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NUR 330 > NUR 325 exam 4 > Flashcards

NUR 325 exam 4 Flashcards

1
Q

biggest concern with anticoagulants

A

bleeding

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2
Q

how to monitor for bleeding

A

H&H, vitals (increased HR, decreased BP)

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3
Q

anticoagulants moa

A

inhibits action or formation of clotting factors
prevents clots

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4
Q

antiplatelet moa

A

inhibit platelet aggregation
prevents the platelet plug from forming

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5
Q

antiplatelet indications

A

prevent stoke and heart attack

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6
Q

heparin moa

A

activates antithrombin
inactivates thrombin and factors Xa
inhibits fibrin formation

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7
Q

heparin indication

A

prompt anticoagulation activity
(stoke, pe, massive dot, open heart surgery, dialysis, disseminated intravascular coagulation)

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8
Q

heparin side effects

A

bleeding, hematoma, thrombocytopenia

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9
Q

how we dose heparin

A

based on clotting time labs (anti-Xa and aPTT)

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10
Q

heparin routes

A

IV or subQ

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11
Q

heparin onset

A

quickly

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12
Q

heparin antidote

A

protamine sulfate

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13
Q

heparin nursing considerations

A

caution in spinal epidural anesthesia

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14
Q

enoxaparin class

A

low molecular weight heparin

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15
Q

enoxaparin moa

A

only inactivates factor Xa (not thrombin)

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16
Q

enoxaparin indications

A

prophylaxis and treatment

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17
Q

enoxaparin nursing considerations

A

don’t need labs
slower onset, longer 1/2 life
leave air bubble in syringe
caution in spinal epidural anesthesia

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18
Q

enoxaparin side effects

A

bleeding, thrombocytopenia, HIT

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19
Q

enoxaparin route

A

subQ
can be given at home

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20
Q

enoxaparin antidote

A

protamine

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21
Q

warfarin class

A

vitamin k inhibitor

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22
Q

warfarin moa

A

prevents synthesis of 4 coagulation factors (VII, IX, X, prothrombin)

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23
Q

warfarin indications

A

prevent DVT/VTE/PE, thrombotic events with afib, heart valves, MI, TIA

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24
Q

warfarin side effects

A

bleeding, lethargy, muscle pain, purple toes

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25
Q

warfarin nursing considerations

A

given PO at 5pm
hold before surgery
many drug, alcohol, food (vitamin K) interactions

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26
Q

warfarin onset

A

24hr onset, 2-5 day duration

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27
Q

warfarin lab monitoring

A

PT/INR
normal range- 1
therapeutic for warfarin- 2-3.5
monitor monthly after therapeutic

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28
Q

heparin induced cytopenia

A

decreased platelet and increased thrombi
caused by antibody development
monitor platelet labs
stop heparin if platelet <100,000

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29
Q

apixaban / rivaroxaban moa

A

directly inhibits factor Xa

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30
Q

apixaban / rivaroxaban indications

A

prevents strokes with afib
postop thromboprophylaxis
DVT/PE

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31
Q

apixaban / rivaroxaban side effects

A

bleeding, hematoma, dizziness, rash, gi upset, peripheral edema

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32
Q

apixaban / rivaroxaban bbw

A

spinal hematoma with epidural
risk of thrombosis if stopped abruptly

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33
Q

apixaban / rivaroxaban nursing considerations

A

many drug interactions
no routine monitoring
monitor liver function

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34
Q

apixaban / rivaroxaban antidote

A

andexxa

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35
Q

aspirin moa

A

blocks prostaglandin synthesis through cox enzyme pathway
prevents platelet aggregation

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36
Q

aspirin indication

A

prevent MI / ischemic stoke

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37
Q

aspirin side effects

A

bleeding, nausea, vomiting, drowsiness, confusion

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38
Q

aspirin nursing considerations

A

chew baby aspirin for acute event
Reye’s syndrome (not for children with viruses)

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39
Q

aspirin antidote

A

DDAVP

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40
Q

clopidogrel / ticagrelor class

A

anti platelet ADP inhibitor

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41
Q

clopidogrel / ticagrelor moa

A

alter platelet membrane so it can’t receive the signal to aggregate

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42
Q

clopidogrel / ticagrelor indications

A

risk of stroke, prophylaxis of TIA, post MI

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43
Q

clopidogrel / ticagrelor side effects

A

chest pain, edema, flu-like symptoms, gi upset, rash, itching, nosebleed

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44
Q

clopidogrel bbw

A

increases cardiovascular event risk with genetic abnormalities

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45
Q

ticagelor bbw

A

risk for bleeding with aspirin over 100mg

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46
Q

clopidogrel nursing consideration

A

decreased effectiveness with certain other drugs

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47
Q

clopidogrel / ticagrelor antidote

A

DDAVP or platelet transfusion

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48
Q

argatroban / bivalrudin class

A

direct thrombin inhibitors

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49
Q

argatroban / bivalrudin moa

A

inhibit thrombin (factor IIa)

