NURS 350 Final Exam Review
What are the components of collecting patient drug history?
-current prescription meds -use of recreational/drugs substances -home remedies -self-treatment with complimentary & alternative drugs -use of OTC's
What are the major responses to anticholinergics ?
-decrease in GI motility -decrease in salivation -dilation of pupils
What are side effects/adverse reactions of Prednisone?
-headache -flushing -euphoria -depression -psychosis -increased appetite -sweating -thin skin with purpura -tachycardia -hypertension -*hyperglycemia* -edema -sodium and water retention -adrenal atrophy -abnormal fat deposits (leading to coronary artery plaque development) -muscle wasting -glaucoma -peptic ulcers -growth retardation
What are glucocorticoids used for?
-inflammation -autoimmune disorders -ulcerative colitis -glomerulonephritis -allergies -drug reactions -anaphylaxis -prevent organ rejection
How long does it take for benzodiazepine withdrawal symptoms to occur?
2 to 10 days and can last several weeks depending on the benzodiazepine's half-life
What is insulin glargine/lantus used for ?
24 hour glucose control
What is the duration of insulin glargine/Lantus ?
24 hours
What is the duration of regular insulin ?
3-5 hours (short)
What is the onset of action of regular insulin ?
30 min to 1 hour (rapid)
For the prevention of osteoporosis, what is the oral weekly dosage of alendronate?
35 mg
For the treatment of osteoporosis, what is the oral weekly dose of alendronate?
70 mg
decreases vasoconstriction
ACE inhibitor
What is Methylphenidate (Ritalin) used for ?
ADHD
What type of drug is gentamicin ?
Aminoglycoside
What is Nystatin ?
Antifungal drug
What is Nystatin used for ?
Candida infections
Government set rules for the manufacture and distribution of drugs considered to have the potential for abuse
Controlled Substances Act 1970
What drug is used to treat fluid retention?
Furosemide
What are the side effects and adverse reactions to cephalosporin?
GI disturbances alteration in blood clotting time nephrotoxcity
I am a nonnarcotic antitussive and I am widely used in OTC cold remedies, what drug am I ?
Guaifenesin
What other precautions should the nurse tell the client when taking Prednisone?
If they have a fever, sore throat or malaise they should report it
What drug is effective against influenza A and B?
Oseltamivir (Tamiflu)
What should the nurse evaluate before giving a patient a heparin injection?
PTT and APTT values
I am anticonvulsant and highly protein bound, what drug am I ?
Phenytoin (Dilantin)
Why should vitamin K be limited when taking Warfarin Sodium?
Vitamin K is a anticoagulant antagonists
Prior to administering a drug with pregnancy category, what should you ask your patient?
When was your last menstrual period?
What is a Albuterol mdi Proventil?
a quick relief agent
concentration of a drug is greatly reduced before it reaches the systemic circulation
first pass
What should be limited when taking Warfarin Sodium (Coumadin)?
foods high in vitamin K
What foods should be avoided when taking monoamine oxidase inhibitors (MAOIs)?
foods that contain tyramine such as figs, bananas, sauerkraut
What is Tretinoin used for?
for mild to moderate acne
How should levothyroxine be administered?
gradually increase dosage over a period of weeks
What are the side effects of Omeprazole?
headache, dizziness, edema, diarrhea, abdominal pain, constipation
What medications can be problematic for elderly?
high protein bound medications, anticholinergics and drugs with narrow therapeutic range
What are the systemic side effects of a topical glucorticoid?
hypercalcemia and suppression of parathyroid hormone
What are the side effects of Methylphenidate (Ritalin)?
hypertension, growth suppression and transient weight loss in children.
When should you take Simvastatin ?
in the evening
What should the nurse encourage the patient to do when taking guaifenesin?
increase fluid intake to help with secretions
A patient with low serum albumin taking phenytoin may be at risk for ?
increased sedative effects
What happens when a broad-spectrum antibiotic such as a amoxicllin is combined with a beta-lactamase enzyme inhibitor such as clavulanic acid what is the result of the antibiotic combination?
it inhibits the bacterial beta-lactamases, making the antibiotic effective and extending its antimicrobial effect
What is an expected adverse reaction of silver sulfadiazine?
itching/burning sensation
What are local side effects of a topical glucorticoid ?
local side effects include burning, pruritus, edema, peeling, dryness, and erythema
What type of insulin is glargine/lantus ?
long-acting
What should the nurse instruct patients taking antibiotics such as amoxicillin clavulanate (augmentin) ?
may be taken with food/meals
What are some side effects of phenytoin ?
may cause swelling and bleeding of the gums
I cause missing dentition and dental caries, what drug am I ?
methamphetamine
What should the nurse monitor when administering methylphenidate (Ritalin)?
monitor height, weight and blood pressure
What should be monitored when taking Warfarin Sodium (Coumadin)?
monitor medications with PT/INR levels
What should be monitored before a nurse gives a patient cephalosporin?
