Semester 3: Exam 1: Pharmacology
Positive Inotropic drugs
increases contractility of the heart
Opioid antagonist
inhibits stimulation of opioid receptor
Dystonia
involuntary muscle contractions
Which 2 supplements may be ordered along with epoetin alfa?
iron and vit b12
What organ produces erythropoietin?
kidneys
side effects of reglan?
drowsiness and diarrhea, increased risk of extrapyramidal symptoms, and restlessness.
Neoadjuvant chemotherapy
drugs are given before primary therapy (surgery or radiation) to reduce the size of a tumor
What are anti-emetics?
drugs that help control vomiting
Dromotropic drugs
effect conduction of the heart
Chronotropic drugs
effect heart rate
Inotropic drugs
effect the contraction of the heart
What is ventricular hypertrophy?
enlargement or thickening of the ventricle(s) in the heart.
What medication is used to stimulate erythropoiesis?
epoetin alfa
What side will your edema be on if you have left sided heart failure?
left side.
Pain tolerance
level of pain a person is willing to accept
What 3 locations in the body is iron stored?
liver, spleen, and bone marrow.
What are 2 reasons anemia occurs?
maturation defect and excessive rbc destruction.
Adjuvant drugs
med given in addition to primary treatment to help it work better.
What medication is both a dopamine antagonist and a prokinetic?
metoclopramide (reglan)
Uses of Opioid agonist-antagonists and partial agonists.
moderate to sever pain, opioid dependence, adjunct for anesthesia, and labor pain.
Uses of opioid analgesics
moderate to severe pain, sedation, diarrhea, and cough suppression.
What are the 2 types of chemotherapy?
neoadjuvant chemo, and adjuvant chemo
Uses of opioid antagonist
opioid, alcohol abuse (reversal agent), opioid induced constipation.
What 3 routes can iron be given?
oral, IM, and IV.
Visceral pain
pain originating in the internal organs or smooth muscles. Harder to centralize or identify.
Partial agonist
partially stimulates the opioid receptor.
What are 4 contraindications for giving a patient epoetin alfa?
patients are risk of thrombosis, patients with uncontrolled hypertension, renal patients with a hgb >11, and cancer patients with a hgb >10.
How long does the therapeutic response for epoetin alfa take?
2-6 weeks
What is anemia?
A deficiency in red blood cells or hemoglobin.
What is hemophilia?
A disorder in which blood doesn't clot normally due to a DNA mutation of factors VIII or IX.
A nurse is caring for a patient who is experiencing an acute ischemic cerebrovascular event due to a thrombus in the cerebral vessel. Which of the following drugs should the nurse expect to administer? A. Alteplase. B. Aspirin. C. Clopidogrel. D. Heparin.
A. Alteplase.
What are the contraindicators for dopamine antagonists?
patients with severe respiratory depression, cardiovascular disease, hepatic disease, and patients under 2 years old.
What is erythropoiesis?
production of red blood cells
What are 2 examples of dopamine antagonists?
promethazine, and prochlorperazine.
Examples of anti-emetic antihistamine drugs
promethazine, meclizine, dimenhydrinate, and diphenhydramine.
Equianalgesia
providing equivalent pain relief of different drugs and doses.
Erythrocytes
red blood cells
Opioid agonist-antagonist
stimulates one opioid receptor, inhibits the other.
How does epoetin alfa work?
stimulates progenitor cells in bone marrow to produce rbcs and speed up rbc maturation.
Opioid analgesics
stimulates the opioid receptor
What are 2 contraindicators to anti-emetic antihistamines?
taking K supplements, and peptic ulcer disease.
What is heart failure?
the heart is not able to effectively pump blood out of the heart, leading to decreased perfusion.
What causes adverse effects of epoetin alfa?
the increase in rbcs in the serum.
How does atherosclerosis cause pulmonary edema?
the narrowing of the arteries caused by atherosclerosis causes increased systemic vascular resistance which makes the heart work harder to pump blood out, causing fluid to back up into the lungs.
Pain threshold
the point at which a person feels pain
Drug tolerance
the tendency for larger drug doses to be required over time to achieve the same effect
Adjuvant chemotherapy
the use of chemotherapy after or in combination with another form of cancer treatment such as administering chemotherapy after surgery or with radiation therapy
What do you have to obtain from the patient prior to transfusing factors derived from plasma?
transfusion consent.
