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1

Before deciding whether the patient receives an Alpha Blocker, what are you looking for in your assessment of the patient? pt 1

  • obtain medication history (see if their medications have an additive/antagonistic effect)
  • obtain baseline vitals (BP & HR)
  • Assess renal function as drug toxicity can occur in renal failures (assess urinary output, creatinine level
2

In the diagnosis what would prevent the nurse from using/prescribing an Alpha Blocker?

  • deficient knowledge related to drug therapy
3

What would the nurse's plan include when considering to use an Alpha Blocker on the patient?

  • Patient will verbalize side effects associated with alpha blockers
  • the patient's blood pressure will decrease to 110-140 / 60-80
4

What interventions would the nurse continue to do when administrating an Alpha Blocker?

  • monitor vital signs, if used for BP, full effect may take up to 4 weeks
  • weigh daily to observe fluid retention
  • monitor ankle edema (adverse effect of alpha-blockers)
5

What would the nurse ensure the patient understands when administering an Alpha Blocker?

  • Do NOT stop abruptly (this can cause rebound hypertension )
  • rise slowly, in stages as orthostatic hypertension can occur
  • Teach patient to weigh themselves daily and record weight
  • if there is a weight gain of more than 5 pounds in 2 days they must report it
  • They should avoid OTC cold medications (they could conatin adrenergic stimulating medications and will counteract alpha-blocker
6

Adrenergic blockade at the alpha-adrenergic receptors leads to which of the following effects?

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7

The nurse discovers that the intravenous infusion of a patient who has been receiving an intravenous vasopressor has infiltrated. The nurse will expect which drug to be used to reverse the effects of the vasopressor in the infiltrated area?

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8

A patient has a new prescription for a beta blocker as part of treatment for hypertension. The nurse is reviewing the patient’s current medication and notes that there may be a concern regarding interactions with which medication?

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9

A patient has been given an alpha-blocker as treatment for benign prostatic hyperplasia. Which instruction is important to include when the nurse is teaching him about the effects of this medication?

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10

A patient who has been taking a beta blocker for 6 months tells the nurse during a follow-up visit that she wants to stop taking this medication. She is wondering if there is any problem with stopping the medication today. What is the nurse’s best response?

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11

A patient has been taking tamsulosin (Flomax) for about a year. During today’s office visit, he asks the physician about taking a drug for erectile dysfunction. How does the nurse expect the physician to respond?

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12

When a patient has experienced extravasation of a peripheral infusion of dopamine, the nurse will inject the alpha-blocker phentolamine (Regitine) into the area of extravasation and expect which effect?

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13

When administering beta blockers, the nurse will follow which guideline for administration and initiating and monitoring?

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14

The nurse providing teaching for a patient who has a new prescription for beta₁ blockers will keep in mind that these drugs may result in which effect?

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15

A patient who has recently had a myocardial infarction (MI) has started therapy with a beta blocker. The nurse explains that the main purpose of the beta blocker for this patient is to

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16

Before intitiating therapy with a nonselective beta blocker, the nurse will assess the patient for a history of which condition?

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17

A patient is taking an alpha-blocker as treatment for benign prostatic hyperplasia. The nurse will monitor for which potential drug effects?

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18

Before deciding whether the patient receives a Beta-Blocker, what are you looking for in your assessment of the patient?

  • obtain medication history (look for medications that cause interactions)
  • assess vital signs (BP and HR, hold if Blood pressure is less than 100 systolic or heart rate less than 60)
  • assess for severe pulmonary disease (esp. w/ nonselective beta-blockers)
  • assess for history of diabetes mellitus
19

What would the nurse's plan include when using Beta Blockers?

  • the patients blood pressure will decrease to 110-140/60-80
20

What nursing interventions would the nurse use to minimize adverse effects?

  • monitor blood pressure and heart rate
  • count apical pulse for full minute to determine if HR > 60 BPM (if its less than 60 withold beta blockers AND notify the healthcare provider
  • if the patient is diabetic, monitor patient closely for signs of hypoglycemia as beta-blockers mask
21

What would the nurse ensure the patient knows when administering Beta-Blockers?

