final exam ;( Flashcards
Urinary/Reproductive Lecture-
What are the MOAs for urinary tract analgesics?
common meds
URINARY TRACT ANALGESICS: local anesthetic on the mucosa of the urinary tract
meds: Phenazopyridine (Pyridium)
Urinary/Reproductive Lecture-
What are the MOAs for urinary tract antiseptics?
common meds
broad-spectrum urinary antiseptic with bacteriostatic and bactericidal action. It injures bacteria by damaging its DNA
Common Meds: nitrofurantoin and methenamine
Urinary/Reproductive Lecture-
What possible interactions can happen using spironolactone and Angiotensin II receptor blockers or ACE inhibitors together?
Increased risk of hyperkalemia
Urinary/Reproductive Lecture-
What are the signs and symptoms of hypokalemia (what lab values will be present with each)?
HYPOkalemia: 3.5-5mEq/L
Lethargic, low, shallow respirations, lethal cardiac dysrhythmias, lots of urine, leg cramps, limp muscles, low BP
Urinary/Reproductive Lecture-
What are the signs and symptoms of hyperkalemia (what lab values will be present with each)?
HYPERkalemia: 3.5-5mEq/L
Muscle weakness, urine output little or none, respiratory failure, decreased cardiac contractility, early muscle twitches/cramps, rhythm changes
Urinary/Reproductive Lecture-
What are the complications of loop diuretics (which are their common meds)?
Dehydration, hyponatremia, hypochloremia, hypotension, ototoxicity, hypokalemia, loss of other electrolyte levels
Urinary/Reproductive Lecture-
What are the loop diuretics common meds?
- furosemide (lasix)
- ethacrynic acid (edecrin)
- bumetanide (bumex)
- Toresemide (dytor)
Urinary/Reproductive Lecture-
What are the complications of potassium-sparing diuretics (which are their common meds)?
Hyperkalemia, endocrine effects, drowsiness, metabolic acidosis
Urinary/Reproductive Lecture-
What are the contraindications for oral contraceptives?
- Smokers over the age 35
- Hx of thrombophlebitis and cardiovascular events
- family history of breast cancer
- experiencing abnormal vaginal bleeding
- caution in hypertension
- DM
- gall bladder disease, uterine leiomyoma
- seizure
- migraine headaches
Urinary/Reproductive Lecture-
What important patient teaching do we give to give patients of child-bearing age when taking antibiotics?
extra contraceptive protection
(musculoskeletal medication classifications) Which are the MOAs of DMARDS
slow joint degeneration and progression of rheumatoid arthritis
musculoskeletal medication classifications:
Which are the MOAs of (Selective estrogen receptor modulator) SERM
works as an endogenous estrogen in bone, lipid, metabolism, and blood coagulation
(musculoskeletal medication classifications) Which are the MOAs of bisphosphonates
decrease the number and action of osteoclasts, and inhibits bone resorption
(musculoskeletal medication classifications) Which are the MOAs of calcitonin
decreases bone resorption by inhibiting the activity of osteoclasts in osteoporosis, and increases renal calcium excretion by inhibiting tubular resorption
(musculoskeletal medication classifications) Which are the MOAs of calcium supplements
maintenance of musculoskeletal, neurologic, and cardiovascular function
Musculoskeletal lecture-
What are the signs/symptoms of hypercalcemia?
Hypercalcemia: bone pain, arrythmias, cardiac arrest, kidney stones, muscle weakness, excessive urination
Musculoskeletal lecture-
What are the complications of calcium supplements?
hypercalcemia
Musculoskeletal lecture-
Which common medications belong to the biphosphonate classification?
Alendronate, Ibandronate, Risedronate
Musculoskeletal lecture-
What are the nursing implications of giving DMARDs?
- Let clients know that DMARDS can take 3-6 weeks to start to take effect, several months for full
- Monitor for side effects/adverse effects
- Monitor potassium levels and blood glucose levels
- Get baseline CBC, and monitor platelet counts periodically
- Monitor liver enzymes
- Monitor closely for infections
- Obtain baseline eye exam and follow-up eye exam q6 months
Musculoskeletal lecture-
What are the complications of methotrexate (DMARD)? What kinds of signs and symptoms would patients complain about if they had these complications?
- Increased risk of infection
- hepatic fibrosis and toxicity
- bone marrow suppression
- GI ulcerations
Musculoskeletal lecture-
What medications/drinks interact with methotrexate (DMARD)?
Salicylates/ other NSAIDS, sulfonamides, PCN, tetracyclines, Folic Acid
Musculoskeletal lecture-
What are the nursing implications of calcium supplements?
Nursing Implications: chewable tablets are preferred, monitor calcium levels, observe for signs of hypercalcemia
Musculoskeletal lecture-
What are the patient teaching of calcium supplements?