Pseudoparkinsonism
tremor, shuffling gait, drooling, rigidity
What do low level of factor VIII and IX cause?
uncontrolled bleeding.
What 5 ways can you prevent skin staining when giving iron IM?
use a large needle (20g), change the needle after drawing up the medication from the vial, do not massage, give the injection in a large muscle (ventrogluteal site), and use z-track method to ensure medication is trapped in the muscle.
What medications do neurokinin antagonists decrease the effectiveness of?
warfarin, oral contraceptives.
What two groups of people require more iron?
women and children.
In assessing a patient before administration of a cardiac glycoside, the nurse knows that which lab result can increase the toxicity of the drug? A. Potassium level 2.8. B. Potassium level 4.9. C. Sodium level 140. D. Calcium level 10.
A. Potassium level 2.8.
A nurse is monitoring a patient who is undergoing anticoagulant therapy with heparin. Which of the following findings should the nurse identify as a possible indication of hemorrhage? A. Rapid pulse. B. Yellowing of the sclera. C. Elevated BP. D. Pale colored stools.
A. Rapid pulse.
A patient will be taking oral iron supplements at home. The nurse will include which statements in the teaching plan for this patient? (Select all that apply.) A. Take the iron tablets with meals. B. Take the iron tablets on an empty stomach 1 hour before meals. C. Take the iron tablets with an antacid to prevent heartburn. D. Drink 8 ounces of milk with each iron dose. E. Taking iron supplements with orange juice enhances iron absorption. F. Stools may become loose and light in color. G. Stools may become black and tarry. H. Tablets may be crushed to enhance iron absorption.
A. Take the iron tablets with meals, E. Taking iron supplements with orange juice enhances iron absorption, G. Stools may become black and tarry.
A nurse is caring for a patient who is scheduled for an outpatient surgical procedure and reports taking aspirin 81mg daily, including this morning. The nurse should identify that this places the patient at risk for which of the following complications? A. Uncontrolled bleeding. B. Myocardial infarction. C. Respiratory depression. D. Decreased renal perfusion.
A. Uncontrolled bleeding.
A patient is prescribed iron tablets for iron deficiency anemia. Which teachings should be provided? A. You should increase your water and fiber intake. B. Call prescriber if you have black stools. C. Take with yogurt or milk to decrease GI upset. D. Do not eat foods that contain Fe+ while taking this medication.
A. You should increase your water and fiber intake.
What teaching would be included for a patient on the following medications: -Aprepitant -Warfarin -Rosuvastatin -Oral contraceptive Select all that apply: A. You will need to monitor you PT and INR closely. B. You will need to monitor you PTT closely. C. You will need to use condoms during sexual intercourse. D. You will need to monitor you LDL levels closely.
A. You will need to monitor you PT and INR closely, C. You will need to use condoms during sexual intercourse.3
What 2 ways can you prevent skin staining when giving iron IV?
Administer it slowly and administer it in the largest vein possible.
What teaching is needed to decrease the risk of infection in patients on chemo? Select all that apply: A. Frequent handwashing. B. Avoid Crowds. C. Take your temperature every day. D. Wear a condom during sex.
All of the above.
Why is chemo given on a strict schedule?
Allows time for normal cells to recover, but not enough time for cancer cells to recover.
A nurse is caring for a patient who recently started alteplase therapy. The nurse should monitor the patient for which of the following adverse reactions? A. Bronchodilation. B. Headache. C. Edema. D. Hypertension.
B. Headache.
What are 7 types of drugs can act as anti-emetics?
Antihistamines, anticholinergics, cannabinoid agonists, prokinetic drugs, serotonin blockers, anti-dopaminergic drugs, and neurokinin blockers.
What are 2 examples of Neurokinin Antagonists?
Aprepitant (PO), and Fosaprepitant (IV)
Where should chemo be stored?
Away from other medications.
The nurse is administering intravenous iron dextran for the first time to a patient with anemia. After giving a test dose, how long will the nurse wait before administering the remaining portion of the dose? A. 30 minutes B. 1 hour C. 6 hours D. 24 hours
B. 1 hour
A nurse is administering epoetin intravenously to a patient who has renal failure. Which of the following actions should the nurse take? A. Shake the vial before using. B. Administer via IV bolus over 1-3 mins. C. Dilute the drug first with D5W. D. Save the vial for the next dose.
