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NUR 314 > Drugs > Flashcards

Drugs Flashcards

0
Q

Following spinal anesthesia, what should you do if a Pt complains of a HA?

A

Lay hob FLAT, NO pillows

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1
Q

What drug would likely be administered with fentanyl for conscious sedation and amnesia?

A

Midazolam

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2
Q

If following spinal anesthesia, a Pt becomes hypotension, what should you do?

A

Elevate hob

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3
Q

What drug is likely to be administered for induction of anesthesia, maintenance of anesthesia, or sedation for mechanical ventilation?

A

Propofol

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4
Q

How do thiopental and Propofol differ in terms of onset and duration?

A

Thiopental-onset within seconds, duration 10-20 min.

Propofol-duration is even shorter..3-5 min.

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5
Q

What drug can prolong the effects of IV lidocaine?

A

Epinephrine

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6
Q

What four things does nitroglycerin decrease by vasodilation?

A

1) decrease venous return (preload)
2) decrease ventricular filling
3) decrease wall tension
4) decrease O2 demand

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7
Q

What 2 drugs would be contraindicated with nitrates?

A

1) hypotension drugs

2) phosphodiesterase inhibitors (ED Rx)

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9
Q

What are the two main AE of Nitroglycerin?

A

1) Hypotension

2) reflex tachycardia

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10
Q

What would be an example of protecting from “unintentional harm”, in a patient receiving IV lidocaine?

A

Making sure the pt’s gag reflex is intact is an example of unintentional harm.

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11
Q

What non-anesthetic adjunct often given for pain , is given 30 minutes prior to the OR, and exhibits anticholinergic effects? (what are anticholinergic effects?)

A

Morphine.

Anticholinergic effects: decreases r/f decreased HR and dry secretions by vasodilation.

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12
Q

The nurse knows that in large doses, Diazepam (valium) will result in…

A

loss of consciousness

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13
Q

Antianginal drugs work by what 3 factors?

A

1) Restore supply&demand of O2
- Improve blood oxygen delivery to the heart by
2) dilating vessels and..
3) decreased work load of the heart

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14
Q

Why is nitroglycerin not given PO often?

A

because of the first pass effect; heavily metabolized by the liver. Doses must be large, and are given prophylactically for angina.

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15
Q

Lidocaine is a local anesthetic, as well as an antiarrhythmic drug. What anti arrhythmic properties does it have, and what is it indicated for?

A

Lidocaine IM or IV is indicated for SHORT-TERM Tx of Ventricular Dysrhythmias.

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16
Q

What potential side effect does the nurse know can occur when giving high doses of lidocaine?

A
  • Dizziness
  • Resp. Depression
  • Paresthesias**
  • Seizure**
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17
Q

List the four prototype anti arrhythmic drugs according to their class.

A

Class I–Na+ channel blocker–Lidocaine
Class II–B-Blocker–Propanolol
Class III–K+ channel blocker– Amiodarone
Class IV–Ca2+ channel blocker–Verapamil

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18
Q

Beta 1 receptors innervate the __________.

Beta 2 receptors innervate the __________.

A

Beta 1–heart

Beta 2–bronchioles

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19
Q

What can be given IV to treat hypokalemia? Are there special NIs to note?

A

KCL–MUST be diluted to <40mEq/L, and NO FASTER than 10 mEq/hr

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20
Q

What may be given to treat hyperkalemia?

A

Glucose and insulin infusion, calcium gluconate (for cardiac effects), kayexelate (PO, rectal), and if life threatening, hemodialysis

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21
Q

What IV solution may be given to treat hypocalcemia?Are there special NIs to note? (rate? monitoring? administration?)

A

IV calcium gluconate

  • MUST GIVE SLOWLY–0.6-2 mL/min
  • Dedicated IV line
  • Cardiac monitoring
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22
Q

What may be given to treat hypercalcemia? What non-pharmaceutical interventions can you instruct the pt to do?

A
  • Rx: loop diuretic

- Teach pt: adequate hydration to promote excretion, and mobilization to promote reabsorp. to bone

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23
Q

____calcemia is associated with hyperactive reflexes.

____calcemia is associated with muscle twitching.

A

Hypocalcemia is associated with hyperactive reflexes

Hypercalcemia is associated w/ muscle twitching.

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24
Q

What are the most important AEs to monitor for in a hypokalemia?

A
  • ECG changes
  • Postural hypotension
  • Bradycardia
  • Digitalis tox.
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25
Q

How will hypophosphatemia be treated? (Mild, and severe?)

A

Mild–PO

Severe–IV sodium phosphate

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26
Q

How will hyperphosphatemia be treated?

A

Treatment is aimed at the underlying cause.

–Phosphate binding gels and adequate hydration

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27
Q

What are normal Electrolyte values of calcium, sodium, potassium, phosphate, and magnesium?

A 
Calcium: 9-11 mg/dL
Mg: 1.5-2.5 mEq/L
Phosphate: 2.5-3.5 mEq/L
Potassium: 3.5-5 mEq/L
Sodium: 135-145 mEq/L
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28
Q

Are are normal arterial values for pH, PaCO2, and HCO3-?

A

pH: 7.35-7.45
PaCO2: 38-44 mmHg
HCO3-: 22-25 mEq/mL

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29
Q

List whether pH, PaCO2, and HCO3- increases/decreases in the following conditions:

1) respiratory acidosis
2) resp. alkalosis
3) Metabolic acidosis
4) Respiratory alkalosis

A

1) Resp. acid.: pH down, PaCO2 up, HCO3- normal/up
2) Resp. alka.: pH up, PaCO2 down, HCO3 normal/down
3) Meta. acid.: pH down, PaCO2 normal/down, HCO3- down
4) Meta alka.: pH up, PaCO2 normal/up, HCO3- up

30
Q

What are potential AE for propranolol?

