Exam 2 Pharmacology

lithium side effects

renal toxicity, polyuria, hand tremor, upset GI

Furosemide adverse effects

-Hyponatremia -hypochloremia -dehydration -hypotension (loss of volume, relaxation of venous smooth muscle) -hypokalemia -ototoxicity -hyperglycemia -hyperuricemia

lantus insulin administration and patient education

-No "peak" of action -Prolonged duration of action (up to 24 hours) -Once-daily subQ dosing to treat adults and children

How nitroglycerin works

-acts directly on vascular smooth muscle to promote vasodilation on veins

epoetin alfa therapeutic effects

-anemia associated with chronic renal failure -chemotherapy-induced anemia -HIV-infected patients taking zidovudine -anemia in patients facing surgery

nitroglycerin therapeutic effects

-angina therapy -IV for preop control -heart failure -miocardial infarction -unstable angina

Alteplase (activase) side effects and how to treat them

-bleeding: blood products, aminocaproic acid -fever

Tricyclic antidepressant therapeutic effects

-blocks neuronal reuptake of EN and serotonin -depression -dipolar disorder -fibromyalgia

nitric oxide side effects

-blushed lips -lightheadedness -slow heartbeat -fainting -decreased cardiac output

Verapamil adverse effects

-bradycardia -hypotension -AV block -heart failure -peripheral edema -consipation -elevated digoxin -increased risk when mixed with beta blocker

What types of medications hemophilia patients can take for pain

-cant take NSAIDS or apsirins -can take tylenol, acetaminophen, and opioids

Digoxin toxicity S&S

-cardiac dysrhythmias -hypokalemia -heart disease -elevated digoxin level

lidocaine adverse effects

-chest pain -difficulty breathing -cold, clammy skin -difficulty swallowing -dizziness/ lightheadedness

side effects of amiodarone

-cough -dizziness, fainting -fever -numbess and tingliness in fingers -painful breathing -sensitivity to light -trembling of hands -trouble with walking

Lithium medication interactions

-diuretics -Nonsteroidal anti-inflammatory drugs -anticholinergic drugs

Lithium drug interactions

-diuretics -nonsteroidal anti-inflammatory -anticholinergic drugs

Cardizem side effects

-dizziness -flushing -headache -edema of lower extremeties -exacerbates bradycardia -heart failure -sick sinus syndrome -second or third duress heart block

Foods to avoid while taking MAOIs

-foods that are right in tyramine -aged foods, cured meats

nitroglycerin side effects

-headache -orthostatic hypotension -reflex tachycardia

Nitric oxide indications

-hypoxic respiratory failure

lab values to monitor for epoetin alfa

-iron levels -hemoglobin

Lithium associated lab values

-low therapeutic index (0.6-1.2) or excessive greater than 1.5

Cardizem therapeutic effects

-lower blood pressure -hypertension -cardiac dysrhythmias -angina pectoris

dangerous side effects of inhaled anesthetics and assesment findings

-malignant hyperthermia

Lidocaine + Epinephrine therapeutic effects

-most widely used anesthetic (both epidural and spinal) -effects extended if given together

opioid overdose S&S

-pale face -skin cold -N and V -breathing/heartbeat slows/stops -cannot be awaken and unable to speak

lithium toxicity S&S

-polydipsia -slurred speech -hand tremors -weakness -ataxia -diarrhea

lab values to monitor in patients taking hydrochlorothiazide

-potassium levels, -blood glucose, - BUN, -serum uric acid levels

Mannitol (osmitrol) indications/reason for giving

-promotes diuresis by creating osmotic force -prophylaxis of renal failure -reduction of intracranial pressure -reduction of intraocular pressure

Nitroprusside indications

-reduce bleeding -lower blood pressure

Midazolam (versed) therapeutic effects

-relaxation and amnesia

tricyclic antidepressants side effects

-sedation -orthostatic hypotension -anticholinergic effects -seizures -hypomania -cardiac toxicity -may increase risk for suicide

