Pharmacology Exam 2
Answer: A, B, and D. Adenosine is administered as a very quick IV push. The physician must be present in the room and the crash cart must be on hand. An ekg monitor should be in the room to monitor the effectiveness of the medication.
. The nurse is preparing to administer adenosine to the patient with the following rhythm which is symptomatic. What should the nurse plan on having in the patient room? (Select all that apply) a) Physician b) Crash cart c) IV pump d) EKG monitor e) Lidocaine
protamine sulfate
Antidote for Heprin
supraventricular tachycardia
Adenosine is used to treat which condition?
Blocks the action of acetylcholine as a competitive edge antagonist at muscarinic receptor sites and smooth muscle, secretory glands in the CNS. It works by blocking parasympathetic response and allowing sympathetic response to take over.
Atropine sulfate mechanism of action pharmacologically does what?
clarithromycin
Special Consideration: Older pts taking Calcium Channel Blocker >> may become hypotensive or go into shock Azithromycin is drug of choice in these situations.
GLUCOCORTICOIDS
THESE DRUGS ARE USED IN THE TREATMENT OF CONDITIONS REQUIRING: - SUPPRESSION OF THE IMMUNE SYSTEM - DECREASE INFLAMMATORY RESPONSE ALSO USED IN: - ADDISON'S DISEASE. - COPD - IMMUNE DISORDERS
Pulmonary
The most severe adverse effects of amiodarone are evidenced in which body system?
B. hypokalemia
A client is taking hydrochlorothiazide 50 mg/day and digoxin 0.25 mg/day. What type of electrolyte imbalance does the nurse expect to occur? a. Hypocalcemia b. Hypokalemia c. Hyperkalemia d. Hypermagnesemia
b. To loosen bronchial secretions so they can be eliminated by coughing
A client has been prescribed guaifenesin (Robitussin). The nurse realizes that the purpose of the drug is to accomplish what? a. To treat allergic rhinitis and prevent motion sickness b. To loosen bronchial secretions so they can be eliminated by coughing c. To compete with histamine for receptor sites, thus preventing a histamine response d. To stimulate alpha-adrenergic receptors, thus producing vascular constriction of capillaries in nasal mucosa
Take the medication on ice
A client is scheduled for an intravenous pyelogram and has been instructed to take liquid magnesium citrate on the day before the scheduled procedure. The client asks the nurse about the administration procedure for this medication. Which of the following instructions will the nurse provide to the client? 1. "Take the medication on ice." 2. "Mix the medication with apple juice only." 3. "Mix the medication with a full glass of water." 4. "Drink the medication at room temperature."
D. Regular bowel movements
A client is taking docusate sodium (Colace). The nurse monitors which of the following to determine whether the client is having a therapeutic effect from this medication? A. Abdominal pain B. Reduction in steatorrhea C. Hematest-negative stools D. Regular bowel movements
a. Instruct the client to use the albuterol (Proventil) inhaler instead * salmeterol (Serevent) is a LABA, so it needs time to build up an effect. The patient needs to use a SABA (albuterol) during an attack
A client reaches for the salmeterol (Serevent) inhaler with the onset of an asthma attack. What is the nurse's best action? a. Instruct the client to use the albuterol (Proventil) inhaler instead b. Assist the client to use oxygen for 3 breaths between the two puffs of the inhaled drug c. Instruct the client to attach the space to the inhaler before using it and inhale as rapidly as possible
a. Acts on smooth intestinal muscle to gently increase peristalsis
A client who has constipation is prescribed a bisacodyl suppository. The nurse explains that bisacodyl does what? a. Acts on smooth intestinal muscle to gently increase peristalsis b. Absorbs water into the intestines to increase bulk and peristalsis c. Lowers surface tension and increases water accumulation in the intestines d. Pulls hyperosmolar salts into the colon and increases water in the feces to increase bulk
3. "The medications will kill the bacteria and stop the acid production." Rationale: Triple therapy for Helicobacter pylori infection usually includes two antibacterial drugs and a proton pump inhibitor. Clarithromycin and amoxicillin are antibacterials. Esomeprazole is a proton pump inhibitor. These medications will kill the bacteria and decrease acid production.
A client with a peptic ulcer is diagnosed with a Helicobacter pylori infection. The nurse is reinforcing teaching for the client about the medications prescribed, including clarithromycin (Biaxin), esomeprazole (Nexium), and amoxicillin (Amoxil). Which statement by the client indicates the best understanding of the medication regimen? 1. "My ulcer will heal because these medications will kill the bacteria." 2. "These medications are only taken when I have pain from my ulcer." 3. "The medications will kill the bacteria and stop the acid production." 4. "These medications will coat the ulcer and decrease the acid production in my stomach."
Enhanced pain relief Combination of analgesics with different mechanisms of action can afford greater pain relief. Tylenol No. 3 is a combination of 300 mg of acetaminophen and 30 mg of codeine; Tylenol No. 4 is a combination of 300 mg of acetaminophen and 60 mg of codeine.
A postoperative client has a prescription for acetaminophen with codeine. What should a nurse recognizes as a primary effect of this combination? Prevention of drug tolerance Increased onset of action Enhanced pain relief Minimized side effects
B
A pt with a rapid, irregular heart rhythm is being treated in the ER with adenosine. During administration of this drug, the nurse should be prepared to monitor the pt for which effect? A. nausea and vomiting B. transitory asystole C. muscle tetany D. hypertension
Seizures do not occur. Rationale: For a client with preeclampsia, the goal of care is directed at preventing eclampsia (seizures). Magnesium sulfate is an anticonvulsant rather than an antihypertensive agent. Although a decrease in blood pressure may be noted initially, this effect is usually transient.
A woman with preeclampsia is receiving magnesium sulfate. Which indicates to the nurse that the magnesium sulfate therapy is effective?
ANS: 2 Cardioversion is used if the patient is unstable. Anticoagulants are used if the arrhythmia has stuck around for 48 hr +. Adenosine may be used with a narrow QRS and regular RR interval. I made up Altemose.
A. nursing student is aware that which of the following is the treatment for unstable atrial flutter? 1) Adenosine (Adenocard) 6 mg rapid IVP. 2) Cardioversion with adjacent Heparin therapy 3) Defibrillation STAT followed by CPR. 4) Altemose 3 mg IVP over 1-2 seconds.
C
When assessing a pt who has been taking amiodarone for 6 months, which adverse reaction might the nurse identify? A. glycosuria B. dysphagia C. photophobia D. urticaria
Metronidazole
Antibiotdic, causes metallic taste
Calcium Gluconte
Antidote for Magnesium Sulfate
Amiodarone hydrochloride (Cordarone)
Antidysrhythmic: Potassium Channel Blocker. Given PO&IV. Used to treat both atrial and ventricular dysrhythmias. Blocks K ions, Na ion channels, and inhibits sympathetic activity to the heart. Adverse effects include blurred vision, photosensitivity, nausea, vomiting & anorexia. May produce new dysrhythmias or worsen existing ones. Other adverse effects include hypotension, HF, heart block, bradycardia, and a pneumonia-like syndrome. Contraindicated in pts allergic to iodine.
