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Pharm > Asess 3 > Flashcards

Asess 3 Flashcards

1
Q

How should the nurse respond to an injection to relieve pain?

A

Anesthetic creams, sprays, suppositories can be rubbed on the skin before an injection

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2
Q

How should the nurse best respond to apply a local anesthetic?

A

rubbed on the skin before an injection

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3
Q

What type of local anesthetic are anesthetic creams?

A

locals and lidocaine

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4
Q

What is a prototype drug for topical anesthesia?

A

lidocaine aka Xylocaine

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5
Q

What essential information should the nurse include in the medication instruction to apply topical lidocaine? (4)

A
  • Apply a thin layer on small areas of skin
  • I must wear gloves when I apply the lotion
  • Do not allow it to come into contact with the eyes.
  • Wash hands after use/before touching eyes
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6
Q

Why should topical lidocaine not be applied to large areas?

A

there can be significant absoption

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7
Q

Which priority lab result should the nurse assess for Direct-acting antispasmodics?

A

Assess aspartate aminotransferase (AST) and alanine aminotransferase (ALT)

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8
Q

What are some adverse affects of Direct-acting antispasmodics?

A

Hepatitis
hepatitic toxicity/necrosis

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9
Q

What is the MOA of Direct-acting antispasmodics?

A

interferes with release of calcium ions in skeletal muscle to relieve dystonias and leg cramps

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10
Q

What information should the nurse include in the teaching plan for the pharmacokinetics of Dantrolene Sodium?

A

Onset is 1-2h , Peak is 5 hours, and duration is variable

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11
Q

What priority assessment question should the nurse ask the client prior to administration of an Dantrolene Sodium (Dantrium)?

A

Assess for pregnancy/lactation prior to administration

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12
Q

What information should the nurse include in the teaching plan for Cyclobenzaprine taking?

A

Increase the intake of fiber while taking this medication because it causes constipation

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13
Q

What priority assessment should the nurse complete prior to administering cyclobenzaprine? Why?

A

How old are you, because those older than 65 can experience confusion, hallucinations, and adverse cardiac events from the drug
and younger patients

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14
Q

Which assessment finding should the nurse instruct the client to report immediately when taking Cyclobenzaprine?

A

Experience confusion, hallucinations, and adverse cardiac events from the drug

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15
Q

What information should the nurse include in the teaching plan for Osteoporosis nonpharmacologic interventions?

A

avoid drinking alcohol
exercise 3-5 times/wk
Walk every day for 30 minutes
drink milk regularly

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16
Q

What types of exercise are effective for osteoporosis?

A

weight-bearing
walking for 30 minutes/day

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17
Q

What information should the nurse include in the teaching plan for calcium supplement therapy?

A

Take calcium supplement and vitamin D
Avoid alcohol
Take with meals

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18
Q

What priority physical assessment should the nurse complete prior to administering this calcium supplement therapy? (3)

A

Assess IV site for extravasation
Look for necrosis of the tissue

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19
Q

What teaching should the nurse include in the plan of care for Vitamin D therapy?(2)

A

Spending 20 mins/day in the sunlight on most days provides all the Vitamin D required

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20
Q

What physical priority assessment question should the nurse ask the client prior to administration of Bisphosphonates for Osteoporosis?

A

Muscle spasms and facial twitching

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21
Q

What does Muscle spasms and facial twitching when taking bisphosphonates mean in terms of electrolytes?

A

low calcium levels

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22
Q

What essential information should the nurse include in how to take Alendronate (Fosamax) instruction?

A

Remain in an upright position for at least 30 minutes after a dose and until after the first food of the day to reduce esophageal irritation.

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23
Q

What information should the nurse include in the teaching plan for Alendronate swallowing? (3)

A

All doses must be taken on an empty stomach, preferably in a fasting state 2 hours before breakfast
With a full glass of water to ensure absorption
Do not lie down for at least 30 minutes after taking the medication.”

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24
Q

Which priority lab result should the nurse assess for Alendronate administration?

A

Perform a bone density scan (test)
During and after treatment – to determine effectiveness of the medication

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25
Q

What teaching should the nurse include in the plan of care for Alendronate in regards to Vitamin D?

A

Spend 15-20 minutes in the sun on most days
Vitamin D is supported by sun exposure
Provides all the Vitamin D required

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26
Q
  1. What priority outcome should the nurse expect the client to report about Alendronate (Fosamax)?
A

report heartburn and esophagitis to provider

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27
Q

What priority assessment should the nurse complete prior to and after administering Alendronate?

A

Assess for new onset thigh or groin pain
atypical fracture

28
Q

Which finding should the nurse instruct the client to report immediately for Alendronate ADR’s?

A

thigh or groin pain

29
Q

What teaching should the nurse include in the plan of care for Acetaminophen and other OTCs?

A

Teach parents to read medication labels including OTC medications

30
Q

Why is it important to teach parents to read medication labels including OTC medications?

A

avoid toxicity

31
Q

What information should the nurse include in the teaching plan of contraindications for NSAIDs?

A

thrombotic events, MI, and stroke, which can be fatal.

32
Q

Which finding should the nurse instruct the client to report immediately for NSAIDs?

