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pharmNR130 final
pharm NR130final
| Question | Answer |
|---|---|
| 1. Identify priority nursing interventions prior to the administration of digoxin (Lanoxin) | Check apical pulse for 1 full minute. For apical pulse less than 60 or greater than 100 beatsper min hold dose, notify dr. (dig level 0.5-2), Baseline VS., Heart sounds, breath sounds, Weight,I/O,ECG, |
| 2. Identify the interaction of digoxin with potassium | Increases Dig Toxicity with hypokalemia & hypomagnesemia, Causes life threatening cardiac dysrhythmias and dig overdose.in severe digoxin overdose, hyperkalemia or a higher than normal level of potassium in the bloodstream can occur |
| 3. Identify adverse effects of milrinone | Ventricular Dysrhythmias, vision (yellow halos) HA, weakness, malaise, heart block, drowsy. not first line for HF, monitor ECG |
| 4. Identify how the nurse would evaluate for therapeutic responses to inamrinone | Increased urinary output, Decreased edema, SOB, Dyspnea, Crackles, fatigue, Improved peripheral pulses, skin color, temperature, HF drug, Phosphodiasterase inhibitor, increases intracell CA to increase contraction |
| 5. Identify indication for administration of Lidocaine | Acute Ventricular Arrhythmias during cardiac surgery or MI, Class I Antiarrhythmic that blocks sodium channels in cell membrane during action potential; given b4 Lidocaine, toxic effects confusion restlessness |
| 6. Identify priority nursing interventions prior to the administration of adenosine (Adenocard) | ECG monitor, emergency equipment incl defibrillator, educate pt. CV, Respiratory, VS., renal/liver function, no smoking, allergies, neuro status, Supravent tachycardia, Short half life,stops heart IV – anticubital or higher administration |
| 7. Identify indications for administration of diltiazem (Cardizem) | Essential HTN, angina, arrhythmias (A-fib, A-flutter), also used for migraine, Reynauds, Smooth muscle relaxant that decreases BP, Cardiac workload, & Myocardial oxygen consumption, Too much firing of HR causes A-fib or A-flutter |
| 8. Describe the process of application for topical nitroglycerin | Use gloves, Remove old patch and wash area before placing new patch (prevents severe hypotension), Rotate sites, don’t massage |
| 9. Identify client education measures related to the administration of sublingual nitroglycerin | subling under tongue,3 tabs every 5 mins & call 911,should fizzle effect,brown bottle/no sun,Taper slowly, Monitor BP/Pulse B4 each dose, do not give if BP<100, Safety,lie or sit after, help w/ambulation,tachycardia & syncope, Avoid Alcohol |
| 10. Identify nursing interventions for common side effects of calcium channel blockers | Dizziness,fatigue, HA,Flushing, rash, Bradycardia, Change positions slowly, safety measures. Most freq s/e is edema in extremities,with meals,increase fiber & fluid for constipation, nutrition& exercise, Decreases contractility,& demand for O2 |
| 11. Identify education measures related to administration of metoprolol (Lopressor) | Change positions slowly, Hold if HR <60 and BP <100, Take with food for GI upset, adhering to med &Do not stop abruptly(rebound htn), Diet modification, exercise, Monitor BP/Pulse, masks hypoglycemia, Monitor diabetic pts for tachycardia, Safety |
| 12. Identify adverse reactions related to carvedilol (Coreg) | Non selective BB good for HF but not so good for Htn, decreases HR & Vasodilates, Drops HR & BP fast: Dizziness, Vertigo, fatigue, decreased exercise intolerance, Bradycardia, hypotension, Gastric pain, flatulence, Impotence, Bronchospasm, Dyspnea, Cough |
| 13. Identify the drug(s) of choice given to diabetic clients with hypertension | Ace Inhibitors (prils), First dose effect - syncope |
| 14. Identify common side effects of antihypertensive therapy | Hypotension, sedation, sexual dysfunction, BB have lung effects like bronchospasm CCB – bradycardia, peripheral edema, constipation, BB – bradycardia, decreased AV conduction, reduced cardiac contractility, bronchoconstriction |
