Exam 1 Study Guide Flashcards
What should you monitor in patients taking Cholinergic drugs?
Monitor for therapeutic effects of:
Myasthenia gravis
Alzheimers (decreased confusion, etc.)
Postop patients w/ decreased GI peristalsis (increased bowel sounds, flatulence, bowel movements)
Patients w/ urinary retention (should urinate w/in 60 minutes).
What should you monitor in patients taking Anti-Cholinergic Drugs?
Monitor for therapeutic effects in:
Patients with Parkinson’s (fewer tremors and decreased salivation and drooling)
Patients with urologic problems (improved urinary patterns, less hyper-motility, increased time between voiding)
Monitoring for Cholinergic Crisis
SLUDGE (salivation.lacrimation.urinary incontinence.diarrhea.GI cramps.emesis) Bloody diarrhea CA Circulatory collapse Hypotension, shock
Treatment for Cholinergic crisis
For early treatment: atropine is used. For severe cardiovascular reactions of bronchoconstriction: epinephrine is used
Monitoring a patient taking an adrenergic drug
Monitor for therapeutic effects on the cardiovascular system (decreased edema, increased urinary output, return to normal VS, improved skin color and temp, increased LOC) and respiratory system (normal RR, improved breath sounds, increased air exchange, less dyspnea, decreased cough, improved blood gases, increased activity tolerance)
Monitoring a patient taking an adrenergic blocking drug
Monitor for decreased chest pain in patients with angina.
Return to normal BP and HR.
Adrenergic Blocking Drugs include
Beta Blockers (Atenolol) Alpha Blockers (Phentolamine, prazosin, tamsulosin)
What are adverse effects of Atenolol?
bradycardia, depression, constipation, impotence
What are the nursing implications for patients taking Atenolol?
Inform patient tor export weight gain of more than 2 pounds in 1 day or 5 pounds in 1 week, edema of the feet or ankles, SOB, excessive fatigue or weakness, syncope or dizziness to their HCP.
Important Cholinergic blocking drugs include:
Dicyclomine and oxybutynin
Dicyclomine
Cholinergic blocking drug.
Used primarily in the treatment of functional disturbances of GI motility such as irritable bowel syndrome.
Oxybutynin
Anticholinergic drug.
Used for the treatment of an overactive bladder.
What are adverse effects of Dicyclomine?
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What are adverse effects of oxybutynin?
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What are nursing implications for patients taking Dicyclomine?
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What are nursing implications for patients taking oxybutynin?
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What is a Cerebrovascular accident?
Impairment of one or more vessels in the cerebral circulation -> interrupts blood supply -> ischemia of brain tisssue
What is the purpose for the use of warfarin in patients with a CVA?
Prevents the formation of clots and keeps existing clots from getting bigger.
What are adverse effects of warfarin?
Bruising, bleeding, N/V, stomach pain, bloating, gas, or altered taste.
What is used to reverse too much warfarin?
Vitamin K
Is there any OTC herbal products that can interact with anticoagulant therapy?
Ginseng
Types of Seizures
a. Generalized seizure
b. Simple partial seizure
c. Complex partial seizure
Generalized seizure
Seizures originating simultaneously in both cerebral hemispheres.
Simple partial seizure
No impaired consciousness Motor symptoms Hallucinations of seeing, hearing or taste along with tingling. ANS responses Personality changes.
Complex partial seizure
Impaired consciousness Memory impairment Behavioral effects Purposeful behaviors Aura, chewing, and swallowing movements, unreal feelings and bizarre behavior. Tonic, clinic or tonic-clinic seizures.
What are the types of antiepileptic drugs?
Phenytoin
Phenobarbital
What are therapeutic effects of phenytoin?
desensitizes sodium channels
What are the therapeutic effects of phenobarbital?
Changes the actions of GABA (neurotransmitter inhibitor)
What are the adverse effects of phenobarbital?
dependence, drowsiness, vitamins deficiencies and laryngospasm.
High potential for dependence and low margin for safety.
What are the adverse effects of phenytoin?
CNS depression, gingival hyperplasia, skin rash, cardiac dysrhythmias, hypotension.
What should you monitor in patients taking phenobarbital and phenytoin drugs?
Serum-drug levels
Signs of toxicity
Blood dyscrasias and bleeding disorders.
Liver an kidney function (fatal hepatotoxicity can occur)
What drugs are typically used for status epilepticus?
Diazepam Fosphenytoin Lorazepam Phenobarbital Phenytoin
What are adverse effects of drugs used to treat status epilepticus?
Apnea
Hypotension
Somnolence
Cardiac Dysrhythmias
What is Parkinson’s disease?
Progressive loss of dopamine. Can cause tremors, muscle rigidity, abnormal movement and posture.
What are the drugs used to treat Parkinson’s disease?
Levodopa and levodopa-carbidopa
What are the therapeutic effects of levodopa and levodopa-carbidopa?
increases biosynthesis of dopamine within nerve terminals (restore balance of dopamine)
What is the main focus of drug therapy in treating Parkinson’s disease?
Restores balance of dopamine (restores dopamine function) and ACh in the brain (blocks ACh).
What are the adverse effects of levodopa and levodopa-carbidopa?
Dizziness, light-headedness, sleep dysfunction, fatigue, nausea vomiting, constipation, orthostatic hypotension, dystonia, dyskinesia.