Varapamil therapeutic effects

-slows ventricular rate (a-fib or flutter) -terminate SVT caused by AV nodal reentrant circuit

how lovastatin should be administered

-taken with meals -extended release (one dose a day at bedtime)

Verapamil indications

-treat heart rhythm problems -severe angina -hypertension

therapeutic effects of digoxin

-treats heart failure and abnormal rhythms -increases responsiveness of SA node -increases myocardial contractility -increases urine production -decreases renin release

Normal serum postassium level

3.5-5

patient asks the nurse why a vitamin with folic acid is needed during pregnancy. Which response by the nurse is most appropriate? A. "Folic acid prevents a birth defect called spina bifida." B. "You should talk to your healthcare provider." C. "Vitamins with folic acid prevent scurvy during pregnancy." D. "Without folic acid, the fetus may develop cerebral palsy."

A. "Folic acid prevents a birth defect called spina bifida."

A patient with angina pectoris is prescribed sublingual nitroglycerin. Which statement made by the patient indicates understanding of the medication teaching?A. "I may experience a headache as a side effect." B. "The chest pain should be relieved within 30 minutes." C. "I should swallow the tablet and drink a glass of water." D. "I should take this medication in the morning before breakfast."

A. "I may experience a headache as a side effect."

The nurse teaches a patient about benazepril [Lotensin]. Which statement by the patient requires an intervention by the nurse? A. "I use NoSalt instead of salt to season foods." B. "I eat sweet potatoes once or twice a week." C. "I drink 4 ounces of prune juice each morning." D. "I like asparagus because it's high in vitamin K."

A. "I use NoSalt instead of salt to season foods."

A patient is receiving an intravenous infusion of heparin to treat a pulmonary embolism. What laboratory value will the nurse monitor to evaluate treatment with this medication? A. Activated partial thromboplastin time (aPTT) B. Prothrombin time (PT) C. Platelet count D. Hemoglobin and hematocrit

A. Activated partial thromboplastin time (aPTT)

A patient with which condition would most likely be prescribed a glucocorticoid in low doses for replacement therapy? A. Addison's disease B. Rheumatoid arthritis C. Systemic lupus erythematosus D. Cushing's syndrome

A. Addison's disease

A patient has a serum potassium level of 3.1 mEq/L. It is appropriate for the nurse to take which action? A. Administer the ordered sustained-release potassium tablets [K-Dur]. B. Immediately stop the infusion of the maintenance IV, which has 30 mEq of potassium in it. C. Prepare to administer the ordered intravenous dose of furosemide [Lasix]. D. Administer the prescribed dose of sodium polystyrene sulfonate [Kayexalate].

A. Administer the ordered sustained-release potassium tablets [K-Dur].

When providing discharge teaching for a patient who has been prescribed furosemide [Lasix], it is most important for the nurse to include which dietary items to prevent adverse effects of furosemide [Lasix] therapy? A. Bananas, spinach, and potatoes B. Baked fish, chicken, and cauliflower C. Tomato juice, skim milk, and cottage cheese D. Oatmeal, cabbage, and bran flakes

A. Bananas, spinach, and potatoes

Cholestyramine has been prescribed for a patient. Which instruction should the nurse include in patient teaching? A. Cholestyramine can impair absorption of fat-soluble vitamins. B. Stop taking the drug if you develop constipation. C. Take cholestyramine with other drugs you are prescribed to enhance absorption. D. Do not take the medication if the formula is cloudy after mixing with water.

A. Cholestyramine can impair absorption of fat-soluble vitamins.

The nurse cares for a patient receiving digoxin [Lanoxin]. What indicates to the nurse that treatment with this medication is effective? A. Improved cardiac output B. Reduced exercise tolerance C. Increased body weight D. Decreased cardiac contractility

A. Improved cardiac output

The healthcare provider prescribes sustained-release verapamil [Calan SR] to an 82-year-old patient who takes digoxin [Lanoxin] daily. Which action is most appropriate for the nurse to take? A. Monitor the patient's cardiac rhythm continuously. B. Assess the patient for tachycardia and hypertension. C. Maintain the patient on bed rest for 8 to 10 hours. D. Reduce dietary fiber to prevent loose, watery diarrhea.