Osmotic laxatives like Magnesium citrate
Attracts water into the large intestine to produce bulk and stimulate peristalsis
Binds to diarrhea-causing bacteria for excretion
Bismuth subsalicylate (Pepto-Bismol), an absorbent, has which mech of action
bivalirudin
Direct Thrombin inhibitor
Mannitol (Osmitrol) Mannitol is the drug of choice to prevent increased intracranial pressure after a closed head injury; although it works along the entire length of the nephron, it reduces intracranial pressure and cerebral edema by reducing cellular edema. Metolazone and furosemide are loop diuretics and hydrochlorothiazide is a thiazide diuretic; they are of little benefit in reducing cerebral edema.
Disseminated intravascular coagulopathy (DIC) and severe diffuse edema develop in a 24-year-old female patient after a serious motor vehicle accident (MVA). Which of these diuretics can the nurse administer to avoid aggravating the coagulopathy?
Visual halos, Hypothyroidism, Photosensitivity, and Blue gray skin discoloration
For patients prescribed amiodarone (Cordarone), the nurse should monitor for which potential adverse effects of this drug?
"This drug will help my heart muscle pump less." Rationale: The ability to increase the strength of contractions is a characteristic of cardiac glycosides. It may result in a decrease in pulse. Initially the client may experience some fatigue. Symptoms of CHF, such as dyspnea, should improve.
The client is prescribed digoxin (Lanoxin) for treatment of HR. Which of the following statements by the client indicates the need for further teaching by the nurse? "I should not get short of breath anymore." "This drug will help my heart muscle pump less." "I may notice my heart rate decrease." "I may feel tired during early treatment."
Administer guaifenesin.
The client tells the nurse that she has a bad cold, is coughing, and feels like she has "stuff" in her lungs. What should the nurse do? a. Administer dextromethorphan. b. Administer guaifenesin. c. Encourage the client to drink fluids hourly. d. Administer fluticasone (Flonase).
C
The nurse administers what drug to terminate supraventricular tachycardia? A) Lidocaine (Lidocaine Parenteral) B) Flecainide (Tambocor) C) Adenosine (Adenocard) D) Dronedarone (Multaq)
Lipid pneumonia
The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will take measures to prevent which potential problem that may occur with mineral oil?
d. Salmeterol has a longer duration of action
The nurse is instructing a client about the advantages of salmeterol (Serevent) over other beta2 agonists such as albuterol (Proventil). How will the nurse explain to the client the difference in these two medications? a. Salmeterol has a shorter onset of action. b. Salmeterol does not have any side effects. c. Albuterol has a longer onset of action. d. Salmeterol has a longer duration of action.
Pregnancy
The nurse would question the prescription of misoprostol in a client with what condition?
2. "heparin does not thin the blood but prevents clots form forming as easily in the blood vessels"
The patient receiving heparin therapy asks how the "blood thinner" works. The best response by the nurse would be: 1. "heparin makes the blood less thick" 2. "heparin does not thin the blood but prevents clots from forming as easily in the blood vessels" 3. "heparin decreases the number of platelets so that blood clots more slowly" 4. "heparin dissolves the clot"
A. Furosemide (Lasix)
To treat a patient with pulmonary edema, the nurse prepares to administer which diuretic to this patient? A. Furosemide (Lasix) B. Amiloride (Midamor) C. Triamterene (Dyrenium) D. Spironolactone (Aldactone)
1) Pulmonary Embolism 2) Venous Thrombosis 3) Prophylaxis after MI
What are some uses for Heprin?
D) abrupt medication withdrawal may lead to a rebound hypertensive crisis.
When teaching a patient about beta-blockers such as atenolol (Tenormin) and metoprolol (Lopressor), it is important to inform the patient that A) these medications may be taken with antacids to minimize gastrointestinal distress. B) hot baths and showers will help enhance the therapeutic effects and are encouraged. C) alcohol intake is encouraged for its vasodilating effects. D) abrupt medication withdrawal may lead to a rebound hypertensive crisis.
Mannitol (Osmitrol) Mannitol is the drug of choice to prevent increased intracranial pressure after a closed head injury; although it works along the entire length of the nephron, it reduces intracranial pressure and cerebral edema by reducing cellular edema. Metolazone and furosemide are loop diuretics and hydrochlo rothiazide is a thiazide diuretic; they are of little benefit in reducing cerebral edema.
Which diuretic is the drug of choice for the prevention of tissue damage after a closed head injury?
25. 2. An 85 year old man with benign prostate hyperplasia (Atropine causes urinary retention to worsen in clients with BPH).
Which factor in the client's history would cause the nurse to question a medication order for atropine? 1. A 42 year old woman with a history of drug abuse 2. An 85 year old man with benign prostate hyperplasia 3. An 18 year old man with IBS 4. A 22 year old woman on the 2nd day of her menstrual cycle
Platelet count of 80,000 A platelet count of less than 100,000 indicates thrombocytopenia. Because the patient is receiving heparin, which interferes with normal coagulation, adequate platelets are necessary to prevent hemorrhage in the event of trauma or bleeding.
Which finding in the patient receiving heparin would require an immediate intervention by the nurse? aPTT of 45 WBC of 8.5 RBCs of 4.2 Platelet count of 80,00
Cough Suppressant / Antitussive
A patient with a diagnosis of pneumonia asks the nurse, "Why am I receiving codeine when I have no pain?" The nurse's response is based on knowledge that codeine also has what effect?
Action -Reduce gastric acid by blocking H2 receptors of parietal cells in stomach - Promote healing of ulcer by eliminating cause Side effects -Headaches, dizziness, diarrhea, constipation, reversible impotence, gynecomastia
Antiulcer drugs - Histamine2 blockers EX- Ranitidine (Zantac) Famotidine (Pepcid))
a. cough
The nurse notes in a patient's medication history that the patient is taking benzonatate (Tessalon Perles) as needed. Based on this finding, the nurse interprets that the patient has which problem? a. Cough b. Seasonal allergies c. Chronic rhinitis d. Motion sickness
Omeprazole (Prilosec) There is a potential link between proton pump inhibitor use and bone metabolism. Long-term use or high doese of these may increase the risk of fractures of the hip, wrist, and spine. Lower doses or shorter duration of therapy should be consider
A 74 y.o. female pt w/ GERD takes over-the-counter meds. For which med, if taken long-term, should the nurse teach about increased risk of fractures? Sucralfate (Carafate) Cimetidine (Tagamet) Omeprazole (Prilosec) Metoclopramide (Reglan)
B. Heartburn ,omeprazole (Prilosec) is used for GERD
A client has been taking omeprazole (Prilosec) for 4 weeks. The nurse determines that the client is receiving the optimal intended effect of the medication if the client reports absence of which of the following symptoms? A. Diarrhea B. Heartburn C. Flatulence D. Constipation
A. Myalgia (pain in muscles or group of muscles) Pravastatin is used to treat hyperlipidemia. Muscle pain could indicate rhabdomyolysis, a serious complication of this medication.
