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Med/Surg Nursing II
Pharm Exam 1
Question | Answer |
---|---|
Diprivan (Propofol) is used for? What is the Mechanism & Side effects (SE)? | Sedation of a MV Pt. Mechanism: decrease anxiety -Produce amnesia NO PAIN RELIEF. SE: cardiac depression |
What are the Nursing Activities for Diprivan (Propofol)? | Monitor for SE and TE. Monitor level of sedation (Modified Ramsey Scale) |
Pavulon (Pancuronium) is used for? What is the Mechanism & SE? | Is a Neuromuscular Blocking Agent used for a Pt on a MV. Mechanism: non-depolarizing agent produces prolonged paralysis to prevent "bucking" of the ventilator ***Needs concomitant sedation & analgesia* SE: Prolonged skeletal muscle weakness |
What are the Nursing Activities for Pavulon (Pancuronium)? | Protect Pt from environment Monitor for TE/prevent side effects. Evaluate level of paralysis q4h w/peripheral nerve stimulator *"Train of Four" (ulnar nerve stimulator "how many times does thumb twitch?" |
Name 3 bronchodilators & Adjuncts for Pt's on MV. | Albuterol Atrovent (lpratropium) Mucomyst -KP says worst smell!! |
What is the Mechanism and SE of Albuterol? | Mechanism: relaxes smooth muscle SE: tachycardia, increased bp |
What is the Mechanism and SE of Atrovent (lpratropium)? | Mechanism: blocks constriction of smooth uscle SE: relatively few side effects |
What is the Mechanism and SE of Mucomyst? | Mechanism: Liquifies secretion SE: bronchospasm (usually given with bronchodilator) |
What is Beciomethasone and how is it used? | Inhaled corticosteroid |
What is Beciomethasone Mechanism and SE? | Mechanism: suppresses inflammatory response SE: increased risk for infection!! |
What lab value is monitored when giving a Pt Heparin? | PTT |
What is the therapeutic level for Heparin? | 1.5 X Control |
What is the antidote for Heparin | Protamine Sulfate (remember PMS) |
What is monitored when giving Heparin? | Monitor for HIT (Heparin Inudced Thrombocytopenia) Platelets <100,000 |
What is the average dose of LMWH lovenox ? | 1mg/kg subq q12h profalxis would be 40mg every day |
What lab value should be checked when giving coumadin? | PT/INR Therapeutic PT 1.5 X control & INR 2-3 |
how long does coumadin take before it reaches the therapeutic leve? | 36-72 hours. |
What is the antidote for coumadin? | Vitamin K (coumadin hard C sound) |
Why would Morphine be used for pulmonary edema? | It has vasodilating properties (decreases afterload) |
Why would Dopamine be used for a PE? | Vasoconstrictor. Inotropic agent to increase preload. Titrate and monitor BP. Give dopamine to increase BP if it falls under 90. |
Name two vasodilators for a PE | Nitroglycerine (venous vasodilator) Nitroprusside (arterial and venous vasodilator) |
Which drug was once known as viagra? Think about what effects it would have on the body besides the first one that pops up. Used for PAH Pulmonary HTN | Sildenafil (Revatio) Oral Phosphodiesterase inhibitor Selective pulmonary vasodilator |
What does Epoprostenol (Flolan) do? | relaxes smooth muscle in PAH |
What does Bosentan (Tracleer) do? | Vasodilator, Endothelin-receptor antagonist |
What does Nitric Oxide do? | Inhaled selective pulmonary vasodilator |
Medication used during mechanical ventilation fall into four categories. What are they? | Sedatives: benzodiazepines, barbituates, and propofol. Neuroleptics: Haldol Analgesics: Morphine (drug of choice)but if Pt can't tolerate hypotension use fentanyl (sublimaze) or hydromorphone (dilaudid). Paralytics: Succinylcholin (Anectine) |
What is the method of testing the level of paralysis? | single, tetanic, and train-of-four (TOF). TOF is most common and involves delivering four consecutive electrical stimul to the ulnar nerve (thumb twitches). |