ATI cardiac medications Keyla Pacheco PDF

Preview

Summary

homework...

Description

ATI NCLEX style case scenario: cardiac medications Individual Project

Learning objectives: 1. Identify how a cardiac medication will treat heart failure. 2. Discuss what laboratory tests should be checked prior to administering cardiac medications. 3. Explain any situations that the nurse should hold/stop a cardiac medication. Instructions: 1. After viewing the ATI video case studies on Heart Failure and Medication Interactions, complete the following questions using the pharmacology texts. 2. Cite your information in your answers. Include a reference section in APA format. Answers should be at least one to two paragraphs. 3. Post your completed project in the Forums section of the Reggienet course. 4. The assignment is worth 12 points. Due Friday 3/19 at 11:30pm. Heart Failure; Medication Interactions: Scenario: The nurse is caring for a client, Mr. Stone, who has developed heart failure. The nurse receives a report of hypertension and heart failure. The client has not taken his medication for hypertension or any other medications. The client reports fatigue, shortness of breath, paroxysmal nocturnal dyspnea, and recent weight gain. An electrocardiogram, chest X-Ray, and blood tests were done. The client is alert and oriented. BP 168/98, P 98, R 22. Oxygen saturation was 90% on room air; increased to 94% with oxygen at 2L per nasal cannula. In addition to a cardiac glycoside and a diuretic, the provider prescribes an ACE inhibitor to treat the client’s heart failure. Enalapril 5 mg PO is given.

1. What is the action of Enalapril? What laboratory tests should you check before giving the medication?

The action of Enalapril is to function as an Angiotensin-converting enzyme (ACE) inhibitor. Which blocks the conversion of angiotensin I to the vasoconstrictor angiotensin II. In addition, ACE inhibitors prevent the degradation of bradykinin and other vasodilatory prostaglandins. Finally, ACE inhibitors also increase plasma renin levels and decrease aldosterone levels. Resulting in systemic vasodilation (Vallerand & Sanoski, 2020). In order to secure patient safety, one needs to ask for certain labs before administering the medication ATI (2021). These include labs to determine BUN, serum creatine, and potassium levels. We monitor these levels in the blood because Enalapril may cause hyperkalemia and increase BUN and serum creatine levels (Vallerand & Sanoski, 2020). High BUN and serum creatine levels would mean the patient is experiencing renal failure. Furthermore, the nurse needs to assess the patient’s blood

pressure and pulse prior to administration and periodically 4 to 6 hours after administration, because that is the peak of action (Frandsen & Pennington, 2021, p. 608).

2. The nurse should teach the client that what over-the-counter medications can reduce the effectiveness of the ACE inhibitor? What other interactions with the ACE inhibitor should the nurse teach the client about?

Over-the-counter medications that can reduce the effectiveness of the ACE inhibitor are NSDAIS (like aspirin, ibuprofen, and naproxen). NSAIDs may cause the body to retain sodium and water, thus resulting in the ACE inhibitors not working well (Frandsen & Pennington, 2021, p. 518). However, there are other interactions with the ACE inhibitor that needs to be taught. These include the contraindication of using Enalapril with sacubitril, which can increase the risk of angioedema. Using Enalapril with diuretics increases the chances of excessive hypotension as well. Increase the risk of hyperkalemia with concurrent use of potassium supplements, potassium-sparing diuretics, or potassium-containing salt substitutes. In addition, NSAIDs and selective COX-2 inhibitors may blunt the antihypertensive effect and increase the risk of renal dysfunction (Vallerand & Sanoski, 2020).

3. Are there any situations in which you should hold/stop the medication and notify the provider?

There are several situations where you would stop the medication and notify the provider when using Enalapril. For example, when assessing the patient if there is a report for any signs of angioedema (swelling of face, extremities, eyes, lips, tongue, difficulty in swallowing or breathing) during therapy, one has to discontinue the medication, provide supportive care, and notify the provider (Vallerand & Sanoski, 2020). The same interventions have to be done if there are any signs or symptoms of neutropenia (an abnormally low count of a type of white blood cell), agranulocytosis occurs. Finally, other situations that one would hold the medication and notify the provider are if there are any signs or symptoms of a rash, dysgeusia (altered taste), or persistent dry cough (Frandsen & Pennington, 2021, p. 518).

References

Assessment Technologies Institute. (2021). Heart failure [Video]. Video Case Studies RN 2.0. https://atitesting.com Frandsen, G., & Pennington, S. S. (2021). Abrams' clinical drug therapy: Rationales for nursing practice (12th ed.). Philadelphia, PA: Wolters Kluwer Vallerand, A. H., Sanoski, C. A., & Quiring, C. (2020). Enalapril, enalaprilat. In Davis's Drug Guide (16th edition). F.A. Davis Company. https://www.drugguide.com/ddo/view/Davis-Drug-Guide/51258/all/enalapril, enalaprilat

Grading Rubric for ATI Projects Outcome

Criteria

Points

Used proper citation format Shared responsibility Checked spelling/grammar Included pharm texts Submitted on time

APA format Indicated role of each group member if group project < 3 spelling/grammar errors Included pharm texts in references Submitted by due date

3 points

Accurate and thorough responses to questions

Addressed each question and supports with citation (s) Each part of question is addressed if has multiple questions One to two paragraphs written for each of the questions

Each question is worth 3 points

Note: points will be deducted if criteria is not met....