| 15. Identify side effects of sodium nitroprusside (Nipride) (vasodilator) | Cyanide Toxicity apprehension, HA,retrosternal pressure, palpitations, Bradycardia, Diaphoresis, N/V, abdominal pain, Irritation @ injection site, Interferes with glucose, Decreases BP for hypertensive crisis |
| 16. Identify common side effects of quinapril (Accupril) | Most common w/ACE inhibitors is cough, Taste impairment, Dizziness, HA, tachycardia, MI, Hyperkalemia, Neutropenia, Rash, pruritis, GI irritation, Peptic ulcers, proteinuria |
| 17. Identify drug-drug reactions related to lisinopril (Prinivil) | Allopurinol, probenecid, NSAID, digoxin, lithium |
| 18. Identify education measures related to warfarin (Coumadin) | Do not alter intake of dark leafy green veggies (vit K rich foods), Monitor for bleeding& platelet count, routine labs (PT/INR), Small freq meals for GI upset,Safety–electric razor, soft tooth brush, Pressure dressing for invasive procedure, |
| 19. Identify adverse effects of heparin | Heparin induced thrombocytopenia (decreased platelets), Bruising, Bleeding –signs of bleeding: decreased BP, tachycardia, edema d/t low oncotic pressure, Abdominal cramps, Loss of hair, chills, fever, osteoporosis, renal suppression |
| 20. Identify antidotes for Heparin and Warfarin (Coumadin) | Coumadin – Vitamin K Heparin – Protamine Sulfate |
| 21. Identify normal values for PT/INR and aPTT | PT: 10-12 seconds, INR: 1-2 , aPTT– 30-40 secs |
| 22. Identify herbal supplements to be avoided while on Warfarin (Coumadin) | Avoid: Capsicum pepper, garlic, ginger, gingko, ginseng, feverfew |
| 23. Identify measures to minimize effects of niacin | Low cholesterol diet, take 4-6 hrs after bile sequestrant, night time to maximize effectiveness, Fluids for uric acid crystals, low dose aspirin to help, Associated with cutaneous flushing, nausea, abd pain and increases serum level of uric acid |
| 24. Identify client education related to administration of cholestyramine | Low cholesterol diet, Take meds with drug-drug interactions 4-6 hrs before bile sequestrant, Mix powder in fluids –anything not carbonated or grapefruit!, Do not crush/chew tablets, Give before meals, Bowel program to prevent constipation |
| 25. Identify adverse effects of atorvastatin (Lipitor) | Myopathy (Muscle aches) that can lead to rhabdomyolysis, headache, Rash, Mild transient GI - Flatulence, abdominal pain, cramps, constipation, Acute renal failure, Liver failure |
| 26. Identify therapeutic responses to vasopressin (diabetes insipidus) | Help increase water absorption causing increased BP, increased blood volume, & increased strength of Cardiac muscle contractions; Increase BP for severe hypotension and shock, increases urine specific gravity |
| 27. Identify client education measures related to somatropin | Routine monitoring of height & weight, Discontinue when epiphyses close, Proper admin of SQ/IM injections (done at night), Proper needle disposal, Refrigerate med, Comfort measures for muscle pain (pharm/non-pharm ie turning, pillows) |
| 28. Identify contraindications to thyroid replacement therapy | Hypersensitivity, Acute thyrotoxicosis, recent MI, Caution w/lactation, DM, adrenal insufficiency |
| 29. Identify adverse effects of levothyroxine (Synthroid) | Cardiac Dysrhythmias most significant a/e, Tachycardia, palpitations, hypertension, tremors, HA, anxiety, increased bone reabsorption, hair loss in children, weight loss, heat intolerance |
| 30. Identify dietary education related to propylthiouracil (PTU) | Avoid foods high in iodine –seafood, soy sauce, tofu, iodized salt |
| 31. Identify drug-drug reactions related to levothyroxine (Synthroid) | Cholestyramine – take 2 hrs apart, Oral coagulants – effectiveness increased-increasing bleeding; lower coag dose, Digitalis – decreased effectiveness,Theophylline, BB, statins, iron salts, estrogen, protease inhibitor, sulcralfate, No grapefruit juice |
| 32. Identify administration recommendations for levothyroxine (Synthroid) | Take in morning before breakfast. 30-60 minutes prior |
| 33. Identify onset, peak and duration of various insulins Humalog | <15 mins 30-90 mins 2-5 hrs |
