Physiological Integrity- Cardiovascular Drugs

Learn how to review the most important  Cardiovascular medications for NCLEX- NextGen. For more information or for questions please visit NurseFirstNP.org

Transcript

Hey guys

And welcome to N-Deep with NCLEX NextGen Podcast

I am Dr. Nanette Spencer. I am a doctorally Prepared Family Nurse Practitioner, Nursing Tutor, and founder of NurseFirstNp an online nursing tutoring service designed to empower nursing students with the confidence and competence to pass nursing school and NCLEX. I am dedicated to teaching nursing students how to think like a nurse so they can understand nursing content not just memorize it. 
 If your looking for a nursing tutor who doesn’t just teach you what to know but also teaches you how to think like a nurse to pass nursing test in the comfort of your home, or while doing whatever it is that keeps you on the go. You are in the right place. Make sure you subscribe and leave a review. Also, feel free to leave me a message on my website NurseFirstNP.org of any content you would like me to discuss on a future podcast… I am here to serve you guys. 

Hey guys its Dr. Spencer from NurseFirstNP.  You are listening to N-Deep with NCLEX NextGen weekly videos to guide you on what to and how to study to pass NCLEX NextGen on your first attempt. 

In this weeks video, I am going to be talking about… Pharmacology… As mentioned in my last episode, me and pharmacology have a love/hate relationship. I had to take pharmacology twice in nursing school but now that I know it, it has made my nursing career so much easier while working on the floor. 

The Physiological Integrity portion of the NCLEX Next-Gen specifically addresses the pharmacological and parenteral therapies, and it accounts for 16% of NCLEX test questions. 

Okay lets talk about the heart…

Just like other medication, you want to group/memorize the medication names based off similarities in names such common prefixes or suffixes such as beta blockers all ending -lol .

 When studying these medications know what medications are used for what? 

 Although multiple blood pressure medications can be used for different things, they all have something they are better at doing than others. 

 For example, know which blood pressure medications affect cardiac output (as someone with heart failure), or blood pressure, or heart rate. 

 A trick to help you guys not fall into memorizing the content is to study pharm like your creating a care plan/ or writing a nursing diagnosis.  

 For example,

Diuretics is related to low potassium and magnesium and as evidenced by the patient experiencing muscle twitching, muscle cramping, and heart palpitations…. So forth and so on!!

Because  NCLEX is testing whether you understand the impact medications have on a patient. 

 Also when studying cardiac medications group the similarities of side effects in a drug class and then the outliers (those ones which care different from the rest). 

 For example, we all know diuretics pull fluid off which results in low potassium and sodium. But we do know there is one particular drug class that pulls fluids off but can increase the level of potassium. 

I know you want to learn everything about all the medications but in order to pass NCLEX you have to strategically study to be more proficient in what you do know…

 Side effects is a big thing when it comes to cardiac drugs because your dealing with the heart and minor side effects if not intended to can cause someone their life.

 So when studying make sure you focus on how to know if the medication is working or not working for the patient and what to do if the patient experiences a side effect or an adverse reaction.

 For medications specifically used for blood pressure such as ACEI and ARBS, calcium channel blockers, and beta blockers make sure you know which medications are best for those following a heart attack, and a stroke as well those good for stroke prevention. It also good to know which blood pressure medications are best for cardiac dysrhythmias i.e. high heart rates and low heart rates. 

 Think about what type of blood pressure medications do you not want to give to those with heart failure, heart blocks, asthma, and those with diabetes. 

 Like I said before what do you tell your patient to do if they have to take too much of a medication because it is not working. 

 For example, how do you instruct your patient to take nitroglycerin and what are some side effects you should mention to your patient. What should they do if the nitroglycerin doesn’t work after the 3rd dose. 

 As it relates to medications for cholesterol…

What are the major side effects you would want to tell your patient to monitor for? What should they do if they experience these side effects. What lab values would tell you your patient is experiencing an adverse reaction to the medication?

 If you don’t remember anything else about cardiac medications please know about anticoagulants. Why? Because if things go sideways with the medication, the patient is at higher risk for morbidity/mortality. 

 Make sure you know when the blood thinner is working or if the dosage is too much or not enough?

What patients symptoms would indicate that the blood thinner is too much or not enough?

What are the antidotes to these cardiac medications? This is really big because like I stated earlier. 

An expected side effect or adverse reaction to these medications can mean life or death for a patient. So you want to make sure you have anti-dotes readily available and know what to do if your patient experiences a reaction. 

Make sure you know when to use what? 

For example, when would a person be on coumadin vs heparin. 

Are you going to send your patient home on heparin??? 

How do you successfully wean your patient off heparin to get them to coumadin to get ready for discharge home.

What lab levels would you check to make sure the coumadin and the heparin are in therapeutic range. 