A. Monitor the patient's cardiac rhythm continuously.

After surgery, a patient has morphine prescribed for postoperative pain. It is most important for the nurse to make which assessment? A. Respiratory rate B. Heart rate C. Pain level D. Constipation

A. Respiratory rate

A patient is prescribed NPH insulin. Which statement should the nurse include in the discharge instructions? A. The insulin will have a cloudy appearance in the vial. B. The onset of action is rapid. C. The patient should not mix NPH with short-acting insulin. D. The patient will have no risk of allergic reactions with this insulin.

A. The insulin will have a cloudy appearance in the vial.

A patient is prescribed insulin glargine [Lantus]. Which statement should the nurse include in the discharge instructions? A. The insulin will have a cloudy appearance in the vial. B. The insulin should be injected three times per day. C. The patient should mix Lantus with the intermediate-acting insulin. D. The patient will have less risk of hypoglycemic reactions with this insulin.

A. The insulin will have a cloudy appearance in the vial.

The nurse prepares to administer lithium to a patient. Which laboratory result should first be assessed? A. Urinary creatinine clearance B. Serum troponin I and T levels C. Fasting blood glucose level D. Serum lipid profile

A. Urinary creatinine clearance

A nurse instructs a patient about signs and symptoms of digoxin toxicity. The nurse determines that teaching is successful if the patient makes which statement? A. "If my heart is racing, the dose may be too high." B. "I should report any muscle weakness or nausea." C. "My doctor should be notified if diarrhea occurs." D. "The dose will be reduced if I develop memory loss."

B. "I should report any muscle weakness or nausea."

The nurse instructs a patient about taking levothyroxine [Synthroid]. Which statement by the patient indicates the teaching has been effective? A. "To prevent an upset stomach, I will take the drug with food." B. "If I have chest pain or insomnia, I should call my doctor." C. "This medication can be taken with an antacid." D. "The drug should be taken before I go to bed at night."

B. "If I have chest pain or insomnia, I should call my doctor."

The nurse instructs a patient about taking nifedipine [Procardia ]. Which statement made by the patient indicates an understanding of medication teaching? A. "I'll stop taking my beta blocker." B. "The pill should be swallowed whole." C. "The drug will cause diarrhea." D. "This drug treats heart rhythm problems."

B. "The pill should be swallowed whole."

A patient with hemophilia reports mild joint pain. Which over-the-counter medication should the nurse recommend to this patient? A. Ibuprofen [Motrin] B. Acetaminophen [Tylenol] C. Enteric-coated aspirin D. Ginkgo biloba

B. Acetaminophen [Tylenol]

During administration of alteplase [Activase], the patient's IV site starts to ooze blood around the catheter. Which action by the nurse is most appropriate? A. Discontinue the infusion of alteplase. B. Assess the patient's vital signs. C. Apply direct pressure over the puncture site. D. Administer aminocaproic acid [Amicar].

B. Assess the patient's vital signs.

A patient is prescribed ferrous sulfate (iron) and complains of stomach upset after taking the medication. Which action by the nurse is most appropriate? A. Instruct the patient to take the medication with food or milk. B. Contact the prescriber to reduce the dosage. C. Have the patient take the medication with an antacid. D. Switch the medication to a liquid form and mix with juice.

B. Contact the prescriber to reduce the dosage.

The patient has received isoflurane [Forane] as a general anesthetic. What should the nurse closely observe the patient for during the immediate postoperative period? A. Elevated blood pressure B. Decreased respiratory rate C. Malignant hyperthermia D. Decreased pulse rate

B. Decreased respiratory rate

A patient receives a dose of epoetin alfa [Epogen] 3 times a week. What laboratory value will the nurse monitor to determine the therapeutic benefit of this medication? A. White blood cell count B. Hemoglobin C. Serum potassium D. Platelet count

B. Hemoglobin

A patient is prescribed metformin. Which statement about metformin does the nurse identify as true? A. Metformin increases absorption of vitamin B12. B. Metformin can delay the development of type 2 diabetes in high-risk individuals. C. Metformin causes patients to gain weight. D. Metformin use predisposes patients to alkalosis.

