• change position slowly

• get up from a sitting position quickly

Dropdown

Nifedipine extended-release tablets are prescribed. The client has an NG tube. The nurse should ​ ​

Select answer

Congestive Heart Failure

Diuretics

• HCTZ

• Furosemide

• Spironolactone

Digoxin

Foods High in Potassium

• Tomato sauce (can) - 909 mg

• Spinach (cooked) - 839 mg

• Prunes (dried) - 828 mg

• Banana - 594 mg

• Brussels sprouts - 504 mg

• Raisins - 1089 mg

• Baked potato - 1081 mg

Cardiac Glycoside

• Digoxin

Multiple Choice

When administering spironolactone, the nurse monitors the client for which of the following electrolyte imbalances?

• Hypernatremia

• Hyponatremia

• Hyperkalemia

• Hypokalemia

Multiple Choice

The nurse is seeing a client in the clinic 1 week after starting a diuretic. Which of the following data would indicate the client in not taking the diuretic?

• Serum potassium 3.0 mEq/mL

• Urine output 200 mL in 2 hours

• Blood pressure 130/90 mm Hg

• Weight gain of 4 lb

Multiple Choice

The nurse suspects a client is experiencing digoxin toxicity. Which of the following symptoms would the nurse expect to observe?

• Insatiable hunger

• Constipation

• Halo in vision field

• Muscle cramping

Myocardial Infarction

Antilipemics & Nitrates

• Atorvastatin (-statin)

• Nitroglycerin

Poll

A prescription for sublingual nitrate is to be faxed to the client's pharmacy for his heart condition. Which of the following medications on his profile would prompt the nurse to notify the provider first?

• Cimetidine

• Ibuprofen

• Lisinopril

• Sildenafil

Cardiac Dysrhythmias

Antidysrhythmics

• Amiodarone

• Verapamil

Multiple Choice

Common adverse reactions of the antiarrhythmic drugs include _________.

• lightheadedness, hypotension, and weakness

• headache, hypertension, and lethargy

• weakness, lethargy, and hyperglycemia

• anorexia, GI upset, and hyptension

• Anemia

• Deep vein thrombosis (DVT)

• Stroke/TIA

• Neutropenia

​

Hematologic Disorders

Vitamins/Mineral

• Iron Preparations

  • Ferrous Sulfate

• Vitamin B12/Cyanocobalamin

• Thrombolytics

  • Alteplase (tPA)

• Antiplatelets

  • Clopidogrel

• Anticoagulants

  • Heparin

  • Enoxaparin

• Vit K Inhibitor

  • Warfarin

Coagulation

• Erythropoietic

  • Epoetin alfa

• Leukopoietic

  • Filgrastim

Growth Factors

Poll

A patient receiving a continuous IV heparin infusion for a pulmonary embolism develops sudden bleeding from the injection site and increased bruising. Which medication should the nurse anticipate administering to reverse the effects of heparin, and what is a critical nursing consideration during its administration?

• Vitamin K; monitor for signs of thrombosis

• Protamine sulfate; administer slowly and monitor for allergic reactions

• Fresh frozen plasma; check for fluid overload

• Calcium gluconate; monitor heart rate closely

Multiple Choice

Optimal INR during warfarin therapy is ______

• more than 5

• less than 1

• between 1.8 and 2

• between 2 and 3

Multiple Choice

The clinic nurse prepares teaching materials to give a client using warfarin. Which statement would cause her to contact the provider immediately?

• "I noticed my bowel movements were black yesterday."

• "I ordered a medical alert bracelet."

• "My mother died of a stroke."

• "A nutritious meal will make my blood better."