3rd exam Flashcards
When preparing an IV solution that contains potassium, which of these conditions must a nurse recognize as a contraindication to the potassium infusion?
serum potassium level of 5.6mEq/L
during a counseling session for a group of teenage athletes, the use of androgenic steroids is discussed. the nurse will explain that which problem is rare but devastating effect of androgenic steroid use
kidney failure
a patient who has a history of asthma is experiencing an acute episode of shortness of breath and needs to take a medication for immediate relief. the nurse will choose which medication that is appropriate for the situation
a leukotriene receptor antagonist, such as montelukast
After a nebulizer treatment with the beta agonist
albuterol, the patient complains of feeling a little
“shaky,” with slight tremors of the hands. The patient’s
heart rate is 98 beats/min, increased from the
pretreatment rate of 88 beats/min. The nurse knows
that this reaction is an
An expected adverse effect of the
medication
A patient is receiving ipratropium via inhaler. The
nurse will assess the patient for which of these
adverse effects? Select all that apply:
-
Dry mouth or throat, nasal congestion,
headache
-
B,d,e
A patient is receiving ipratropium via inhaler. The
nurse will assess the patient for which of these
adverse effects? Select all that apply:
-
Dry mouth or throat, nasal congestion,
headache
-
B,d,e
During a teaching session for a patient who will be
receiving a new prescription for the LTRA montelukast
(Singulair), the nurse will tell the patient that the drug
has which therapeutic effect?
Reduces inflammation in the airway
A patient who is taking a xanthine derivative for
chronic bronchitis asks the nurse, “I miss my morning
coffee. I can’t wait to go home and have some.” What
is the nurse’s best response?
It’s important not to take coffee or other
caffeinated products with this medicine
as it may cause an increased heart rate
as well as other problems
A client has been taking Iansoprazole (proton-pump
inhibitor) the nurse should monitor the client for the
relief of which symptom?
Heartburn
A client is taking amiloride hydrochloride daily. The
nurse should tell the client to take the dose at what
time?
In the morning with breakfast
Theophylline is prescribes for a client with bronchial
asthma. The nurse provides dietary instructions to the
client and should tell the client to avoid consuming
which item?
Iced tea
The nurse is preparing to administer medications to a
hospitalized client and notes that the client takes
levothyroxine daily. The nurse suspects that the client
has a history of which condition?
Hypothyroidism
Which of the following classes of antihypertensive
drugs is not recommended for initial treatment?
Potassium sparing diuretics
A 55-yr-old woman, who is devoted to singing in her
church chorus, has hypertension which has been well
controlled with enalapril for the past month. She calls
to report a new, intolerable side effect, and she
requests to be switched to a different drug. Which of
the following adverse effects is most likely to be
intolerable to this patient
Dry cough
During her annual physical examination, a 45-yr-old
patient with a history of asthma is found to have an
elevated blood pressure. Elevated pressures are
confirmed on 2 additional readings in the physician’s
office. In evaluating therapies for this patient, which
class of antihypertensive drugs is contraindicated?
Beta blockers
A digitalis preparation is effective for treating which of
the following health conditions?
Heart failure (HF)
What is lidocaine primarily used to treat?
Ventricular dysrhythmias
Which of the following medication is the most potent
calcium channel blocker?
Nifedipine (Procardia)
When testing a metered-dose inhaler (MDI) canister to
estimate whether it is empty, the inhaler canister (not
the mouthpiece) is dropped into a container that is
wider and longer that the inhaler and filed up to threequarters fill with water. Which of the following indicates
that the inhaler canister is nearly empty?
