Exam 1

Question 1

Agonist

Answer 1

Medication that enhances an effect

Question 2

Antagonist

Answer 2

A medication that reverses an effect

Question 3

Sympathetic nervous system

Answer 3

Adrenergic
Norepinephrine
“Fight it flight”

Question 4

Parasympathetic nervous system

Answer 4

Cholinergic
Acetylcholine
“Rest and digest”

Question 5

Oncotic pressure

Answer 5

Proteins maintain pressure to hold water in the capillary
W/O proteins, water leaves and 3rd spacing occurs

Question 6

Hydrostatic pressure

Answer 6

Force of H2O in the capillary bed
This is what pushes H2O across the membrane into the interstitial space

Question 7

Pharmacokinetics

Answer 7

How a drug moves
Liberation - into the body
Absorption - into the bloodstream
Distribution - moves around the body
Metabolism - broken down
Excretion - removed from the body

Question 8

Pharmacokinetics for children and geriatrics

Answer 8

Children and geriatrics metabolize drugs slower than the average adult

Question 9

Protein binding

Answer 9

Serum protein levels, if a drug binds to a protein, then that portion of the drug is unuseable

Question 10

Half-life

Answer 10

The time it takes for half of the drug to be metabolized

Question 11

First pass phenomenon

Answer 11

When the liver takes a cut of the drug
For PO meds, when being absorbed, a portion is taken by the liver and not used

Question 12

Controlled substances

Answer 12

The scheduling system
1 - high potential for abuse, no medical use
2 - high potential for abuse, medical use
3 - moderate potential for abuse, medical use
4 - mild potential for abuse, medical use
5 - low potential for abuse, medical use

Question 13

IV fluids

Answer 13

Hypertonic - above .9% saline or 5% dextrose
Isotonic - .9% saline and 5% dextrose
Hypotonic - below .9% and 5%

Question 14

Reasons for variation in drug responses

Answer 14

Oral preparations
Tablet disintegration time, enteric coatings, sustained-release formulations
Changes in gastric pH, diarrhea, constipation, food in stomach

Question 15

Lab values for sodium, potassium, and calcium

Answer 15

Na- 135-144
K- 3.5-5
Ca- 8.5-10.5

Question 16

Causes of hypocalcemia

Answer 16

Low PTH
Poor oral intake
Acute pancreatitis
Low VD intake
Chronic kidney disease
Mobility issues

Question 17

Body water composition variations between elderly and adults

Answer 17

Elderly
Less body water
GFR is lower
Increased fat in internal organs
Decreased muscle mass
Roughly 50% water in older patients

Question 18

Edema

Answer 18

Increased capillary permeability
(Burns/ inflammatory response)
Increased capillary hydrostatic pressure
(Venous obstruction, salt and water retention, heart failure)
Lymph obstruction
Decreased capillary oncotic pressure

Question 19

RAAS

Answer 19

Renin - low perfusion to kidneys, they release renin
Angiotensin - renin works on angiotensinogen. Angiotensin 1: inactive. Angiotensin 2: vasoconstriction and pituitary for aldosterone
Aldosterone - kidneys retain sodium. Water follows salt

Question 20

FVE in infants

Answer 20

Swelling
High BP
Rapid weight gain

Question 21

FVD in infants

Answer 21

Fontanelles are sunken
Rapid weight loss
Low BP

Question 22

Aspirin

Answer 22

Salicylate prototype
Mechanism of action - antipyretic, anti-inflammatory, analgesic, anticoagulation
Classification - non-narcotic, salicylate
Adverse effects - nausea, GI bleeding, bruising, Tinnitus, confusion, tachypnea
Nursing implications - watch the dose for a given condition, give with food to protect stomach, monitor for signs of bleeding, false positive occult blood stool
Antidotes -
Teaching - don’t take more than prescribed, take with meals, watch for tennitis, stop taking prior to surgical, avoid alcohol

Question 23

Ibuprofen

Answer 23

Mechanism of action - analgesic, anti-inflammatory, anticoagulant
Classification - NSAIDS
Adverse effects - GI bleeding, nephrotoxicity (elevated BUN and creatinine), dyspnea, Bronchospasm, tinnitus
Nursing implications - give with food, monitor bleeding time
Teaching - take with food, drink plenty of fluids, watch for bleeding, watch for changes in respiratory

Question 24

Morphine

Answer 24

Mechanism of action - analgesic
Classification - opioid
Adverse effects - CNS depression, constipation
Nursing implications - monitor breathing, lowest dose and work up, cannot be crushed, PCA
Antidotes - naloxone
Teaching - high fiber diet, do not operate machinery, short term use will not cause addiction

Question 25

Acetaminophen

Answer 25

Mechanism of action - antipyretic, analgesic
Classification - non narcotic
Adverse effects - liver damage
Nursing implications - acute or chronic overdose can result in liver damage or liver necrosis, therapeutic dose can harm those who abuse alcohol
Antidotes- acetylcysteine
Teaching - many different drugs have acetaminophen in them
4g - 4000mg

Question 26

Opioids

Answer 26

Morphine is the prototype

Question 27

Naloxone

Answer 27

Antagonist for opioids

Question 28

Pain pathway

Answer 28

Transduction - activation of nociceptors
Transmission - conduction if pain signal to dorsal horn and up spinal cord
Perception - conscious awareness of pain
Modulation - increase or decrease in transmission (the body controlling how much or how little to feel the pain)

Question 29

Chemical mediators

Answer 29

Histamine
Cytokines

Question 30

Phases of Covid

Answer 30

Incubation - 5-6 days - time between entrance of pathogen and appearance of first symptoms
Prodromal - onset of nonspecific symptoms, microorganisms grow and multiply
Invasion or illness - symptoms specific to the illness
Convalescence - when infection disappears