B. Metformin can delay the development of type 2 diabetes in high-risk individuals.

The nurse cares for a patient with primary hypoaldosteronism who took excessive doses of fludrocortisone [Florinef]. It is most important for the nurse to assess the patient for what? A. Increased urine output and hypotension B. Muscle weakness and an irregular heartbeat C. Hypotension and poor skin turgor D. Weight loss and hyperactive reflexes

B. Muscle weakness and an irregular heartbeat

A patient is prescribed hydralazine. What is most important for the nurse to teach the patient? A. Precautions for postural hypotension B. Prevention of reflex tachycardia C. High initial dose for slow acetylators D. Recognition of hypertrichosis

B. Prevention of reflex tachycardia

The nurse administers the preoperative medication midazolam [Versed]. The nurse will monitor the patient for which intended effect of this medication? A. Decreased bronchial secretions B. Reduction in anxiety C. Respiratory depression D. Suppression of cough

B. Reduction in anxiety

The nurse prepares to administer the first dose of an antipsychotic agent to a patient. One hour after administration, it is most important for the nurse to assess what? A. The range of motion of the upper and lower extremities B. The orthostatic blood pressure measurements C. The abdomen for distention and bowel sounds D. The tympanic membrane with an otoscope

B. The orthostatic blood pressure measurements

A patient takes levothyroxine [Synthroid] 0.75 mcg every day. It is most appropriate for the nurse to monitor which laboratory test to determine whether a dose adjustment is needed? A. Thyrotropin-releasing hormone (TRH) B. Thyroid-stimulating hormone (TSH) C. Serum free T4 test D. Serum iodine level

B. Thyroid-stimulating hormone (TSH)

A patient is prescribed lovastatin [Mevacor]. The nurse will teach the patient to take the medication at which time? A. With any meal B. With the evening meal C. 1 hour before breakfast D. 2 hours after any meal

B. With the evening meal

The nurse teaches a patient diagnosed with chronic stable angina about the mechanism of action of nitroglycerin. The nurse should include which instruction? A. "Nitroglycerin reduces vasospasms of the heart's arteries, which improves blood supply." B. "Nitroglycerin opens the arteries to allow more oxygen to be delivered to the heart muscle." C. "Nitroglycerin dilates veins, which decreases the amount of oxygen needed by the heart." D. "Nitroglycerin improves blood flow to the heart muscle by increasing blood pressure."

C. "Nitroglycerin dilates veins, which decreases the amount of oxygen needed by the heart."

The caregiver of a patient with hemophilia is learning how to administer clotting factor VIII at home. Which statement, made by the caregiver, indicates understanding of the instructions? A. "I will inject the solution into the fatty tissue of the abdomen." B. "An aspirin should be taken first to prevent clotting." C. "I will watch for hives, difficulty breathing, and facial swelling." D. "I will give the clotting factors once or twice a month."

C. "I will watch for hives, difficulty breathing, and facial swelling."

A patient is prescribed a nitroglycerin transdermal patch. The nurse should include which statement when teaching the patient how to use this medication? A. "Apply the patch to the chest over the heart." B. "Change the patch each week." C. "Remove the patch at bedtime." D. "Put on the patch before exercising."

C. "Remove the patch at bedtime."

A pediatric patient is prescribed somatropin [Humatrope] for growth hormone deficiency. It is most appropriate for the nurse to take which action? A. Perform a venipuncture to give the medication intravenously. B. Obtain a straw to prevent staining of the tooth enamel. C. Draw up the drug into a syringe and give it subcutaneously. D. Mix the medication in 30 mL of fruit juice.

