vasovagal hypotension
TRANSCRIPT
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 1/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
NURSING HEALTH HISTORY
BIOGRAPHIC DATA:
Patient¶s name: G.T.S.S.
Address: South Bantayan, Dumaguete City
Age: 25 years old
Birth date: October 20, 1985
Civil Status: Married
Religion: Roman Catholic
Nationality: Filipino
Date and time of admission: April 17, 2011
Source of information: Patient: 60 %; S.O: 20%; Chart: 20%
Healthcare financing: Phil health
Chief complaint:
³nag huot aqng dughan og lisud e ginhawa´, as verbalized by the patient.
History of Present Illness:
Hours prior to admission the patient had work-out and afterwards he took a rest but then
experienced a sudden onset of chest tightness which was accompanied with fast and difficulty
breathing. He medicated it with his own maintenance medication but then the signs and
symptoms worsened. The patient was immediately brought to holy child and subsequently
admitted.
Past Health History:
Patient GTS had experienced childhood illnesses such as fever, mumps, colds, and
managed it with OTC medications like paracetamol and neozep. The patient had received
complete immunization, which includes 1 BCG at birth, he had 3 OPV, 3 Hep B, 3 DPT, polio
vaccine and measles. His past hospitalizations were as follows: last 2008 - admitted due to
dyspnea and last november 1010 - admitted due to hypertension with. He is not allergic to any
food, medications and other allergen. He did not experience any major accidents or injuries.
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 2/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
Family History:
Patient verbalized that maternal grandparents died due to complication of hypertension
while his paternal grandparents died due to respiratory problems. His father is also hypertensive.
His other siblings are asthmatic.
Genogram:
Legend: - Female
- Male
- Patient
N.I
A. I
N.I
44 y.o
J. I
68 y.o
P.I
9 y.o
M.I
N.I
N.I
J. I
68 y.o
J. I
68 y.o
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 3/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
Lifestyle
Patient¶s diet is composed of meat, fish and vegetables. He is an occasional drinker and
does not smoke. He also drinks coffee every morning and afternoon. he usally sleeps 7-8 hours aday. Her usual time of sleep is between 8-9 PM and wakes up at around 4 in the morning because
of hunger. he also takes naps in the afternoon. During his leisure time he would be spending it
with his wife and family.
Social Data
The patient lives in concrete house with his father, siblings, her wife and there baby. She
has a good relationship with her family and has a clean and peaceful environment. His wife is a
housewife and the primary caregiver of the patient. Patient is a graduate of engineering and pursued his career by working in a motor shop in which he was exposed with chemicals for
painting..
Patterns of Healthcare
For them also consultation to medical practitioner is effective and efficient. If they
experienced minor illnesses such as fever, colds, and cough that are not immediately relieved,
they go seek for clinical check-up or consultation in the hospital.
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 4/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
LABORATORY RESULTS
Urinalysis
The urinalysis is used as a screening and/or diagnostic tool because it can help detect
substances or cellular material in the urine associated with different metabolic and kidney
disorders
URINALYSIS April , 2011 INTERPRETATION
COLOR YELLOW Normal color of urine
TRANSPARENCY CLEAR
UROBILINOGEN NORMAL
GLUCOSE NEGATIVEKETONE +1
BILIRUBIN NEGATIVE
PROTEIN NEGATIVE
NITRITE NEGATIVE
PH 8.0
BLOOD NEGATIVE
SPECIFIC GRAVITY 1.015 Normal
LEUKOCYTES NEGATIVE
Ketones in urine can give an early indication of insufficient insulin in a person who has
diabetes. Severe exercise, exposure to cold, and loss of carbohydrates, such as with frequent
vomiting, can also increase fat metabolism, resulting in ketonuria.