A client who has an elevated serum cholesterol level is started on pravastatin (Pravachol). A nurse should teach the client to monitor for side effects, which include • Myalgia • Hypertension • Tremors • Tachycardia
3. Pruritus, or itching, and jaundice, a yellowish discoloration of the skin, are associated with fatty degeneration of the liver, a serious adverse effect of tetracycline.
A client who has been receiving therapy with tetracycline reports itching and yellowish discoloration of the skin. The nurse knows these symptoms could be associated with which adverse effect of tetracycline? 1. Cholestatic hepatitis 2. Acute pancreatitis 3. Fatty degeneration of the liver 4. Exfoliative dermatitis
a. Maintenance treatment of asthma
A client with COPD is taking a leukotriene antagonist, montelukast (Singulair). The nurse is aware that this medication is given for which purpose? a. Maintenance treatment of asthma b. Treatment of an acute asthma attack c. Reversing bronchospasm associated with COPD d. Treatment of inflammation in chronic bronchitis
Checking apical pulse before administering medication. Monitor serum electrolytes. Rationale: Digoxin is a cardiac glycoside. which can slow heart rate, and an apical heart rate is checked prior to administration. Lasix is a loop diuretic used in treatment of CHF, which promotes not only water loss, but also loss of electrolytes. A low potassium level increases risk of digoxin toxicity. Fluids are often restricted with CHF. H and H level do not need to be checked, and green, leafy vegetables would not need to be restricted.
A client with congestive heart failure, CHF, is prescribed digoxin (Lanoxin) and furosemide (Lasix). Nursing interventions will include: (Select all that apply.) Encourage intake of water and fruit juices. Restrict intake of green, leafy vegetables. Checking apical pulse before administering medication. Monitor hemoglobin and hematocrit levels. Monitor serum electrolytes.
ANS 3: Rationale: Angioedema is a rare but potentially serious adverse effect from ACE inhibitors; because this client has had a previous reaction to another drug within the same group (enalapril/Vasotec), the nurse should confirm the order with the provider. Options 1, 2, and 4 are incorrect. The use of diuretics along with ACE inhibitors must be closely monitored but this client was previously on diuretic therapy and it may be assumed that the client is no longer taking it. The use of antihistamines concurrently with lisinopril may help to relieve any dry cough that occurs with the lisinopril. While a history of alcoholism may suggest more frequent hepatic monitoring, the client is currently abstaining.
A client with heart failure has an order for lisinopril (Prinivil, Zestril). Which of the following conditions in the client's history would lead the nurse to confirm the order with the provider? 1. A history of hypertension previously treated with diuretic therapy 2. A history of seasonal allergies currently treated with antihistamines 3. A history of angioedema after taking enalapril (Vasotec) 4. A history of alcoholism, currently abstaining
1,2,3. Food, especially milk or diary products, decreases the absorption of tetracycline. Tetracycline does cause photosensitivity that makes the skin more susceptible to sunburn. Women on oral contraceptives and tetracycline have a higher incidence of vaginal yeast infections.
A clinic nurse is teaching a group of teens taking tetracycline for acne. Which teaching points should take priority? Select all that apply. 1. Take tetracycline on an empty stomach to increase absorption. 2. Tetracycline may cause photosensitivity, making the skin susceptible to sunburn. 3. Tetracycline may cause vaginal yeast infection in women who are using oral contraceptives. 4. Tetracycline is one of the safest antibiotics to take during pregnancy. 5. Tetracycline commonly causes diarrhea. The client should start a clear liquid diet and slowly resume a normal diet.
A. Omeprazole (Prilosec): Omeprazole causes irreversible inhibition of the proton pump; it is the enzyme that generates gastric acid. It is a powerful suppressant of acid secretion. Famotidine and ranitidine block histamine2 receptors on parietal cells. Misoprostol protects against NSAID-induced ulcers by stimulating the secretion of mucus and bicarbonate and maintaining submucosal blood flow.
A nurse administers which of these medications to inhibit an enzyme that makes gastric acid in a patient who has a duodenal ulcer? a. Omeprazole (Prilosec) b. Famotidine (Pepcid) c. Misoprostol (Cytotec) d. Ranitidine (Zantac)
B Tetracyclines are bacteriostatic antibiotics; photosensitivity and severe sunburn are common adverse effects. A full course of antibiotics must always be taken. Blood studies are not necessary for therapeutic levels. Absorption decreases after ingestion of chelates, such as calcium and magnesium, so doses should be given 2 hours before or 2 hours after ingestion of milk products.
A nurse assessing a patient who is 12 years old should associate which complication with the patient's receiving tetracycline (Sumycin) as a younger child? A) Delay in long bone growth B) Early onset of puberty C) Severe face and body acne D) Discoloration of the teeth
c. Tachycardia * Albuterol can cause HYPOkalemia * Candidiasis is r/t inhaled glucocorticoids, such as beclomethasone
A nurse is caring for a pt who has asthma and is receiving albuterol. For which of the following adverse effects should the nurse monitor the client? a. Hyperkalemia b. Dyspnea c. Tachycardia d. Candidiasis
ANSWER: D. The client taking nitroglycerin should expect the therapeutic effect of absence of chest pain.
A nurse is monitoring a client with angina for therapeutic effects of nitroglycerin. Which assessment finding indicates that the nitroglycerin has been effective? A) a. Blood pressure 120/80 mm Hg B) b. Heart rate 70 beats per minute C) c. ECG without evidence of ST changes D) d. Client stating that pain is 0 out of 10
Respirations of 10 breaths/min Magnesium sulfate depresses the respiratory rate. If the rate is 12 breaths/min or slower, continuation of the medication must be reassessed. Acceptable urine output is 30 mL/hr or more. Urine output of 20 mL in 30 minutes is adequate. Deep tendon reflexes of 2+ are normal. The fetal heart tone is within normal limits for a resting fetus.
A nurse is performing assessments every 30 minutes on a client who is receiving magnesium sulfate for preeclampsia. Which finding would prompt the nurse to contact the health care provider?
d. Albuterol * Rescue bronchodilator Cromolyn sodium: anti-inflammatory agent for maintenance therapy Prednisone: administer following an acute attack to promote anti-inflammatory effects Fluticasone/salmeterol: maintenance therapy of asthma because it combines a glucocorticoid and a LABA
A nurse is planning care for a client who has asthma. Which of the following medications should the nurse plan to administer during an acute asthma attack? a. Cromolyn sodium b. Prednisone c. Fluticasone/salmeterol d. Albuterol
D. "You will have your deep-tendon reflexes monitored while you are receiving magnesium." Rationale = The nurse should instruct the client on the need to monitor deep-tendon reflexes during administration of magnesium. This assessment helps identify hypermagnesemia that can occur during IV administration of magnesium sulfa
A nurse is providing education for a client who has severe hypomagnesemia due to alcohol use disorder. The client is to receive magnesium sulfate. Which of the following information should the nurse include in the teaching? A. "You will receive magnesium in a series of IM injections B. "You should receive a prescription for a thiazide diuretic to take with the magnesium." C. "You should eliminate whole grains from your diet until your magnesium level increases." D. "You will have your deep-tendon reflexes monitored while you are receiving magnesium."
