chemo & heart drugs chemo drugs and heart drugs

January 24, 2018 Off By admin
Question Answer
unusually rapid, uncontrolled cell growth and division and impairs nutrients to normal tissue malignancy
travel of malignant cells from original site to adjacent tissues or distant parts of the body metastasis
original site of cancer in the body primary site
site the malignant cells have traveled from primary site secondary site
tumors or abnormal growths; can be malignant or benign neoplasms
drugs used to tx malignant diseases by slowing cell growth or delaying the spread of malignant cells chemotherapy
what normal, rapidly dividing and growing cells does chemo also affect GI tract, bone marrow, hair follicles, lymph tissue, mouth, testes, ovaries
what percentage of the first chemo regime theoretically kills cancer cells 90%
used in combination or alone/often c radiation antineoplastic agents
agents that interfere with cell division alkylating
preparations not used as antiinfectives antitumor antibiotic
affect cell metabolism antimetabolites
cancerous cells that have the ability to travel throughout the body, spreading into other areas, are what metastasis
antibiotic preparations work in the treatment of cancer by preventing or delaying cell division
administration of this may counteract chemo's adverse effect of nausea antiemetic
bone marrow depression is commonly seen after chemo and may result in this complication infection
administration of chemo requires the LPN to adhere to what specific state and institutional scope of practice policies and undergo specialized training
the patient has undergone a mastectomy for breast cancer. in addition to chemo treatment, she will require this physical therapy for muscle strengthening
an elderly male patient receiving leuprolide (Lupron) for treatment of prostate cancer. this agent is prescribed for its what hormonal activity
a female pt w/lymphoma has undergone chemo tx. to reduce serum uric acid levels, the Dr. will prescribe allopurinol (Zyloprim)
a photosensitizing agent used in the tx of esophageal cancer is profimer (Photofrin)
a drug classified as a misc agent that may be used in the tx of hep. B/C and some forms of cancer is interferon alfa-2b (Intron A)
interferes with the normal process of cell division in both malignant and normal cells alkylating agents
delays or prevents cell division of the malignant cells antibiotics
disrupts normal cell functions; most effective in the cells that are most rapidly dividing antimetabolites
counteracts the effect of sex hormones used by the tumors male and female hormones
directly interferes with or stops cell division mitotic inhibitors
list four adverse reactions seen with almost all antineoplastics nausea vomiting anorexia diarrhea
the initial dose of antineoplastic medications is often calculated precisely for the pt's weight
cisplatin (platinol-AQ) is used to treat advanced bladder cancer and some mestastic testicular and ovarian tumors
cite 3 geriatric considerations for adverse reactions to antineoplastics encourage fluids, monitor strength, do not become overly exhausted
adverse reactions to chemo N/V/D, anorexia, wt loss, stomatitis, alopecia, bone marrow depression, sterility
4 types of adverse reactions to bone marrow depression leukopenia, thrombocytopenia, anemia, pancytopenia (all 3)
nurse assessment for chemo drugs VS, wt, hydration level, mood
cbc, platelets, LFT lab results
response to drug and SE
nursing diagnosis for chemo drugs imbalence nutrition, D, fluid volume, impaired oral muc membranes, risk of infection, anxiety, knowledge deficit
nursing planning for chemo drugs dose mg/kg body wt, monitor lab results and report as needed, let pt discuss feelings
nursing implementations and eval for chemo drugs safety hazards in preparations, administer antimetic, pain meds, and additional hydration per dr order, skin and oral care, S/S to report
SA node bpm 60-100
AV node bpm 40-60
purkinje fibers bpm 20-40
order of heart conduction pathway SA node-AV node-Bundle of His-Rt and Lt Bundle Branches-Purkinje Fibers
known as the 'pacemaker' of the heart SA node
which type of medication is indicated for a pt with hypertension peripheral vasodialater
nitroglycerin is a drug of choice for pts who have angina pectoris
old topical nitroglycerin ointment should be removed when before the new ointment is applied
which drugs are used to treat premature ventricular contractions digoxin lidocaine
what is an undesirable effect of antidysrhythmic medications bradycardia
what antihyperlipidemic agent is taken once daily in the evening simvastatin (Zocor)
cardiotonic medications act by directly stimulating the myocardium
what is digoxin immune Fab (Digibind) used for digoxin toxicity
it works by lowering the blood levels of digoxin
the negative chronotropic side effect in pts receiving digoxin is evidenced by decreased heart rate
when thiazide and loop diuretics are administered, the pt should be monitored for low potassium levels
