Exam 1 Flashcards

1
Q

The clinic nurse develops a plan of care for a client w/emphysema who will be started on a long-term steroid therapy. Which specific instruction would the nurse include in the plan of care?

A

Instruct the client to return to the clinic for monitoring of blood glucose levels

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2
Q

A client w/ a severe allergic reaction is prescribed IV steroids. The RN would expect that which desired effect would be achieved?

A

⬇️Decreased inflammation

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3
Q

A client who had a cold is seen in the ER w/an inability to void. Because the client has a hx of BPH, the RN determines that the client would be questioned about the use of which Rx?

A

Decongestants

Urinary retention is triggered by decongestants

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4
Q

A client has an Rx to take Guifenesin. The RN determines that the client understands the proper administration of this Rx if the client states they will perform which action?

A

Take the tablet with a full glass of water

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5
Q

The RN is preparing to administer a dose of noloxone IV to a client w/an opioid overdose. Which supportive medical equipment would the RN plan to have at the clients bedside?

A

Resuscitation equipment

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6
Q

A client had begun therapy with theophylline. The nurse would teach the client to limit the intake of which items while taking this medication?

A

Coffee, cola, and chocolate

Theophylline is a bronchodilator & must limit xanthine containing foods

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7
Q

A client who experiences allergic rhinitis asks the RN about a nasal steroid. How would the nurse reply?

A

This medication works locally & decreases inflammation

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8
Q

The RN is administering a dose of albuterol to a client. The RN would monitor for which side effect of this med?

A

Increased pulse

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9
Q

The RN is caring for a client with COPD who is receiving theophylline. The RN monitors the serum theophylline level & concludes that the Rx dosage may need to be increased if which value is noted?

A

5mg/ml

The therapeutic serum range is 10-20mg/ml

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10
Q

A client has been given a Rx for benzonatate. Which observation would the RN look for to evaluate the effectiveness of the Rx?

A

Calming the clients persistent cough

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11
Q

A client has begun to use methylxanthine bronchodilator. What beverage would the nurse plan to teach the client to avoid while taking this Rx.

A

Coffee

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12
Q

A client is taking albuterol by inhalation cannot cough up secretions. What would the RN suggest that the client do to assist in expectoration of secretions

A

Drink increased amounts of fluids daily

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13
Q

A client w/a Rx to take theophylline daily has been given Rx instructions by the RN. What statement by the client indicates the need for further education regarding the Rx?

A

“I will take the daily dose at bedtime”

This Rx should be taken in the morning

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14
Q

Cromolyn sodium is prescribed for the client with allergic asthma. What goal does the RN expect to achieve by administration of this Rx?

A

Inhibition of the release of mediators from mast cells after exposure to an antigen

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15
Q

A client has an Rx to take guaifenesin. The Rn would conclude that the client understands the most effective use of this Tx if the client states the need to take which action?

A

Take the tablet with a full glass of water

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16
Q

The RN is preparing to administer albuterol to a client. Which parameters would the Rn assess before and during therapy?

A

Lung sounds and presence of dyspnea

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17
Q

A home care nurse has observed a client self-administer a dose of an Andrenergic bronchodilator via metered dose inhaler. Within a short time, the client begins to wheeze loudly. The RN understands that this is the result of which occurrence?

A

Paradoxical bronchospasm, which must be reported to the PCP

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18
Q

A client receiving the oral theophylline is due to have a level drawn. The RN would question the client to ensure that the client has not ingested which substance before the blood sample is drawn?

A

Coffee

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19
Q

The client questions the RN as to why the PCP switched the usual Rx from a metered dose inhaler to a dry powder inhaler. The RN would respond correctly by providing which facts?

A

Dry powdered inhalers pose no environmental risks
Dry powdered inhalers deliver more Rx to the lungs
Dry powdered inhalers require less hand-to-lung coordination

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20
Q

Which statement made by a client taking montelukast indicated the need for further teaching?

A

“I will take the medication when I first notice I am having trouble breathing”

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21
Q

When evaluating an asthmatic clients knowledge of self care, the RN recognizes that additional instruction is needed when the client states?

A

“ I use my corticosteroid inhaler each time I feel SOB”

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22
Q

The RN would monitor the client receiving the 1st dose of albuterol for which side or adverse effect of this Rx?

