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Pharmacology-NRSE-3010-001 > Exam 2 > Flashcards

Exam 2 Flashcards

1
Q

Hydrochlorothiazide should not be given to patients with what?

A

severe renal impairment; therefore, an decreased creatinine clearance

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2
Q

A client is taking an aminoglycoside ABX and furosemide. What symptom should the nurse teach the client to report?

A

ringing in the ears

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3
Q

A pt on dig has been Rx furosemide. VS- BP 132/84 HR irreg 87 bpm RR 23. Crackles are present. What lab is concerning?

A

potassium levels that are not within range

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4
Q

What symptoms would the nurse monitor for in a patient with suspected hypokalemia caused by diuretic use?

A

muscle weakness and lethargy

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5
Q

A nurse assesses dyspnea, bilat crackles, & pitting edema in a pt RX spironolactone. Which intervention is appropriate?

A

request an order for furosemide

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6
Q

A pt has 2+ pitting edema of BLE. The nurse hears crackles. The serum K+ level is 6. Which drug would the nurse question

A

spironolactone

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7
Q

A pt is taking furosemide 4 HTN & CHF. The dr has just added dig. What other drug does the nurse suspect will be added?

A

spironolactone

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8
Q

A pt w/ CHF has been taking dig&HCTZ. Spironolactone has just been added. What statement indicates teach’g is effective?

A

“I need to stop taking potassium supplements.”

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9
Q

What time of day would the nurse teach a client that it is best to take their diuretic medication?

A

morning

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10
Q

What time of day would the nurse teach a client that it is best to take their diuretic medication?

A

reduces intracranial pressure.

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11
Q

What electrolyte imbalances might occur in a pt taking 40 mg furosemide daily?

A

low serum potassium, sodium, magnesium, and calcium

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12
Q

What kind of drug is aspirin/NSAIDs/ASA (acetylsalicylic)?

A

antiplatelets

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13
Q

What kind of drugs are P2Y12 ADP Receptor Blockers (clopidogrel/prasugrel)?

A

antiplatelets

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14
Q

When are antiplatelet medications used?

A

treatment of acute MI, reinfarction prevention, ischemic strokes/TIAs, and acute coronary symptoms (they prevent clots in arteries by suppressing platelet aggregation)

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15
Q

What are the adverse effects of clopidogrel/prasugrel and aspirin?

A

bleeding and GI effects

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16
Q

What are the effects of aspirin/NSAIDs/ASAs?

A

gastric bleeding, hemorrhagic stroke, thrombocytopenia, tinnitus/hearing loss(aspirin overdose)

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17
Q

What is the antidote for for heparin?

A

protamine sulfate

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18
Q

What lab is prevalent for heparin? What range is considered therapeutic?

A

PTT (120-140 secs)
aPTT (60-80 secs)

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19
Q

Describe heparin subcutaneous injection administration.

A

Get accurate weight. Use a 1/2-5/8 in; 25-26 G needle. Give in abdomen, 2in from umbilicus. Don’t rub site

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20
Q

Describe heparin IV administration.

A

aPTT before initiating/changing rate. Accurate weight. verify with second nurse. Use pump. No IVPB, must have separate line.

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21
Q

What is the antidote for warfarin?

A

Vitamin K

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22
Q

What is warfarin used for?

A

treat DVT, prevent thrombus formation in those with A-fib or prosthetic heart valves, prevent MI/ TIA/ PE/ DVT

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23
Q

What labs are prevalent to warfarin?

A

PT (18-24 secs) and INR (2-3: <2 indicates it is not working)

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24
Q

What patient education should be provided by the nurse for a patient starting warfarin?

A

inform dentist before operations, smoking cessation (it can increase warfarin metabolism), avoid aspirin, wear medical alert bracelet, and eat consistent vitamin K foods

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25
Q

What pregnancy category is warfarin?

A

category X

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26
Q

What are effects of erythropoietin meds (ex. epoetin alfa)?

A

HTN, risk for thrombotic events, DVT, headache, and body aches

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27
Q

What are the indications for oprelvekin (thrombopoietic growth factors)?

A

thrombocytopenia (low platelet) and decreases need for platelet transfusion following chemo

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28
Q

How is effectiveness of oprelvekin determined?

A

platelet level of 50,000, so CBC should be done before and after

29
Q

What are the side effects of filgrastim (leukopoietic growth factors)?

A

bone pain, leukocytosis, splenomegaly, and risk of splenic rupture with long-term usage

30
Q

What some examples of thiazide diuretics?

A

HCTZ (hydrochlorothiazide), Chlorthalidone, and Metolazone

31
Q

What are the contraindications for thiazide diuretics?

A

renal failure, pregnancy, allegry to sulfonamides, and anuria (no urine production)

32
Q

What lab interactions can be expected with a patient on a thiazide diuretic?