A

Ask patient to report any bleeding while on this medication

33
Q

What Black Box warning is on NSAIDs

A

can increase risk of serious thrombotic events, MI, and stroke and bleeding

34
Q

What information should the nurse include in the teaching plan for pregnancy and fetuses for NSAIDs?

A

Cause adverse effects on a pregnant woman’s fetus
Premature closure of the ductus arteriosus in the fetus
Do not give during the third trimester of pregnancy

35
Q

What priority assessment question should the nurse ask the client prior to administration of an Aspirin?

A

Are you or could you possibly be pregnant?
Cause adverse effects on a pregnant woman’s fetus
Premature closure of the ductus arteriosus in the fetus
Do not give during the third trimester of pregnancy

35
Q

What questions/ actions should the nurse plan to include in the nursing management for clients with pain? (4)

A
  • Would you please rate your pain on a scale of 1 to 10?
  • Listen carefully to the patient’s comments about pain.
  • Show respect for the patient’s preferences about pain.
  • Ask questions about the patient’s beliefs and customs regarding pain management.
36
Q

Which statement by the client should the nurse recognize that the client is experiencing a side effect to the Morphine?

A

I feel like I am going to throw up- nausea and vomiting

37
Q

Which client should the nurse recognize as being at highest risk for developing side ADR for morphine?

A

patients with sickle cell anemia

38
Q

Which client should the nurse recognize as being at highest risk for developing ADR for Acetaminophen?

A

African-Americans
because many with higher rates of G6PD enzyme deficiency.

39
Q

Which priority lab result should the nurse assess for Acetaminophen overdose?

A

G6PD enzyme deficiency

40
Q

What is the overdose treatment for Acetaminophen?

A

N-acetylcysteine (Acetadote), which protects the liver from toxic metabolites

41
Q

What teaching should the nurse include in the plan of care for NSAIDs and it’s therapeutic class?

A

anti-inflammatory drug, antipyretic Analgesic and It may take several weeks to achieve therapeutic effect

42
Q

Which statements by the client should the nurse evaluate as a good understanding of the duration of NSAIDs to be effective?

A

It may take several weeks to achieve therapeutic effect

43
Q

What are some types of neuropathic pain?

A

carpal tunnel
degenerative disk
diabetic retinopathy
intractable cancer
phantom limb
postsurgical
sciatica

44
Q

What receptors do morphine bind to?

A

mu and kappa

45
Q

Why are sickle cell anemia patients at risk for mophine overdose?

A

because they are always in a lot of pain and they have emergencies with O2

46
Q

Whay are morphines contraindicated for those with head injuries?

A

it can increase intercranial pressure and mean arterial pressure
it can mask ALOC

47
Q

What are four actions of NSAIDS?

A

Analgesic
Antipyretic
Antiinflammatory
Antiplatelet

48
Q

what is the difference between COX-1 and COX-2?

A

COX-1
protects stomach lining
decreases fever
promotes platelet aggregation

49
Q

Why should patients take aspirin with food or milk?

A

to decrease GI irritation because COX-1, which protects stomach lining, is inhibited with aspirin

50
Q

Why should aspirin not be given to people with H. pylori?

A

it can increase the risk of stomack ulcers

51
Q

What assessment question should a pregnant person on aspirin be asked?

A

how far along are you? no third trimester because it can kill the fetus

52
Q

What does acetaminophen inhibit?

A

inhibits warfarin metabolism

53
Q

What are contraindications to Tylenol?

A

hypersensitivity
phenacetin
chronic alcoholism

54
Q

what is the difference between spinal and epidural injections?

A

spinal takes away both spinal and movement and injected into the CSF
epidural- movement is still intact

55
Q

What does General Anesthetics produce?

A

unconsciousness
lack of responsiveness to painful stimuli
given as inhalation or IV

56
Q

What do you monitor after giving general anesthetic before eating?

A

assess for gag reflex before giving the patient anything to eat or drink to reduce risk for aspiration

57
Q

Why is exercise important to corticosteroids?

A

long term use can lead to osteoporosis

58
Q

What is acute gout triggered by?

A

alcohol, aspirin, dehydration, injury, other stress

59
Q

what can organ damage cause?

A

skin blisters, raw mucus membranes
rashes
organ failure and then death

60
Q

What are some assessments for the patient for muscle relaxants?

A

withdrawal syndrome
muscle tone, range of motion, degree of muscle spasm
side effects
c/p dysfunction
alcoholism

61
Q

Why will calcium supplement therapy cause extravasation?

A

it is a vescicant and can cause skin irritation

62
Q

What drug tpes might lower the Ca levels in the blood?

A

corticosteroids
anticonvulsants
immunosuppressants

63
Q

What are some S/S of hypercalcemia?

A

drowsiness, lethargy, weakness
headache
anorexia
n/v
thirst and increased peeing

64
Q

What is a prototype drug for vitamin D?

A

calcitrol

65
Q

What is the prototype drug for Bisphosphonate?

A

alendronate (Fosamax)

66
Q

Why should a patient taking alendronate not lay down after taking the medication?

A

it can cause esophageal irritation

Pharm (10 decks)

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