Med Cards for Exam 4

Question 1

metamucil

Answer 1

laxative

Question 2

expected pharmacological action: metamucil

Answer 2

Combines with water in the intestinal contents to form an emollient gel or viscous solution that promotes peristalsis and reduces transit time.

Question 3

therapeutic use: metamucil

Answer 3

relief and prevention of constipation

Question 4

complications: metamucil

Answer 4

bronchospasm, cramps, intestinal or esophageal obstruction, nausea, vomiting

Question 5

contraindictions/precautions: metamucil

Answer 5

Hypersensitivity; Abdominal pain, nausea, or vomiting (especially when associated with fever); Serious adhesions; Dysphagia.

Use Cautiously in: Some dosage forms contain sugar, aspartame, or excessive sodium and should be avoided in patients on restricted diets

Question 6

interactions: metamucil

Answer 6

May decrease absorption of oral medications

Question 7

nursing interventions: metamucil

Answer 7

Assess client for abdominal distension, prescence of bowel sounds, and usual pattern of bowl movements.

Assess the stool for color, consistency, and how much stool was produced.

Question 8

evaluation of med effectiveness: metamucil

Answer 8

A soft, formed bowel movment, usually within 12-24 hrs after administration. May require up to 3 days of taking it to see these results

Question 9

client education: metamucil

Answer 9

Encourage client to also use other forms of bowel regulation, such as exercise, hydration, eating more food. Make sure the client knows what a normal bowel pattern is for them so they know if it is returning to abnormal

Advise not to take if client has any abdominal pain, vomiting, or nausea

report constant diarhea

Question 10

docusate sodium

Answer 10

surfactant laxative/stool softner

Question 11

therapeutic use: docusate sodium

Answer 11

Constipation
* Prevention of fecal impaction, straining during defecation, painful
elimination of hard stools

Question 12

adverse drug reactions: docusate sodium

Answer 12

Diarrhea, mild abdominal cramps
* Throat Irritation
* Rashes

Question 13

interventions: docusate sodium

Answer 13

• Monitor for abdominal distention severe diarrhea and dehydration.
• Administer with a full glass of water or juice, on an empty stomach for
  best results
• Assess stool color, consistency, and amount

Question 14

admin: docusate sodium

Answer 14

give orally with at least 8 oz of fluid

expect soft stools serveral days after initiating therapy

Question 15

client instructions: docusate sodium

Answer 15

Report severe diarrhea and stop taking the drug.
* Drink plenty of fluids.
* Advise clients to increase exercise and fluid intake (at least 2 to 3 L/day)
and consume high-fiber foods (bran, fresh fruits/vegetables).

Question 16

contraindictions: docusate sodium

Answer 16

Gastrointestinal obstruction, perforation
* Concurrent use of mineral oil
* Fecal impaction
* Nausea, vomiting
* Undiagnosed abdominal pain

Question 17

precautions: docusate sodium

Answer 17

Use cautiously with clients prone to developing a laxative dependency

Question 18

interactions: docusate sodium

Answer 18

Do not administer within 2 hr of any other laxative, esp. mineral oil.

Question 19

bisacodyl

Answer 19

laxative

Question 20

expected pharma action: bisacodyl

Answer 20

Stimulating enteric nerves to cause peristalsis

Question 21

therapeutic use: bisacodyl

Answer 21

To treat and help with constipation in SHORT term

Question 22

complications: bisacodyl

Answer 22

nausea, vomiting, diarrhea, tetany, alkalosis, a sensation of buring of the recal mucosa and mild proctitis

Question 23

med admin: bisacodyl

Answer 23

PO and rectally

PO: 5-15 mg

Rectally: 10 mg

Question 24

contraindications/precautions: bisacodyl

Answer 24

Hypersensitivity to drug, intestinal obstruction, gastroenteritis, appendicitisUse cautiously in: hypersensitivity to tannic acid severe cardiovascular disease, anal or rectal fissures, pregnant or breastfeeding patients.