B. Administer via IV bolus over 1-3 mins.
A nurse is caring for a patient who is about to begin Alteplase therapy to treat a pulmonary embolism. Which of the following drugs should the nurse have available in the event of a severe adverse reaction? A. Vitamin K. B. Aminocaproic Acid. C. Protamine. D. Deferoxamine.
B. Aminocaproic acid.
Because Digoxin slows the electrical conduction rate, what will we need to monitor for? A. Tachycardia. B. Bradycardia. C. Hypotension. D. Hypertension.
B. Bradycardia.
A nurse is caring for a patient who has hemophilia A and is about to begin taking desmopressin to prevent bleeding. The nurse should monitor the patient for which of the following adverse reactions? A. Weight loss. B. Edema. C. Polyuria. D. Bradycardia.
B. Edema
A patient is brought into the emergency department for a fentanyl overdose. The patient is unresponsive to pain, HR= 60, BP= 85/56, RR= 8, O2 sat= 88% RA. What is the nurse's priority intervention? A. Start an IV and give naloxone to the patient. B. Give breaths to the patient using bag-valve-mask. C. Call for respiratory to intubate the patient. D. Document a head to toe assessment on the patient.
B. Give breaths to the patient using bag-valve-mask.
An oral iron supplement is prescribed for a patient. The nurse would question this order if the patient's medical history includes which condition? A. Decreased hemoglobin B. Hemolytic anemia C. Weakness D. Concurrent therapy with erythropoietics
B. Hemolytic anemia
The nurse is reviewing the orders for a patient and notes a new order for an angiotensin-converting enzyme (ACE) inhibitor. The nurse checks the current medications orders, knowing that this drug class may have a serious interaction with what other drug class? A. Digoxin. B. Acetaminophen. C. Nonsteroidal anti-inflammatory drugs. D. Nitrates.
C. Nonsteroidal anti-inflammatory drugs.
A nurse is giving instructions to a patient who will be receiving oral iron supplements. Which instructions will be included in the teaching plan? A. Take the iron tablets with milk or antacids. B. Crush the pills as needed to help with swallowing. C. Take the iron tablets with meals if gastrointestinal distress occurs. D. If black tarry stools occur, report it to the doctor immediately.
C. Take the iron tablets with meals if gastrointestinal distress occurs.
A patient who was receiving morphine 5mg IV push every 4 hours is now going home on morphine 10mg PO every 4 hours. The patient's caregiver wants to know why they have increased the dose of morphine. The nurse's best response is: A. "We expect the patient's pain to worsen when she is at home." B. "We want to make sure her pain is controlled well, so she doesn't have to be readmitted." C. "The patient cannot go home on an IV push medication." D. "The oral dose is about the same as what she is getting through her IV."
D. "The oral dose is about the same as what she is getting through her IV."
A patient has been taking Digoxin at home but took an accidental overdose and has developed toxicity. The patient has been admitted to the telemetry unit, where the physician has ordered Digoxin immune fab (Digifab). The patient asks the nurse why the medication is ordered. What is the nurse's best response? A. "It will increase your heart rate." B. "This drug helps lower your potassium levels." C. "It helps convert the irregular heart rhythm to a more normal rhythm. D. "This drug will bind to Digoxin and prevent it from acting in your body."
D. "This drug will bind to Digoxin and prevent it from acting in your body."
A nurse is caring for a patient who is taking ferrous sulfate to treat iron-deficiency anemia and develops iron toxicity. Which of the following drugs should the nurse expect to use to treat this complication? A. Flumazenil. B. Acetylcysteine. C. Naloxone. D. Deferoxamine.
D. Deferoxamine.
A nurse is teaching a patient who is starting treatment with warfarin. The nurse should plan to include information on which of the following topics to promote the effectiveness of the drug? A. Sleep modifications. B. Fluid manifestations. C. Driving modifications. D. Dietary modifications.
D. Dietary modifications.
A nurse is caring for a patient who is about to begin factor VIII therapy to treat hemophilia A. When administering factor VIII, which of the following actions should the nurse take? A. Administer the powdered form orally. B. Premedicate with Aspirin. C. Administer it via rapid IV bolus. D. Have emergency equipment readily available.
D. Have emergency equipment readily available.
A nurse is reviewing the medication record of a patient who is receiving alteplase following an acute myocardial infarction. Which medications should the nurse expect the patient to be takin in addition to the alteplase? A. Protamine. B. Desmopressin. C. Ferrous sulfate. D. Heparin.