1. Fatigue Not constipation but -- nausea, vomiting & diarrhea 3. Anorexia b/c GI disturbances 5. Diplopia -- visual changes , halo, yellow-tinged vision.
A nurse is providing teaching to a client who has a new prescription for digoxin (Lanoxin) Which of the following may indicate dig toxicity & should be reported to the provider? 1. Fatigue 2. constipation 3. Anorexia 4. Rash 5. Diplopia
If I take my montelukast 2 hours before I exercise I should take it again right before I start. This requires further education as no additional dose should be taken for at least 24 hours and no additional doses should be taken for EIB if it is already taken on a daily schedule.
A nurse knows a patient requires further education when a patient states what about frequency of Monteleukast taken for EIB?
Patient who cannot use inhaled glucocorticoids or an inhaled glucocorticoid is not enough,those who require relief from allergic rhinitis, EIB, or maintenance of asthma in those at least 1 year of age
A nurse knows that patients who are best suited for Montelukast (Singulair) are..
B. Argatroban Lepirudin (Refludan) and argatroban are indicated for the treatment of thrombosis in patients with a history of HIT. Because these medications are given as an initial IV bolus followed by a continuous infusion, the desired effect of direct thrombin inhibition is achieved more quickly. Because of warfarin's delayed onset of effects, it is not useful in emergency situations, such as pulmonary embolism (PE). Intravenous bivalirudin given in combination with aspirin helps prevent clot formation in patients undergoing coronary angioplasty. Eptifibatide (Integrilin), a glycoprotein IIb/IIIa receptor inhibitor, is an antiplatelet drug that is used short term to prevent ischemic events in patients who have acute coronary syndrome or who are undergoing percutaneous coronary intervention.
A patient admitted with deep vein thrombosis (DVT) and subsequent pulmonary embolism (PE) requires immediate anticoagulation. What would be appropriate in this situation, given that the patient has a history of heparin-induced thrombocytopenia (HIT)? A. Warfarin B. Argatroban C. Bivalirudin D. Eptifibatide
Alcohol
A patient age 32, is started on metronidazole (Flagyl) for treatment of a trichomonas vaginal infection. While she is on this medication she must avoid
Due to your hepatic impairment it would be dangerous for you to take this medication.
A patient has severe liver impairment. He comes into the clinic seeking help for his exercise induced bronchospasms. When he suggests taking Montelukast for this issue what should the nurse tell him?
Answer: Atropine and epinephrine Rationale: Normally the patient in asystole cannot be successfully resuscitated. However, administration of atropine and epinephrine may prompt the return of depolarization and ventricular contraction.
A patient in asystole is likely to receive which of the following drug treatments? a. Atropine and epinephrine b. Lidocaine and amiodarone c. Digoxin and procainamide d. β-Adrenergic blockers and dopamine
Potassium
A patient is taking an ARB for the treatment of hypertension. Which laboratory value should be most closely monitored for this patient?
B Digoxin Digoxin can slow conduction through the AV node and can contribute to AV nodal block. Amlodipine is a dihydropyridine calcium channel blocker which does not clinically affect the AV node (whereas non-dihydropyridine calcium channel blockers such as verapamil and diltiazem can). Furosemide, aspirin and benazepril do not affect AV nodal conduction.
A patient presents to the emergency department complaining of fatigue and lightheadedness. He has a history of hypertension, heart failure, coronary artery disease and atrial flutter. His home medications include aspirin, metoprolol, benazepril, digoxin, furosemide, and amlodipine. The patient is found to be in third degree AV block. Which of the following drugs most likely contributed to this bradyarrhythmia? Answer A Furosemide B Digoxin C Amlodipine D Benazepril E Aspirin
Whether the patient's pulse and blood pressure are within normal limits Rationale: Potassium channel blockers such as amiodarone, like other antidysrhythmics, may cause significant bradycardia and hypotension. The light-headedness and dizziness may be associated with a drop in cardiac output due to bradycardia and hypotension. The significant finding of dizziness would first be assessed in relation to the known adverse effects of the drug
A patient was admitted from the emergency department after receiving treatment for dysrhythmias and will be started on amiodarone (Cordarone, Pacerone) because of lack of therapeutic effects from his other antidysrhythmic therapy. When the nurse checks with him in the afternoon, he complains of feeling lightheaded and dizzy. The nurse will first assess: 1. Whether there is the possibility of sleep deprivation from the stress of admission to the hospital 2. Whether an allergic reaction is occurring with anticholinergic-like symptoms 3. Whether the amiodarone level is not yet therapeutic enough to treat the dysrhythmias 4. Whether the patient's pulse and blood pressure are within normal limits
This patient with diabetes should have a baseline assessment of renal function to detect any decline in renal function and electrolyte levels. Hyperkalemia may occur during drug therapy with lisinopril (Prinvil) and patients with renal insufficiency may be at greater risk. The patient should be taught to maintain normal amounts of potassium-containing foods in his diet; avoid the use of salt substitutes, which contain potassium; and return regularly for laboratory tests to monitor his kidney function and other values. The lisinopril will also treat the patient's hypertension but the nurse should assess what other medications the patient is currently taking for the condition. Safety should be emphasized, especially regarding postural hypotension and the patient should be taught to rise slowly from a lying or sitting position to standing.
A patient who has diabetes and hypertension is started on lisinopril (Prinivil) for mild heart failure. What teaching is important for this patient?
3. increased bowel movements
A patient's serum ammonia level is elevated and the healthcare provider prescribes 30 mL of lactulose. Which side effect is common for this drug? 1. increased urine output 2. improved level of consciousness 3. increased bowel movements 4. nausea and vomiting
Pregnancy
ARBs are contraindicated for which patient?
3. Heart failure Rationale: Calcium channel blockers such as verapamil (Calan) are used cautiously or are contraindicated in patients with heart failure because of the negative inotropic effects on cardiac muscle which may precipitate or worsen heart failure. Verapamil and calcium channel blockers are often prescribed to treat these conditions.
Because of its effect on the heart, verapamil (Calan,Covera- HS, Isoptin SR, Verelan) should be used with extra caution or is contraindicated in patients with: 1.Hypertension 2.Tachycardia 3.Heart failure 4.Angina
D
Before emergency surgery, the nurse would anticipate administering which medication to a patient receiving heparin? A. Vitamin K (Phytonadione) B. Vitamin E C. Phenytoin (Dilantin) D. Protamine (Protamine sulfate)
Assess blood pressure - Isosorbide mononitrate is a drug used principally in the treatment of angina pectoris and acts by dilating the blood vessels so as to reduce the blood pressure.
Before the nurse administers isosorbide mononitrate (Imdur), what is a priority nursing assessment? a. Assess serum electrolytes. b. Measure blood urea nitrogen and creatinine. c. Assess blood pressure. d. Monitor level of consciousness.