A
  • Heart, AV block
  • HF, Hypotension
  • Bronchospasm (asthma)–beta 2 receptors
31
Q

Amiodarone is a ______-channel blocker.

It is indicated for…….

A

Potassium channel blocker.

Indicated for life-threatening dysrhythmias.

32
Q

What functional test is important to monitor with amiodarone? Why?

A

LFTs!!!!!

  • Must have baseline–if it increases 3x the drug must be discontinued!!
  • Highly lipid soluble
  • Accumulates in the tissues, esp. in liver and lungs.
  • Prolonged half life (25-100days!)
33
Q

A patient asks why he must continue monitoring for toxicity in amiodarone when he is no longer taking it anymore. How does the nurse respond?

A

Amiodarone has a prolonged half life of 25-100 days, where toxicity can continue for weeks after d/c.

34
Q

What 4 organs do you watch for AEs/Toxicities in when taking amiodarone?

A
  • Pulmonary toxicity
  • Cardiotoxicity
  • Corneal microdeposits–Eye
  • Optic neuropathy–Eye
  • Liver toxicity
35
Q

What AE do you watch out for in Verapamil?

What is a common SE in PO forms of Verapamil?

A

-Bradycardia
-Hypotension, Vasodilation
AV block, HF
-Peripheral edema
-Constipation (PO common)

36
Q

T/F

Beta2 receptors exert the same effects as Ca2+ receptors.

A

FALSE.

Beta1 and Ca2+ receptors exert the same effects.

37
Q

___________ pressure is controlled by plasma proteins

38
Q

___________= sequestering of a fluid in space that does not participate in extracellular exchange

A

third space losses

39
Q

Abnormalities in intracellular regulation of enzymes is associated with which electrolyte?

40
Q

Shift in K+ b/w intra and extracellular components to prevent large changes in extracellular potassium is accompanied by changes in ________ ion concentration.

41
Q

Is hypo or hypermagnesemia associated w/ muscle twitching?

A

HYPOmagnesemia

42
Q

A person on tube feedings following a stroke is most likely at risk for what electrolyte imbalance?

A

Hypernatremia

43
Q

The most important factor for determining pH is the ratio of _____ to _______ (20:1)

A

bicarbonate to carbonic acid

44
Q

Vomiting is associated with what type of acid-base imbalance?

A

Metabolic acidosis b/c you’re losing acids and salt.

45
Q

In a pt with fluid volume deficit, what do do you infuse first, then thereafter?

A

NS friefly to treat deficit, THEN hypotonic solution for maintainence

46
Q

What common IV solution is contraindicated for metabolic alkalosis?

A

LR. converted into bicarb, which would further alkalize

47
Q

A dehydrated pt is treated w/ NS, and starts to have difficultly breathing. What do you suspect and what do you do?

A

Suspect fl. volume overload. D/c infusion and call provider.

48
Q

What are two common drugs that, when combined, prolong anesthesia by vasoconstriction, and reduces toxicity?

A

Epi + lidocaine

49
Q

A pt taking lidocaine has a HR of 60, BP 90/60. What potential AE are you worried about?

A

Heart block

50
Q

What is the most important intervention for a patient who has had spinal anesthesia?

A

Monitor vitals; HYPOtension is a common SE.

51
Q

The nurse is prepping a Pt for a colonoscopy under conscious sedation. Which med does the RN expect the pt to receive?

A

Fentanyl + midazolam

52
Q

What drug would be indicated for an uncomfortable, brief procedure?

53
Q

What type of angina is associated with a small lipid core, and a thick cap?

A

Stable angina

54
Q

30-50% of pts w/ acute MI die of what kind of dysrhythmia?

A

Ventricular dysrhythmia

55
Q

Troponin is detectably elevated after an MI for ____days

56
Q

Following MI, scar tissue serves to…

A

maintain structural integrity of the heart

57
Q

A stable pt with AF begins to develop Sx for dysrhythmia. The nurse expects the MD to prescribe an IV ________ to slow conduction thru the AV node, decreasing contractility, HR, and workload.

58
Q

_______ are effective in treating stable angina by dilating arterioles and decreasing afterload

A

Ca2+ ch blockers

59
Q

A pt is taking amiodarone for chronic a fib. what need to be done prior to administration of this Rx?

A

Baseline test

60
Q

A pt is Dx w/ STEMI, and about to undergo reperfusion Tx. What combo of Rxs do you expect to be prescribed? (what drug is always given with repercussion Tx?)

A

Heparin and ASA

61
Q

Aortic regurgitation leads to a decrease in _________ perfusion.

A

coronary perfusion

62
Q

What structural change is associated with aortic stenosis?

A

L vent. hypertrophy

63
Q

What lab value is the best indicator of HIV Tx?

A

Viral load

64
Q

What is a long-term AE of Zidovudine?

A

Neutropenia

65
Q

What should you warn a pt about when taking efavirenz and its SE?

A

Insomnia and vivid dreams

66
Q

A pt is on vancomycin and has a rash and decreased UO. What do you anticipate?

A

Holding the dose. Look at peak and trough levels, as well as Cr.

67
Q

What lab test is most important for a pt on amphotericin B?

A

Cr, BUN, K+

68
Q

What toxicity is common in gentamycin

A

Hearing loss/ototoxicity

69
Q

Loss of continence, consciousness, and impaired respirations is a manifestation of what type of seizure?

A

Tonic-clonic

70
Q

Pt on phenytoin has a level of 30mcg/mL, what do you do?

A

Hold dose, contact MD.

71
Q

What drug is used to terminate a seizure?

NUR 314 (2 decks)

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