PHARM FINAL

Heparin

Anticoagulant

A client is admitted to the emergency department with a severe headache, nausea, shortness of breath, and blood pressure of 200/120 mm Hg. Which response should the nurse prioritize?

Continuously monitor the client's status

HDL levels

HDL: <40 mg/d; low and major risk >60+= high

Levels of hypertension

normal <120. <80 Elevated; 120-129. <80 HS1: 130-139. 80-89 hs2 1. 40+. 90+ hTE: 180+. 120+

can oral diabetics be mixed with insulin

yes

Digoxin level

0.8-2.0 ng/mL

LDL levels

<100 optimal <120 near/above optimal 130-159= borderline 160-189= high 190+ = very high

cholesterol levels

<200mg/dl= desirable 200-239= borderline 250mg/dl+= high

Diphenhydramine

Benadryl

The nurse is teaching a client with hypertension about losartan which the health care provider has prescribed. The nurse can explain that losartan exerts which action on the body?

Blocks angiotensin II receptors

The nurse is preparing a teaching session for a client with rhinitis about the prescribed decongestant. Which potential adverse reaction should the nurse point out?

Blurred vision

Increase doses of statins

Cause rhabdomyolysis and myopathy especially while taking cytolosproins or Asian or have renal insufficiencies usually given in 5mg

how tot each pts to lower cholesterol levels

Cholesterol-lowering diet Physical activity Smoking cessation Weight management TLC diet is low saturated-fat, low cholesterol, includes 200 mg if dietary cholesterol per day

patient teachings for electrolytes

Explain the reasons for IV solutions and administration • Emphasize the importance of notifying nurse if there is a problem with the IV site or IV machine alarms • Explain the importance of adherence to prescribed dosage schedule • Encourage client to keep all appointments with provider for follow-up evaluation • Educate clients that overuse of sodium bicarbonate as an antacid can result in alkalosis

client education specific cholestorl meds

Gemfibrozil: teach client to observe caution while driving or performing hazardous tasks; notify provider if nausea, vomiting, or diarrhea occurs Niacin: take with meals; can cause flushing, warmth, itching, and headache; provider may prescribe aspirin to take 30 minutes before niacino Ezetimibe: teach client to take at least 2 hours before or 4 hours after a bile acid sequestrant; report adverse effects to provider

common cause of edema

Heart failure Endocrine disturbances Kidney and liver diseases Fluid overload from other causes

stain client education

Inform client that statins should be taken in the evening or at bedtime Do not take statins with grapefruit juice Take antacids at least 2 hours after rosuvastatin Teach the client that statins may cause photosensitivity and to wear sunscreen and protective clothing

types of athsma drugs

Long-Term Control Medications Step-wise approach Inhaled corticosteroids Mast cell stabilizers Leukotriene formation inhibitors Leukotriene receptor agonists Immunomodulators Quick-Relief Medications Inhaled short-acting beta2-adrenergic (β2-adrenergic) agonists (SABAs) Oral steroids

Intermediate insulin

NPH (Humulin N, Novolin N) 1.5 hrs onset 4-10 hr peak 14 hr duration

A nurse is reviewing the laboratory test results of a client who is receiving diuretic therapy. The nurse determines that the client is at risk for electrolyte imbalance based on which result(s)? Select all that apply.

Potassium 2.9 mEq/L Correct! Sodium 124 mEq/L

what to look out for w/ electrolytes

Potassium: signs of hyperkalemia, monitor pulse and blood pressure; cardiac monitoring; inspect IV site every 5 to 15 minutes • Calcium: signs of hypercalcemia; take vital signs before, during, and after every 5 to 15 minutes until client is stable • Sodium: during, after administration for signs of hypernatremia; observe clients receiving 3% or 5% NaCl solution IV for signs of pulmonary edema • Magnesium: continuous monitoring; of vital signs; monitor intake and output • Bicarbonate: observe for signs of clinical improvement; monitor blood pressure, pulse, respiratory rate as ordered by primary healthcare provider; frequent lab monitoring of blood gases • Fat Emulsions: monitor for lipidemia by assessing results of labs

cholesterol pt teachings

Provide and review the recommended client with the client and family Explain the importance of taking the drug at prescribed time intervals and as directed Explain the necessity of contacting the primary health care provider immediately if symptoms occur

The nurse is preparing to administer furosemide to a client. Which factor(s) should the nurse prioritize on the preadministration assessment? Select all that apply.