A. weak
Compared with B agnoists, theophylline has what degree of bronchodilating effect? a. weak b. comparable c. strong d. very strong
d. 1, 2, 3, and 4
Cardiovascular side effects associated with theophylline use include which of the following? 1. hypotension 2. ventricular dysrhythmias 3. supraventricular tachycardia 4. palpitations a. 1 and 2 b. 2 and 3 c. 1, 3, and 4 d. 1, 2, 3, and 4
B. Metroprolol
For the client taking epinephrine, the nurse realizes there is a possible drug interaction with which drug? a. albuterol (Proventil) b. metoprolol (Lopressor) c. bethanechol (Urecholine) d. tolterodine tartrate (Detrol)
b. metoprolol (Lopressor)
For the client taking epinephrine, the nurse realizes there is a possible drug interaction with which drug? a. albuterol (Proventil) b. metoprolol (Lopressor) c. bethanechol (Urecholine) d. tolterodine tartrate (Detrol)
Supraventricular tachyarhythmias
For which condition are the most common calcium channel blocker verapamil used?
A,B,C
Dronedarone carries a black box warning against use in which of the following types of patients: (Select ALL that apply.) Answer A Class IV heart failure B Permanent atrial fibrillation C Recurrent atrial fibrillation D Paroxysmal atrial fibrillation E Peripheral arterial disease
141. Antihypertensive: angiotensin II receptor blocker (ARB)
Drug Class of valsartan
System: Cardiovascular Antiarrythmic: Antiarrhythmic agents are a group of pharmaceuticals that are used to suppress abnormal rhythms of the heart (cardiac arrhythmias), such as atrial fibrillation, atrial flutter, ventricular tachycardia, and ventricular fibrillation. amiodarone: Treats life-threatening heart rhythm problems (arrhythmias) in patients who have already taken other antiarrhythmic medicines. Amiodarone is used to treat ventricular tachycardia or ventricular fibrillation. Do not use this medication if you are allergic to amiodarone or iodine, or if you have certain heart conditions such as "AV block," or a history of slow heart beats...many serous side-effects. dronedarone: Treats heart rhythm problems in patients who have a history of atrial fibrillation.
Drugs that end in -arone are what class?
c. 2, 3, and 4
In which of the following formulations is theophylline available? 1. aerosol 2. IV 3. oral 4. rectal suppository a. 1 and 2 b. 2 and 3 c. 2, 3, and 4 d. 1, 2, 3, and 4
B. 1 and 3
It is suggested to give a patient with COPD theophylline for its nonbronchodilating effects. These effects would include: 1. ventilatory drive stimulation 2. reduced bronchial secretions 3. enhanced respiratory muscle function 4. enhanced cardiac output a. 2 and 4 b. 1 and 3 c. 1, 2 and 3 d. 1, 2, 3 and 4
bleeding Low-molecular-weight heparin interferes with the normal clotting cascade and may lead to bleeding. Additionally, these drugs can cause thrombocytopenia.
What does the nurse recognize as the major adverse effect of low-molecular-weight heparin? thrombocytosis anaphylaxis infection bleeding
Answer: 1, 3, 4 Rationale: Common adverse effects of lisinopril (Prinvil) and other ACE inhibitors include cough, headache, dizziness, change in sensation of taste, vomiting and diarrhea, and hypotension. Hyperkalemia may occur, especially when the drug is taken concurrently with potassiumsparing diuretics. Options 2 and 5 are incorrect. Hypercalcemia and heartburn are not adverse effects associated with the ACE inhibitors.
Lisinopril (Prinivil) is part of the treatment regimen for a client with HF. The nurse monitors the client for the development of which of the following adverse effects of this drug? (Select all that apply.) 1. Hyperkalemia 2. Hypocalcemia 3. Cough 4. Dizziness 5. Heartburn
Pepsin (the chief digestive enzyme in the stomach, which breaks down proteins into polypeptides.)
Misoprostol works to inhibit the secretion of what substance?
False - Motelukasytt (Singulair) is a second line therapy for Asthma.
Montelukast is a first line therapy. T/F
A Maintenance of sinus rhythm in recurrent atrial fibrillation Dronedarone is only indicated for the maintenance of sinus rhythm in patients with recurrent paroxysmal or persistent atrial fibrillation.
Multaq is indicated for which of the following situations? Answer A Maintenance of sinus rhythm in recurrent atrial fibrillation B Conversion of atrial fibrillation to sinus rhythm C Slowing of ventricular rate in atrial fibrillation D Prevention of ventricular tachycardia E Treatment of ventricular tachycardia
clarithromycin
Name the drug: Broad-spectrum Antibiotic Bacteriostatic. They inhibit bacterial growth and reproduction by interfering with their ability to make proteins. Treatment for: Systemic infections local bacterial infections of the respiratory tract, gi tract, and soft tissue. Also used to treat acne, STI, prevent whooping cough and prevent endocarditis in dentistry (prophylaxis). Nursing Consideration: -Administer on an empty stomach -Never with gastric acids or acidic fruit juices. -Monitor liver function tests (HEPATOtoxic) -These drugs are used to treat a wider range of infections than penicillin and can be used in pts with pen allergies. ADR: GI complaints, suprainfections, hepatoxic, dysrhythmias, ototoxicity, pseudimembranous colitis (C. difficile colitis), anaphylaxis
Increased shortness of breath and orthopnea. Rationale: Nifedipine (Procardia) is a calcium channel blocker. Calcium channel blockers decrease myocardial contractility, increasing the risk of heart failure. Dizziness can occur, especially when the medication is started. The BP is a desired reading.
Nifedipine (Procardia) 30 mg p.o. is prescribed for a client. The nurse teaches the side effects and instructs the client to immediately report: Blood pressure 110/70-114/78 for two successive readings. Dizziness when changing positions. Increased shortness of breath and orthopnea. Weight loss of two pounds per week.
Nifedipine (procardia) a CCB may cause hypotension with Reflex Tachycardia.
Nifedipine (Procardia) has been ordered for a client with HT. In the care plan, the nurse includes the need to monitor for which ADVERSE effect? 1. Rash & chills 2. Reflex tachycardia 3. Increased U/O 4. Weight Loss
montelukast
What drug is a Leukotriene Receptor antagonist that -Binds with leukotriene receptors to inhibit smooth muscle contraction and bronchoconstriction Inhibit bronchoconstriction caused by specific antigens and reduce airway edema and smooth muscle constriction
46. Administration of a non-dihydropyridine calcium channel blocker or a beta blocker as ordered Administration of heparin as ordered Administration of ibutilide intravenously as ordered Cardioversion Preparation of the client for radiofrequency catheter ablation Explanation • Atrial flutter is an abnormal cardiac rhythm characterized by rapid, regular atrial depolarizations at a characteristic rate of approximately 300 beats per minute and a regular ventricular rate of about 150 beats per minute in patients not taking atrioventricular (AV) nodal blockers. • It can lead to symptoms of palpitations, shortness of breath, fatigue, or lightheadedness, as well as an increased risk of atrial thrombus formation that may travel elsewhere, causing cerebral or systemic emboli. • Administration of a non-dihydropyridine calcium channel blocker or a beta blocker will help reduce heart rate. • Anticoagulation is imperative to prevent systemic embolization, initially with heparin in clients with atrial flutter. • Intravenous ibutilide, a short-acting antidysrhythmic medication, has a 60% to 90% success rate for converting atrial flutter. • Cardioversion promptly restores sinus rhythm in atrial flutter, usually at energy levels as low as 25 to 100 joules. • Due to the high rate of recurrence of atrial flutter in patients without a correctable cause, and because of its high success rate, radiofrequency catheter ablation is the definitive treatment. • Incorrect: Sternal massage is not a treatment for atrial flutter.