Patient Teaching: take at least 1 hour apart from glucocorticoids and tetracyclines and at least 4 hours apart from thyroid hormone, take with 8oz of water
Musculoskeletal lecture-
Which medication belongs to SERM classification?
Raloxifene
Musculoskeletal lecture-
What are the complications of SERM medications?
Increased risk for pulmonary embolism and deep vein thrombosis, hot flashes
Musculoskeletal lecture-
What are the nursing implications of Calcitonin meds?
- Can be given SQ, IM, or intranasally
- keep the container in an upright position
- monitor for hypocalcemia
- monitor bone density scans periodically
Neurologic lecture-
What are the MOAs for Benzodiazepines
enhance the inhibitory effects of gamma-aminobutyric acid in the CNS
Neurologic lecture-
What are the MOAs for Muscle Relaxants
acts in the CNS to enhance GABA, produce sedative effects, and depress hyperactive spasticity of muscles
Neurologic lecture-
What are the MOAs for Anticonvulsants:
& meds
control seizure disorder by slowing the entracne sodium and calcium back into the neuron, suppressing neuronal firing, and enhancing the inhibitory effects of gamma butyric acid (GABA)
Phenobarbital, Phenytoin, Carbamazepine, Valproic Acid
Neurologic lecture-
What are the MOAs for Antiparkinsons Agents:
relief of dyskinesias and ability to perform ADLs by maintaining the balance between dopamine and acetylcholine in the extrapyramidal nervous system
Neurologic lecture-
What are the MOAs for Antidementia Agent:
prevent the enzyme cholinesterase from inactivating acetylcholine thereby increasing the amount of acetylcholine available at receptor sites
Neurologic lecture-
What are the MOAs for Migraine:
prevent inflammation and dilation of the intracranial blood vessels, thereby relieving migraine pain
Neurologic lecture-
Benzodiazepines meds
Alprazolam, Diazepam, Lorazepam, Clonazepam
Neurologic lecture-
Muscle Relaxants meds
(b,c,d
Diazepam, Baclofen, Cyclobenzaprine
Neurologic lecture-
Anticonvulsants meds
Phenobarbital (Solfoton)
Phenytoin (Dilantin)
Carbamazepine (Tegretol)
Valproic acid (Depakote)
Neurologic lecture-
Antiparkinsons Agents meds
Levodopa/Carbidopa
Neurologic lecture-
Antidementia Agent med
Donepezil
Neurologic lecture-
Migraine meds
Serotonin receptor agonists, ergot alkaloids (ergotamine, dihydroergotamine), aspirin-like NSAIDS/acetaminophen
Neurologic lecture-
What is the patient teaching points for antiparkinsons agents?
- Take as directed, do not adjust dosage without consulting with provider
- May cause sleepiness/drowsiness, avoid activities that require alertness
- May cause harmless darkening of saliva, urine, or sweat
- Notify your provider if you experience any GI distress, palpitations, involuntary movements or behavioral changes
Neurologic lecture-
What is the patient teaching points for anticonvulsants?
- Take medications as prescribed
- you will need periodic blood work
- avoid activities that require alertness until seizures are fully controlled and medication effects are known
- avoid pregnancy
- do not stop medication without consulting your provider
Neurologic lecture-
Which medications are given for migraines?
Serotonin receptor agonists, ergot alkaloids (ergotamine, dihydroergotamine), aspirin-like NSAIDS/acetaminophen
Neurologic lecture-
What are the complications of antidementia agents? Which signs/symptoms will the patient complain of if they are experiencing them?
- Excessive muscarinic stimulation (increased GI motility, secretions, diaphoresis, increased salivation)
- Cholinergic crisis (respiratory depression, paralysis of the respiratory muscles can be fatal)
intro lecture:
What is the difference between generic names and brand names of medications?
Generic is the official name of the drug and Brand is the company created name
intro lecture:
Pharmacodynamics:
what the drug or medication does to the body
intro lecture:
Pharmacokinetics
how medications travel through the body
intro lecture:
What is genomic medicine and how can it help diverse populations?
Personalize medications for a specific group or person
Safety/Dosage Calc lecture:
What are the steps to performing a safe medication administration?
Three checks of 6 rights
Safety/Dosage Calc lecture:
What are the six rights of medication administration?
Patient, Medication, Dose, Time, Route, Documentation
Pain/Inflammation lecture:
Which are common medications that belong to the NSAID classification?
Aspirin, Ibuprofen, Naproxen, Indomethacin, Diclofenac, Ketorolac, Meloxicam, Celecoxib
Pain/Inflammation lecture:
What are the contraindications for opioids?
Pregnancy Cat D Biliary tract surgery preemies during/after delivery kidney failure head injuries extremely obese hepatic or renal disease hypotension
Pain/Inflammation lecture:
What are the antidotes for opioids and non-opioid analgesics?