Respiratory rate Pulse Weight temp

bile acid resin client education

Take the drug before meals unless otherwise directed Cholestyramine powder must be mixed with 2 to 6 ounces of water or a noncarbonated beverage and shaken Colestipol granules must be mixed in liquids, soup, cereal, carbonated beverage, or pulpy fruits; use about 90 mL of liquid Colestipol tablets should be swallowed whole, one at a time with a full glass of water • Do not sip or hold liquid preparations in the mouth; tooth discoloration and enamel decay • GI symptoms may occur but usually subside with continued therapy

client/family teaching COPD

To monitor breathing status and regulate medications based on the asthma action plan How to use a peak flow meter and when to notify the primary health care provider How to use an inhaler or nebulizer correctly and how to care for equipment

protamine

antidote for heparin

A client with cerebral edema is prescribed mannitol. Which assessment should the nurse prioritize during the ongoing assessment?

do pupils respond to light

A nurse is preparing to administer diphenhydramine to a client with bronchial irritation. Which activity should the nurse prioritize during the preadministration assessment?

document color and cost. of sputum if any

The health care provider has prescribed ezetimibe for a client diagnosed with hyperlipidemia. The nurse is prepared to prioritize which assessment to evaluate the drug's effectiveness?

frequently monitor blood cholesterol

A client is prescribed an inhaled corticosteroid. The nurse would instruct the client about which as a possible adverse reaction(s)? Select all that apply.

fungal infection and pharyngeal irritation

how do ace inhibitors work

inhibit the activity of ACE, which converts angiotensin I to angiotensin II causes vasoconstriction and secretion of aldosterone (retention of sodium and water); prevention of this process means that sodium and water are not retained and blood pressure decreases

After teaching a group of nursing students on the mechanism of action of angiotensin-converting enzyme inhibitor (ACEI) drugs, the instructor determines the session is successful after the students correctly choose which action as the result of aldosterone?

inhibits rennin sec

long acting insulins

insult degludec 1hr. 9hr 25 hr insulin detemir: 3/4 hours 6/8 hours 24 hours insulin glargine: 1hr steady no peak, 24hr duration

A client is admitted in acute renal failure and prescribed mannitol. The nurse prepares to administer this drug via which route?

iv

Short/Rapid Acting Insulin

lasts no more than 8hrs regular insulin- 30/60 min onset. peaks 2-4 hours. 5-8 hr duration aspart(novlog): 5-15.. 1-3 hrs duration 3-5 hrs lispro(Humalog) 5-10, peak 30-1.5hrs duration 3-5 hrs glusline (insulin anaglogue) 15-30 min. 30-60 4 hr duration

pt teachings for diuretics

o Explain the importance of taking the drug at prescribed time intervals and as directed o Advise about the importance of completing the entire course of treatment o Emphasize the importance taking the drug with food o Advise the client to take the drug early in the morning unless the provider directed otherwise o Do not reduce fluid intake to reduce the need to urinate o Instruct client to avoid alcohol and nonprescription drugs o Emphasize observing caution while driving or performing hazardous tasks o Explain necessary interventions if dizziness or weakness or signs of dehydration or electrolyte imbalance occurs; notify provider Instruct client to weigh themselves daily and track their weight; notify provider if weight loss or gain exceeds 3 to 5 pounds in a week. o If foods or fluids high in potassium are recommended by the provider, educate the client about potassium-rich food and fluid sources; o Explain the importance of avoiding exposure to sunlight or ultraviolet light o Explain to clients with diabetes mellitus and who take loop or thiazide diuretics to contact health care provider if increase in blood glucose level o Clients on potassium-sparing diuretics: teach clients to avoid eating foods or drinking fluids high in potassium o Clients on thiazide diuretics: explain the necessity of contacting the primary health care provider if sudden joint pain occurs o Clients on carbonic anhydrase inhibitors: explain the necessity of contacting the primary health care provider immediately if eye pain is not relieved or increased; if be being used for a client with seizures, all seizures should be documented

HDL function

o Take cholesterol from the peripheral cells and transport it to the liver

LDL function

o Transport cholesterol to the peripheral cells o Elevation of LDLs: o Atherosclerotic plaque formation o Increases the risk for heart disease

The nurse is preparing to teach a child with asthma and caregivers about the prescribed corticosteroids. Which factor should the nurse point out will require monitoring?

rate of growth

A primary health care provider has prescribed a loop diuretic for hypertension in a client with diabetes mellitus. Which assessment should the nurse prioritize?

sudden increase in weight

The nurse is preparing to administer niacin to a client with hyperlipidemia. Which adverse reaction should the nurse prioritize on ongoing assessment?

tingling

oral antidiabetics

treat type 2 diabetes mellitus by stimulating the pancreas to produce more insulin and decrease peripheral resistance to insulin

any herbal drug should be used with caution with

warfarin

nursing diagnosis for electrolytes

• Fluid Overload related to adverse effects resulting from too rapid intravenous infusion • Hypovolemia related to inability to take oral fluids, abnormal fluid loss, other factors (specify cause of deficient fluid volume) • Malnutrition Risk related to anorexia caused by opioids • Injury Risk related to adverse drug effects (muscular weakness) • Acute Confusion related to adverse drug effects • Decreased Cardiac Output related to adverse drug effects (cardiac arrhythmias)