Nurses can expect which of the following interventions to help regulate or treat patients with atrial flutter? Select all that apply. Administration of a non-dihydropyridine calcium channel blocker or a beta blocker as ordered Administration of heparin as ordered Administration of ibutilide intravenously as ordered Sternal massage Cardioversion Preparation of the client for radiofrequency catheter ablation
b. Administer the albuterol first, wait 5 minutes, and administer ipratropium bromide, followed by beclomethasone several minutes later
The health care provider orders ipratropium bromide (Atrovent), albuterol (Proventil), and beclomethasone (Vanceril) inhalers for a client. What is the nurse's best action? a. Question the order; three inhalers should not be given at one time. b. Administer the albuterol first, wait 5 minutes, and administer ipratropium bromide, followed by beclomethasone several minutes later. c. Administer each inhaler at 30-minute intervals. d. Administer beclomethasone first, wait 2 minutes, and administer ipratropium bromide, followed by the albuterol several minutes later.
Decreased ammonia levels Hepatic encephalopathy is a complication of liver disease and is associated with elevated serum ammonia levels. Lactulose traps ammonia in the intestinal tract. Its laxative effect then expels the ammonia from the colon, resulting in decreased serum ammonia levels and correction of hepatic encephalopathy.
The health care provider orders lactulose for a patient with hepatic encephalopathy. The nurse will monitor for effectiveness of this medication for this patient by assessing what? Relief of constipation Relief of abdominal pain Decreased liver enzymes Decreased ammonia levels
a (IM injections are avoided in patients receiving anticoagulation. A PTT of 50 seconds is withinthe therapeutic range. Vitamin K is used to reverse warfarin. Pulse quality is not affected by VTE.)
The health care provider prescribes an infusion of argatroban (Acova) and daily partial thromboplastin time (PTT) testing for a patient with venous thromboembolism (VTE). The nurse will plan to A. avoid giving any IM medications to prevent localized bleeding. B. discontinue the infusion for PTT values greater than 50 seconds. C. monitor posterior tibial and dorsalis pedis pulses with the Doppler. D. have vitamin K available in case reversal of the argatroban is needed.
Answer: QT interval; Heart rate and rhythm; Magnesium level Rationale: Amiodarone causes prolongation of the QT interval, which can precipitate dysrhythmia. Antidysrhythmic medications cause changes in cardiac rhythm and rate; therefore monitoring of heart rate and rhythm is needed.Electrolyte depletion, specifically potassium and magnesium, may predispose to further dysrhythmia. Although it is always important to monitor vital signs and urine output, these assessments are not specific to amiodarone.
The nurse administers amiodarone (Cordarone) to a client with ventricular tachycardia. Which monitoring by the nurse is necessary with this drug? Select all that apply. a. Respiratory rate b. QT interval c. Heart rate and rhythm d. Magnesium level e. Urine output
C
The nurse cares for a patient with a history of asthma and bronchitis. The physician prescribes montelukast (Singulair). The nurse recognizes that which statement is true about montelukast (Singulair)? a. Montelukast (Singulair) is used to treat acute asthma attacks. b. Montelukast (Singulair) prevents colds from developing into more serious conditions. c. Montelukast (Singulair) takes several weeks to lessen the effects of chronic asthma. d. Montelukast (Singulair) prevents bacterial infections.
adenosine
What drug is the following: Class: antidysrhythmic. I: Drug of choice for terminating paroxysmal SVT. NI: Short half-life. Administered by rapid IV bolus as close to the heart as possible.
Strategy: Think about each answer. aka Go-lytely, Miralax Class: Osmotic laxatives --pulls water into stools Adverse effects: GI distress NP: dont take more than 2 weeks, goal for prep is clear liquid stools (1) correct—colon should not have remaining soft stool (2) anything eaten after midnight would not appear as stool by the next morning (3) not expected; need to clean gastrointestinal tract for surgery (4) assumption; not substantiated
The nurse cares for an older patient scheduled for a colon resection this morning. The nurse notes the patient had polyethylene glycol-electrolyte solution (GoLYTELY) and a soapsuds enema the previous evening. This morning the patient passes a medium amount of soft brown stool. Which of the following conclusions by the nurse is MOST accurate? 1. The bowel preparation is incomplete. 2. The patient ate something after midnight. 3. This is an expected finding before this type of surgery. 4. The patient passed the last stool left in the colon.
C. Epigastric pain Famotidine is an H2-receptor antagonist that inhibits parietal cell output of HCl acid and minimizes damage to gastric mucosa related to hyperacidity, thus relieving epigastric pain. Famotidine is not indicated for nausea, belching, and dysphagia.
The nurse determines that a patient has experienced the beneficial effects of therapy with famotidine (Pepcid) when which symptom is relieved? A. Nausea B. Belching C. Epigastric pain D. Difficulty swallowing
phytonadione
The nurse is caring for a patient admitted with gastrointestinal bleeding who is anticoagulated with warfarin (Coumadin). Which medication should the nurse anticipate administering?
2. Improved mental status. Hepatic encephalopathy in cirrhosis results from higher serum ammonia levels that cause neurotoxic effects, including mental confusion. Oral lactulose is given to reduce the ammonia by trapping it in the gut and then expelling it with a laxative effect. Improved mental status implies reduction of ammonia levels. Patients with cirrhosis typically have hypokalemia due to hyperaldosteronism (as aldosterone is not metabolized by the damaged liver). Hypokalemia can also result from diuretics used to treat the fluid retention and ascites. Lactulose is not intended to treat this pathology. Lactulose is a laxative. In cirrhosis, constipation (Which allows more ammonia to be absorbed) and hard stool are to be avoided. However, the main purpose of lactulose is expelling the ammonia, with resulting benefits. Abdominal distention (ascites) in cirrhosis is treated with diuretics and paracentesis. Lactulose does not influence this pathology or symptom.
The nurse is caring for a patient with cirrhosis who has hepatic encephalopathy. The patient is prescribed lactulose. Which assessment by the nurse will most likely indicate that the medication has achieved the desired therapeutic effect? 1. Higher potassium level 2. Improved mental status 3. Looser stool consistency 4. Reduced abdominal distension
d. "This will reduce the amount of HCl in the stomach until the nasogastric tube is removed and you can eat a regular diet again." Famotidine is an H2-receptor antagonist that inhibits gastric HCl secretion and thus minimizes damage to gastric mucosa while the patient is not eating a regular diet after surgery. Famotidine does not prevent air from accumulating in the stomach or stop the stomach from bleeding. Heartburn is not a side effect of general anesthesia.
