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NUR 106 > Mod 3 > Flashcards

Mod 3 Flashcards

1
Q

How are ulcers diagnosed?

A

BMP
stomach acid analysis
endoscopy

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2
Q

What is ZES?

A

Tumors develop in pancreas or duodenum that produce hormone gastrin which makes your stomach produce acid

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3
Q

How do ulcers feel?

A 
Heartburn
Upper abdominal pain
Nausea
Vomiting
Bloating
Bloody emesis or stool
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4
Q

How do antacids work?

A

Neutralize gastric acid

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5
Q

How do H2RAs work?

A

Decrease acid secretion by inhibiting action of histamine at H2 receptor site

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6
Q

How do PPIs work?

A

Inhibit parietal cells from producing acid by preventing transport of hydrogen into gastric lumen

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7
Q

What is ranitidine?

A

H2RA

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8
Q

What is ranitidine indicated for?

A

Short term and maintenance of EE

Treatment of ZES

Relief of GERD

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9
Q

What are routes of ranitidine?

A

Oral, IM, IV

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10
Q

What type of drug is magnesium/aluminum hydroxide?

A

Maalox/Mylanta

Antacid

Neutralizes gastric acid and inactivates pepsin

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11
Q

What is administration of magnesium/aluminum hydroxide?

A

PO only

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12
Q

Which anti-ulcer should not be taken with a sugar allergy?

A

Magnesium/aluminum hydroxide

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13
Q

In combination therapy of magnesium/aluminum hydroxide, what causes diarrhea and what causes constipation?

A

Aluminum-constipation

Magnesium-diarrhea

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14
Q

Which PPI potentiates effects of Coumadin?

A

Esomeprazole

Lansoprazole

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15
Q

When should patients take Esomeprazole?

A

One hour before meals

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16
Q

What is administration of Esomeprazole?

A

PO and IV

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17
Q

What is administration of omeprazole?

A

PO only

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18
Q

Which PPI potentiates effects of digoxin and Coumadin?

A

Omeprazole

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19
Q

Which PPI is contraindicated in breastfeeding?

A

Pantoprazole

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20
Q

What is administration of Pantoprazole?

A

PO and IV

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21
Q

Which PPI can cause hyperglycemia?

A

Pantoprazole

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22
Q

What is administration of lansoprazole?

A

PO only

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23
Q

Which PPI causes headache, diarrhea, and dizziness

A

Lansoprazole

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24
Q

What are nursing implications for PPIs?

A

Monitor liver function

Access and monitor abdominal pain

Monitor PT/INR when applicable

Monitor administration before meals

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25
Q

What is the patient teaching for anti-ulcers?

A

Take as directed

Report dark, tarry stools and diarrhea

Avoid alcohol

Avoid with aspirin and NSAIDS

report worsening of symptoms

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26
Q

What is action of bronchodilators?

A

They treat only reversible airway obstruction

Act by dilating the bronchi or bronchioles in lungs

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27
Q

What do bronchodilators treat?

A

Reversible airway obstruction such as bronchospasms, inflammation, mucus accumulation

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28
Q

What are the symptoms of airway obstruction?

A

Coughing, wheezing, SOB

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29
Q

Who is at risk for ulcers?

A 
Anyone over 50
People who consume too much alcohol
Chronic NSAID users
Family history 
H. Pylori
Poor diet
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30
Q

If patient is experiencing vasoconstriction what does this mean for broncho?

A

Bronchodilation

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31
Q

If patient experiencing bronchodilation what does this mean for vaso?

A

Vasoconstriction

32
Q

What does acteylcholine cause?

A

Vasodilation and bronchoconstriction

33
Q

Which drugs are the beta-adrengeric agonists?

A

Levabuterol, albuterol, salmeterol

34
Q

What are the anticholinergic drugs?

A

Ipratropium, tiatropium

35
Q

What are the nursing considerations for bronchodilators?

A

Use cautiously in cardiac and hormone disorders

May inversely interact with beta blockers

36
Q

What are the nursing management considerations ? There are 3

A

Cardiac monitoring during therapy

Respiratory assessment and monitoring

Side effects include nervousness, tremors, restlessness, palpitations, and dry mouth

37
Q

What is the patient education for bronchodilators?

A

Proper inhaler use

Indications for and proper use of spacers

Avoid xanthine products

Avoid respiratory irritants

Increase fluid intake
Oral care

38
Q

What products contain xanthine?

A

Caffeine, coffee, tea, colas, chocolate

39
Q

Which class of drugs should be avoided if patient consumes xanthine?

A

Bronchodilators

40
Q

Which bronchodilators are used for acute exerbations?

A

Beta-Agonists

Albuterol

Levalbuterol

Fluticasone/salmeterol (corticosteroid/bronchodilator combo)

41
Q

Which two drugs are used for chronic maintenance of airway obstruction disorders?

A

Anti-cholergenics

Tiotropium
Ipratropium bromide (Atrovent)
42
Q

What are the diagnostics for bronchodilators?