Question 25

nursing interventions: bisacodyl

Answer 25

Do not give medication within 1 hours of consumption of dairy products or antacid; continue to assess stools for frequency and consistency; continue to monitor client for hydration status and electrolyte levels

Question 26

interactions: bisacodyl

Answer 26

antacids and dairy products can cause gastric irritation, dyspepsia

Question 27

client ed: bisacodyl

Answer 27

Do not take medication within 1 hour of consumption of dairy products or antacids This is short term thearpy Educate ways to allow good bowel movements, such as hydration, exercise, increase food in diet.

Question 28

evaluation of med effect: bisacodyl

Answer 28

soft, formed bowel movements, typically with in 6-24 hrs post medication administration

Question 29

gabapentin

Answer 29

anticonvulsant

Question 30

expected pharm action: gabapetin

Answer 30

Affect the transportation of amino acids across and stabilize neuronal membranes

Question 31

therapeutic use: gabapentin

Answer 31

Decrease of seizures, decrease pain, decrease leg restlessness

Question 32

complications: gabapentin

Answer 32

Agitation, seizures, peripheral edema, aphasia, hypotension, hypertension, CNS tumors, delusions, , apathy, anxiety, angina, palpitations,

Question 33

medication administration: gabapentin

Answer 33

PO 300 mg (3 times daily) for adults

Question 34

contraindications/precautions: gabapentin

Answer 34

Hypersensitivity to gabapentin or to its components

Question 35

nursing interventions: gabapentin

Answer 35

Monitor for a change in the client's mood and interactions that would further indicate behaviors of suicidal thoughts, seizures, and restlessness

Question 36

interactions: gabapentin

Answer 36

Hydrocodone- decreased hydrocodone exposure Antacids- decreased gabapentin bioavailability Morphine- increased CNS depression Depressants- increased CNS depression

Question 37

eval of med effect: gabapentin

Answer 37

Decrease in seizure frequency, an increase in stability, and an overally decrease in leg restlessness

Question 38

client education: gabapentin

Answer 38

Client should take medication as directed, if missed dose, just take immediately. Try to avoid taking medication with driving and within 2 hours after taking antacid.

Question 39

aspirin

Answer 39

NSAID

Question 40

therapeutic use: aspirin

Answer 40

Inflammation suppression * Analgesia for mild to moderate pain * Fever reduction * Dysmenorrhea * Inhibition of platelet aggregation (aspirin)

Question 41

adverse drug reactions: aspirin

Answer 41

Gastric upset, heartburn, nausea, gastric ulceration * Bleeding (less with non-aspirin NSAIDs) * Kidney dysfunction * Salicylism (aspirin) * Reye’s syndrome (aspirin) * Thromboembolic events (non-aspirin NSAIDs)

Question 42

interventions: aspirin

Answer 42

Monitor for signs of gastrointestinal bleeding (black or dark-colored stools, abdominal pain, nausea, hematemesis). * Test for and treat Helicobacter pylori infection prior to long-term therapy. * For clients at high risk for gastric bleeding, recommend a proton pump inhibitor. * Monitor for signs of bleeding (easy bruising, petechiae, excessive bleeding from minor injuries). * Monitor intake and output; watch for low urine output and fluid retention. * Monitor for rapid rises in BUN and creatinine. * Monitor for tinnitus, diaphoresis, headache, dizziness, and respiratory alkalosis. Stop aspirin therapy for clients reporting these symptoms. * Recommend acetaminophen (Tylenol) and not aspirin or NSAIDs for children and adolescents under age 18 who have viral infections, particularly chickenpox and influenza. * Recommend non-aspirin NSAIDs for short periods and in low doses only. * Recommend low-dose aspirin to prevent these events if prescribed by provider. * Monitor for signs of myocardial infarction and cerebrovascular accident.