 How do you give lovenox and heparin? Intramuscular, Subcutaneously. Where would you give the injection if your patient is very thin…BMI of 18. 

 Also make sure you know how to safely administer blood. 

So lets say you get a test question stating your patient has been hemorrhaging badly from a car accident and you get an order to give blood. 

So your giving blood… 

What type of IV line do you give blood through?? Can you give medications in the same line as blood?

Which blood products would you give and why??

 Like would you give this patient whole blood, packed red blood cells, platelets. Fresh frozen plasma, or albumin.  

What patient assessments would you gather  prior to , during, and after the blood administration? 

 What would you monitor for during the blood transfusion and what patient signs/symptoms would indicate the blood transfusion is working?

Can you do it by yourself? 

How long do you have to sit with your patient after starting the blood?

 Can you delegate blood administration to your LPN or CAN on your team? 

 Who can you not give blood to based off religious issues. 

 What type of blood products would you not want to give to said patient?

Like if a patient blood pressure high vs low. Would you give that patient packed red blood cells or albumin?

 And a big one guys make sure you know what to do if your patient has an allergic reaction to the blood?

 How do you know if your patient is having an reaction to the blood, what would you do, how would you stop the transfusion, as well as who is at risk for reactions to blood transfusions?

 What’s the protocol if the nurse gets splashed with a patient’s blood?

 These are questions you should be asking yourself when study this portion for NCLEX. I want to guide you guys into thinking like a nurse because just simply remembering the information and not understanding the why is not going to get you to pass NCLEX on your first attempt.  

Remember care plans when studying pharm??

 For example, patients are at risk for bleeding as it relates to anticoagulants usage as evidenced by increase in heart rate, decrease in blood pressure, hematomas, and black tarry stools.

 These are the type of questions you need to ask yourself when reviewing anticoagulants. 

 Okay so lets say  your bleeding patient is now stable and now its time to tend to your other patients. 

 For NCLEX purposes…make sure you know how to give medications as it relates to route based off patient conditions such as age, body weight, and illness. Know the difference between intravenous medication via bolus, and intermittent intravenous infusion.  

 When it comes to IV lines… Make sure you know difference between a central line, PICC, midline and peripheral line?

 Can you give TPN through a peripheral line? Why or why not? What do you have to use instead?

Do you have to use a filter?

Also think of some  IV complications you want to monitor for such as infiltration… and What do you do if your patient experiences infiltration, phelebitis, or hematoma?

 Central lines is big one guys. Mainly because if things go wrong, it can mean life or death for the patient. And when choosing NCLEX answers as a priority make sure you key in on the answers dealing with airway, breathing, and circulation medications. 

Make sure you know how to properly care for central lines and what to do if one comes out? 

Also what type of nutrition goes through a Central IV? Does it require a filter?

 Make sure you guys know how to properly care for central lines, what goes through central lines vs peripheral lines. 

How are central lines placed and do you a certain kind of verification  prior to using a central line. 

What to do if your central line isn’t flushing or you are having a hard time getting blood return. 

Lets say your patient experienced hypovolemic shock from an extensive burn and now they are on prn pain medications via PCA. Know how to instruct your patient to use the PCA. As well as signs of overdose… like what would you want to monitor for and what are some things you may see?  

What if your patient started using the PCA and now says they don’t want it anymore. How do you waste narcotics??

Can you do it by yourself?

 Lets say that same patient now requires TPN. Make sure you know how to administer TPN, and if you need another nurse with you for verification. 

 Can you run TPN in the same line as another medication? 

Whats the difference between TPN and Enteral Feedings?  

So you can’t give medication with TPN feedings but can you give medications with nasogastric/ enteral feedings. 

Make sure you know how to administer medications through a nasogastric, or PEG tube.

What would you do if NG tube and PEG tube clogs? 

What would you check for? What are some patient complaints that may indicate the PEG tube is clogged???

 Okay guys that wraps up how to  review cardiac medications in preparation for NCLEX. I aim to not lecture you guys because I am sure you guys have had enough of that but rather guide you in how to study for NCLEX NextGen and think like a nurse. I use to hate when test questions would ask what would the nurse do in certain situations. I be like I don’t know you tell me I am not a nurse yet… So hopefully this review helps you guys think like a nurse so you can pass NCLEX Next-Gen. See you guys next week. 

 Okay guys I think you guys get the point on how to study cardiac medications in preparation for the NCLEX next-gen.  Thank you guys so much for listening, I pray that this serve as a guide to help you become more confident and competent in taking NCLEX. 

 If you have any questions or need additional clarification on topics presented in this podcast i feel free to message me on my social media handles.. there are links within the description or leave me a message me on my website NurseFirstNP.org  If your looking for one on one NCLEX tutoring that service is offered on my website as well.

 Remember, guys you don’t need to know everything to pass NCLEX NextGen just the most important things. So study with Strategy!! See you next week.