MICROSCOPIC
EXAM
April , 2011 INTERPRETATION
MUCUS RARE
RBC 0 - 1
WBC 0 ± 2
EPITHELIAL CELLS FEW
BACTERIA FEW Normal
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 5/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
Complte Blood Count
The CBC is used as a broad screening test to check for such disorders as anemia,
infection, and many other diseases. It is actually a panel of tests that examines different parts of the blood.
COMPLETE BLOODCOUNT
RESULTS REF.RANGE INTERPRETATION
HEMOGLOBIN 14.8 % 15 ± 17 % Decrease
HEMATOCRIT 43.2 % 47 ± 54 % Decrease
WBC 11.7T/ cumm 5-10T/cumm Increase
RBC 5.45 4.5 - 6 Normal
DIFFERENTIAL
COUNT
NEUTROPHIL 66% 50-80% IncreaseLYMPHOCYTE 25% 20-35% Normal
MONOCYTE 7% 2-10% Normal
EOSINOPHIL 2% 0-5% Normal
PLATELET COUNT 147,000/cumm 150-400T/cumm Decrease
y Slight decrease Hemoglobin which means a decrease in amount of oxygen-carrying
protein in the blood.
y WBC may be increased with infections, inflammation
Electrolytes
It is used to screen for an electrolyte or acid-base imbalance and to monitor the effect of
treatment on a known imbalance that is affecting bodily organ function.
Electrolytes RESULTS REF.RANGE INTERPRETATION
Potassium 3.3 mmo/L 3.5 ± 5.1 Decrease
Sodium 140 mmo/L 136 ± 145 mmo/L Normal
Hypokalemia can occur if you have diarrhea and vomiting or if you are sweating
excessively. Potassium can be lost through your kidneys in urine; in rare cases, potassium may
be low because you are not getting enough in your diet.
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 6/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
THEORETICAL BACKGROUND
y Hypertension
Hypertension is the term used to describe high blood pressure.
Blood pressure is a measurement of the force against the walls of your arteries as the heart
pumps blood through the body.
Blood pressure readings are measured in millimeters of mercury (mmHg) and usually given astwo numbers -- for example, 120 over 80 (written as 120/80 mmHg). One or both of these
numbers can be too high.
The top number is your systolic pressure.
y It is considered high if it is over 140 most of the time.
y It is considered normal if it is below 120 most of the time.
The bottom number is your diastolic pressure.
y It is considered high if it is over 90 most of the time.
y It is considered normal if it is below 80 most of the time.
Pre-hypertension may be considered when your:
y Top number (systolic blood pressure) is between 120 and 139 most of the time, or y Bottom number (diastolic blood pressure) is between 80 and 89 most of the time
If you have pre-hypertension, you are more likely to develop high blood pressure.
If you have heart or kidney problems, or if you had a stroke, your doctor may want your blood pressure to be even lower than that of people who do not have these conditions.
Causes, incidence, and risk factors
Many factors can affect blood pressure, including:
y How much water and salt you have in your bodyy The condition of your kidneys, nervous system, or blood vessels
y The levels of different body hormones
You are more likely to be told your blood pressure is too high as you get older. This is becauseyour blood vessels become stiffer as you age. When that happens, your blood pressure goes up.
High blood pressure increases your chance of having a stroke, heart attack, heart failure, kidney
disease, and early death.
You have a higher risk of high blood pressure if you:
y Are African Americany Are obese
y Are often stressed or anxiousy Eat too much salt in your diet
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 7/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
y Have a family history of high blood pressurey Have diabetes
y Smoke
Most of the time, no cause is identified. This is called essential hypertension.
High blood pressure that is caused by another medical condition or medication is called
secondary hypertension. Secondary hypertension may be due to:
y Alcohol abusey Atherosclerosis
y Autoimmune disorders such as periarteritis nodosay Chronic kidney disease
y Coarctation of the aortay Cocaine use
y Diabetes (if it causes kidney damage)
y Endocrine disorders, such as adrenal tumors (pheochromocytoma, aldosteronism),thyroid disorders, and Cushing syndrome
y Medications
o Appetite suppressantso Birth control pills
o Certain cold medicationso Corticosteroids
o Migraine medicationsy Renal artery stenosis
Symptoms
Most of the time, there are no symptoms. Symptoms that may occur include:
y Confusiony Ear noise or buzzing
y Fatigue
y Headache
y Irregular heartbeaty Nosebleed
y Vision changes
If you have a severe headache or any of the symptoms above, see your doctor right away. Thesemay be signs of a complication or dangerously high blood pressure called malignant
hypertension.