Question 43

admin: aspirin

Answer 43

Make sure clients swallow enteric-coated or sustained-release forms whole and do not crush or chew them. * Discontinue 1 week before scheduled surgery. * Monitor for initial and continued therapeutic effects.

Question 44

nifedipine

Answer 44

calcium channel blocker

Question 45

therapeutic use: nifedipine

Answer 45

Treats mild to moderate hypertension * Treats stable (exertional) angina and variant (vasospastic) anginas

Question 46

adverse drug reactions: nifedipine

Answer 46

Reflex tachycardia causing increased angina pain in clients with angina Note: This effect is most likely with faster-acting tablets than the sustained release form. * Headache, Lightheadedness, dizziness (caused by vasodilation) * Facial flushing, perception of heat (caused by vasodilation) * Peripheral edema of feet and legs * Arrhythmias * Gingival hyperplasia (growth of gum tissue, bleeding gums) – rare

Question 47

interventions: nifedipine

Answer 47

Give nifedipine along with an ordered beta-blocker to prevent reflex tachycardia * Monitor heart rate * Monitor for and report this effect * Assist with ambulation as needed * Inform client that facial flushing may occur * Monitor for and report edema (a diuretic may be prescribed if edema occurs) * Monitor blood pressure carefully as starting dosage is established * Notify provider and withhold dose for BP below 90 mm Hg systolic or for prearranged parameter * Advise regular dental care

Question 48

admin: nifedipine

Answer 48

Available for oral use in capsules and sustained-release tablets; sustained release form is approved to treat hypertension * Sustained-release form must be swallowed whole and not chewed or crushed * To prevent reflex tachycardia, nifedipine may be combined with a betablocker

Question 49

client instructions: nifedipine

Answer 49

Report rapid heartbeat, increase in angina pain to provider * Do not perform hazardous activities such as driving until effects are known * Be aware that this side effect may occur * Report swelling of feet and legs to provider * Advise client to take as prescribed and not increase dosage * Report dizziness, syncope to provider * Report HR less than 50 bpm * Report bleeding gums, gum tissue growth to provider * Obtain regular dental care

Question 50

cimetidine

Answer 50

histamine h2 antagonist

Question 51

therapeutic use: cimetidine

Answer 51

Gastric and duodenal ulcers * Heartburn, dyspepsia * Erosive esophagitis * Gastrointestinal reflux disease (GERD) * Aspiration pneumonitis * Hypersecretory disorders such as Zollinger-Ellison syndrome (gastrin), systemic mastocytosis (histamine)

Question 52

adverse drug reactions: cimetidine

Answer 52

Impotence, reduced libido with cimetidine (Tagamet) * Confusion, aplastic anemia, agranulocytosis, and arrhythmia * Increased susceptibility to pneumonia

Question 53

interventions: cimetidine

Answer 53

For clients who report impotence, reduced libido, or CNS effects, recommend that they discuss with their provider. * Monitor older clients for confusion.

Question 54

admin: cimetidine

Answer 54

Give orally, IM, or IV. * Give with or without food (given with meals, immediately afterwards, or at bedtime does prolong effect). * Administer IV preparation slowly to avoid bradycardia. * Do not give antacids within 1 hr of administration. * Make sure clients dissolve effervescent tablets in water and do not chew them, swallow them whole, or allow them to dissolve on the tongue.

Question 55

client instructions: cimetidine

Answer 55

Take all medication as prescribed * Avoid smoking * Avoid foods or medications that irritate GI tract * Tell clients to report any signs of obvious or occult gastrointestinal bleeding, such as coffee-ground emesis.