monitor serum BUN, creatinine and liver function tests
What should the nurse monitor before giving a patient gentamicin?
monitor serum drug levels
When should Oseltamivir be taken ?
must be taken 48 hours of symptom onset
What should the nurse instruct the client to do when taking inhaled glucorticoid?
must rinse mouth after use to avoid developing an oral fungal infection
monitor serum peak and trough
narrow therapeutic index
Digoxin has a narrow therapeutic index. What are the signs and symptoms the nurse should monitor with digoxin toxicity?
nausea, drowsiness, photophobia, seeing halos around bright lights
If the patient has a heart rate of 60 or less should the nurse proceed to administer Digoxin ?
no, the nurse should hold it
What are some nursing considerations when giving infants or young children ?
offer beverage of choice after "bad tasting" medication
What is the more common use of Nystatin?
oral suspension for Candida infection in the mouth
How can fluconazole be administered?
orally or intravenously
How is Nystatin administered ?
orally or topically
What causes systemic side effects of a topical glucorticoid?
overapplication
What are the serious adverse reactions to aminoglycosides ?
oxtotoxicity and nephrotoxicity
What should the patient monitor before administering Digoxin to the patient ?
patient's heart rate
Dipenhydramine (Benadryl) can have a reverse effect in which particular population?
pediatric
how a drug moves through the body
pharmacokinetics
When is Albuterol mdi Proventil taken ?
prn (as needed)
What can Ostetamivir (Tamiflu) be used as?
prophylaxis for inlfuenza A within 48 hours of exposure
Generally speaking when patients are pharmacologically treated for psychiatric illness what is the best practice a nurse can add?
psychotherapy
What are the pharmacological action of Omeprazole ?
reduce gastric acid by inhibiting hydrogen/potassium ATPase
How must the patient be positioned when taking Alenodronate?
remain upright for 30 minutes (sitting or standing)
Using Benadryl in children can increase the risk of serious side effects such as :
restlessness, irritability or agitation
If a medication is expired what should you do as a nurse ?
return expired medications to pharmacy
refers to a drug's ability to preferentially produce a particular effect and is related to the structural specificity of a drug binding to receptors
selectivity
What type of insulin is regular insulin ?
short and rapid
How should the nurse administer a heparin injection?
subcutaneously and the injection site should be rotated to prevent pain and bruising
What should be suggested for the patient who is being treated with anticholinergic?
suggest hard candy, chewing gum and oral hygiene for the patient
How should alendronate be taken?
taken with 8 ounces of water 30 minutes before ingesting any food, liquids, or drug
What are precautions should be taken when taking Prednisone?
taper off gradually upon discontinuation
Why should Prednisone be tapered off gradually upon discontinuation?
to allow adrenal glands to resume normal function
What should the nurse instruct a diabetic patient taking propanolol ?
to continue checking their blood sugar, as they may not show signs of hypoglycemia
If a patient taking trimethoprim-sulfamethoxazole experiences rash all over what should the nurse instruct the patient?
to discontinue the medication immediately
What is the primary use of Theophylline for?
to stimulate respiration
What is Fluconazole used for ?
to treat systemic fungal infections
What is silver sulfadiazine ?
topical cream
What is tretinoin?
topical retinoid
What is Metronidzole (Flagyl) used for ?
treat anaerobic bacterial infections
What should the nurse instruct the patient to do when using retinoids ?
use suncreen when using this product
What is topical glucorticoid used for?
used for dermatologic disorders
What is silver sulfadiazine (Silvadene) used for?
used to treat burns
What is Pilocarpine used for?
used to treat glaucoma by relieving (intraocular) fluid pressure
How should medication be administered to infants and young children ?
using an oral syringe
why should benzodiazepines not be discontinued abruptly?
withdrawal symptoms are likely to occur
How can Oseltamivir be taken?
without regard to food
What two groups of people should not take tetracycline ?
women in the last trimester of pregnancy and children younger than 8 years
What are anticholonergics topically used in ?
eye exams for the dilatation of pupils
What is the pharmacological action of glucocorticoids?
-affect inflammatory response -affect carbohydrate, protein, and fat metabolism -affect muscle and blood cell activities
What is testosterone used for ?
-androgen deficiency, hypogonadism -replacement therapy for testicular failure -delayed puberty in adolescents
What should the nurse teach the client when taking Levothyroxine Sodium (Synthroid) ?
-monitor pulse rate -take medication in the morning -notify MD of any chest pain -take medication same time each day -may take 1-3 weeks for full effect
How can you decrease adverse drug reactions in the elderly?
-take a thorough drug history (including OTCs) -monitor lab results & clinical response to drugs -monitor for drug-and-drug and drug-nutrient interactions -help patient avoid medications on BEERS list
What is the onsest for Setraline?
1-4 weeks
Balanced anesthesia may include
1. A hypnotic given the night before 2.Premedication with an opiod analgesic or benzodiazepine plus an anticholinergic given about 1 hour before surgery to decrease secretions 3. A short-acting nonbarbiturate such as propofol 4. An inhaled gas, often a combination of an inhalation anesthetic, nitrous oxide, and oxygen 5. A muscle relaxant given as needed
What are side effects of Fluphenazine (Prolixin)?