Signs and tests
Your health care provider will perform a physical exam and check your blood pressure. If the
measurement is high, your health care provider may think you have high blood pressure. Themeasurements need to be repeated over time, so that the diagnosis can be confirmed.
If you monitor your blood pressure at home, you may be asked the following questions:
y What was your most recent blood pressure reading?y What was the previous blood pressure reading?
y What is the average systolic (top number) and diastolic (bottom number) reading?y Has your blood pressure increased recently?
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 8/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
Other tests may be done to look for blood in the urine or heart failure. Your doctor will look for signs of complications in your heart, kidneys, eyes, and other organs in your body.
These tests may include:
y Blood testsy Echocardiogram
y Electrocardiogramy Urinalysis
y Ultrasound of the kidneys
Treatment
The goal of treatment is to reduce blood pressure so that you have a lower risk of complications.You and your health care provider should set a blood pressure goal for you.
There are many different medicines that can be used to treat high blood pressure, including:
y Alpha blockersy Angiotensin-converting enzyme (ACE) inhibitors
y Angiotensin receptor blockers (ARBs)y Beta blockers
y Calcium channel blockersy Central alpha agonists
y Diureticsy Renin inhibitors, including aliskiren (Tekturna)
y Vasodilators
Your health care provider may also tell you to exercise, lose weight, and follow a healthier diet.If you have pre-hypertension, your health care provider will recommend the same lifestyle
changes to bring your blood pressure down to a normal range.
Often, a single blood pressure drug may not be enough to control your blood pressure, and you
may need to take two or more drugs. It is very important that you take the medications prescribedto you. If you have side effects, your health care provider can substitute a different medication.
In addition to taking medicine, you can do many things to help control your blood pressure,
including:
y Eat a heart-healthy diet, including potassium and fiber, and drink plenty of water.y Exercise regularly -- at least 30 minutes a day.
y If you smoke, quit -- find a program that will help you stop.y Limit how much alcohol you drink -- 1 drink a day for women, 2 a day for men.
y Limit the amount of sodium (salt) you eat -- aim for less than 1,500 mg per day.y Reduce stress -- try to avoid things that cause stress for you. You can also try meditation
or yoga.y Stay at a healthy body weight -- find a weight-loss program to help you, if you need it.
Your health care provider can help you find programs for losing weight, stopping smoking, and
exercising. You can also get a referral from your doctor to a dietitian, who can help you plan adiet that is healthy for you. Your health care provider may ask you to keep track of your blood pressure at home. Make sure you get a good quality, well-fitting home device.
Expectations (prognosis)
Most of the time, high blood pressure can be controlled with medicine and lifestyle changes.
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 9/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
Complications
y Aortic dissectiony Blood vessel damage (arteriosclerosis)
y Brain damage
y Congestive heart failurey Chronic kidney diseasey Heart attack
y Hypertensive heart diseasey Peripheral artery disease
y Pregnancy complicationsy Stroke
y Vision loss
Calling your health care provider
If you have high blood pressure, you will have regularly scheduled appointments with your doctor.
Even if you have not been diagnosed with high blood pressure, it is important to have your blood pressure checked during your yearly check-up, especially if someone in your family has or had
high blood pressure.
Call your health care provider right away if home monitoring shows that your blood pressure
remains high or you have any of the following symptoms:
y Chest pain
y Confusiony Excessive tirednessy Headache
y Nausea and vomitingy Shortness of breath
y Significant sweatingy Vision changes
Prevention
Adults over 18 should have their blood pressure checked routinely.