C. Draw up the drug into a syringe and give it subcutaneously.

The nurse cares for a patient who is receiving lithium. Which medication, if prescribed by the healthcare provider, should the nurse question? A. Levothyroxine [Synthroid] B. Sulindac [Clinoril] C. Furosemide [Lasix] D. Propranolol [Inderal]

C. Furosemide [Lasix]

An adult patient receives lidocaine by injection before a procedure. Which finding indicates that the patient is experiencing a systemic reaction and toxicity? A. Mean arterial pressure of 75 mm Hg B. Temperature of 100.8°F (38.2°C) C. Heart rate of 42 beats/min D. Respiratory rate of 12 breaths per minute

C. Heart rate of 42 beats/min

A child with type 1 diabetes mellitus is diagnosed with growth hormone deficiency and is started on somatropin [Humatrope]. It is most appropriate for the nurse to monitor the child for which condition? A. Renal insufficiency B. Hypertension C. Hyperglycemia D. Hypothyroidism

C. Hyperglycemia

The nurse cares for a patient who received nitric oxide along with a primary anesthetic. The nurse should assess the patient for which adverse effect of nitric oxide? A. Urinary retention B. Elevated temperature C. Nausea and vomiting D. Depressed respiratory rate

C. Nausea and vomiting

A patient who is diagnosed with BPD is prescribed lithium. To monitor for lithium toxicity, the nurse should observe the patient for which signs and symptoms? A. Insomnia, increased appetite, and abdominal distention B. Dry cough, hyperactive reflexes, and hypertension C. Polydipsia, slurred speech, and fine hand tremors D. Constipation, asterixis, and generalized edema

C. Polydipsia, slurred speech, and fine hand tremors

What is the antidote for heparin? A. Ferrous sulfate B. Atropine sulfate C. Protamine sulfate D. Magnesium sulfate

C. Protamine sulfate

A patient is prescribed spironolactone [Aldactone] for treatment of hypertension. Which foods should the nurse teach the patient to avoid? A. Baked fish B. Low-fat milk C. Salt substitutes D. Green beans

C. Salt substitutes

A patient is prescribed digoxin [Lanoxin] and furosemide [Lasix]. It is most important for the nurse to assess which value before administering these medications? A. Serum sodium B. Blood urea nitrogen C. Serum potassium D. Plasma B-natriuretic peptide

C. Serum potassium

A patient is prescribed isocarboxazid [Marplan] (an MAOI) for the treatment of depression. Which foods should the patient be taught to avoid? A. Broccoli, shrimp, and yogurt B. Tomatoes, chicken, and milk C. Turkey, smoked fish, and smoked cheese D. Apples, steak, and cottage cheese

C. Turkey, smoked fish, and smoked cheese

Which manifestations does the nurse associate with tardive dyskinesia? A. Pacing and squirming, and then abrupt stopping B. Mask-like face with drooling, tremors, rigidity, and shuffling gait C. Twisting, worm-like movements of the tongue and face D. Sudden high fever, sweating, and blood pressure fluctuationsC. Twisting, worm-like movements of the tongue and face

C. Twisting, worm-like movements of the tongue and face

Which patient would be at highest risk for systemic toxicity from the topical administration of a local anesthetic? A. A 42-year-old patient who receives epinephrine with a local anesthetic B. A 72-year-old patient who receives a local anesthetic that is topically applied to intact skin C. A 58-year-old patient who receives a local anesthetic to a 10-cm×20-cm abrasion D. A 34-year-old patient given an injection of bupivacaine as a nerve block

C: A 58-year-old patient who receives a local anesthetic to a 10-cm×20-cm abrasion

Nitroprusside therapeutic effects

Chest pain or discomfort. fast, pounding, or irregular heartbeat or pulse. lightheadedness, dizziness, or fainting. slow heartbeat. trouble breathing. unusual tiredness.

The nurse teaches a patient with Addison's disease about hydrocortisone replacement therapy. Which statement, made by the patient, indicates that the teaching was effective? A. "I can expect my heart rate to be high." B. "If I become ill, the dose needs to be reduced." C. "It's important to take the medication at bedtime." D. "I should keep an emergency supply of this drug available at all times."