It can cause acute dystonia (muscle spams of the face, tongue, neck, and back; facial grimacing; abnormal or involuntary upward eye movement; and laryngeal spams that can impair respiration)
What is a drug of choice for opioid overdose with signs of respiratory, depression, drowsiness, and unresponsiveness?
Naloxone (Narcan)
What should the nurse educate a patient taking phenytoin ?
educate meticulous oral hygiene practices
SSRI for depression, OCD, PTSD, panic disorder, social anxiety disorder
Sertraline (Zoloft)
What is a life-threatening adverse reaction taking trimethoprim-sulfamethoxazole?
Stevens-Johnson syndrome
What drug encourages foods with potassium ?
Thiazide
combination of drugs frequently used in general anesthesia
balanced anesthesia
What are the two important things thing the nurse should be when giving medications to pediatrics?
be honest and truthful
Why shouldn't children younger than 8 years of age not take tetracycline ?
because it irreversibly discolors the permanent teeth
Why does propanolol have many side effects ?
because of its non-selective response in blocking both beta 1 and beta 2 receptors
How should retinoids used for?
before or after extended sun exposure because they can increase the risk of sunburn and intensify existing sunburn
never crush, cut or dissolve tablet.
extended-release tabs
What are the side effects/adverse reactions of testosterone?
acne, masculinization, irregular menses, urinary urgency, gynecomastia, priapism, red skin, jaundice, depression, increases cholesterol, alters thyroid and liver function, sodium and water retention
two drugs with similar actions are administered to achieve additive effect
additive
how avidly a drug binds its receptor or how the chemical forces that cause a substance to bind its receptor
affinity
What are the withdrawal symptoms caused by short-term benzodiazepine ?
agitation, nervousness, insomnia, tremor, anorexia, muscle cramps, and sweating
What should the nurse instruct the patient not to consume when taking metronidazole ?
alcohol
I am a bisphosphonate and I am used to treat osteopenia and osteoporosis, what drug am I ?
alendronate
What type of drug is Theophylline ?
analeptic
What are side effects of gentamicin ?
anorexia, stomatitis, nausea, vomiting, alopecia, rash, pruritus, skin/ocular irritation, visual disturbances, photosensitivity, headache, dizziness, confusion, depression, *tinnitus*, weakness, arhtralgia
What are side effects of trimethoprim-sulfamethoxazole ?
anorexia, stomatitis, nausea, vomiting, diarrhea, abdominal pain, weakness, rash, depression, headache, vertigo, insomnia, photosensitivity, tinnitus, arthralgia, myalgia
What is Fluconazole (Diflucan)?
antifungal drug
What should the nurse teach the client when using a topical glucorticoid?
apply thin film and gently rub into the affected area
What should the nurse teach a client who is taking topical glucorticoid?
apply thin film and gently rub the affected area
When should Insulin glargine/Lantus be administered?
at bedtime
the proportion of a drug or other substance which enters the circulation when introduced into the body and so is able to have an active effect
bioavailability
placed on antidepressants due to the increased risk for suicidal thinking and behavior in children and adolescents
black box warning
What should be monitored when a patient is taking Simvastatin?
blood work for liver failure every 2 months
What is digoxin used for?
bradycardia
Combination oral contraceptives are contraindicated in what type of patients ?
breast cancer patients & endometriosis
What are the routes of administration of testosterone ?
buccal, nasal, transdermal, parenteral
How can a nurse properly assess what medications an elderly patient is taking?
by requesting they bring all medications in the bottles to each visit
What are the side effects of diphenydramine (Benadryl)?
dizziness, drowsiness, loss of coordination; dry mouth, nose, or throat; constipation, upset stomach; dry eyes, blurred vision; or day-time drowsiness or "hangover" feeling after night-time use.
What are common side effects of risperidone (Risperdal)?
drowsiness & headache
What substance should be avoided when taking Theophylline ?
caffeine
Why should caffeine be avoided when taking Theophylline?
caffeine is a CNS stimulant
What supplements and vitamins are administered for bone support and suggested to those at risk for osteoporosis?
calcium supplements & vitamin D
What is Fluconazole effective against?
candidiasis, coccidiomycosis, cryptococcosis, histoplasmosis, and paracoccidiodomycosis
What type of drug is Digoxin (Lanoxin) ?
cardiac glycoside
What color is regular insulin ?
clear
If the patient feels better over time should the patient stop taking the medication or continue the medication for the duration of prescribed time?
continue the medication for the duration of prescribed time
What is Levothyroxine?
drug of choice for replacement therapy
What type of drug is Pilocarpine?
direct acting cholinergic agonist that constricts the pupils of the eyes
What drug reaction may occur when metronidazole is taken with excessive amounts of alcohol ?
disulfiram-like reaction