Lifestyle changes may help control your blood pressure:
y Avoid smoking. (See: Nicotine withdrawal)y Do not consume more than 1 drink a day for women, 2 a day for men.
y Eat a diet rich in fruits, vegetables, and low-fat dairy products while reducing total andsaturated fat intake (the DASH diet is one way of achieving this kind of dietary plan).
(See: Heart disease and diet)y Exercise regularly. If possible, exercise for 30 minutes on most days.y If you have diabetes, keep your blood sugar under control.
y Lose weight if you are overweight. Excess weight adds to strain on the heart. In some
cases, weight loss may be the only treatment needed.y Try to manage your stress.
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 10/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
y Asthma
Asthma is a chronic lung disease that inflames and narrows the airways. Asthma causes recurring
periods of wheezing (a whistling sound when you breathe), chest tightness, shortness of breath,
and coughing. The coughing often occurs at night or early in the morning
The airways are tubes that carry air into and out of your lungs. People who have asthma haveinflamed airways. This makes the airways swollen and very sensitive. They tend to react strongly
to certain inhaled substances.
When the airways react, the muscles around them tighten. This narrows the airways, causing less
air to flow into the lungs. The swelling also can worsen, making the airways even narrower.Cells in the airways may make more mucus than normal. Mucus is a sticky, thick liquid that can
further narrow your airways.
This chain reaction can result in asthma symptoms. Symptoms can happen each time the airwaysare inflamed.
Asthma
Figure A shows the location of the lungs and airways in the body. Figure B shows a cross-section
of a normal airway. Figure C shows a cross-section of an airway during asthma symptoms.
Sometimes, asthma symptoms are mild and go away on their own or after minimal treatmentwith an asthma medicine. Other times, symptoms continue to get worse.
When symptoms get more intense and/or more symptoms occur, you're having an asthma attack.
Asthma attacks also are called flareups or exacerbations
Causes and Risk Factors
Asthma is caused by inflammation in the airways. When an asthma attack occurs, the musclessurrounding the airways become tight and the lining of the air passages swells. This reduces the
amount of air that can pass by.
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 11/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
In sensitive people, asthma symptoms can be triggered by breathing in allergy-causingsubstances (called allergens or triggers).
Common asthma triggers include:
y Animals (pet hair or dander)y Dust
y Changes in weather (most often cold weather)y Chemicals in the air or in food
y Exercisey Mold
y Polleny Respiratory infections, such as the common cold
y Strong emotions (stress)y Tobacco smoke
Aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) provoke asthma in some patients.
Many people with asthma have a personal or family history of allergies, such as hay fever (allergic rhinitis) or eczema. Others have no history of allergies.
Symptoms
Most people with asthma have attacks separated by symptom-free periods. Some people havelong-term shortness of breath with episodes of increased shortness of breath. Either wheezing or a cough may be the main symptom.
Asthma attacks can last for minutes to days, and can become dangerous if the airflow is severely
restricted.
Symptoms include:
y Cough with or without sputum (phlegm) production
y Pulling in of the skin between the ribs when breathing (intercostal retractions)
y Shortness of breath that gets worse with exercise or activity
y Wheezing, which:o Comes in episodes with symptom-free periods in between
o May be worse at night or in early morningo May go away on its own
o Gets better when using drugs that open the airways (bronchodilators)o Gets worse when breathing in cold air
o Gets worse with exerciseo Gets worse with heartburn (reflux)
o Usually begins suddenly
Emergency symptoms:
y Bluish color to the lips and facey Decreased level of alertness, such as severe drowsiness or confusion, during an asthma
attack
y Extreme difficulty breathing
y Rapid pulse
y Severe anxiety due to shortness of breath
y Sweating
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 12/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
Other symptoms that may occur with this disease:
y Abnormal breathing pattern --breathing out takes more than twice as long as breathing iny Breathing temporarily stops
y Chest pain
y Nasal flaringy Tightness in the chest
Signs and tests
Allergy testing may be helpful to identify allergens in people with persistent asthma. Common
allergens include:
y Cockroach allergens
y Dust mitesy Molds
y Pet dander y Pollens
Common respiratory irritants include:
y Fumes from burning wood or gas
y Pollutiony Tobacco smoke
The doctor will use a stethoscope to listen to the lungs. Asthma-related sounds may be heard.However, lung sounds are usually normal between asthma episodes.