D. Heparin.
A nurse is caring for a patient who is about to begin taking aspirin to reduce the risk of a cardiovascular event. The nurse should identify that the drug inhibits platelet aggregation by which of the following mechanisms? A. Activating thromboxane a2. B. Blocking adenosine diphosphate receptor agonists. C. Suppressing specific clotting factors. D. Inhibiting cyclooxygenase action in platelets.
D. Inhibiting cyclooxygenase action in platelets.
The nurse is teaching a patient with iron-deficiency anemia about foods to increase iron intake. Which food may enhance the absorption of oral iron forms? A. Milk B. Yogurt C. Antacids D. Orange juice
D. Orange juice
What is the antidote for iron toxicity/overdose?
Deferoxamine mesylate.
What are the 2 types of Epoetin Alfa?
Epogen, Procrit
What 4 things are needed to make red blood cells?
Erythropoietin, iron, folate (vit b9), and cobalamin (vit b12)
How often should the anticholinergic patch be changed?
Every 3 days.
What symptoms should a patient receiving chemo report to the provider?
Fever, cough, dysuria, pain at access site, new drainage, skin changes, or mucous membrane changes.
What 2 medications would you give to a neutropenic patient?
Filgrastim or Pegfilgrastim (stimulate WBC production)
What are 5 symptoms of severe withdrawl?
GI distress, seizures, neurological changes, behavioral changes, and cardiovascular changes.
Which 2 vital signs are a priority to monitor when a patient is administered epoetin alfa?
HR and BP
What is erythropoietin (EPO)?
The hormone that stimulates the production of red blood cells in our bone marrow
Why should you avoid these?
These things can bind to the iron and you will not be able to absorb it properly.
Neurokinin Antagonists
Inhibits substance P
What does the SA node do?
Initiates the electrical conduction of the heart.
What could cause excessive RBC destruction?
Intrinsic- rbcs are malformed/malfunctioned, and the body destroys it quicker (ex: sickle cell) Extrinsic- problem with the environment (ex: autoimmune disease or virus.)
What is the IM/IV form of iron called?
Iron Dextran.
What 2 things could cause a maturation defect?
Lack of ingredients (iron, b12) or bone marrow is not producing enough.
Why do women require more iron?
Menstruation.
How will the nurse monitor the effectiveness of epoetin alfa?
Monitor Hct
Can you shake the vial?
No, you have to roll it.
What other products can you give while giving epoetin alfa IV?
None. Cannot be given with any other products.
Examples of serotonin antagonists?
Ondansetron, Granisetron, Palonsetron
What medication is given to patients who are thrombocytopenic?
Oprelvekin (stimulate platelet production)
What lab value would cause a patient to be considered thrombocytopenic?
PLT <150
Somatic pain
Pain that originates from skeletal muscles, ligaments, or joints. Well localized, can be intermittent or constant.
Superficial pain
Pain that originates from the skin or mucous membranes. Small, well defined area.
What are 3 contraindicators for Reglan?
Patients with pheochromocytoma, cardiovascular disease, and seizures.
What are extrapyramidal symptoms?
Pseudoparkinsonism, Dystonia, Akathisia, and tardive dyskinesia.
Drug dependence
Psychological or physiological need for the drug.
What routes can epoetin alfa be given?
SQ and IV
What is an example of an anticholinergic drug?
Scopolamine (patch that goes behind ear)
What are 3 of the different classifications of pain?
Somatic, visceral, and superficial.
What if the patient starts to show any tardive dyskinesia symptoms while on reglan?
Stop the medication immediately.
Serotonin antagonists
Used to block serotonin; prevent emesis
What 2 lab values would cause a patient to be considered neutropenic?
WBC <3, and ANC <1.9
Abstinence syndrome
a characteristic cluster of symptoms that results from a sudden decrease in the level of usage of a substance (withdrawal)
Tardive dyskinesia (TD)
a motor disorder with facial movements.
What are 3 side effects of taking iron?
abdominal pain, constipation, black/dark green stool.
What 2 things must you have for epoetin alfa to be effective?
adequate iron and bone marrow function.
How do you test to see if a patient is going to have a reaction to iron?
administer a test dose prior to giving a dose. 25mg/15min, then wait 15 mins to see if there's a reaction.
How do you administer factors?
administer slowly, iv push, pull back and mix with their blood.