Naloxone
Cardiovascular lecture:
What are the complications of beta blockers?
- Bradycardia
- orthostatic hypotension
- decreased cardiac output
- heart block; nonselective:
bronchoconstriction - inhibited glycogenesis
Cardiovascular lecture:
What are the therapeutic effects of ACE inhibitors?
- Vasodilation
- excretion of sodium and water and retention of potassium by actions in the kidneys
- reduction in pathological changes
- in the blood vessels and heart that result from the presence of angiotensin II and aldosterone
Cardiovascular lecture:
What are expected side effects for organic nitrates?
orthostatic hypotension
headache
reflex tachycardia
tolerance
Cardiovascular lecture:
Which are common medications belonging to ARBs?
losartan, irbesartan, candesartan, Olmesartan
Respiratory lecture:
What is the patient teaching for antihistamines?
- Take before bed
- don’t operate heavy machinery/drive while on meds
- increase fluids and fiber
- suck on sugar free hard candy to avoid dry mouth
Respiratory lecture:
What are the complications of antihistamines?
Sedation, anticholinergic effects, GI discomfort, respiratory depression
Respiratory lecture:
What is the patient teaching when giving an inhaled glucocorticoid?
Use with a spacer as directed, rinse mouth after each use
Respiratory lecture:
What is the MOA of expectorants?
Promotes increased cough production by increasing and thinning mucous secretions
Hematology/Immune lecture:
Which lab values would indicate that epoetin alfa is therapeutic?
Hg 10-11 g/dL
Hct 33%
Hematology/Immune lecture:
What is the patient teaching for Vitamin K inhibitors?
- Take in evening
- avoid alcohol or NSAIDS
- avoid high vitamin K foods
- watch for bruising
- bleeding gums
- use soft toothbrush and safety razor
- regular blood tests
Hematology/Immune lecture:
ptt normally and on heparin
normal: 30-40 sec
heparin: 60-80 sc
Hematology/Immune lecture:
platelet count
150,000-450,000
Hematology/Immune lecture:
hematocrit
38%- 54%
Hematology/Immune lecture:
hemoglobin
12-18
Hematology/Immune lecture:
pt normally
pt on warfarin
normal: 9.5-11.8 sec
warfarin: 18-24 sec
Hematology/Immune lecture:
INR normal
INR on warfarin
normal: 0-1.1
warfarin 2-3
Hematology/Immune lecture:
AST
7-46
Hematology/Immune lecture:
ALT
10-30
Hematology/Immune lecture:
total billrubin
.3- 1.2
Antimicrobials lecture:
What are the complications of antifungal medications?
- IV infusion reactions
- thrombophlebitis
- nephrotoxicity
- electrolyte imbalance
- bone marrow suppression
Antimicrobials lecture:
What is the general patient teaching for all antibiotics?
Finish entire course, take back up BC methods
Antimicrobials lecture:
When are peak and trough levels drawn?
Trough is draw immediately before the next dose of the drug and peak is drawn 1-several hours after admin
GI lecture:
What is the patient teaching for Mucosal protectants?
- Take therapy for 4-8 weeks even if feeling better
- increase fluid intake
- fiber and dietary bulk to prevent constipation
- follow up with GI specialist
GI lecture:
What are the nursing implications for Antacids?
- Admin 1-3 hours before meals or at bedtime
- shake the suspension well before admin
- monitor for hypercalcemia and hypermagnesemia
- use caution with antacids that contain sodium with hypertension or heart failure patients
GI lecture:
potassium level
3.5-5.1
GI lecture:
sodium level
135-145
GI lecture:
calcium level
8.5-10.5
GI lecture:
magnesium
1.8-2.2
endocrine lecture:
Rapid acting: Insulin Lispro: ONSET & PEAK
ONSET: 15-30 min
PEAK: 0.5-2.5 hours
endocrine lecture:
Rapid acting: Insulin Aspart: ONSET & PEAK
ONSET: 10-20 min
PEAK: 1-3 hours
endocrine lecture:
Rapid acting: Insulin Glulisine: ONSET and peak
ONSET: 10-15 min
PEAK: 1-1.5 hours
endocrine lecture:
short acting: Regular Insulin: ONSET and PEAK
ONSET: 30-60 min
PEAK: 1-5 hours
endocrine lecture:
Intermediate acting: NPH Insulin: ONSET and PEAK
ONSET: 1-2 hours
PEAK: 6-14 hours
endocrine lecture:
Long acting: Insulin Glargine: ONSET & PEAK
ONSET: 70 min
PEAK: none
endocrine lecture:
Long acting: Insulin Detemir: ONSET and peak
ONSET: 1-2 hours PEAK: 12-24 hours
endocrine lecture:
Which food/drink interactions are there with patients taking oral antidiabetic medications?
ALCOHOL