A

Tachycardia

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23
Q

The client has a prescription to receive pirbuterol 2 puffs & beclomethasone dipropionate 2 puffs by metered dose inhaler. The RN plans to give these medications in which way to ensure effectiveness?

A

Administering the pirbuterol before the beclomethasone

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24
Q

A client is taking Theophylline has a serum level of 15mcg/ml. How does the RN interpret the lab value?

A

In the middle of the therapeutic range.

The range is 10-20mcg/ml

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25
The PCP prescribed cromolyn for the client w/asthma. The RN identifies that the client correctly understands the purpose of this med when the client states that the med will produce which effect t?
Suppresses an allergic response
26
The RN is teaching a client about the effectiveness of diphenhydramine, an ingredient in the cough suppressant prescribed for the client. The RN would plan to tell the client to take which measure while taking this med?
Avoid activities requiring mental alertness
27
A client has begun therapy with a xanthine bronchodilator. The RN determines that the client understands dietary alterations if the client states to limit which items while taking this med?
Coffee and chocolate
28
A cromolym sodium inhaler is prescribed for a client w/allergic asthma. The RN provides instructions regarding the adverse effects of this medication & would tell the client that which undesirable effect is associated with/this medication
Bronchospasm
29
Terbutaline is prescribed for a client with bronchitis. Which disorder in the clients medical history required caution by the nurse?
Diabetes millitus
30
The RN has a prescription to give you a client salmetrol, 2 puffs, & beclomethasone dipropionate, 2 puffs, by metered dose inhaler. The RN would administer the med using which procedure?
Salmetrol first then beclomethasone
31
A client begins therapy with/theophylline. The RN plans to reach the client to limit the intake of which items while taking this med?
Coffee, cola, and chocolate
32
The RN is dating for a client receiving an albuterol/ipratropium nebulized breathing treatment. Which report from the client would the RN note as expected side effect of this combo med?
“I feel as though my heart is racing”
33
What are Antineoplastic Drugs? (Auntie-o-plastic) 👩🏻-o-plastic
💊 to treat CA Narrow therapeutic 🪟 Myelosuppression
34
RBC value ♥️
4.5-6
35
WBC Value 🤍
5,000-10,000
36
Platelet 🍽️ Value
150-400
37
Absolute neutrophil count ✖️➕➗🟰
(% segs ➕% bands) ✖️ WBC✖️10 🟰ANC
38
Methotrexate
Folate antagonist Lowers immune Bright 💛 urine Drug 🩸levels need to be drawn 🛟💊- leukovorin Adverse- Pulmonary fibrosis 🫁
39
Cladribine is what class of drugs?
Purine antagonist
40
cytarabine 👀 (See-why-Tara-bee) 👓👀🤷🏽‍♀️💃🏼🐝
You C with your 👀- conjunctivitis 🦠 Pyrimidine antagonist Cytarabine syndrome: 🤒, 💪🏽& 🦴 pain, rash, conjunctivitis Pretreat w/ Benadryl, APAP, steroids (APAP not NSAIDs)
41