Maturation defect
an issue with not creating enough rbcs
What are 3 complications of iron?
anaphylaxis, hypotension, iron toxicity (overdose)
What are the side effects of dopamine antagonists?
anticholinergic effects, drowsiness, and hypotension.
2 causes of heart failure
atherosclerosis and blocked renal tubules.
Why are breastfed babies at a higher risk of iron deficiency anemia?
because there is no iron in breast milk.
Why do children require more iron?
because they are growing and their bodies are not yet making enough.
What can Iron Dextran IV/IM cause?
black staining on the skin.
Anticholinergic drugs
blocks acetylcholine receptors
Dopamine antagonists
blocks dopamine receptors
What is the route that blood travels when it is pumped and returned
blood leaves the right side of the heart to the lungs, then the left side of the heart to the kidneys, and back to the right side of the heart.
What is a side effect of anticholinergic drugs?
blurred vision, decrease secretions (dry mouth, urinary retention, constipation), decrease peristalsis (GI discomfort), CNS depression (sedation)
If you are going to administer a transfusion of factors, what laboratory department has to release them?
Blood bank, and you must personally pick it up, and verify the documentation with a second nurse.
The nurse will teach a patient who is receiving oral iron supplements to watch for which expected adverse effects? A. Palpitations B. Drowsiness and dizziness C. Black, tarry stools D. Orange-red discoloration of the urine
C. Black, tarry stools
What potential complications could arise due to thrombocytopenia? A. Inflammation. B. Infection. C. Bleeding. D. Dehydration.
C. Bleeding.
A nurse is monitoring a patient following ferrous sulfate administration. The nurse should monitor the patient for which of the following adverse reactions? A. Phlebitis. B. Dark orange colored stools. C. Constipation. D. Injection site pain.
C. Constipation.
A nurse is preparing to administer a prescribed dose of desmopressin to a patient who has hemophilia A. The client's lab results indicate that the client has a sodium level of 130 mEq/L. Which of the following actions should the nurse take? A. Clarify the prescription with the provider. B. Administer the drug with an analgesic. C. Administer the required dose only. D. Assess factor IX levels.
A. Clarify the prescription with the provider.
A nurse is caring for a patient who has chronic stable angina. The nurse should identify that which of the following drugs inhibits the action of adenosine diphosphate receptors (ADP) on platelets and can be prescribed to reduce the patient's risk for myocardial infarction? A. Clopidogrel. B. Heparin. C. Warfarin. D. Alteplase.
A. Clopidogrel.
Which medication may cause increased adverse effects when used with an ACE inhibitor or Angiotensin Receptor Blocker (ARB)? Select all that apply: A. Diuretics. B. Antacids. C. Antihypertensives. D. Acetaminophen.
A. Diuretics, C. Antihypertensives.
What adverse effect might a patient on an ACE inhibitor exhibit that would not be present in a patient on an angiotensin receptor blocker (ARB)? A. Dry cough. B. Angioedema. C. Increased K levels. D. Orthostatic hypotension.
A. Dry cough.
A nurse is teaching a patient about taking ferrous sulfate to treat iron-deficiency anemia. Which of the following instructions should the nurse include? Select all that apply. A. Eat iron-enriched foods. B. Spread the dosage across each day. C. Take the drug on an empty stomach. D. Report dark green or black stools. E. Increase dietary fiber intake.
A. Eat iron-enriched foods, B. Spread the dosage across each day, C. Take the drug on an empty stomach, E. Increase dietary fiber intake.
Anticholinergic drugs would most likely be contraindicated for which of the following medical conditions? Select 2: A. Enlarged prostate. B. Hypotension. C. Intestinal obstruction. D. Overactive bladder.
A. Enlarged prostate, C. Intestinal obstruction.
What safety precaution would a nurse implement for a patient on an ACE inhibitor or ARB? Select 2. A. Fall risk precautions. B. Standard precautions. C. Seizure precautions. D. Contact precautions.
A. Fall risk precautions, B. Standard precautions.
A nurse is caring for a patient who has renal failure and is receiving epoetin. The nurse should monitor the patient for which of the following adverse effects? A. Hypertension. B. Muscle pain. C. Edema. D. Dry mouth.
A. Hypertension.
What would be the top 2 nursing priorities for a patient on promethazine? A. Implementing fall risk precautions. B. Monitoring vital signs. C. Assessing for abdominal pain. D. Monitoring for extrapyramidal symptoms.
