Exam 1

Pregnancy Category A Drugs

-Studies performed with pregnant women -No increased risk of fetal abnormalities shown

chronic pancreatitis causes

90% caused by alcohol abuse

Which patient could an RN safely assign to an LPN?

A young adult who has hematuria from a kidney stone

MOA of an ACE inhibitor blocks ACE from converting Angiotensin 1 to angiotensin 2.What does this do?

Decrease in aldosterone production, decrease BP, small increase in serum potassium along with sodium and fluid loss

True or False? The primary treatment for CHF is to make the heart beat harder and faster

False. Primary treatment involves increasing muscle contractility, bringing the system back to balance

True or False? The use of a loop diuretic is the first drug used in the Step Care management program to treat HTN.

False. Thiazide Diuretic first line drug to treat HTN

Acute pancreatitis cause

GB stones

Type 3 drug allergy

IgG or IGm Immune complex (serum sickness) itchy rash, high fever, swollen lymphnodes

Type 2 drug allergy

IgG or IGm Attack on specific cells, usually blood cells. Red Blood Cells, cell destruction cytotoxic

Type 1 Drug Allergy

Immediate IgE Anaphylactic Mast cells, quick response, eosiniphils hives, rash, dyspnea

Schedule 4 controlled substances

Includes substances that have a low potential for abuse and dependence. Includes diazepam, zolpidem, eszopicline, aprazolam, chlordiazepoxide, and clonazepam.

Which patient would the nurse monitor closely for the development of hypovolemic shock? Adult male with Acute MI Middle aged Acute Addisonian crisis Elderly female following insertion of central line Young adult male with pulmonary embolism

Middle-aged patient in acute Addisonian crisis.

The nurse is caring for a patient who has presented to the ER with signs and symptoms of an acute MI. While making initial assessment of this patient, the nurse notes the patient has had adverse reactions to digoxin and a history of CHF. The Dr. writes admission orders. Which of the following would be a drug of concern? Furosemide Milrinone Propranolol Aspirin

Milrinone (Primacor) They are contraindicated for MI

Pregnancy category B drugs

No evidence of risk to animal fetuses but no well-controlled studies in pregnant women

Which of the following needs to be included in a physician's order for a patient so the nurse can use the "rights of safe admin" when giving meds?

Patients name

Which intervention would the nurse predict to be of least benefit for hypotension when the patient is in cardiogenic shock following an acute MI? Prompt, aggressive thrombolysis Vasopressor agents (catecholamines) vasodilating agents (nitrates) Plasma volume replacement therapy

Plasma volume replacement therapy

A premature atrial contraction signifies a change in focus of which of the following? Automaticity SA node AV node Contractility

SA node

Which type of shock would the nurse recognize as being different from all other classic presentations of shock?

Septic Shock

Pregnancy Category X

Studies in animals or humans have demonstrated fetal abnormalities and/or there is positive evidence of human fetal risk based on adverse reaction data from investigational or marketing experience, and the risks involved in use of the drug in pregnant women clearly outweigh potential benefits.

Schedule 3 controlled substances

Substances with some potential for abuse and with currently accepted medical uses. Abuse may lead to moderate or low physical dependence or high psychological dependence. Examples - Codeine, Ketamine, Anabolic Steroids, Opium or Morphine Mixtures

Schedule 5 controlled substances

Substances with very low potential for abuse and currently accepted medical uses. The substances has very limited physical or psychological dependence liability. Examples - Codeine mixtures, Ephedrine

When the patient is in shock, which clinical parameter is used initially to evaluate the effectiveness of treatment?

Systolic blood pressure

Type 4 drug allergy

T cell Delayed hypersensitivity rxn contact dermatitis

Drug labels are a source of information. What information might a drug label provide? A. The manufactured date B. The expiration date C. When the patent expires D. The binding properties of the drug

The expiration date

What would cause a drug-drug interaction with bile acid sequestrants?

Thyroid hormones

What is an action of a drug?

To depress or slow cellular activities

True or False? Earlier discharge of patients from the inpatient setting is occurring much more than in the past?

True

True or False? Poisoning occurs when too much of a drug causes damage to multiple systems of the body

True

True or False? When Reading an ECG a knows that the P-R interval represents the normal delay of the conduction at the AV node

True

True or false? Groups of similar drugs, all of which are derived from a prototype, are available today because of technological advances that make particular drugs more desirable in a specific situation

True

True or false? LDL enter circulation as a tightly pack unit consisting of cholesterol, triglycerides and lipids.

True

Nurse is caring for a 27 year old African American woman who was just prescribed an ACE inhibitor for HTN management. What should be advised related to contraception?

Use barrier contraceptives to prevent pregnancy while taking these drugs

Pregnancy category c drugs

animal studies showed an adverse effect; but no studies done in pregnant women or animals

An infant delivered and with the birth cry developed cyanosis and marked dyspnea. Which nursing assessment would confirm obstructive shock?

concave abdomen. Abdominal organs sucked upward into the thoracic cavity result in the concave appearance

What does Starling's Law of the Heart state?

contractile properties of the heart; The more stretch gives you more force of contraction and that gives you more SV. Until it is stretched to the point at which it will not react at all

Pregnancy category d drugs

there is evidence of fetal risk but the benefits from use in pregnant women may be acceptable despite risk

Schedule 2 drugs

• High abuse potential • Accepted medical use • Severe physical and/or psychological dependence

Following spinal anesthesia, mother and unborn baby are at risk for the effects of distributive shock due to loss of sympathetic vasomotor tone. Which intervention is a priority?

Administer IVF bolus of isotonic solution

An unresponsive patient arrives in ER wearing medic-alert bracelet with severe peanut allergy. Respiratory arrest and collapse occur after ingestion of a chocolate candy- topped ice cream desert. What is the immediate intervention?

Administer epinephrine and antihistamines to relieve teh bronchospasm in anaphylactic shock.

A post MI patient shows signs and symptoms of early cardiogenic shock. What intervention takes priority?

Administer oxygen per nasal cannula

Following insertion of a central line, the nurse notes the CVP is elevated, yet the systolic BP is steadily decreasing. What is the first intervention?

Apply O2 per nasal cannula

Schedule 1 controlled substances

Are classified as high potential for abuse. No accepted medical use. Labeled C-1. -Examples: 1. heroin 2 hallucinogens 3. LSD 4. Marijuana(except when prescribed for cancer treatment.

The nurse is caring for a patient taking a HMG-CoA inhibitor. What would be an appropriate intervention for this patient?

Arrange for periodic ophthalmic exams. Genetic inhibition of HMG-CoA reductase associated with greater risk for cataracts

Two patients are receiving injections of penicillin G. One patient is a male, 35 years old, weighing 165 pounds. The other patient is female, 18 years old, weighing 125 pounds. You know that you will see the effects of the drug first in the male patient. What is the rationale for this? A. Women have less fat cells than men B. Men have more vascular muscles than women C. Women have a smaller circulatory system than men D. Drugs are generally tested on healthy males

B. Men have more vascular muscles than women