A

HYPO- kalemia, magnesemia, natremia

HYPER- calcemia, glycemia, lipidemia, uricemia

33
Q

What patient teaching should be provided for thiazide diuretics?

A

Take in the AM, monitor blood glucose (hyperglycemia), potassium-rich foods, take daily weight, sunblock, change positions slowly

34
Q

What kind of medication is furosemide (potassium-wasting) ?

A

loop diuretics

35
Q

What are reasons that loop diuretics are given?

A

CHF, edema, HTN, acute renal failure, acute pulmonary edema, and hypertensive crisis

36
Q

What are the contraindications of loop diuretics (furosemide)?

A

sulfonamides/sulfa allergies and uncorrected hypokalemia

37
Q

A client on lovastatin complains of muscle pain, what condition may the nurse suspect?

A

rhabdomyolysis

38
Q

What is a very common side-effect of nicotinic acid (aka Niacin or Vitamin B3)?

A

flushing ( red face, neck, ears and face)

39
Q

What kind of medications end in -pril?

A

ACE inhibitors

40
Q

What kind of drugs end in -sartan?

A

ARBs (angiotensin II-receptor blockers)

41
Q

What class is valsartan?

A

ARB

42
Q

If the dry cough caused by lisinopril becomes too severe for the patient to handle, what type of medication may be taken into consideration for them to switch to?

A

ARBs (valsartan)

43
Q

What should individuals on an ACE inhibitor avoid?

A

high K= foods (salt substitutes, bananas, prunes)

44
Q

What type of antihypertensives are effective for diabetics? Why?

A

ACE no glucose effect and less effect on kidneys (diabetes damages kidneys)

45
Q

What type of diuretic should be avoided for a patient on an ACE inhibitor? Why?

A

potassium sparing (spironolactone), because ACE inhibitors can cause elevated potassium (hyperkalemia)

46
Q

What are the black box warnings for lisinopril?

A

angioedema and pregnancy

47
Q

Clonidine is an antihypertensive medication that causes anticholinergic effect. Name a few.

A

dry mouth, constipation, sedation, drowsiness

48
Q

Hypotension, bradycardia, dry mouth, constipation, sedation, drowsiness, and peripheral edema are all effects that could be caused by which antihypertensive medications?

A

clonidine

49
Q

Diltiazem, verapamil and drugs ending in
-dipine are what class of medication, and used for what?

A

calcium channel blockers and antihypertensives

50
Q

What are the intended effects of calcium channel blockers?

A

decease hypertension, vasodilation

50
Q

What are the indications for calcium channel blockers (verapamil, diltiazem and
-dipine drugs?

A

arrythmias, angina and hypertension

50
Q

What are some side effects of calcium channel blockers?

A

edema (peripheral), chronic heart failure, syncope, hypotension, and bradycardia

51
Q

What patient teaching should be provided from individuals taking a calcium channel blocker?

A

avoid grapefruit juice and statins, report chest pain/SOB, taper dose, and change positions slowly

52
Q

How are beta blockers recognized?

A

-olol

53
Q

In which patients should beta blockers not be used as initial treatment or monotherapy?

A

African American

54
Q

In which ethnic group should lower dosages of beta blockers be considered, due to their sensitivity to antihypertensives?

A

Asian individuals

55
Q

What are the contraindications for thiazide diuretics?

A

renal failure, pregnancy, allergy to sulfonamides, and anuria (no urine production)

56
Q

What lab interactions are expected to occur with thiazide diuretics?

A

HYPER (GLUC) HYPO (KMN)
hyper (glycemia, lipidemia, uricemia, and calcemia)

hypo (kalemia, magnesemia, and natremia)

57
Q

What is the antidote for warfarin?

A

Vitamin K

58
Q

What are some effects of warfarin?

A

bleeding, hemorrhage, and hepatitis

59
Q

What class of drug is warfarin?

A

anticoagulant

60
Q

What is the mechanism of action for anticoagulants (heparin/warfarin)?

A

don’t dissolve clots, but prevent new ones forming/growing

61
Q

What are the indications for warfarin?

A

DVT, prevent thrombus formation in those
with A-fib or prosthetic heart valves, prevent MI, TIA, PE,
and DVT

62
Q

What should individuals wear who are on warfarin?

A

medical alert bracelet

63
Q

What should be avoided while taking warfarin?

A

aspirin and smoking

64
Q

Which food type should be eaten at a consistent level for those on warfarin?

A

Vitamin K

65
Q

In what cases should warfarin not be given?

A

pregnancy, active bleeding, hemorrhagic stroke and used in caution with other highly protein bound drugs

66
Q

What is the antidote for heparin?

A

protamine sulfate

67
Q
A

Pharmacology-NRSE-3010-001 (12 decks)

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