PHARM 3

Which is a Class Ia

Procainamide

A provider is considering the various drug therapy options for treating a patient's cardiac dysrhythmia. He should be aware that which of the following antidysrhythmic drugs is appropriate only for short-term use because of its severe adverse effects with long-term use?

Procainamide it is a sodium channel blocker and broad- spectrum antidysrhythmic. It should not be used for long-term treatment for dysrhythmias because of its riak for seriousadverse effects, including cardiotoxicity and arterial embolism.

A patient comes into the urgent care and asks to speak to a RN. He is very concerned as he has just started on simvastatin 20mg and his arms have started to hurt a little. He is aware of the serious side effect (rhabdomyolysis) caused by statin and he would like to stop taking his simvastatin. Which of the following statements is CORRECT?

Rhabdomyolysis is a rare adverse effect of simvastatin, however, given the recent onset of pain in patient's arms and his concern, the nurse should notify the physician at the urgent care!

What is concerning about Atrial Fibrillation?

The fibrillation of the atria makes the -person more prone to clots.

Identify the following rhythm.

V-Tach

what med is used to treat SVT

adenosine

which antidysrhythmic med is given via rapid IV push

adenosine

what med is used to treat v-fib and v-tach

amiodarone

a nurse is caring doe a client taking digoxin and develops changes on their ECG tracing and other manifestations that indicate the client has several digoxin toxicity. Which of the following drugs should the nurse expect to administer to treat this complication?

antigen- binding freagments acntigen- binding fragments also called digoxin immune Fab, binds to digoxin and blocks its action. The nurse should prepare to administer this antidote IV to clients who have severe digoxin toxicity.

which med is uded to treat bradycardia and exposure to chemical nerve agents?

atropine

When should simvastatin be taken

bedtime

A client with hypertension becomes pregnant. The drug of choice for this client is an angiotensin II receptor blocker centrally acting adrenergic inhibitor an ACE inhibitor: methyldopa - (NOT) a calcium channel blocker

centrally acting (mathadopa)

a nurse is administering hydrochlorothiazide to a client who has gouty arthristis. The nurse should monitor the client for which of the following findings that indicate an adverse effet on this drug

hyperuriceme or increased uric acid levels, along w gouty arthritis, can occur in clients who have a history of these conditions and are taking hydrochlorothiazide

a nurse is caring for a client who is taking spironolactone to treat hypertension. The nurse should recognize that which of the following client lab values requires immidiate intervention?

potassium 5.2 mEq/L it is a diuretic and an aldoterone antagonist that can cause hyperkalemia andplaces the client at risk for cardiac dysrrhythmias. This potassium level is outside the expected reference range of 3.5 to 5.0 mEq/L and requires immidiate intervention.

a nurse is caring for a client who is taking a diuretic. the nurse should instruct the client to include which of the following foods in their diet to increase potassium intake?

raisins diuretics can deplete the body of Ka, so the nurse instructs the client to include potassium- rich foods in the diet, such as raisings and other dried fruits.

A nurse is caring for a client who has a new prescription of verapamil. The nurse should clarify the prescription with the provider if the client has a history of which of the following conditions?

second- degree AV block it is a calcium channel clocker, can affecr AV conduction and is contraindicated for clients who have sick sinus syndrome or second or third degree AV block. Verapamil is indicated for HTN, angina pectoris, and the management of atrial flutter and fibrillation. It is also prescribed for the management of migrane headaches.

What is a blood clot attached to the interior wall of a blood vessel?

thrombus

a nurse is teaching a client who has a new prescription of quinidine. WHich of the following statements should the nurse include?

"monitor your pulse and report changes" sodium channel blockers, like quinidine, can worsen dysrhythmias, or cause new ones. The nurse should teach the client to monitor their pulse rate for the provider.

•A nurse has been caring for a 49-year-old man who was hospitalized with recurrent ventricular fibrillation and received IV amiodarone. The man is now scheduled to be discharged on oral amiodarone, and the nurse has just completed discharge instructions. Which of the following statements made by the patient indicates that further instruction is necessary?

)"I am going on a cruise next week & plan to just lie in the sun all day" The nurse will be concerned if the patient is planning to go on a cruise and lie in the sun all day. Photosensitivity is a problem for some patients who take amiodarone. With long-term treatment, a blue-gray discoloration of the exposed skin may be seen. The risk is increased in patients with fair complexions and with excessive sun exposure. The photosensitivity reverses slowly after the drug is discontinued. However, sometimes it is irreversible.

What is the half life of heparin? What is the aPTT goal needed to be achieved?

23 mins to 2.48 hours; 1.5 to 2.5 times normal value

What is the normal platelet count? Where are they produced?