capecitabine (Cape-cite-a-bean) 🦸🏽‍♀️cite-a-🫘
For breast & colon CA Pyrimidine antagonist Adverse effects- 🚽D/N/V🤮, 👋🏼🦶🏼👄syndrome, painful erythema
42
fluorouracil (Flu-or-a-seal) 🤒or a 🦭
Palliative tx for CA Pyrimidine antagonist
43
gemcitabine 💎♦️💠
1st line for Pancreatic CA Pyrimidine antagonist
44
etopside topsie-turbie 😵‍💫
Mitotic inhibitor Adverse effect: ⬇️ Significant Hypotension
45
paclitaxel (pack-lit-ax-el) 🎒🔥🪓el
Mitotic inhibitor Breast, ovarian. Kaposis Sarcoma Poorly tolerated Pre 💊- dexamethasone, diphenhydramine💗, antacids (Dark rash)
46
vincristine 👩🏻🦶🏼
Never intrathecal, spine will 💀 Adverse effects: Constipation 🚽-senna 💊 Peripheral neuropathy 📌 🦶🏼drop- notify Dr change 💊
47
tOpOtecan
topoisomerase inhibitor (only) Metastatic ovarian CA & 🫁 CA Wait ⏳24hrs from chemo to give GCSF 💊
48
L- asparaginase
antineoplastic enzymes Made from ecoli 💩 Allergic reaction is common 🥵 Cor cart close ⚕️ Adverse affects: N/V 🤮, 🫃🏻abd pain Pancreatitis- notify Dr ⏳prolonged clotting 🩸times
49
Erwinia asparaginase
antineoplastic enzymes made w/ erwina vs ecoli so less reaction Expensive 🤑
50
Chemotherapy administration 💊
Central line 🩸 (Peripheral can cause necrosis) Chemo approved 🧤 Stay in room for 15 min ⏰
51
Medication to stop vesicant reaction
hyaluronidase 💊 🧊cold compress
52
Tumor Lysis Syndrome
Cell breaks open: ⬆️uric acid- shuts down kidneys ⬆️ phosphate- shuts down kidneys ⬆️ potassium (ekg) ⬇️ calcium Symptoms: flank pain, 🤮, oliguria Tetany 🤌🏽 Cardiac dysrhythmia Seizures 🫨, ☠️
53
Alktlating Drugs saying
-B- nice to your lungs and -D- heart and -C- your kidneys and bladder not bleed
54
What are the three types of Alkylating drugs? 💊
Classic 🎼 alkylstors Nitrosureas 🏎️💨 Miscellaneous alkylators 🤷🏽‍♀️
55
mechlorethamine (Mikalo 🧑🏼💨)
(Nitrogen Mustard) Used to be gas Blisters 💦 and get 🦠
56
cyclophosphamide
Classic alkylator 💊 Adverse effects: Hemorrhagic cystitis( Inflam> to🩸) IVF hydrated 💧(⬇️ chemo in bladder) Mesna💊- protects bladder 💧infuse before & after 💊 At least 2 liters Needs to pee 💛 q 2-3 hours “C your kidneys and bladder not 🩸”
57
ifosfamide
Classic alkylator 🎼 Adverse effects: Hemorrhagic cystitis(Inflam > to 🩸) IVF Hydrated- 💧dilute 💊 in bladder Mesna💊- protects bladder At least 2 L of 💧 💛pee q 2-3 hours “ C your kidneys & bladder not 🩸)
58
cisplatin 💚🍌 (Plantain)
Miscellaneous alkylator🤷🏽‍♀️ Adverse effects: Nephrotoxicity 2,000-3,000 IVF 💧/ during Peripheral neuropathy 📌 Ototoxicity- test 👂🏼frequently “C your kidneys & bladder not 🩸”
59
carboplantin (Carb-plantain) 🍝💚🍌
Miscellaneous alkylator🤷🏽‍♀️ Adverse effects: Severe 🦴marrow suppression Nephrotoxicity 2,000-3,000 💧IVF during tx “C you bladder & kidneys not 🩸”
60
busulfan (Bus of fan) 🚏🚌 of 🪭
Miscellaneous alkylator🤷🏽‍♀️ Adverse effect: Pulmonary fibrosis🩻- 🫁get infiltrate Hyperuricemia- ⬆️uric acid needs allopurinol 💊 “B nice to your lungs”
61
Cytotoxic Antibiotics 💊
Too toxic 💀 to treat infections 🦠 Lifetime maximum 🛑🫷 🦴 marrow suppression 2types: Anthracyclines & other cytotoxic Abx
62
doxrubicin (Dox- ruby- cin) 💎♦️