Tests may include:
y Arterial blood gasy Blood tests to measure eosinophil count (a type of white blood cell) and IgE (a type of
immune system protein called an immunoglobulin)y Chest x-ray
y Lung function testsy Peak flow measurements
TreatmentThe goal of treatment is to avoid the substances that trigger your symptoms and control airwayinflammation. You and your doctor should work together as a team to develop and carry out a
plan for eliminating asthma triggers and monitoring symptoms.
There are two basic kinds of medication for treating asthma:
y Control drugs to prevent attacksy Quick-relief drugs for use during attacks
Control drugs for asthma control your symptoms if you don't have mild asthma. You must takethem every day for them to work. Take them even when you feel okay.
The most common control drugs are:
y Inhaled corticosteroids (such as Azmacort, Vanceril, AeroBid, Flovent) preventsymptoms by helping to keep your airways from swelling up.
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 13/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
y Long-acting beta-agonist inhalers also help prevent asthma symptoms. Do not take long-acting beta-agonist inhaler drugs alone. These drugs are generally used together with an
inhaled steroid drug. It may be easier to use an inhaler that contains both drugs.
Asthma quick-relief drugs work fast to control asthma symptoms:
y You take them when you are coughing, wheezing, having trouble breathing, or having an
asthma attack. They are also called "rescue" drugs.y They also can be used just before exercising to help prevent asthma symptoms that are
caused by exercise.y Tell your doctor if you are using quick-relief medicines twice a week or more to control
your asthma symptoms. Your asthma may not be under control, and your doctor mayneed to change your dose of daily control drugs.
Quick-relief drugs include:
y Short-acting bronchodilators (inhalers), such as Proventil, Ventolin, and Xopenexy Your doctor might prescribe oral steroids (corticosteroids) when you have an asthma
attack that is not going away. These are medicines that you take by mouth as pills,
capsules, or liquid. Plan ahead. Make sure you do not run out of these medications.
A severe asthma attack requires a check-up by a doctor. You may also need a hospital stay,
oxygen, and medications given through a vein (IV).
Asthma action plans are written documents for anyone with asthma. An asthma action planshould include:
y A plan for taking asthma medications when your condition is stabley A list of asthma triggers and how to avoid themy How to recognize when your asthma is getting worse, and when to call your doctor or
nurse
A peak flow meter is a simple device to measure how quickly you can move air out of your
lungs.
y It can help you see if an attack is coming, sometimes even before any symptoms appear.Peak flow measurements can help show when medication is needed, or other action needs
to be taken.
y Peak flow values of 50% - 80% of a specific person's best results are a sign of a moderateasthma attack, while values below 50% are a sign of a severe attack.
Support Groups
You can often ease the stress caused by illness by joining a support group, where members share
common experiences and problems.
Complications
The complications of asthma can be severe. Some include:
y Deathy Decreased ability to exercise and take part in other activities
y Lack of sleep due to nighttime symptomsy Permanent changes in the function of the lungs
y Persistent cough
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 14/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
y Trouble breathing that requires breathing assistance (ventilator)
Prevention
You can reduce asthma symptoms by avoiding known triggers and substances that irritate the
airways.
y Cover bedding with "allergy-proof" casings to reduce exposure to dust mites.y Remove carpets from bedrooms and vacuum regularly.
y Use only unscented detergents and cleaning materials in the home.y Keep humidity levels low and fix leaks to reduce the growth of organisms such as mold.