250,000 cells; Produced in the bone marrow

The nurse is caring for a client admitted to the ED with a chief complaint of nausea, and vomiting. The nurse asks the client about the home medications being taken. The nurse would be most concerned if the client stated that which medication was being taken at home? A. Digoxin B. Captopril C. Losartan D. Furosemide

A. Digoxin

A nurse is prepared to administer a prescribed cardiotonic drug to a client based on the understanding that this group of drugs act in which way? A. They affect intracellular calcium levels in the heart muscle B. They block the sympathetic nervous system C. They block the renin angiotensin system D. They block the parasympathetic influence on the heart muscle

A. They affect intracellular calcium levels in the heart muscle

ACE inhibitors work on the renin-angiotensin system to prevent the conversion of angiotensin I to angiotensin II. Because this blocking occurs in the cells in the lung, which is the site of this conversion, the use of ACE inhibitors often results in A. pneumothorax B. pneumonia C. unrelenting cough D. respiratory depression

A. unrelenting cough

Select all of side effects from toxic levels of Quindine

AV block Ventricular Tachycardia -increase digoxin concentration

Which drug is used during SVT? - (NOT) Amiodarone - Adenosine - Atropine (NOT) - Amitriptyline

Adenosine

What is the medication of choice for any type of bradycardia? - (NOT) Epinephrine - (NOT) Dopamine - Atropine - (NOT)Amiodarone

Atropine

The nurse provides medication instructions to a client about digoxin.Which statement by the client indicates understanding of its adverse effects? A. Blurred vision is expected side effect of this medication B. If my pulse drops below 60 bpm, I should let my cardiologist know C. This medication may cause headache and weakness but that is nothing to worry about D. If I am nauseated or vomiting, I should stay on liquids and take some liquid antacids.

B. If my pulse drops below 60 bpm, I should let my cardiologist know

A client taking an ACE inhibitor is scheduled for surgery. The nurse should A. stop the drug B. alert the surgeon and mark the chart prominently C. cancel the surgery and consult with the prescriber D. monitor fluid levels and make sure fluids are restricted prior to the surgery

B. alert the surgeon and mark the chart prominently

Quinapril hydrochloride is prescribed for a client with heart failure. After administering the first dose, the nurse should monitor which item as the priority? a). Blood pressure b). Lung sounds c). Urine output d). Weight

Blood pressure

A patient with anemia who is given iron salts could expect to show a therapeutic increase in hematocrit A. within 72 hours B. within 2 to 3 weeks C. within 6 to 10 months D. withing 1 to 2 weeks

C. within 6 to 10 months

The stepped care approach to the treatment of hypertension includes A. lifestyle modification, including exercise, diet, and decreased smoking, and alcohol intake. B. use of a diuretic, beta-blocker, or ACE inhibitor to supplement lifestyle changes C. a combination of antihypertensive drug classes to achieve desired goal. D. all of the above

D. all of the above

The nurse would expect the physician to prescribe epoetin alfa (Epogen) as the drug of choice A. for acute blood loss during surgery B. to replace blood loss from traumatic injury C. for treatment of anemia during lactation D. for treatment of anemia associated with renal failure

D. for treatment of anemia associated with renal failure

a nurse is caring for a client who has a new prescription of verapamil to treat arterial fibrillation. The nurse should instruct the client to avoid drinking grapefruit juice while taking the med because it can cause the client to experience which of the following conditions?

HYPOtension larhe amounts of greapefruit juice can increase blood levels of verapamin by inhibiting its metabolism. An excess amount of the drug in the body can intesnsify otherwie theraputic effects like hypotension, causing serious risk for syncope and dizziness.

What two lab examination evaluate oral anticoagulants - PT; aPTT (NOT) - INR; PT - INR; aPTT (NOT) - INR; aPTT (NOT)

INR; PT

Which one of the these Class III antiarrhythmics is a pure potassium blocker? - NOT Sotalol - (NOT) Amiodarone - NOT Bretylium - Ibutilide

Ibutilide

Which statement about class IC mediation is true - (NOT) It cause no change in phase 0 on the cardiac myocytes - It is the most potent class I anti-arrhythmic - (NOT) It increases the (Effective Refractory Period) ERP interval - (NOT) First line therapy for atrial arrhythmias

It is the most potent class I anti-arrhythmic

All of the following are used in the treatment of hyperlipidemia except: - Lipitor - Lopressor - (NOT) Niaspan ER - (NOT) Questran

Lopressor

a nurse is caring for a client who has a new prescription for propranolol to treat a tachysysrhythmia. The nurse should instruct the client to avoid taking which of the followint types of OTC drugs while taking propanolol?

NSAID can interact w propranolol and decrease the anti-hypertensive action because vasoconstriction can occur in some COX- 2 inhibitors. The nurse should i nstruct the client to avoid NSAID and propranolol at the same time.