Anthracycline 🚴‍♀️ EKG, Echo L- ventricular🫀 ejection ➗ Adverse side effects: 🫀💀cardiotoxic 🫀Heart Failure 🫃🏻weight gain- daily ⚖️ 🫁sounds- crackles “D heart”
63
daunorubicin (Dawn dish soap- ruby-cin) 🧼🧴♦️💎
Anthracycline 🚴‍♀️ 🧡/❤️ urine Adverse effects: 🫀💀cardiotoxic 🫀⬇️ heart failure 🫃🏻weight gain- daily ⚖️ 🫁👂🏼- crackles ECHO/EKG “D heart”
64
bleomycin (Ble-my-son) 🐝👆🏼👦🏻
Other cytotoxic antibiotics Adverse effects: Pneumonitis 🫁 Pulmonary fibrosis - PFT & CXR 🩻 “B nice to your lungs”
65
bevacizumab (Beverly (Bev)- scissor-mob) 💃🏼a✂️🇮🇹mob
Miscellaneous Antineoplastic 🚂🪀 Angiogenesis inhibitor (🛑new 🩸🪢to tumor) ▪️warning❗️- 🙅🏼‍♂️28 ☀️before surgery 🔪 Wound dehiscence 🥓 ⬇️ wound healing ❤️‍🩹 Adverse: HTN, Hypotension
66
hydroxyurea (Hydro-xy-uria) 💦xy💛
Miscellaneous Antineoplastic 🚂🪀 Sickle cell disease In conjunction with/ radiation ☢️
67
Hormonal Drugs
Can be Estrogen ➕or progesterone➕ 🛑✋🏽growth Contraindicated in DVT🩸, clotting disorders
68
tamofixen (Tammy is fixin ) 💃🏼🛠️
Treats & prevents breast CA Adverse effects: Hypercalcemia⬆️🍊 (constipation, kidneys, flank pain) “Tammy💃🏼 is fixin 🛠️to go to the bathroom 🚽 💩“ Hypolipidemia- lowers LDL 🙌🏽
69
megestrol (Megace) 🦈 (Strong shark)
Suppresses luteinizing hormone Adverse effects: DVT 🪢🩸 Weight gain🫃🏻- good for people w/ HIV or geriatric 👵🏽👴🏼
70
Immunosuppressant drugs⬇️🧗‍♀️
For immune disorders Organ transplant ⬇️ T-lymphocyte Risk for 🦠 or CA Metabolized by p450 enzymes (Lowers immune so body doesn’t attack or reject organs)
71
cyclosporine 🚴‍♀️🚵‍♀️
Immunosuppressant drugs⬇️🧗‍♀️ Narrow therapeutic 🪟 Tastes gross 🤮 🧃 🚫styrofoam🥤- attaches med & breaks down 🚫grapefruit- changes☠️metabolism ▪️warning ❗️ ☠️🦠 (🤒 is an emergency) Nephrotoxicity 🫘 Hepatotixicity Encephalopathy 🧠 Skin CA Adverse effects: Infx, 👄💭gum hyperplasia, ⬆️hair growth🧔🏼‍♀️, HTN
72
tacrolimus (Tac-ro-lime-us) 📌ro🍋‍🟩🇺🇸
Immunosuppressant drugs⬇️🧗‍♀️ x💯potent than cyclosporine 🚫🥤- attaches to med 🚫grapefruit ☠️ ▪️warning❗️ Malignancy, ☠️🦠infections Adverse effects: Diarrhea 🧻, HTN, ⬆️hyperglycem💉
73
sirolimus (siren- lime-us) 🚨🍋‍🟩🇺🇸
Immunosuppressant drugs⬇️🧗‍♀️ Not as ☠️ as tacrolimus 🚫🥤 🚫grapefruit ▪️warning❗️ Malignancies, ☠️🦠 Adverse side effects: 🧻diarrhea, HTN, hyperglycemia 💉
74
mycophenolate mofetil “My mocos are late- muffins” 🤧🦠- 🧁
Immunosuppressant drugs⬇️🧗‍♀️ Intercept cells 🏈 HTN ▪️warning❗️ Congenital malformations 🧟 Spontaneous abortion 😢
75
Nursing implications for Immunosuppressant drugs⬇️🧗‍♀️
Taken for life ☀️- take with 🧃 👀Watch for 🦠 Birth control attacks 👶🏽 🚫💉vaccinations
76
What is erythropoiesis?
Lower RBC 🩸 Normal RBC value is 4.5-6 Norma Reticulocyte is. 0.5-2% Reticulocytes are just babies 👶🏽
77
What are ESAs?
Eythoropoiesis- stimulating Anents Treatment of: End stage kidney 🫘disease Chemo induced anemia Zidovudine induced anemia Side effect- 🦴pain 😖
78
epoetin Alfa (💪🏽)
Synthetic form of hormone erythropoietin Takes 2-3wks for effects darbepoetin (alternative)- long acting
79
Nursing implications for ESAs
