Final Exam Highlight Reel

Question 1

Notes about potassium:

Answer 1

• NEVER going to see more than 40 mEq/ hr
• its given slowly and diluted; and infused over IV in severe cases or the Pt is NPO
• In 1 hour, the heart can only handle 10 mEq of potassium BUT it must be diluted in 100 mL of fluid

Question 2

Define: Neutropenia

Answer 2

WBC

Question 3

Define: Thrombocytopenia

Answer 3

Platelets

Question 4

Define: Pancytopenia

Answer 4

Entire bone marrow

Question 5

Define: Virustatic

Answer 5

Suppresses growth

there are no meds that kill viruses

Question 6

Administering Potassium:

Answer 6

40 mEq PO daily - safe
NO IV PUSH – 20 mEq IV push of potassium daily: NOT SAFE because youre giving the potassium all at once
10 mEq of potassium IV diluted in 100 mL of normal sailene infused in 1 hour – Safe
20 mEq IV diluted in 20 mL of NS infused in 2 hours – not safe
20 mEq IV diluted in 1 L – safe
3.1 mEq/L is low – Administer the ordered sustained release potassium tablets

Question 7

What type of drugs are used for both Asthma and COPD?

Answer 7

Bronchodilators
Anti-inflammatory
Mucolytic

Question 8

Inhaler Medication Notes:

Answer 8

Bronchodilators are administered first, THEN the anti-inflammatory med because it allows for the greatest widening effect
+ Aerosol Inhalers:
- Shake
-Wait 1 minute between puffs if the same med
- Wait 5 min between puffs if the DIFFERENT MED
+ Dry powder meds:
- Rise your mouth after or brush your teeth because this med can cause infection if left in the mouth
- NO Shake

Question 9

A POS TB skin test is greater than _________.

Answer 9

10 mm

Has induration and the skin is harder

Question 10

Therapeutic level of Heparin?

Answer 10

1.5 – 2.5 times the control value (whatever that normal apt value means for that lab) – should take them twice as long
Example: Normal aPTT is 30 seconds – a therapeutic pt aPTT is 60 seconds

Question 11

Heparin Notes:

Answer 11

Heparin is given IV or subcutaneous
NOT pills
Dosed in units – the unit of measurement for heparin is units 1000 of units that are mixed in some sort of dilution fluid**

Question 12

Warfarin (Coumadin) Notes:

Answer 12

• Lab tests: PTINR/ INR
• It is not unusual for a pt to be taking heparin and then transition to warfarin.
• If pt is in hospital getting an infusion for a clot that is happening, they can decide once they have it under control to stop the heparin and send the pt home with a pill, they are going to start clotting again because the pill does not work immediately
• INR is in between 2 – 3 {Therapeutic INR = 2 – 3}
  If pt is taking Warfarin we want them to be therapeutic

Question 13

{Final Exam Question}: How is promethazine (Phenergan) administered?

Answer 13

1. Deep IM injection into a large muscle is the preferred parenteral route of this med
2. Giving the drug in concentrations in no larger than 25 mg/mL
3. Administering the drug at a rate no greater than 25 mg / per minute
4. Injecting the drug through the tubing of an infusion set that’s running and is known to be working satisfactory
5. Stopping the injection immediately if the pt reports burning
6. Starting IV does 6.25 - 12.25 the starting dose
7. Give through large bore vein
8. Check the patency of access site
9. Port furthest from vein
   Phenergan – give it in the furthest port away [so that when we take syringe and attach to the catheter and the fluid is running, it is slowly pushing a little bit of the med, it is diluting the fluid before it goes into the pt]

Question 14

13 Types of Vitamins:

Answer 14

+ Water Soluble: We need to eat on a daily basis. Our body does NOT store this.
- Vitamin B and C

+ Fat Soluble: Our body DOES store. We loose it a lot slower.

• Vitamin A, D, E, K (All Dogs Eat Kibble)
• Vitamin A excess as well as vitamin A deficiency associated with birth defects

Question 15

Benzodiazepine Receptor Agonist Notes:

Answer 15

• BRA: Work off the same receptor sites as benzodiazepines, BUT they are NOT benzodiazepines
• BRA first line of prescribed sleeping medication, less likely to be addictive than normal benzodiazepines

Question 16

What are the normal BG levels?

Answer 16

+ Normal Blood Glucose: 70 -110

• Less than 70 = HYPOglycemic
• Greater than 110 = HYPERglycemia

Question 17

What is the focus of Fibrates?

Answer 17

Fibrates: the focus is triglycerides; this is the med that focuses on lowering specifically on triglycerides

Question 18

Status Epilepticus is a seizure lasting longer than __________.

Answer 18

5 minutes

Question 19

Phenergan Notes {Part 2}

Answer 19

+ Phenergan (Phenothiazine) {Antiemetic} WILL BE ON THE FINAL*

• Potential serious A/E: tissue necrosis
• Deep IM injection is the preferred route// we DON’T see the vesicant damage when its in muscle tissue.
• With Phenothiazine, tardive dyskinesia is possible {repetitive movements with antiemetics and anti psychotics}
• Antiemetics and antipsychotics is the two categories that we see tardive dyskinesia with
• Less than 25 mg is the recommended dose, the ideal dose is 12.5 mg and DILUTED
• S/E is sedation
• Sedation is the main S/E for all antiemetics EXCEPT 5HT3 Antagonist (ex. Ondansetron [Zofran] Granisetron [Kytril])

Question 20

Male Testosterone Replacement therapy routes:

Answer 20

Routes: IM, transdermal, gel, subcutaneous pellets, patches to put in gums of mouth, everything EXCEPT oral.
- Very rarely will we see testosterone given in oral form because of the risk for liver damage.

Question 21

Thyroid-Suppressing Drug treating hypERthyroidism are:

Answer 21

methimazole (Tapazole)

propylthiouracil (PTU)

Question 22

What serious adverse effects are possible with hypertension medications?

Answer 22

•	Steven Johnson Syndrome
- Calcium channel blocker
- Vasodilators
•	Angioedema 
-	 ACE inhibitors
-	ARBS