what types of foods would a pt with hypokalemia need to consume high potassium foods like bananas and citrus fruits
what medication would a pt admitted to the er for CHF be ordered to take digoxin
what color might the urine be of a pt taking phenazopyridine for a UTI orange or red
adverse effect of quinidine tinnitus
lidocaine may be used for treating which type of dysrhythmia life-threatening dysrhythmias
primarily an antidysrhythmic drug verapamil
a nitrate compound that is used therapeutically to abort acute attacks of angina pectoris nitroglycerin
vasodilators play an important role in the tx of what (3) prevention and tx of angina due to coronary heart disease, peripheral vascular disease, hypertension
the effects of nitrates, CCB, and peripheral vasodilators on smooth muscle relax smooth muscles on the blood vessel walls, and help to provide more oxygen supply
two types of nitrate medication nitro
isosorbide dinatrate (Isordil)
two types of CCB medication verapamil (Calan)
diltiazem (Cardiazem)
one type of PV vasodilator medication hydralazine (Apresoline)
which antianginal meds are most often given sublingually nitro, isosorbide dinitrate, isosorbide mononitrate, ranolazine
under what circumstances are nitroglycerin given via IV severe angina in acute MI, severe angina during heart surgeries such as cardiac catheterization, ICU or CCU with cardiac monitoring for severe hypertension
adverse effects of antoanginal and PV medications flushing, postural hypotension, tachycardia, confusion, dizziness, vertigo, HA, weakness, Pruritus, N/V, burning mouth, dysrhythmias, allergic reactions
what changes should be made to medication if pt develops nitrate tolerance after prolonged use alternate diff types of coronary vasodilators (nitro-CCB-PV), transdermal-remove patch every 12-24 hours to reduce tolerance
S/S of digitalis toxicity bradycardia, N/V, visual changes
what is the therapeutic blood level for digoxin 0.5-2.0 ng/mL
what should pts be taught to do if they suspect dig toxicity call doctor
what type of lung sounds may indicate CHF crackles
what is a common loading dose of digoxin 0.5-1 mg 2x day
what should the nurse do if she suspects dig toxicity hold the dose and call doctor
what should a nurse do before giving digoxin take apical pulse for 1 minute
S/S of CHF edema, JVD, wt gain, cough, SOB, xtra fluid builds up in lungs and tissue, bllod backs up in chambers of heart, decreased CO, ventricular failure
what serum drug level is considered toxic for digitalis >2.5 ng/mL
patients taking digoxin should eat foods rick in potassium
the nurse should hold digoxin for a heart rate less that what 60 beats per minute
what type of visual changes occur with dig toxicity yellow green
what is the typical maintenance dose of digoxin 0.125mg-.25mg daily
what time should you tell pts to take their digoxin same time every day
5 types of hypertensive drugs diuretic, adrenergic inhibitors, ACE inhibitors, calcium channel blockers, vasodilators
what is the action of ACE inhibitors prevents formation of angiotensin II, a vasoconstrictor, prevents release of aldosterone, renin released
side effects of ACE inhibitors hyperkalemia, dry, harsh hacking unproductive cough, edema
name two ACE inhibitor drugs captopril
benazepril
2 types of angiotensin-related agents ACE inhibitors
Angiotensin II receptor antagonist
what is the action of Angiotensin II receptor antagonists blocks angiotensin II receptor sites in tissues, a vasoconstrictor, vasodilates to decrease blood pressure
name 2 Angitensin II receptor drugs irbesarten
losartan
adverse reactions to hypertensive agents orthostatic hypotension, hypokalemia, drowsiness, impotence, bradycardia, vertigo, constipation (CCB), cough (beta blockers)
what is the action of Vasodilators relax smooth vascular muscle, decrease peripheral vascular resistance
name 2 vasodilator drugs hydralazine
minoxidil
what is the action of Calcium Channel Blockers blocks extracellular Ca+ movement thru cell membrane in cardiac, vascular, and smooth muscles, vasodilates vasculature to decrease BP
name two types of CCBlocker drugs nifedipine
verapamil
side effects of CCB constipation, hypotension, bradycardia
3 types of diuretics thiazide/sulfonimide, loop, potassium sparing
what is the action of thiazide/sulfonimide diurectics work to prevent reabsorption of Na+ and chloride thru direct action on the distal end of the loop of Henle
what is the action of loop diuretics works @ascending/proximal loop & distal tubules to excrete Na, Cl, and water
what is the action of potassium-sparing diuretics increase the excretion of water and sodium, but not potassium
action of fluid and electrolytes provide calories, minerals, and electrolytes: Na, K, Cl, Ca, Ph
uses of fluid and electrolytes NPO pt, D/V, bowel obstruction, fever
S/S of dehydration weight loss, dry skin, lack of sweat, dry mucous membranes, decreased UO, hypotension, tachycardia
name a urinary tract analgesiac phenazophridine
does a urinary tract analgesiac cure a UTI NO, it does nothing for the infection