Significant HTN ⬆️ 🚫if Hgb is low: >10 w/out renal disease >11 w/renal🫘 disease 🚫shake 💊 Keep 🧊 Sub q injection
80
Leukopenia Drug
Given before pt has an 🦠, but not W/in 24 hrs of Chemo Goal of WBC >10,000 Adverse effects: 🦴pain, ruptured spleen (no sports 🏈 )
81
filgrastim
Leukopenia drug Stimulates granulocytes G-CSF (granulocyte colony stimulating factor)
82
pegfilgrastim In commercial ❗️
Leukopenia drug Lasts longer that filgrastim, reduces number of injections 💉
83
sargeamostim
Leukopenia drug Stimulsted granulocytes & macrophages GM-CSF
84
Thrombocytopenia Drugs
oprelvekin- for 🩸disorders & CA (⬇️# of platelet transfusions) romiplostim- for idiopathic thrombocytopenia purpura (ITP)
85
Interferon Drugs
Antiviral, Antitumor, and Immunomodulating Adverse effects: flu like sx, fatigue, 🤒, hypotension, GI issues, liver issues, seizure🫨, depression Pre💊- APAP & Benadryl (fever & itch)
86
Interferon Classes
Alpha💪🏽- for CA, Hep C, Kaposi’s sarcoma Beta🐠- for MS Gamma👵🏽- osteoporosis
87
Monoclonal Antibodies
CA, RA, MS, organ transplant 🎯CA cells Suffix-mab ▪️warning❗️: Risk for lymphomas & other CA 🫀failure Contraindicated: TB, active 🦠 Adverse effects: 🤒, dyspnea, chills 🥶
88
adalimumab In commercial ❗️
Monoclonal Antibodies For RA, psoriatic arthritis, Crohn’s disease
89
belimumab
Monoclonal Antibodies For lupus
90
bevacizumab
Monoclonal Antibodies Colon/rectal CA, liver, glioblastoma
91
infliximab (Remicade)
Monoclonal Antibodies Very common 💊 For RA, Crohn’s disease, ulcerative colitis
92
rituximab
Monoclonal Antibodies Non-Hodgkin lymphoma
93
trastuzumab
Monoclonal Antibodies For breast CA ▪️warning❗️-cardiomyopathy
94
Interleukin Drugs
Contraindicated in: TB, active 🦠 Adverse effect: Capillary leak syndrome (☠️, 🚫perfusion, leads to hypotension)
95
aldesleukin
Interleukin 💊 For Melanoma, HIV, and AIDs
96
secukinumab In commercial ❗️
Interleukin 💊 for plaque psoriasis, psoriatic arthritis, ankylosing spondylitis
97
Disease modifying antirheumatic drugs DMARD
Treat w/ NSAIDS & corticosteroids 💊 Properties: Anti inflammatory 💭 Antiarthritic Immunomodulating Contraindicated: TB, active infx 🦠
98
etanercept (e-tan-intercept) ☀️👙🏈
Showed on commercial❗️ Antirheumatic 💊 Better shelf life due to latex Watch for latex allergy⚠️
99
methotrexate
Yellow pill 💊 Use with leukovorin 💊 for methotrexate toxicity
100
Screen & treat for this disease prior to start of biological response modifying drugs
Tuberculosis 🦠
101
Adverse effect of leukopenia 💊
🦴pain
102
Lymphoma from monoclonal antibodies
▪️warning ❗️
103
Gamma 👵🏽 interferon is used to treat this disease
Osteoperosis 🦴
104
Potentially ☠️effect of interlukins
Capillary leak 🚰syndrome
105
Beta 🐠 interferon is used to treat those diseases
Multiple sclerosis
106
Stimulates megakaryocytes to produce thrombocytes
Oprelvekin
107
Mab ending
Monoclonal antibodies
108
Goal is to ⬆️ WBCs
Leukopenia drugs
109
Anti-inflammatory, immunodilatong, & antiarthritic properties
DMARD properties
110
Important to premeditate w/benadryl and APAP
Interferon drugs 💊
111
Be careful giving when giving etanercept
Latex