Question

Laboratory Test Results

INR	3.6
Serum Potassium Level	5.2 mEq/L

The new Prescriptions for the client include:

• Benazepril
• Maalox
• Nifedipine
• Simvastatin
• Warfarin

A client on a medical unit has a diagnosis of atrial fibrillation. Which medications should the nurse notify the health care provider regarding the appropriateness of the orders? Select all that apply.

a) Benazepril

b) Maalox

c) Nifedipine

d) Simvastatin

e) Warfarin

For each of the medications above, state the purpose of the medication, one adverse effect, and one side effect.

Answer 1

INR:- in the result is 3.6 :- In healthy people an INR of 1.1 or below is considered normal. An INR range of 2.0 to 3.0 is generally an effective therapeutic range for people taking warfarin for disorders such as atrial fibrillation or a blood clot in the leg or lung. When the INR is higher than the recommended range, it means that your blood clots more slowly than desired, and a lower INR means your blood clots more quickly than desired.

Blood potassium level :- in the result is 5.2 mEq/L . Normal range is 3.6 to 5.2 millimoles per liter (mmol/L). A very low potassium level (less than 2.5 mmol/L ) can be life-threatening and requires urgent medical attention.

Benazepril

Purpose:- Benazepril is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. Benazepril is an ACE inhibitor and works by relaxing blood vessels so that blood can flow more easily.

Side effects:- Dizziness, lightheadedness, drowsiness, or headache may occur as your body adjusts to the medication. Dry cough may also occur. serious side effects : fainting, symptoms of a high potassium blood level (such as muscle weakness, slow/irregular heartbeat).

Maalox

Purpose:-This medication is used to treat the symptoms of too much stomach acid such as stomach upset, heartburn, and acid indigestion. Aluminum and magnesium antacids work quickly to lower the acid in the stomach.

Side effects:- This medication can cause nausea, constipation, diarrhea, or headache, symptoms of low phosphate: (loss of appetite, unusual tiredness, muscle weakness). serious side effects :black/tarry stools, slow/shallow breathing, slow/irregular heartbeat, mental/mood changes (e.g., confusion), deep sleep, pain with urination, stomach/abdominal pain, vomit that looks like coffee grounds.

Nifedipine:

Purpose:-Nifedipine is a medicine used to treat high blood pressure. Taking nifedipine helps to prevent future heart disease, heart attacks and strokes.Nifedipine is also used to prevent chest pain caused by angina. Occasionally, it's used to treat Raynaud's phenomenon and chilblains.

Side effects:-The most common side effects include headache, flushing, constipation, feeling tired and swollen ankles. Do not eat grapefruit or drink grapefruit juice while you're taking nifedipine. It can make side effects worse.

Nifedipine isn't suitable for some people.

• have had an allergic reaction to nifedipine or any other medicine in the past
• are trying to get pregnant, are already pregnant or you are breastfeeding
• have liver disease
• have any heart problems (other than high blood pressure), including a recent heart attack, heart failure or unstable angina
• have diabetes.

Simvastatin

Purpose:- Simvastatin is used along with a proper diet to help lower "bad" cholesterol and fats (such as LDL, triglycerides) and raise "good" cholesterol (HDL) in the blood. It belongs to a group of drugs known as "statins." It works by reducing the amount of cholesterol made by the liver. Lowering "bad" cholesterol and triglycerides and raising "good" cholesterol decreases the risk of heart disease and helps prevent strokes and heart attacks.

Additional lifestyle changes that may help this medication work better include exercising, losing weight if overweight, and stopping smoking.

Side effects:- Many people using this medication do not have serious side effects. Rare effects :-mild memory problems or confusion.

Warfarin

Purpose:- This medication is used to treat blood clots (such as in deep vein thrombosis-DVT or pulmonary embolus-PE) and/or to prevent new clots from forming in your body. Preventing harmful blood clots helps to reduce the risk of a stroke or heart attack. Conditions that increase your risk of developing blood clots include a certain type of irregular heart rhythm (atrial fibrillation), heart valve replacement, recent heart attack, and certain surgeries (such as hip/knee replacement). Dosage is based on your medical condition, laboratory tests (such as INR), and response to treatment.

Side effects:- Nausea, loss of appetite, or stomach/abdominal pain may occur. This medication can cause serious bleeding if it affects your blood clotting proteins too much (shown by unusually high INR lab results). So this should be notified to the doctor.