what is benign prostatic hyperplasia enlargement of the prostate gland
how long does BPH drugs take to see desired response 6-12 months
S/S of K+ depletion leg cramps, anorexia, confusion, N/V, and canlead to heart dysrhythmias
disturbance in electrical conduction system of the heart: can be fast, slow, irregular or regular dysrhythmia/arrhythmia
causes of dysrhythmias MI, electrolyte disturbances, booze, nicotine, stress, hypoxia
how many classifications of antidysrhythmics 4
uses of CCB angina, HTN, prevent post MI complications
adverse reactions to Nitrates HA, hypotension, flushing, vertigo
how to you store nitrates dark bottle, cool place
how long till nitrates lose potency 3-6 months
uses of Peripheral Vasodilators tx of PV disease- like raynauds, intermittent claudication, HTN, CVA/TIA
adverse reactions to Peripheral Vasodilators decrease BP, tachycardia, HA, weakness, confusion, nervousness, rash
action of sodium channel blockers lengthen time cells can't fire, decrease excitability in heart
common sodium channel blocker drug lidocaine HCL B
adverse effects of Na+ channel blockers D/N/V (quinidine) decrease BP, tinnitus, blurred vision
action of beta andronergic blockers decrease sympathetic excitation to heart by blocking beta receptors
adverse effects of beta blockers bradycardia, orthostatic hypotension, increase S/S of CHF, edema
most common beta blocker drug propranolol HCL NS (non-selective)
action of potassium channel blockers lengthens the time the electrical impulse is in one cell
adverse effects of potassium channel blockers N/V, orthostatic hypotension, dizziness, blue gray skin discoloration
name two K+ channel blocker drugs amiodarone
sotalol
prolongs the cell resting period action of CCB
waxy sterol produced in the liver
>200mg/dl
cholesterol
neutral fats found in highest level in humans
>140-160mg/dl
triglycerides
what are cholesterol and tryglycerides carried by in the body lipoproteins
what is hyperlipidemia increased serum levels of cholesterol
what is LDL low-density lipoproteins
bad guys
what is HDL high density lipoproteins
good guys that clear out bad guys
inhibits HMB-COA enzyme required for synthesizing cholesterol HMB-CoA inhibitors
HMB-CoA inhibitors end in this –statin
uses of statins powerful and effective tx of high cholesterol and tryglycerides, slows atherosclerosis
adverse reactions to statins C/D/N/V, abd distension, increase LFT
most common statin drug atorastatin
(lipitor)
action of fibric acid derivatives increase enzyme lipase to breakdown cholesterol
uses of fibric acid derivatives decrease cholesterol and tryglycerides
adverse reactions to fibric acid derivatives hepatoxicity, cholelithiasis (GB stones), abd pain, D
2 fibric acid drugs gemfibrozil
fenofibrate
action of bile acid sequestrants binds bile acids in the intestine, less to bind and form cholesterol, excreted in bowels
uses of bile acid sequestrants decrease cholesterol levels
adverse reactions of bile acid sequestrants constipation, bloating, farts, nausea
teaching of bile acid sequestrants 3-4x day, ac meals, powder-dissolve slowly, full glass of water
2 bile acid drugs colestipol
cholestyramine
action of niacin same as bile acid sequestrats, least expensive, underused
adverse reactions to niacin flushing , can be taken with aspirin to help flushing
action of selective cholesterol absorption inhibitors new category of drug, inhibits absorption of cholesterol in small intestine
adverse reactions to selective cholesterol absorption inhibitors inflammation of gallbladder and gallbladder stones
can selective cholesterol absorption inhibitors be taken with statins yes
important nursing care and teaching of antihyperlipidemic drugs do not take with other meds, increase fiber, 6-8 glasses water per day, no OH, smoking r/t risk for coronary artery disease
do loop diuretics deplete K+ yes
most common loop diuretic furosemide
most common K+ sparing diuretic spironolactone
drugs ending in-olol andrenergic inhibitor beta blockers
action of andrenergic inhibitor beta blockers plugs receptor sites (non-selective), plug receptor site (selective), check BP and pulse before giving
are andrenergic beta blockers selective yes
are andrenergic beta blockers non-selective yes
sympathetic outflow from the brain is decreased resulting in vascular relation and lowering of BP central inhibitors
adverse reaction of Central Inhibitors dry mouth, sexual dysfunction, fatigue
action of alpha-1 andrenergic blockers relaxation of arterioles/venules-vasodilation
side effects of alpha-1 andrenergic blockers syncope with 1st dose, ortho hypo,
when is the best time to take alpha-1 andrenergic blockers at bedtime-less likely to faint
action of andrenergic inhibitors-combo alpha & beta blockers selective alpha 1 vasodilation
non selective beta cells-plugs beta1 heart & beta2 lungs
what is the cardiac output formula CO=stroke volume x heart rate
what is stroke volume amount of blood circulated by the heart with each beat