Pharmacodynamics: Exam Questions And Answers

STUDY GUIDE NR 340 EXAM TWO

*Remember: The exam questions will test more of the higher level thinking skills (analyzing, application, and evaluating) and fewer lower level (remembering, understanding), with the nursing process and QSEN application. There may be medication calculation and multiple answers.

Pharmacodynamics of medications - i.e. action/therapeutic effects, uses, and nursing implications for the following: crystalloid solutions colloid solutions hypotonic/hypertonic solutions
ACEs
ARBs beta-blockers calcium channel blockers arterior and venous vasodilators dobutamine dopamine norepinephrine vasopressin
Primacor
Aspirin nitroglycerin morphine sulfate tPA Plavix
LMWH
methylprednisolone.
Causes and treatment for elevated/decreased
Hemodynamic calculations and normal values: pulse pressure
MAP
CO
CI
stroke volume
CVP (RAP) 2-6 mmHg
Pressure created by volume of blood on right side of heart; assess fluid balance/responsiveness
Obtained through central line in vena cava, preferably through subclavian/internal jugular vein
Measure at end expiration & end of ventricular diastole
 Fluid overload, right ventricular dysfunction, superior vena cava obstruction, right heart failure, pulmonary hypertension, severe vasocontriction, mechanical ventilation
Causes jugular vein distension: To assess have pt supine w/HOB 30-45 degrees. Stand on pt’s right side, turn head to the left. Observe highest point of pulsation of internal jugular vein, measure distance between pulsation and angle of louis. Add 5cm to number. Normal 7-9cm
Treatment: Diuretics, vasodilators
 Hypovolemia from dehydration or blood loss
Treatment: IV fluids, vasopressin
RAP / SI  = RV dysfunction
RAP / SI  = Hypovolemia
RA
PVR
PAWP
SVR.
Afterload/preload findings with applications to patient conditions
Patient teaching regarding hemodynamic monitoring and ACS
Arterial pressure monitoring and pulmonary artery pressure monitoring: nursing