The nurse is caring for a postoperative patient with a colostomy. The nurse is preparing to administer a dose of famotidine (Pepcid) when the patient asks why the medication was ordered since the patient does not have a history of heartburn or gastroesophageal reflux disease (GERD). What response by the nurse would be the most appropriate? A. "This will prevent air from accumulating in the stomach, causing gas pains." B. "This will prevent the heartburn that occurs as a side effect of general anesthesia." C. "The stress of surgery is likely to cause stomach bleeding if you do not receive it." D. "This will reduce the amount of HCl in the stomach until the nasogastric tube is removed and you can eat a regular diet again."
3. Tetracyclines decrease the effectiveness of oral contraceptive therapy.
The nurse is instructing a female client about therapy with tetracycline (Sumycin). Which statement should be included in the instruction? 1. "Absorption of this drug is not affected by food." 2. "GI upset is a rare side effect." 3. "If taking oral contraceptives, an additional form of birth control is recommended." 4. "Take this drug immediately before bedtime."
ANSWER: D The client should not continue to have chest pain while on IV nitroglycerin. This would prompt the nurse to intervene. Blood pressure of 110/90 mm Hg is not cause for concern and is expected with nitroglycerin. Headache and flushing are common side effects of nitroglycerin.
The nurse is monitoring a client during IV nitroglycerin infusion. Which assessment finding will cause the nurse to take action? A) a. Blood pressure 110/90 mm Hg B) b. Flushing C) c. Headache D) d. Chest pain
Give it as a rapid, IV Push
The nurse is reviewing emergency protocols and administration of adenosine (Adenocard). What is a vitally important task to remember when administering adenosine?
52. A Class IV heart failure B Permanent atrial fibrillation Dronedarone has been shown to be associated with worse outcomes in patients with moderate-severe heart failure, and when used in patients with permanent atrial fibrillation.
The nurse is teaching a class for newly hired cardiac care nurses and is discussing dronedarone (Multaq). What statement, if made by the nurse, is accurate? (Select all that apply.) A) "Dronedarone has properties of all four classes of antiarrhythmics." B) "Dronedarone reduces the risk of hospitalization in patients in atrial fibrillation." C) "Dronedarone has many drug-drug interactions that need to be reviewed." D) "It is an oral drug taken once a day." E) "Common adverse effects of dronedarone include ventricular arrhythmias."
b. hydrochlorothiazide
The nurse knows that which diuretic is most frequently combined with an antihypertensive drug? a. chlorthalidone b. hydrochlorothiazide c. bendroflumethiazide d. potassium-sparing diuretic
Document the result In a patient receiving intravenous heparin, monitoring the aPTT result is necessary to ensure adequate anticoagulation as well as to check for overmedication. Normal aPTT is 40 seconds, and when the patient is receiving heparin, therapeutic effects occur when the aPTT is 1½ to 2 times normal, or between 60 and 80. The patient in this situation has an aPTT of 70, which is in the therapeutic range. It would be appropriate to continue the infusion at the same rate and document the results.
The nurse monitors the aPTT of a patient receiving heparin for a deep vein thrombosis. The nurse notes that the aPTT is 70. What is the most important action to be taken by the nurse? Notify the physician Document the result Increase the infusion rate Decrease the infusion rate
B
The nurse provides discharge instructions to a pt about the use of amiodarone. Which of the following statements indicates that the pt has the knowledge necessary to safely administer the drug? A. as soon as the physician says I can stop taking this medication, I will be able to enjoy the sun again B. the side effects of this med may not begin to show up for several weeks or even months after I start taking it C. If my pulse drops below 100 beats/minute, I should call the physician right away D. If I miss a dose of me, I should take it as soon as I remember it
4. aPT one and half to two and half times the control values. Rationale: aPT is the coagulation study that monitors oral anticoagulant use, such as warfarin. As a result of one and half to two and half times the control value indicates adquate anticoagulation. aPTT is the coagulation study that monitors heparin use. aPT level of one would indicate a less than therapeutic level of anticoagulation.
The nurse receives the patient's lab values throughout warfarin drug therapy. The expected therapeutic level is: 1. aPTT of three to four times the normal control value 2. aPTT one to two times the patient's baseline level 3. aPT one to two times the patient's last result 4. aPT one and half to two and half times the control value.
C. Blurred vision
The nurse teaches the patient receiving atropine (Atreza) to expect which side effect? a. Diarrhea b. Bradycardia c. Blurred vision d. Frequent urination
32. increased bleeding -recall pepto is a form of subsalicylate (asprin) -additive effects especially if given to pt on warfarin -increased bruising -additive effects with NSAIDs
The nurse would question the RX of bismuth subsalicylate (Pepto-Bismol) as an antidiarrheal med for a client RX'd asprin daily because of which potential adverse effect
A. To ease bowel evacuation and its related discomfort Rationale: Docusate sodium (Colace) is a stool softner, retaining water in the stool, softens the mass and makes stool easier and less painful to pass.
The physician prescribes docusate sodium (Colace) fo the client. The client asks the nurse to explain why the medication is needed. Which explanation given by the nurse correctly states the purpose of medication? A. To ease bowel evacuation and its related discomfort B. To irriatate the bowel and promote stool elimination C. To stimulate peristalsis to remove wastes after the digestion D. To reduce intestinal activity and decrease stool size
C. xanthines
Theophylline is chemically referred to as one of which of the following drugs? a. B blockers b. anticholinergics c. xanthines d. aminophylline agonists
C. 2,3, and 4
Theophylline may be used to treat which of the following? 1. pneumonia 2. apnea of prematurity 3. COPD 4. asthma a. 1 only b. 2 and 3 c. 2, 3, and 4 d. 1, 2, 3, and 4
Action: BacteriCIDAL effects against anaerobic bacterial pathogens as well as some Protozoa. Interacts with cell DNA to cause strand breakage and loss of helical structure, responsible for antimicrobial ADN mutagenic actions USES: Asymptomatic and symptomatic trichomoniasis in female and male pt's Acute intestinal amebiasis, giardiasis, c.diff, colitis associated with antibiotics Combined with tetracycline and bismuth for h. Pylori
Uses and action for Metronidazole
A chemical stimulant: bisacodyl (Dulcolax); can be administered in water via enema
What drug, if administered by the nurse, would be classified as a chemical stimulant laxative?
They change it. Examples: insomnia, depressed psychotic, euphoric, mean, irritable
What effects to glucocorticoids have on a person's mood?
1) Those that primarily exert their effects on the arterioles. These are called dihydropyridines. Treat mild to moderate hypertension, stable (exertion) angina, and variant (vasoplastic) anginas. 2) Those that exert their effects on both the arterioles and the heart.