y Keep the house clean and keep food in containers and out of bedrooms -- this helpsreduce the possibility of cockroaches, which can trigger asthma attacks in some people.
y If a person is allergic to an animal that cannot be removed from the home, the animalshould be kept out of the bedroom. Place filtering material over the heating outlets to trap
animal dander.y Eliminate tobacco smoke from the home. This is the single most important thing a family
can do to help a child with asthma. Smoking outside the house is not enough. Familymembers and visitors who smoke outside carry smoke residue inside on their clothes and
hair -- this can trigger asthma symptoms.
Persons with asthma should also avoid air pollution, industrial dusts, and other irritating fumes as
much as possible.
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 15/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
P HARMACOLOGY
y Iterax
Generic Name: H yd rox yzine
Indication: Treatment of anxiety, preoperative sedation, antiemetic, antipuritic,
may becombined with opioid anagesics
Drug classification: antianxiety agents, antihistamines, sedative
Mechanism of action: Competes with histamine for H1-receptor sites on effector cells in
the GIT, blood vessels, and respiratory tract
Dosage: Adult anxiety: 25mg bid-qid or 50-100mgmg at night, premed
general anesthesia 100-200mg the night before the surgerysymptomatic treatment of pruritus and allergic origin 30-
100mg/day Children 30 mos ± 15 yr 1mg/kg/day in divided doses
Special precaution: severe hepatic dysfuncti
Pregnancy risk category: C
Adverse reaction: CNS: drowsiness, agitation, ataxia, dizziness, headache, weaknessResp:wheezing GI: dry mouth, bitter taste, constipation, nausea
Derm: flushingOthers : pain and abscesses at IM site, chesttightness, urinary retention
Contraindicated to: hypersensitivity, pregnancy
Form: Tablets 10mg, Capsules 10mg, syrup 10mg/5ml,oral suspension 25mg/5ml, injection 25mg/ml
Nursing responsibilities:
Assess client for dizziness and drowsiness Assess client with kidney disease
Assess clients for allergic reactions
8/6/2019 vasovagal hypotension
http://slidepdf.com/reader/full/vasovagal-hypotension 16/16
St. Paul University Dumaguete Case Study on
College of Nursing HPN and Asthma
y Norvasc
Generic Name: Amlodipine
Indications: Alone or with other agents in the management of Hypertension,
Angina Pectoris, and Vasospastic (Prinzmetal¶s) Angina.
Drug Classification: Therapeutic: Antihypertensives ; Calcium Channel Blockers
Mechanism of Action: Inhibits the transport of calcium into myocardial and vascular
smooth muscle cells, resulting in inhibition of excitation ± contraction coupling and subsequent contraction.
Therapeutic Effects: Systematic Vasodilation resulting in decreased blood pressure.Coronary Vasodilation resulting in decreased frequency and
severity of attacks of Angina.Dosage: PO (Adults): 5-10mg once daily; antihypertensive in fragile or small patients or
patients already receiving other antihypertensives ± initiate at2.5mg/day, increase as required/tolerated (up to 10mg/day) as an
antihypertensive therapy with 2.5mg/day in patients with hepaticinsufficiency.
Pregnancy Risk Category:CAdverse Reactions: CNS: headache, dizziness, fatigue CV: Peripheral Edema, Angina,
Bradycardia, Hypotension, and PalpitationsGI: GingivalHyperplasia, Nausea. Derm:Flushing
Contraindications: Hypersensitivity; Blood Pressure <90 mmHgForm: Tab 5mg x 100¶s; 10mg x 100¶s
Nursing Responsibilities:
General Info: Monitor blood pressure and pulse before therapy, during dose titration, and
periodically during therapy, Monitor ECG periodically during prolonged therapy.Monitor intake and output ratios and daily weight. Assess for signs of CHF.
Angina: Assess location, duration, intensity, and precipitating factors of patient¶s anginal pain