| 33. Identify onset, peak and duration of various insulins Novolog | 15 mins 1-3 hrs 3-5 hrs |
| 33. Identify onset, peak and duration of various insulins Regular | 30-60 mins 2-4 hrs 8-12 hrs |
| Identify onset, peak and duration of various insulins NPH | 1-1.5 hrs 4-12 hrs 24 hr |
| Identify onset, peak and duration of various insulins | Lantus 60-70 mins None 24 |
| 34. Identify early signs of hypoglycemia | Pallor, trembling, diaphoresis, change in LOC, tachycardia, weakness, numbness, tingling, dizziness, HA, blurred vision, |
| 35. Describe technique for administering mixed doses of insulin | CLEAR BEFORE CLOUDY Draw up clear (regular/short acting) before cloudy (NPH), inject SQ, no aspiration. Preferred site abdomen |
| 36. Identify recommendations for the administration of glyburide | No Alcohol, 15-30 minutes b4 meals, do not skip meals, Lower doses for elderly |
| 37. Identify priority nursing interventions related to hypoglycemia | Schedule procedures early in AM, Be aware of med peak, onset & duration, Advocate for adjustment of medication, Give fruit juice, soda or glucose immediately |
| 38. Identify side effects of methylprednisolone (Solumedrol) | Fat redistribution – moon face, buffalo hump, Increased toxicity in African Americans, Vertigo, HA, hypotension, shock, sodium/water retention, Amenorrhea, Increased appetite, weight gain, increased glucose, Immunosuppression, impaired wound healing |
| 39. Identify mechanism of action of metformin (Glucophage) | Decreases hepatic glucose production and increases the uptake of glucose, Decreases absorption of glucose, sensitizes insulin receptors at sites in fat & skeletal muscles |
| 40. Identify cautions/contraindications related to the administration of glipizide (Glucotrol) | Allergies to sulfas, type 1 diabetics, pregnancy/lactation, ketoacidosis, severe infection, renal or hepatic disease, major surgery |
| 41. Identify education measures related to the administration of iron supplements (po/liquid) | Give pt straw-stains teeth, no meals that with milk, eggs, coffee or tea, Stool dark or green, Constipation–incr fluid/ fiber, Iron rich diet– Liver, eggs, meat, fish & fowl, Take vitamin C to promote absorption, Do not give with antacids or tetracyclines |
| 42. Identify therapeutic responses to iron therapy | Less fatigue, no coldness, no pallor no SOB, Increased production of RBC and hemoglobin for transportation and utilization of oxygen |
| 43. Identify adverse effects of tretinoin | Antiacne. Adverse effects- severe irritation, skin peeling, dryness, burning, photosensitivity, blistering, erythema |
| 44. Identify contraindication for the use of iodine preparations | Highly toxic, many allergies, Not for people with hypersensitivity reactions, Don't take regularly in pregnancy or lactating. , Use a light bandage, non occlusive, May interfere with thyroid tests (they affect the thyroid gland) |
| 45. Identify client education measures related to isotretinoin (Accutane) | Used to treat acne. Taken in oral form to inhibit sebaceous gland activity. Education- use two forms of contraception (category X in pregnancy), monitor for signs and symptoms of depression and suicidal thoughts (required iPLEDGE) |
| 46. Identify contraindications for the use of silver sulfadiazine ointment (burns) | allergy to sulfa, hypersensitivity, pregnancy |
| 47. Identify education measures related to the application of Restasis with other ophthalmic medications | Cyclosporine- increase tear production, Educate- how to administer eye drops. Don't give multiple ones at the same time, space them out 1-2 hours apart |
| 48. Identify measures to minimize the adverse effects of amphotericin B | Pre-treatment with antipyretic, antihistamine, antiemetic, corticosteroids, Use IV infusion pumps, Use most distal veins |
| 49. Identify indications for the use of spironolactone (Aldactone) | Htn & edema, edema in HF, Spares potassium for pts at risk for hyperkalemia; pt must avoid potassium rich foods |
| 50. Identify indications for the use of mannitol (Osmitrol) | Drug of choice in increased cranial pressure or acute renal failure due to shock, drug overdose or trauma, Mannitol given IV, |
