Exam 2: Respiratory and Hematologic

Question 1

LMWH use

Answer 1

Lovenox, enoxaparin
inhibits the action of thrombin to prevent clot formation.
Watch the dosage. pregnancy safe.

Question 2

Patient education about administering Loveonx

Answer 2

Monitor for bleeding, bruising may be present around injection site.
Interactions: increased bleeding with antiplatelet, thrombolytics, NSAIDs.

Question 3

Antiplatelet drugs

Answer 3

Aspirin, Bayer, Ecotrin
irreversibly inhibits platelet aggregation. Inhibits prostaglandin synthesis producing antipyretic and anti-inflammatory effects
Indications: reduce the risk of CV events, also can reduce fever and pain, especially inflammatory pain.

Question 4

Are there any dietary medication restrictions with heparin and coumadin

Answer 4

Coumadin: foods high K. leafy greens,
Heparin: The Gs: Gingko, ginger, ginseng

Question 5

Labs to monitor for heparin

Answer 5

PTT.

Question 6

Labs to monitor for coumadin

Answer 6

INR: 2-3 DVT prophylaxis, ischemic stroke, afib/flutter, anterior MI.
INR: 2.5-3.5 mechanical heart valves

Question 7

Medications to avoid when taking warfarin

Answer 7

too many to list. amiodarone, sulfa drugs, most antibiotics, thyroid drugs, H2 blockers, diuretics, allopurinol, estrogen, OCP, phenytoin, rifampin, vitamins C & K

Question 8

Antidote for heparin

Answer 8

Protamine sulfate.

Question 9

Antidote for warfarin

Answer 9

vitamin K.

Question 10

Antidote for antiplatelet drugs

Answer 10

Platelet transfusion

Question 11

Epoetin alfa (Epogen) what is it used for

Answer 11

treat anemia associated with ESRD, chemotherapy drug therapies.

Question 12

Neupogen (filgrastrin), long acting Neulasta (pegfilgrastrin)

Answer 12

Leukopoietic growth Factors

Prevent or treat neutropenia in patients recieving chemotherapy

Question 13

Adverse effects of Aspirin

Answer 13

anaphylaxis, bleeding, Reyes syndrome in children.

Question 14

Medical condition drugs containing Factor VIII/IX treat?

Answer 14

Factor VIII: advate, hemofil-m, hemophilia a.

Factor IX: benefix, alphanine SD, hemophilia b.

Question 15

Neupogen (filgrastrin), long acting Neulasta (pegfilgrastrin)

Answer 15

Leukopoietic Growth Factors

Prevent or treat neutropenia in patients receiving chemotherapy

Question 16

What is the difference between an anticoagulant and a thrombolytic drug

Answer 16

thrombolytics are used to break up a clot and prevent permanent tissue damage to tissue.

Question 17

Which inhalers are rescue?

Answer 17

albuterol (ventolin)

Question 18

Which inhalers are for maintenance?

Answer 18

Salmeterol and formoterol (beta adrenergic agonists long acting). montelukast, zafirlukast, fluticasone (inhaled steroids)

Question 19

Which inhalers are for asthma?

Answer 19

albuterol for acute.
salmeterol and formoterol for maintenance,
theophylline for rescue bronchospasm, montekulast, fluticasone for maintenance, Cromolyn Sodium for prevention

Question 20

Which inhalers are for COPD?

Answer 20

albuterol for acute. Beta adrenergic agonist long acting (salmeterol and formoterol)
ipatropium and tiotropium for COPD bronchospasm.
theophylline for bronchospasm. fluticasone for maintenance

Question 21

Patient education for inhaled medications

Answer 21

proper delivery system, timing of doses, maximum daily dose, when to seek medical attention, rinse mouth and wash contraption.

Question 22

What are antihistamines for

Answer 22

treatment of allergic reactions, allergic rhinitis, hives, URI symptoms, vertigo
h2: allergic rhinitis, chronic uticaria

Question 23

Signs of theophylline toxicity

Answer 23

sustained v tach, seizures, cardiac arrest

Question 24

Patient education for montelukast

Answer 24

Teach timing of dosage, teach how to treat side effects, do not use for acute asthma attack. side effects, ha, sore throat, fatigue, cough, nausea.

Question 25

What do you monitor when caring for a client taking salmeterol?

Answer 25

ha, sore throat, nasal congestion, rash, tachycardia, tremor. Adverse: bronchospasm, death, laryngospasm, anaphylaxis, htn, hypotension, angina.

Question 26

client teaching about tiotropium

Answer 26

Anticholinergic | timing of medication, how to use, rinse after each use.

Question 27

Benzonate use: when, how long, and what conditions?

Answer 27

Inhibits the cough center in the brain. use short term. for nonproductive cough.

Question 28

side effects of short acting beta 2 agonists?

Answer 28

insomnia, tremor, tachcardia

Question 29

what is the use of expectorants?

Answer 29

Mucinex, guaifenesin aid in the expectoration of excessive mucus. respiratory congestion and cough. decreases the surface tension of the mucus. increase water intake Watch for kidney stones!

Question 30

what is the purpose of leukotriene modifiers?

Answer 30

prophylaxis and long term treatment of asthma, allergic rhinitis, and seasonal allergies.

Question 31

What are antitussives for

Answer 31

inhibit the cough center of the brain (medulla) temporary.

Question 32

phenylephrine

Answer 32

Neo-synephrin: decongestant. used for nasal congestion. rebound congestion!! interacts with increasing blood pressure.

Question 33

Codeine

Answer 33

cough suppressant. narcotic. | check vital signs. sedation!!

Question 34

What are leukotriene inhibitors used for

Answer 34

-lukast :block the receptors to leukotriene. prophylaxis and long term treatment of asthma, allergic rhinitis and seasonal allergies.

Question 35

why would a patient receive an order for a topical/nasal decongestant versus an oral decongestant?

Answer 35

decreased systemic absorption in the case of heart disease, such as CAD, htn. we do not want to systemically constrict the vessels.

Question 36

theophylline

Answer 36

theodur. xanthine derivative. relaxes smooth muscle of the bronchi. not for rescue. not used commonly

Question 37

Why would a patient be ordered a combination inhaler containing a steroid and bronchodilator?

Answer 37

bronchodilation and treat inflammation.

Question 38

What are patient education strategies a nurse would teach a patient using an inhaled steroid or asthma/COPD?

Answer 38

the use of inhalers, rinse mouth after each use, how to clean inhaler, not for acute treatment, need to follow up appointments to monitor drug effectiveness

Question 39

Prednisone

Answer 39

Oral steroid: decreases airway inflammation and mucous production. short term treatment of acute asthma attack (IV). long term use for severe asthma. Pregnancy D!!! increases blood sugar, yeast infections, gi upset. long term bone loss, adrenal gland suppression, peptic ulcers.

Question 40

Cromolyn sodium, nedocromil

Answer 40

intal, tilade, mast cell stabilizers. anti inflammatory. | maintenance. used before exertion.

Question 41

dronase alfa inhaled

Answer 41

pulmozyne. cystic fibrosis drugs. decreases mucous viscosity.

Question 42

mucoclytic drugs

Answer 42

decreases mucous viscosity. Acetylcysteine.