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Cardiovascular Disease (Hypertension (ACE Inhibitors (Lisinopril (Nursing…

- - - - Nursing Implications
        
        Assessment
        
        Monitor Pt's BP and pulse initially and periodically during therapy
        Assess Pt for signs of angioedema (swelling of face, extremities, eyes, lips, tongue, difficulty in swallowing or breathing)
        Monitor serum potassium. May cause hyperkalemia when combined with a high potassium diet or potassium sparing diuretic.
        Monitor weight and assess Pt routinely for resolution of fluid overload
        
        Implementations/
        Education
        
        Instruct Pt to take medication at the same time every day and not to double missed medications
        Caution Pt to avoid driving until response to medication is known
        Educate Pt to notify physician of persistent dry cough
        Advise diabetic Pt to monitor blood glucose, especially during first month, may cause hypoglycemia.
        Educate Pt to avoid excessive sodium, potassium, and alcohol consumption.
  - - - Nursing Implications
        
        Assessment
        
        Monitor Pt's BP and pulse initially and periodically during therapy
        Monitor weight and assess Pt routinely for resolution of fluid overload
        Monitor serum potassium. May cause hyperkalemia when combined with a high potassium diet or potassium sparing diuretic.
        Contraindicated to Pt with diabetes or moderate-to-severe renal impairment
        
        Implementations/ Education
        
        Instruct Pt to take medication at the same time every day and not to double missed medications
        Educate Pt to avoid excessive sodium, potassium, and alcohol consumption
        Caution Pt to avoid driving until response to medication is known
        Educate Pt to notify physician is signs and symptoms of angioedema occur (rare)
- - - - Assessment
        
        Do not administer sildenafil, tadalafil, or vardenafil within 24 hrs, may result in severe hypotension
        Assess location, duration, and precipitating factors of anginal pain
        Monitor Pt's BP and pulse initially and periodically during therapy
      - Implementations/ Education
        
        Caution Pt to avoid driving until response to medication is known
        Advise Pt to avoid concurrent use of alcohol with medication
        Inform Pt that a headache is a common SE
  - - - Assessment
        
        Monitor Pt's BP and pulse initially and periodically during therapy
        Monitor intake and output and daily weights. Assess routinely for signs and symptoms of HF (dyspnea, rales/crackles, weight gain, peripheral edema, jugular venous distention)
        Monitor ECG continuously during administration . Report bradycardia or prolonged hypertension
        Monitor serum potassium. Hypokalemia increase risk for arrhythmia
      - Implementations/ Education
        
        Instruct Pt to notify physician if HR <50 bpm
        Advise Pt to avoid large amounts of grapefruit juice
        Caution Pt to avoid driving until response to medication is known
        Educate Pt on importance of maintaining good dental hygiene and see dentist frequent to prevent tenderness, bleeding, and gingival hyperplasia
        Advise Pt to notify physician if chest pain does not improve, worsens after therapy or with diaphoresis
- - - - Nursing Implications
        
        Assessment
        
        Monitor HR and BP initially and periodically during therapy
        Monitor intake and output and daily weights. Assess routinely for signs and symptoms of HF (dyspnea, rales/crackles, weight gain, peripheral edema, jugular venous distention)
        Take apical prior to administration. If <50 bpm or arrhythmia occurs, withhold medication and notify physician
        
        Implementations/ Education
        
        Educate Pt to not stop medication abruptly, may cause life-threatening arrhythmia, hypertension, or myocardial ischemia
        Caution Pt to avoid driving until response to medication is known
        Advise Pt to notify health care professional if slow pulse, difficulty breathing, wheezing, cold hands and feet, dizziness, confusion, depression, rash, fever, sore throat, unusual bleeding, or bruising occurs
        Educate Pt medication may mask signs and symptoms of hypoglycemia
        Caution in Pt with respiratory problems (COPD, asthma), can cause bronchoconstriction
      - Monitor Pt for signs and symptoms of Stevens-Johnson syndrome
- - - - Assessment
        
        Monitor apical pulse for 1 full minute prior to administration. Withhold dose if pulse if <60 bpm in an adult.
        Monitor ECG for brachycardia or new arrhythmias throughout IV administration and 6 hr after each dose.
        Monitor for Digoxin toxicity (s&s: n/v, vision changes - yellow/ green halos). Hold medications if serum potassium <3.5. (increases risk)
        Normal range: 0.5-2 ng/mL
        Antidote:Digibind
      - Implementations/ Education
        
        Administer oral preparations 1 hours before meal or 2 hr after meal to ensure absorption.
        For IM, administration deep into gluteal muscle and massage area well to reduce painful local reactions.
        Teach Pt to take pulse prior to taking medication. Hold if <60 or >100.
        Advise Pt to avoid consuming grapefruit in large amounts or near medication administration.
- - - - Assessment
        
        Assess Pt for symptoms of stroke, peripheral vascular disease, or MI throughout drug therapy.
        Typically administered following a stent placement.
        Monitor Pt for signs of thrombotic thrombolytic purpura (thrombocytopenia, microangiopathic hemolytic anemia, neurology findings).
        Monitor bleeding time during therapy. Prolonged bleeding time is expected.
      - Implementations/ Education
        
        Advise Pt to notify health care professional if fever, weakness, chills, sore throat, rash, unusual bleeding or bruising, extreme skin paleness, purple skin patches, yellowing of skin or eyes, or neurological changes occur.