Final Exam Study Guide Questions Flashcards
What is the Patient Education about life threatening adverse effects of hormonal contraceptives?
- High doses of estrogen can cause venous thromboembolism (VPE), myocardial infarction (MI), stroke.
- Non life-threatening side effects include dysmenorrhea, menorrhagia, chloasma, cyclic breast changes.
- St. Johns wort can reduce effectiveness
- Chasteberry extract can make it less effective
What are the contraindications to hormone replacement therapy?
1) Pregnancy
2) History of endomentrial cancer
3) Personal history of breast cancer
4) History of thromboembolic disorders
5) Acute or chronic liver disease
6) Active gallbladder or pancreatic disease
7) Coronary artery disease
8) Undiagnosed vaginal bleeding
9) Endometerosis
10) Lifestyle such as smoking
11) History of fibroid tumors - until a year after last menstruation
What is the opportunistic infections in HIV patients?
- Pulmonary TB, pneumococcal pneumonia, cryptosporidium, fungal infections, raposi sarcoma, toxoplasmosis, histoplasmosis, and cytomegalovirus
What is the Patient Education for patients with HIV?
- Educate PT about adherence to the the therapeutic program
- Explain common emotional responses
- For PT of childbearing age, explain how HIV transmission to the the unborn baby can occur
- Teach safe sex and how not to spread HIV
- Inform PT about OTC meds and herbal sups interactions with antiretrovirals
- Assist with a system for taking the correct dose of the correct drug at the correct time
- Counsel PT about the importance of having adequate supply of drugs to avoid interruption in the dosing schedule
What is the assessment you do for patients receiving Amphotericin B?
- Obtain a medical history that included any serious renal or hepatic disorders
- Assess the ability to swallow
- Assess any prior use of antifungals
- Check lab tests for liver function, ALP, ACT, AST, GGT, BUN, bilirubin, serum creatinine
What is the treatment for Candida infection? ***
Nystatin (Mycostatin)
- Can be swished and swallowed or swished and spit*
What is the patient education about isoniazid? ***
- Take 1NH??? 1 hour ac or 2 hours pc
- Must finish the medication
- Collect sputum specimen in early morning
- Take pyridoxine (Vitamin B) to prevent peripheral neuropathy
- Check liver enzymes
- Need frequent eye exams
- Report numbness, tingling, burning
- Teach sun precautions, avoid antacids
- Decreases phenytoin effect when concurrent
What is the patient education about rifampin?
- Warn PT that body fluids may be reddish orange
What is the Patient teaching that is significant about fluconazole?
- Contraindicated with chronic alcoholism (Hepatoxic)
- May affect glycemic control in diabetic patients; monitor blood sugar
- Advise that hypoglycemia may occur with concurrent oral sulfonylureas
- Monitor BUN, creatinine, serum liver enzymes, electrolytes
- DO NOT drink alcohol
- Finish regimen completely - can result in relapse if not alone
What are the nursing intervention for extravasation of intravenous doxorubicin?
Stop the IV infusion of doxoruidicin
What is the Z-track method of medication administration?
- Recommended for IM injections to minimize local skin irritation by sealing the medication in the muscle tissue
- Z track - hold skin taut, inject needle into deep muscle tissue, aspirate for blood, if no blood slowly inject med, keep needle in for 10 seconds then let it go
What are the side effects of Nifedipine?
1) Headache
2) Hypotension
3) Dizziness
4) Flushing of the skin
5) Peripheral edema
- The immediate release form of nifedipine has been associated with an increased incidence of sudden cardiac death *
What is the patient instructions for antibiotic therapy?
- Finish the entire course
- May decrease the effectiveness of oral contraceptives
What is the Patient teaching for bisacodyl (Dulcolax) therapy?
- May cause reddish brown urine, do not take h.s.
- Do not use if pregnant (can cause spontaneous abortion)
- Too much use can cause electrolyte imbalance
- Causes mild cramping and diarrhea
What is the purpose of proton pump inhibitor (PPI) medication?
- Suppress gastric acid secretion by inhibiting the hydrogen (H)/ Potassium (K+) ATpase enzyme system located in the gastric parietal cells
What are the side effects of cimetidine (Tagamet) in elderly patients?
- H2 histamine antagonist, anti-ulcer med
- Geriatric PTs appears on BEERS lists
- Geriatric PTs are more susceptible to adverse CNS reactions
- low dose recommneded
- BEERS list is medications contraindicated in older adults *
What are antacid administration and other medications?
- Antacids diminish absorption of H2 receptor blockers
- Antacids neutralize hydrochloric acid and reduce pepcin activity *
- Administer 2h before or after other drugs !!
- Magnesium based products may cause diarrhea
- Aluminum based may cause constipation or aggravate kidney stones
- Assess PT for signs of renal insufficency
What are peak levels? ***
- Is the highest plasma concentration of drug at a specific time and indicated rate of absorption
- Are requested for drugs that have a narrow therapeutic index and are considered toxic *
What are trough levels? ***
- Lowest plasma concentration of a drug and it measures the rate at which the drug is eliminated
- Are requested for drugs that have a narrow therapeutic index and are considered toxic *
What are the contraindications of tetracycline?
- 1st broad spectrum antibiotic
- DO NOT give to children younger than 8 years or pregnant women it causes discoloration of permanent teeth
- Renal and hepatic dysfunction
- Can cause teratogenic effects in pregnant women
What is the Patient education for tetracycline therapy?
- Instruct PT to store away from heat and light (becomes toxic by breakdown)
- Advise PT to check expiration dates (out of date can be toxic)
- Inform females considering pregnancy to avoid because it can cause teratogenic effects
-Warn that children 8 or younger should not take because it permanently causes discoloration of permanent teeth - Encourage PT to take complete course as prescribed
What are alternative therapy if patient has hypersensitivity to penicillin?
- Erythromycin is commonly prescribed to PT with hypersensitivity to penicillin
(Macrolides, lincosamides, glycopeptides, and ketolides)
What medication should not be given with lansoprazole?
- Rilpivirine - and antiretroviral agent used to treat HIV is contraindicated with all PPI (proton pump inhibitor)
- Lansoprazole is a proton pump inhibitor that suppresses gastric acid secretion by inhibiting the enzyme hydrogen or ATPase which makes gastric acid