| 51. Identify lab tests to monitor for the client taking theophylline | Serum theophylline levels, toxic at levels over 20, WBC, H/H, ABG |
| 52. Identify client education measures related to luticasone (Flovent) | Take as prescribed every day, may take 2-3 weeks to reach effective level, Rinse mouth after use, Proper use of metered dose inhaler, Check for signs of oral Candidiasis, Avoid cigarette smoking |
| 53. Identify adverse effects of furosemide (Lasix) | Dizziness, vertigo, paresthesias, ortho hypertension, rash, urticaria, nausea, anorexia, urinary bladder spasm. |
| 54. Identify adverse effects of vancomycin (Vancocin) | Red man’s syndrome, superinfections, Ototoxicity |
| 55. Identify contraindications for the administration of Bactrim | Sulfa allergy, sulfonylureas or thiazide diuretics, pregnancy, lactation, renal disease or history of kidney stones |
| 56. Identify indications for administration of dexrazoxane (Zenocard) | Cardioprotective drug that interferes with the cardiotoxic effects of doxorubicin in breast cancer |
| 57. Identify indications for the administration of leucovorin | Active form of folic acid that is used to rescue normal cells from adverse effects of methotrexate therapy in tx of osteosarcoma, Tx of megaloblastic anemia |
| 58. Identify client education measures related to chloroquine (Aralen) | Safety precautions incl changing positions slowly, Take drugs with small frequent meal, Report blurring of vision which indicates retinal damage, Report loss of hearing or tinnitus, Fever which indicates resistant strain or non-effective therapy |
| 59. Identify indications for administration of allopurinol (Zyloprim) | Pain in big toe, joint pain, swelling, inflammation, uric crystals/tophi on skin |
| 60. Identify adverse effects of morphine sulfate | Respiratory depression, constipation, Ortho hypotension, cardiac arrest, n/v, anxiety, CNS/LOC, urinary retention/hesitancy |
| 61. Identify indication for the administration of pentamidine (Pentam) | Antiprotozoal that directly kills pneumocystis jirovecii (p. carinii pneumonia) (inhaled thru lungs), Also works on Trichomoniasis, giardiasis, amebiasis |
| 62. Identify clinical manifestations of salicylate toxicity | T innitus, then n/v, hyperventilation leading to respiratory alkalosis, Hyperpnea, tachypnea, hemorrhage, excitement, confusion, pulmonary edema, convulsions, tetany, metabolic acidosis, fever, coma, CV, renal & resp. collapse, metabolic acidosis |
| 63. Identify dietary restrictions for the client taking an monoamine oxidase inhibitors (MAOIs) | Tyramine – aged, pickled, fermented foods which can cause hypertensive crisis, Wash out period |
| 64. Identify recommendations for the administration of calcium carbonate (Tums) | Antacid- neutralize the acid, does not prevent, given by mouth as needed. Has a long duration of acid action but may incr gastric acid secretions (rebound hyperacidity), Caution- may cause constipation or kidney stones (not for people w/ renal disease) |
| 65. Identify recommendations for administration of ondansetron (Zofran) with chemotherapy | Given orally (30-60 minute onset) or IV (immediate onset) - *control of nausea and vomiting associated with chemotherapy |
| 66. Identify education measures related to administration of antiarrhythmics | Change positions slowly, monitor BP/Pulse, Report dysrhythmias or hypotension, apical pulse <60, Safety,Daily weights /I&O, Avoid alkaline food & grapefruit juice, Frequent Lidocaine & dig levels, Monitor for s/e: Hypotension, bradycardia, fatigue |
| 67. Identify education measures related to the administration of pravastatin (Pravachol) | Take at night before bed, Low cholesterol diet & increased exercise, Avoid prolonged exposure to sunlight (photosensitivity), Regular liver tests, Report muscle pain, tenderness or weakness, Do not take if pregnant |
| 68. Identify common side effects of antineoplastic agents | Bone Marrow suppression, Alopecia, N/V, GI disturbances, Anorexia |
Created by:
rivabard
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