Two types of calcium channel blockers
It is an ACE inhibitor and it is used for treatment of mild to moderate hypertension, systolic CHF, acute MI
What is lisinopril and what is it used for?
-inhibits the flow of calcium ions into caridac muscle cells and vascular smooth muscle cells *result: causes vasodilation of peripheral arterioles and reduces contractility of the myocardium'
Verapamil is the the best calcium channel blocker to give to a patient to treat HTN; variant, unstable, chronic angina; or when a class IV antidysrythmic is required. Verapamil's method of action is __________.
Phytonadione (vit K)
Warfrin antidote
Delay wound healing Mask signs of infection Hypokalemia, Hypocalcemia, and Hyperglycemia Osteoporosis
What adverse effects does all glucocorticoid?
generally mild dizziness fatigue DRY NONPRODUCTIVE COUGH chest pain tachycardia Hyperkalemia HYPERmagnesemia
What are adverse effects of ACE inhibitors?
stable and unstable angina rapid acting for acute angina long acting prevention of angina attacks
What are organic nitrates indicated for?
Decreased cardiac output related to effects of medication Rationale: Using the ABCs of prioritization, decreased cardiac output puts the client at highest risk. Although the other nursing diagnoses are pertinent, they are not the priority.
What is the highest priority potential nursing diagnosis for a client who is starting on metoprolol
ARBs have a lower risk of cough
What is the most common reason for stopping ACE inhibitor therapy and changing the drug to an ARB?
c. Monitor blood glucose levels every 4 hours when taking albuterol.
What is the most important thing for the nurse to teach the client with a history of diabetes and asthma who has started on albuterol PRN? a. Take Tylenol for headaches when taking albuterol. b. Monitor for orthostatic hypotension every 2 hours when taking albuterol. c. Monitor blood glucose levels every 4 hours when taking albuterol. d. An antianxiety agent may be prescribed to help with nervousness.
HELICOBACTER PYLORI, GASTRIC ULCER
What is the use for Clarithromycin?
90. Lasix- hypotension Digoxin- bradycardia
What other drugs interfere with metroprolol?
MUST USE IV PUMP CHECK BP HOLD IF systolic BP <100
What should be assessed for IV organic nitrate/vasodilator administration? nitroglycerin (nitrobid) isosorbide (isordi)
Codeine is very constipating.
When administering codeine, the nurse should be aware that: Select the right response: Codeine produces more sedation than other opiates. Codeine causes diarrhea, so the client must take an additional drug to prevent this. Codeine is very constipating. Codeine is an antitussive in high doses.
fat soluble vitamins A, D, E and K
When administering mineral oil, the nurse recognizes that it can interfere with the absorption of which substance?
separate ranitidine (Zantac) and antacid dosage by at least 1 hour if possible.
When administering the histamine2 blocker ranitidine (Zantac), the nurse will
Answer: B Rationale: Antacids can be given 1 hour before or after ranitidine (Zantac) as part of the antiulcer drug regimen. Ranitidine (Zantac) can increase the effect of oral anticoagulants. Patients on ranitidine (Zantac) should eat a diet rich in vitamin B12 to avoid deficiency as a result of drug therapy. The patient's abdominal pain is expected to decrease after 1 to 2 weeks of drug therapy.
When administering the histamine2 blocker ranitidine (Zantac), the nurse will: a monitor laboratory results because ranitidine decreases the effect of oral anticoagulants. b separate ranitidine (Zantac) and antacid dosage by at least 1 hour if possible. c teach the patient to avoid foods rich in vitamin B12. d expect a reduction in the patient's pain to occur after 5 days of therapy.
D
When administering verapamil (Calan), the nurse assesses the patient for which result from this drug? A) Increased afterload B) Increased vasoconstriction C) Increased arterial pressure D) Increased coronary perfusion
B Hyperkalemia
When assessing a patient taking triamterene (Dyrenium), the nurse would monitor for which possible adverse effect? A. Hypokalemia B. Hyperkalemia C. Hypoglycemia D. Hypernatremia
b. Fasting blood glucose level of 140 mg/dL
Which laboratory value will the nurse report to the health care provider as a potential adverse response to hydrochlorothiazide (HydroDIURIL)? a. Sodium level of 140 mEq/L b. Fasting blood glucose level of 140 mg/dL c. Calcium level of 9 mg/dL d. Chloride level of 100 mEq/L b. Fasting blood glucose level of 140 mg/dL
A. Benzonatate suppresses cough by reducing the sensitivity of respiratory stretch receptors (components of the cough reflex pathway). Acetylcysteine reacts directly with mucus to make it more watery and is administered by inhalation treatment. Guaifenesin is an expectorant. Fluticasone furoate is an intranasal glucocorticoid used to treat the clinical manifestations of allergic rhinitis
Which medication is indicated for suppression of cough? A. Benzonatate (Tessalon) B. Guaifenesin (Mucinex) C. Acetylcysteine (Mucomyst) D. Fluticasone furoate (Flonase)
Answer: 3) This is describing ventricular tachycardia (QRS is a giveaway), and the treatment for a stable patient is Amiodarone or cardioversion. If the patient were unstable, we'd go ahead and defibrillate.
Which of the following does the nursing student realize is the treatment for a stable patient presenting with QRS intervals above 0.12 seconds with a regular rhythm and a rate of 100-250 bpm? 1) Atropine 2) Defibrillation 3) Amiodarone 4) Adenosine
C. It decreases the speed of electricity through the AV node.
Which of the following effects does a non-dihydropyridine CCB have on the heart? A. It increases the preload of the heart. B. It increases the force of the contraction. C. It decreases the speed of electricity through the AV node. D. It decreases sodium influx into the heart.
Angioedema
Which side effect of ARBs could be potentially life-threatening?
D. Nitroglycerin is a vasodilator and can cause orthostatic hypotension, resulting in dizziness. Three doses can be taken 5 minutes apart. The tablet should be placed under the tongue to dissolve. The medication should be kept in a readily accessible location for immediate use should chest pain occur.
Which statement indicates to the nurse that the client understands sublingual nitroglycerin medication instructions? A) a. "I will take up to five doses every 3 minutes for chest pain." B) b. "I can chew the tablet for the quickest effect." C) c. "I will keep the tablets locked in a safe place until I need them." D) d. "I should sit or lie down after I take a nitroglycerin tablet to prevent dizziness."
D. it has potential toxicity
Why is theophylline recommended only as an alternative to inhaled bronchodilators in the treatment of COPD? a. it produces excessive secretions b. acute gastritis is produced c. it reduces FEV1 over long-term administration d. it has potential toxicity
A client is prescribed a noncardioselective beta1 blocker. What nursing intervention is a priority for this client? a. Assessment of blood glucose levels b. Respiratory assessment c. Orthostatic blood pressure assessment d. Teaching about potential tachycardia
b. Respiratory assessment
Decreased - tetracyclines have numerous side effects, adverse reactions, toxicities, and drug interactions
does tetracycline have an increased effect or decreased effect on antacids?
tetracycline can disrupt the microbial flora of the body
why is superinfection another adverse reaction that might result when taking tetracyclines?