A. Implementing fall risk precautions, B. Monitoring vital signs.
Which medications may increase the risk of Digoxin toxicity? Select 2. A. Loop diuretics. B. Thiazide diuretics. C. ACE inhibitors. D. Angiotensin receptir blockers (ARBs).
A. Loop diuretics, B. Thiazide diuretics.
What assessment cues would indicate anemia? A. Patient complains of weakness. B. Patient complains of thirst. C. Patient complains of pain D. Patient complains of hunger.
A. Patient complains of weakness.
A patient is taking digoxin (Lanoxin) and a loop diuretic daily. When the nurse enters the room with the morning medications, the patient states, "I am seeing a funny yellow color around the lights." What is the nurse's next action? A. Assess the patient for symptoms of digoxin toxicity. B. Withhold the next dose of the diuretic. C. Administer the digoxin and diuretic together as ordered. D. Document this finding, and reassess in 1 hour.
A. Assess the patient for symptoms of digoxin toxicity.
What will the nurse monitor for while the patient is on an ACE inhibitor or Angiotensin Receptor Blocker (ARB)? Select 3. A. Blood pressure. B. K+ levels. C. Face swelling. D. Urinary output.
A. Blood pressure, B. K+ levels, C. Face swelling.
What assessment cues indicate decreased perfusion? Select 2: A. Cap refill > 3 seconds. B. Strong pulses. C. Pink mucosa. D. HR = 82. E. Edema.
A. Cap refill > 3 seconds, B. Edema.
A patient has been taking iron supplements for anemia for 2 months. During a follow-up assessment, the nurse will observe for which therapeutic response?A. Decreased weight B. Increased activity tolerance C. Decreased palpitations D. Increased appetite
B. Increased activity tolerance
What potential complication could arise due to neutropenia? A. Inflammation. B. Infection. C. Bleeding. D. Dehydration.
B. Infection
The nurse is administering liquid oral iron supplements. Which intervention is appropriate when administering this medication? A. Have the patient take the liquid iron with milk. B. Instruct the patient to take the medication through a plastic straw. C. Have the patient sip the medication slowly. D. Have the patient drink the medication, undiluted, from the unit-dose cup.
B. Instruct the patient to take the medication through a plastic straw.
Which of the following would be a priority nursing intervention for a patient on ondansetron? Select 2: A. Monitor vital signs. B. Monitor labs for electrolytes. C. Monitor for extrapyramidal symptoms. D. Assess for headaches. E. Implement fall risk precautions.
B. Monitor labs for electrolytes, E. Implement fall risk precautions.
A patient, currently undergoing chemotherapy, has a WBC = 1,000. The nurse calls the oncologist with the results. The oncologist orders the following. Which order should the nurse do first? A. Zosyn 1g IV every 12 hours. B. Obtain blood cultures x2. C. CBC every 4 hours. D. Oxygen 2-4L NC ORN for oxygen saturation <92%
B. Obtain blood cultures x2.
The adverse effects of anticholinergic drugs would most likely be increased when taken with which of the following medications? Select all that apply: A. Anti-lipemics. B. Opioid analgesics. C. Antihistamines. D. NSAIDs.
B. Opioid analgesics, C. Antihistamines.
A nurse should identify that clopidogrel is contraindicated for patients who have which of the following conditions? A. Myocardial infarction. B. Peptic ulcer disease. C. Pancreatitis. D. Myasthenia gravis.
B. Peptic ulcer disease.
Which lab would the nurse monitor prior to administering Oprelvekin? A. Electrolytes. B. Platelets. C. Hgb/Hct. D. WBC's E. AST/ALT
B. Platelets.
A nurse is caring for a patient who is about to begin taking folic acid to treat megaloblastic anemia. The nurse should monitor which of the following lab values to determine therapeutic effectiveness? A. Amylase level. B. Reticulocyte count. C. C-Reactive protein. D. Creatinine clearance.
B. Reticulocyte count.
What is the nursing priority for a patient who has thrombocytopenia? A. Increasing protein intake. B. Safety measures. C. Infection precautions. D. Monitoring platelet levels.
B. Safety measures.
What can oral iron cause?
Black staining of the teeth.
Antihistamine drugs
Blocks histamine receptors
A nurse is caring for a patient who is about to begin therapy with recombinant factor IX to treat hemophilia B. The patient asks the nurse about the risk of transmission with recombinant factor IX as compared with plasma-derived factor IX. The nurse should explain that the recombinant factor IX practically eliminates the risk for which of the following? A.HIV. B. Cytomegalovirus. C. Creutzfeldt-Jakob Disease. D. Anaphylaxis.
