Editing Pharmacology – LPN Flashcards (section)

== Cardiovascular ==

;What is checked before giving digoxin, and when is it held?
:The apical pulse counted for a full minute. Hold and report if the rate is below 60 in an adult. Also report anorexia, nausea, vomiting, visual changes such as yellow-green halos, and unusual fatigue, which suggest toxicity.

;What is checked before giving a beta blocker such as metoprolol?
:Heart rate and blood pressure. Hold and report a pulse below 60 or a systolic blood pressure below 90 unless the provider has ordered otherwise. Teach the client never to stop the drug abruptly.

;Why must a client with diabetes taking a beta blocker be taught carefully about hypoglycemia?
:Beta blockers mask the early warning signs of tachycardia and tremor, so the client may only notice sweating or confusion. Teach the client to check the blood glucose rather than rely on symptoms.

;Which foods are encouraged for a client taking furosemide?
:Potassium-rich foods such as bananas, oranges, potatoes, tomatoes, and spinach, unless the client has kidney disease or takes a potassium-sparing diuretic. Also teach morning dosing, daily weights, and rising slowly to prevent dizziness.

;Which diuretic causes high potassium rather than low potassium?
:Spironolactone, a potassium-sparing diuretic. Teach the client to avoid salt substitutes, which contain potassium chloride, and to report muscle weakness or an irregular heartbeat. Gynecomastia is another reported effect.

;What is the sublingual nitroglycerin teaching for chest pain?
:Sit or lie down before taking it, place one tablet under the tongue and let it dissolve, and repeat every 5 minutes up to three doses. Call emergency services as directed if pain is not relieved. Expect headache and dizziness. Store in the original dark container. Never combine with erectile dysfunction drugs such as sildenafil.

;What should a client on a statin be taught to report?
:Unexplained muscle pain, tenderness, or weakness, especially with dark urine, which may signal rhabdomyolysis. Also teach avoiding grapefruit juice with simvastatin, lovastatin, and atorvastatin.