  • do not stop abruptly as this can cause rebound hypertension or potential for myocardial infarction
  • Teach patient how to check BP and radial pulse
  • rise slowly in stages to help prevent injury related to orthostatic hypotension
  • teach patient's with diabetes to monitor blood sugar more closely
  • take w/ small sip of water on morning of surgery unless instructed otherwise by surgeon
22

Before deciding whether the patient receives an ACE inhibitor or ARB , what are you looking for in your assessment of the patient?

  • blood pressure and pulse
  • assess for past history of allergy to ACE inhibors or ARBS (esp for past past angioedema)
23

What would the nurse's plan include when using ACE inhibitors

  • blood pressure will decrease to 100-1120/ 60-80
24

What interventions would the nurse continue to do when administrating an ACE inhibitor or an ARB?

  • hold ARB inhibitor or ARB if blood pressure is less than 100 systolic, or follow the parameter the healthcare provider has written on the order
  • monitor potassium level during therapy
  • monitor for S&S of angioedema -facial swelling, swollen lips, even the patient complaining that their tongue feels thick
  • monitor for dry, hacking cough (adverse effect of ACE inhibitor). If If this occurs, the patient can be switched to an ARB (the health care provider is responsible for prescribing the ARB, not the RN). ARB's have less incidence of cough but are more expensive
25

What would the nurse ensure the patient understands when administering an ACE inhibitor or an ARB?

  • avoid salt substitutes (made with potassium chloride instead of sodium chloride)
  • rise slowly in stages- orthostatic hypotension can occur
  • teach patient that if they feel like their tongue is thick, or their lips are swollen, this is an adverse effect of the medication and should be reported to the physician immediately
  • do not stop the medication abruptly as rebound hypertension can occur
  • teach patient how to take blood pressure at home and to record readings for the healthcare provider to review at follow-up appointments
26

Before deciding whether the patient receives a calcium channel blocker, what are you looking for in your assessment of the patient?

  • blood pressure and pulse (hypotension and reflex tachycardia can occur)
  • assess cardiac rhythm (contraindicated in second-and third-degree heart blocks)
  • assess for food-drug interactions (grapefruit juice, antihypertensives)
27

What would the nurse's plan include when considering to use a calcium channel blocker on a patient?

  • blood pressure will decrease to 100-120/60-80
28

What interventions would the nurse continue to do when administrating calcium channel blockers?

  • hold CCB if blood pressure is less than 100 systolic, or follow the parameter the healthcare provider has written on the order
  • monitor for fluid retentions: ankle edema, weight gain (weigh patient daily)
29

What would the nurse ensure the patient understands when administering a calcium channel blocker?

  • rise slowly in stages- orthostatic hypotension can occur
  • do not stop the medication abruptly as rebound hypertension can occur
  • teach to take blood pressure at home and record for healthcare provider to review
  • teach to weigh daily and report weight gain of 5 pounds in 2 days
30

Before deciding whether the patient receives a vasodilator, what are you looking for in your assessment of the patient?

  • blood pressure and pulse (hypotension and reflex tachycardia can occur)
  • assess for drug interactions (antihypertensives)
31

What would the nurse's plan include when considering to use a vasodilator?

  • blood pressure will decrease to 100-129/60-80
32

What interventions would the nurse continue to do when administrating a vasodilator?

  • hold vasodilators if blood pressure is less than 100 systolic, or follow the parameter the healthcare provider has written on the order
  • monitor for fluid retentions: ankle edema, weight gain (weigh patient daily)
33

What would the nurse ensure the patient understands when administering a vasodilator?

  • rise slowly ins stages- orthostatic hypotension can occur
  • do not stop the medication abruptly as rebound hypertension can occur
  • teach to take blood pressure at home and record for healthcare provider to review
  • teach to weigh daily and report weight gain of 5 pounds in 2 days