The canister floats on top of the water
The following medications are example of Histamine H2 antagonist
Nifedipine (adalat)
Action: decrease secretion of gastric acid and formation of pepsin by blocking histamine 2 receptor sites
Histamine 2 antagonist
Action: reduce stomach acid by working on secretory surface receptors to stop the last phase of acid production
Proton pump inhibitors
Mix with hydrochloric acid to neutralize stomach secretions and prevent transformation of pepsinogen to pepsin
Antacids
Stops secretion of gastric acid and elevates production of mucus and bicarbonate to preserve stomach lining
Misoprostol (Cytotec)
Action: forms a protective coveting of ulcer sites and guards against pepsin, bile salts, and acid, which stops further breakdown of the sites
Sucralfate (Carafate)
Uses:
GERD
Heartburn
Zollinger Ellison Syndrome
Stress ulcer
GI bleeding
Gastric and duodenal ulcer
Histamine 2 antagonist
USE:
short term treatment for gastric and duodenal ulcers, GERD, esophagitis
Long term treatment of hypersecretory diseases
H. pylori infection
Proton pump inhibitors
Use:
Treat and prevent gastritis, GI bleeding, stress ulcers, heartburn, GERD, PUD, esophagitis
Antacids
USE:
Prevention of gastric ulcers from the use of NSAIDs
Misoprostol (Cytotec)
Use:
Duodenal ulcer
Sucralfate (Carafate)
Side/Adverse effect of histamine 2 antagonist (CNS)
Confusion
Hallucinations
Drowsiness
Headache
Dizziness
Side/Adverse effect of histamine 2 antagonist (CV)
hypotension
Arrhythmias
Side/Adverse effect of Histamine 2 antagonist (derm)
Reversible alopecia
Rash
Steven johnson syndrome
Side/Adverse effect of histamine 2 antagonist
F&E
Elevated creatinine
BUN
Serum uric acir
Side/Adverse effect of histamine 2 antagonist
GI
Constipation
Diarrhea
Side/Adverse effect of histamine 2 antagonist
GU
Reversible impotence
Gynecomastia
Galactorrhea
Side/Adverse effect of histamine 2 antagonist
Hematologic
Elevated prothrombin time
Side/Adverse effect of histamine 2 antagonist
Other
Fever
Joint pain in clients with arthritis
Side/Adverse effect of proton pump inhibitors
Cns
Tiredness
Dizziness
Headache
Insomnia
Side/Adverse effect of proton pump inhibitors
Derm
Pruritus
Alopecia
Rash
Dry skin
Side/Adverse effect of proton pump inhibitors
GI
Dry mouth
Nausea
Diarrhea
Abdominal pain
Side/Adverse effect of proton pump inhibitors
GU
Blood/protein in urine
Side/Adverse effect of proton pump inhibitors
Resp
Nasal stuffiness
Hoarseness
Cough
Nosebleed
Side/Adverse effect of proton pump inhibitors
Other
Fever
Back pain
Side/Adverse effect of antacids
F&E
Hypophosphatemia
Hypermanesemia in clients with renal disease
Side/Adverse effect of antacid
GI
Magnesium antacids cause diarrhea
Aluminum antacids cause constipation
Acid rebound
Side/Adverse effect of antacid
Other
Encephalopathy
Osteomalacia
Side/Adverse effect of Misoprostol
Cns
Headache
Side/Adverse effect of Misoprostol
Gi
Constipation
Diarrhea
Nausea
Vomiting
Abdominal pain
Flatulence
Side/Adverse effect of Misoprostol
GU
Menstrual irregularities
Uterine contractions
Side/Adverse effect of Sucralfate
CNS
Insomnia
Dizziness
Side/Adverse effect of Sucralfate
Derm
Rash
Side/Adverse effect of Sucralfate
GI
Constipation
Diarrhea
Nausea
Side/Adverse effect of Sucralfate
Other
Back pain
Antidiarrheals
Action: act directly on the areas of the CNS that control movement of the GI tract
Lomotil
Motofen
Camphorated Opium tincture
Antidiarrheals
Action: works directly on the GI tract lining to slow movement and reduce inflammation
Bismuth subsalicylate (pepto bismol)
Antidiarrheals
Action: acts on GI tract muscle to decrease peristalsis
Loperamide (Imodium)
Antidiarrheals
Action: represses the action of a number of GI enzymes
Octreotide (sandostatin)
Indications of loperamide hcl. (Imodium)
acute nonspecific diarrhea and of chronic diarrhea associated with inflammatory bowel disease
Precautions
in
administering
metoclopramide (Reglan)
should not be used in
patients with a history of seizures or those who
are prone to developing them.
should be used with
caution in patients with Parkinson’s disease
involves
selectively targeting and inhibiting proton
pumps in order to reduce gastric acid
production. This medication has proven to be
highly
effective
in
managing
various
gastrointestinal
conditions
and
providing
much-needed relief for patients suffering from
these ailments.
omeprazole
(Prilosec)
Side effects of Sulfasalazine (Azulfidine)
gastrointestinal distress. This
can manifest as nausea, vomiting, diarrhea,and
abdominal pain.
allergic reactions
Best time to administer sucralfate (Carafate)
one hour before breakfast and two tablets
at bedtime.
Cause water to be retained in the stool, which causes distention of the bowel and result in defecation
Bulk forming laxatives
work by absorbing water
and swelling up in order to increase stool
volume and softness.
Bulk forming laxatives
an
effective
treatment
for
constipation
Lactulose
Mechanism action of lactulose
Constipation
-used to treat
hepatic encephalopathy, a condition that occurs
when the liver is unable to remove toxins from
the blood
-helps reduce ammonia
levels in the blood by promoting its excretion
through the stool.
is a laxative that works by increasing the
amount of water in the stool, making it easier to
pass.
polyethylene glycol (PEG