C. Creutzfeldt- Jakob Disease.
A nurse is caring for a patient who is taking filgrastim to treat neutropenia. The nurse should assess the patient for which of the following adverse effects? A. Dusky nail beds. B. Petechiae. C. Enlarged spleen. D. Swollen calf.
C. Enlarged spleen.
A patient with end-stage renal failure has been admitted to the hospital for severe anemia. She is refusing blood transfusions. The nurse anticipates drug therapy with which drug to stimulate the production of red blood cells? A. Folic acid B. Cyanocobalamin (vitamin B12) C. Epoetin alfa (Epogen) D. Filgrastim (Neupogen)
C. Epoetin alfa (Epogen)
A nurse is caring for a patient who is about to begin taking epoetin. An increase in which of the following lab values should indicate to the nurse that the therapy is effective? A. PT B. WBC C. HGB D. PLT
C. HGB
Which lab would the nurse monitor prior to administering Epoetin alpha? A. Electrolytes. B. Platelets. C. Hgb/Hct D. WBC's E. AST/ALT
C. Hgb/Hct
A patient is to receive iron dextran injections. Which technique is appropriate when the nurse is administering this medication? A. Intravenous administration mixed with 5% dextrose B. Intramuscular injection in the upper arm C. Intramuscular injection using the Z-track method D. Subcutaneous injection into the abdomen
C. Intramuscular injection using the Z-track method
A nurse should assess a patient who has megaloblastic anemia for indications of which of the following vitamin deficiencies? A. Vitamin C. B. Vitamin K. C. Vitamin B12. D. Vitamin D.
C. Vitamin B12.
A nurse is caring for a patient who is taking Clopidogrel to prevent stent restenosis. The nurse should monitor the patient for which of the following adverse reactions? A. Hyperuricemia. B. Hyponatremia. C. Lymphocytopenia. D. Thrombocytopenia.
D. Thrombocytopenia.
A nurse in the emergency department is assessing a patient who has been taking warfarin and is experiencing rectal bleeding. Which of the following drugs should the nurse expect to administer to the patient? A. Filgrastim. B. Deferoxamine. C. Protamine. D. Vitamin K.
D. Vitamin K.
Which lab would the nurse monitor prior to administering Filgrastim? A. Electrolytes. B. Platelets. C. Hgb/Hct. D. WBC's E. AST/ALT
D. WBC's
A patient about to receive a morning dose of digoxin has an apical pulse of 53 beats/min. What will the nurse do next? A. Administer the dose. B. Administer the dose, and notify the prescriber. C. Check the radial pulse for 1 full minute. D. Withhold the dose, and notify the prescriber.
D. Withhold the dose, and notify the prescriber.
What should you tell your patient to do to avoid teeth staining?
Take medication with a straw or dilute it.
What can you not do when taking oral chemo?
cannot touch it, crush it, chew it, split it, or break it.
Opioid overdose triad
coma, respiratory depression, pinpoint pupils
What 4 things should you avoid within an hour of taking iron supplements?
dairy products, antacids, coffee and tea.
Negative Dromotropic drugs
decrease cardiac conduction
Negative Inotropic drugs
decrease contractility of the heart
Negatice Chronotropic drugs
decrease heart rate
What are 3 types of oral iron?
ferrous sulfate, ferrous gluconate, and ferrous fumarate.
Side effects of neurokinin antagonists?
headache, fatigue/drowsiness, decreases effectiveness of other medications.
Side effects of serotonin antagonist?
headache, vertigo, prolonged Q-T intervals, extrapyramidal symptoms.
What is another name for excessive rbc destruction?
hemolytic anemia.
What are 3 causes of blocked renal tubules?
hypertension, diabetes, and medications that put stress on the kidneys.
What are 3 adverse effects of epoetin alfa?
hypertension, thrombolytic event, and embolic event.
Akathisia
inability to sit still.
Positive Dromotropic drugs
increase cardiac conduction
Positive Chronotropic drugs
increase heart rate
What causes blocked renal tubules?
when renal tubules become blocked it causes increased intravascular fluid volume, the fluid that should have gone out as urine gets backed up into circulation causing increases systemic vascular resistance, which increases BP and causes fluid to seep out of vessels, causing edema.