D. "I should keep an emergency supply of this drug available at all times."

A patient is prescribed sustained-release oral nitroglycerin capsules for chronic stable angina. The nurse should include which instruction? A. "Avoid exercising to help prevent chest pain." B. "Place the capsule under the tongue if chest pain occurs." C. "Take the capsule as needed before exercise or exertion." D. "Sit or lie down if dizziness or lightheadedness occurs."

D. "Sit or lie down if dizziness or lightheadedness occurs."

The nurse teaches a patient with hypothalamic diabetes insipidus about desmopressin [DDAVP]. The nurse determines that the teaching was effective if the patient makes which statement? A. "I should increase my fluid intake to prevent dehydration." B. "The medication should be taken every day for 6 months." C. "I can expect to urinate more often while taking this drug." D. "The medication can be taken by inhaling through my nose."

D. "The medication can be taken by inhaling through my nose

Which patient would most likely be prescribed sodium nitroprusside [Nitropress]? A. A patient with a recent diagnosis of essential hypertension B. A patient with heart failure who receives weekly home visits C. A patient who is hypotensive after a myocardial infarction D. A patient with a hypertensive crisis in the intensive care unit

D. A patient with a hypertensive crisis in the intensive care unit

A patient is prescribed doxepin [Sinequan] , a tricyclic antidepressant, for the treatment of depression. Which over-the-counter medication should the nurse teach the patient to avoid? A. Glucosamine sulfate B. Omeprazole [Prilosec] C. Fish oil (omega-3 fatty acids) D. Diphenhydramine [Benadryl]

D. Diphenhydramine [Benadryl]

A patient is brought to the emergency department for the treatment of an overdose of alprazolam [Xanax]. Which medication should the nurse prepare to administer to this patient? A. Protamine sulfate B. Acetylcysteine [Acetadote] C. Naloxone [Narcan] D. Flumazenil [Romazicon]

D. Flumazenil [Romazicon]

A postoperative patient who received an intravenous infusion of morphine has a respiratory rate of 8 breaths per minute and is lethargic. Which as-needed medication should the nurse administer to the patient?A. Methadone [Dolophine] B. Nalbuphine [Nubain] C. Tramadol [Ultram] D. Naloxone [Narcan]

D. Naloxone [Narcan]

A patient is to receive a scheduled dose of diltiazem [Cardizem]. The nurse should hold the medication and contact the prescriber if which of the following is noted? A. The patient's blood pressure is 112/64 mm Hg. B. The patient's cardiac rhythm is atrial fibrillation. C. The patient is complaining of chest pain. D. The patient is in second-degree heart block.

D. The patient is in second-degree heart block.

ACE inhibitor side effects and patient teaching

Dry cough. Increased potassium levels in the blood (hyperkalemia) Fatigue. Dizziness from blood pressure going too low. Headaches. Loss of taste. keep a log of pulse and BP stay

Benzodiazepine overdose treatment

Flumazenil (Romazicon) -patient will experience life threatening reactions, profound hypotension, respiratory and cardiac arrest

types (names) of hypotonic, isotonic, and hypertonic IV solutions

Hypotonic- 0.45% Isotonic- 0.9% Hypertonic- 3%

heparin antidote

Protamine sulfate

lab values to monitor while taking heparin

aPTT 1.5-2.5

Differences between opioid addiction and tolerance

addiction: behavior pattern characterized by continued use of a psychoactive substance despite physical, psychologic, or social harm tolerance:diminished response to a drug when the drug is used repeatidly

cholestyramine (bile-acid sequestrant) side effects

constipation. bloating. stomach pain. gas. upset stomach. vomiting. diarrhea. loss of appetite.

opioid overdose treatment

opioid antagonists -naloxone -methylnaltrexone -alvimopan -neltexone

how to treat low potassium

treatment is with a thiazide or loop diuretic, as well as potassium salts

how to treat high potassium

treatment is withholding foods with potassium, withhold meds that promote potassium, calcium salts, and infusion of glucose and insulin