A

Chest x Ray

43
Q

What do corticosteroids do and what are they?

A

Hormone used to treat inflammatory and allergic conditions by modifying the immune response

44
Q

What is the action of corticosteroids?

A

Mimic hormones produced by the adrenal glands (cortisol and sex)

45
Q

Which two hormones are produced by the adrenal glands?

A

Cortisol and sex hormones

46
Q

What would you need to know if you are getting ready to administer corticosteroids?

A

If there are any known hormone deficiencies

47
Q

Patients taking steroids are at risk for what?

A

Hyperglycemia

48
Q

What are the 3 nursing considerations for corticosteroids?

A

Avoid live vaccines because steroids alter immune system

Avoid serious infections

May increase blood glucose

49
Q

What are the side effects for corticosteroids?

A 
Nausea
Peptic ulcers
Bruising
Hirsutism (abnormal hair growth)
Muscle wasting
Osteoporosis 
Cushingoid appearance
Adrenal suppression
Delayed wound healing
50
Q

What are signs of adrenal suppression?

A

BP drop, weight loss, weakness, nausea, confusion

51
Q

Name the two corticosteroids.

A

Methylprednisolone

Prednisone

52
Q

What are opioids used to treat?

A

Moderate to severe pain

53
Q

Where are opiate receptors found?

A

Only in the brain

54
Q

What do opiate receptors in the brain do?

A

Elicit euphoric effect

55
Q

What are the signs of withdrawal from opioids?

A 
Runny nose
Goosebumps
Yawning
Teary eyes
Muscle aches and pains
Abdominal pain and cramping
Irritability
Insomnia
56
Q

What are the signs of an opioid overdose?

A

Muscle spasms

Seizures as the CNS depresses, body trying to wake itself up

57
Q

What are the nursing considerations for opioids?

A

Use smaller doses for the elderly
Avoid use with alcohol, antihistamines, antidepressants, sedatives, MAOIs
May cause respiratory depression
Gradual discontinuation

58
Q

How are opioids administered?

A

PO, IM, IV, transdermal

59
Q

What is the antidote for opioid overdose?

A

Naloxone (Narcan)

To all 7 opioids

60
Q

Do opioids cause urinary retention?

A

Yes

61
Q

What are side effects of opioids?

A

Dizziness, euphoria, dysphoria, constipation, confusion, hypotension, sedation, nausea, dry mouth

62
Q

What do pupils look like when opioid overdose is expected?

A

Pinpoint

63
Q

What is the patient teaching for opioids?

A

Avoid alcohol and CNS depressants
Turn, cough, deep breathing every 2 hours
Increase fluid intake
Activities with caution
Avoid MAOI
Mgmt of transdermal patches–must remove old one!

64
Q

How do opioids effect pain?

A

They effect perception of pain, not localized to the source to eliminate pain

65
Q

Name the opioids.

A

Meperidine-Demerol

Hydromorphone-Diluadid

Oxycodone/Acetaminophen-Percocet

Hydrocodone/Acetaminophen-Lortab, Vicodin, Norco

Oxycodone-OxyContin

Fentanyl-Duragesic

Codeine

66
Q

What do non-opioid analgesics treat?

A

Mild to moderate pain, they have a peripheral action

67
Q

What are the two effects of non opioid analgesics?

A

Antipyretic

Prostaglandin inhibition

68
Q

How does prostaglandin inhibition work?

A

Pain is thought to be a protective mechanism, prostaglandins are released and cause the pain, fever, and swelling to the effected area which are essentially the ways tbe body uses to heal itself, this is all due to prostaglandins so non-opioid analgesics inhibit the prostaglandins therefore reducing pain, fever, and swelling and inhibiting the healing process

69
Q

What effects the efficacy of non opioid analgesics?

A

Blood flow because this medication works peripherally it depends on blood flow

70
Q

What are the nursing considerations for nonopiod analgesics?

A

Avoid in severe liver and kidney disease

Alcohol caution-liver

Interacts with NSAIDS causing renal dysfunction

Hepatoxicity may occur with acetaminophen

Aspirin interacts with warfarin and acts as a blood thinner

71
Q

What are the two non opioid analgesics?

A

Tylenol-acetaminophen

Aspirin ASA

72
Q

If the liver or brain is swelling do you give Tylenol or aspirin?

A

NO

73
Q

What are NSAIDS used to treat?

A

Mild to moderate pain due to inflammation

Is also a anti-pyretic

74
Q

Which NSAID should not be used for more than 5 days?

A

Ketorolac

75
Q

What are the side effects of NSAIDS?

A

Constipation, dizziness, headache, dyspepsia, nausea, Stevens Johnson syndrome

76
Q

What are the NSAIDS

A

Ibuprofen

Naproxen

Ketorolac (Torodol, Sprix)

77
Q

Which NSAID is not anti-pyre tic?

A

Ketorolac

NUR 106 (6 decks)

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