Question 56

contraindications: cimetidine

Answer 56

Known sensitivity * Some products may contain aspartame so avoid in clients with PKU

Question 57

precautions: cimetidine

Answer 57

Hepatic or renal dysfunction * Acute porphyria * Older adults

Question 58

interactions: cimetidine

Answer 58

Antacids can reduce absorption of histamine H2 receptors. * Cimetidine increases levels of warfarin, also called Coumadin; phenytoin, also called Dilantin; lidocaine, also called Xylocaine; and theophylline, also called Theolair

Question 59

aluminum hydroxide

Answer 59

antacid

Question 60

therapeutic use: aluminum hydroxide

Answer 60

Peptic ulcer disease * Gastrointestinal reflux disease (GERD)

Question 61

adverse drug reactions: aluminum hydroxide

Answer 61

Constipation (aluminum and calcium antacids) * Diarrhea (magnesium antacids) * Hypophosphatemia

Question 62

interventions: aluminum hydroxide

Answer 62

Monitor bowel function. * Administer stool softeners. * Monitor for severe diarrhea. * Monitor phosphorus and magnesium levels.

Question 63

admin: aluminum hydroxide

Answer 63

* Administer orally up to four times a day. * Make sure clients chew tablets thoroughly and follow with at least 8 oz of water * Do not give within 1 to 2 hr of administering drugs that interact with antacids.

Question 64

client instructions: aluminum hydroxide

Answer 64

Increase fluid and fiber intake. * Increase activity and exercise. * Report abdominal pain. * Report severe diarrhea. * Educate client on monitoring phosphate and sodium intake. * Tell clients to report any signs of obvious or occult gastrointestinal bleeding, such as coffee-ground emesis. * Instruct clients to not take aluminum hydroxide with 1 to 2 hr of other medications.

Question 65

contraindications: aluminum hydroxide

Answer 65

Severe abdominal pain of unknown origin

Question 66

precautions: aluminum hydroxide

Answer 66

Hypercalcemia and hypophosphatemia

Question 67

interactions: aluminum hydroxide

Answer 67

* Interferes with absorption of many drugs including: tetracyclines, digoxin, fluoroquinolones, iron salts, salicylates, and chlorpromazine

Question 68

diazepam

Answer 68

benzodiazepine

Question 69

therapeutic use: diazepam

Answer 69

Anxiety and anxiety disorders (alprazolam, diazepam) * Skeletal muscle spasm and spasticity (diazepam) * Seizure disorders – treats status epilepticus (diazepam) * Acute alcohol withdrawal symptoms (diazepam) * Induction of anesthesia (diazepam)

Question 70

adverse drug reactions: diazepam

Answer 70

Drowsiness, slurred speech * Impaired recall of events * Paradoxical reaction (confusion, anxiety) * Hypotension, tachycardia, respiratory depression * Tolerance and physical dependence (especially with alprazolam) * Withdrawal symptoms – insomnia, anxiety, tremors, diaphoresis, dizziness, panic, hypertension, seizures * Overdose/toxicity * Oral – sedation, confusion * Parenteral – possibly life-threatening sedation, hypotension, respiratory depression, cardiac arrest

Question 71

interventions: diazepam

Answer 71

Monitor clients to prevent falls and other injury following administration. * Assess client’s memory following administration. * Monitor clients, especially older adults, for a paradoxical reaction. * Monitor vital signs, especially with IV administration. * Monitor clients for signs of tolerance and dependence. * Taper over 1 to 2 weeks to prevent or minimize withdrawal. * Monitor for signs of withdrawal. * Reverse sedation with IV flumazenil. * Provide airway and blood pressure support as needed for parenteral overdose.

Question 72

admin: diazepam

Answer 72

Give alprazolam orally. * Take oral benzodiazepines with food if gastrointestinal symptoms develop. * Give diazepam orally, rectally, IM, or IV. * Administer IV diazepam slowly and have emergency resuscitation equip- ment nearby. * Be aware that IV diazepam precipitates in solution with some diluents and drugs. * Do not give the emulsion form IM (IV only). * Avoid IM diazepam due to inconsistent absorption; if necessary, inject slowly into a large muscle.