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50
Q

argatroban / bivalrudin indications

A

treat HIT, procedures with high risk for HIT

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51
Q

argatroban / bivalrudin side effect

A

bleeding

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52
Q

argatroban / bivalrudin route

A

IV only

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53
Q

argatroban nursing considerations

A

not for patients with hepatic dysfunction

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54
Q

argatroban / bivalrudin labs

A

monitor anti-Xa, H&H, platelet

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55
Q

glucocorticoids

A

hydrocortisone, prednisone, dexamethasone

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56
Q

glucocorticoids moa

A

mimic cortisol

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57
Q

dexamethasone use

A

checks function of adrenal gland

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58
Q

glucocorticoids acute side effects

A

increased intraocular pressure
fluid retention
increased bp
mood swings
weight gain
cataracts
high blood sugar

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59
Q

glucocorticoids chronic side effects

A

risk of infection
osteoporosis
suppressed adrenal gland
slowed wound healing

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60
Q

glucocorticoids nursing considerations

A

don’t stop abruptly
take at same time throughout the day
monitor weight and blood sugar

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61
Q

fludrocortisone class

A

mineralocorticoids

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62
Q

fludrocortisone indication

A

used with glucocorticoid replacement for salt wasting despite proper kidney function

63
Q

adsorbents

A

bismuth subsalicylate
activated charcoal

64
Q

adsorbants moa

A

coats wall of gi tract
binds to causative agent for elimination

65
Q

adsorbants indications

A

diarrhea

66
Q

bismuth subsalcicylate side effects

A

increased bleeding time (form of aspirin)
constipation
dark stools/dark tongue

67
Q

anti motility drugs

A

loperamide
diphenoxylate

68
Q

anti motility moa

A

slows peristalsis
drying effect

69
Q

antimotility side effects

A

urinary retention
bradycardia, hypotension
flushing, dry skin

70
Q

probiotics

A

lactobacillus organisms
saccharomyces boulardii

71
Q

probiotics moa

A

replenish bacteria and restore normal flora

72
Q

lactobacillus organisms indication

A

diarrhea from antibiotic use

73
Q

saccharomyces boulardii indication

A

diarrhea from cdiff

74
Q

psyllium class

A

bulk forming

75
Q

psyllium moa

A

similar to dietary fiber
absorbs water into intestine, increasing bulk
distends bowel, initiating bowel movement

76
Q

psyllium indication

A

constipation (ok for long term use)

77
Q

psyllium side effects

A

impaction above strictures
fluid/electrolyte imbalances
gas formation
esophageal blockages

78
Q

decussate sodium class

A

emollient

79
Q

emollient moa

A

lubricates fecal wall and material

80
Q

decussate sodium indication

A

opioid induced constipation

81
Q

emollient side effects

A

rash
decreased vitamin absorption

82
Q

mineral oil class

A

emollient

83
Q

mineral oil indication

A

fecal impaction

84
Q

mineral oil route

A

po or pr

85
Q

hyperosmotics

A

glycerin
lactulose
polyethylene glycol

86
Q

hyperosmotics moa

A

increases water content in feces

87
Q

hyper osmotic indication

A

clean out bowel before diagnostic procedures

88
Q

hyperosmotics side effects

A

abdominal bloating
rectal irritation
electrolyte imbalance

89
Q

saline (a class of laxatives)

A

magnesium citrate
magnesium hydroxide
magnesium sulfate
fleet enema

90
Q

saline (a class of laxatives) moa

A

increase osmotic pressure, drawing water into the colon

91
Q

saline (a class of laxatives) side effects

A

magnesium toxicity
electrolyte imbalance
cramping/diarrhea

92
Q

bisacodyl / Senna indication

A

constipation
total bowel evacuation

93
Q

bisacodyl / Senna side effects

A

nutrient malabsorption
gastric irritation
electrolyte imbalance

94
Q

epinephrine moa

A

inhibits the release of cell mediators from mast cells

95
Q

epinephrine indications

A

severe allergic reactions
cardiac arrest
severe asthma attacks

96
Q

epinephrine cardiac side effects

A

angina
arrhythmias
hypertension
tachycardia

97
Q

epinephrine cns side effects

A

nervousness
restlessness
tremor

98
Q

epinephrine route

A

usually subQ
anything but PO

99
Q

epinephrine nursing considerations

A

overdose can be fatal

100
Q

phenazopyridine class

A

urinary tract analgesics

101
Q

phenazopyridine moa

A

unknowns
topical analgesic on urinary mucosa

102
Q

phenazopyridine indication

A

uti pain relief

103
Q

phenazopyridine side effect

A

reddish orange urine

104
Q

mirabegrin class

A

urinary antispasmodic

105
Q

mirabegron moa

A

stimulates beta 3 receptors, relaxing smooth muscle of the bladder

106
Q

mirabegron indications

A

overactive bladder

107
Q

mirabegron side effects

A

HTN
urinary retention / uti

108
Q

oxybutynin class

A

anticholinergic

109
Q

oxybutynin moa

A

blocks action of acetylcholine

110
Q

acetylcholine normal function

A

activates smooth muscles to contract

111
Q

oxybutynin indications

A

overactive bladder
incontinence

112
Q

oxybutynin side effects

A

dry mouth
constipation

113
Q

anxiety and depression meds nursing considerations

A

SSRIs and SNRIs are first line
assess for suicide risk
monitor for 4-8 weeks for efficacy

114
Q

fluoxetine class

A

SSRI

115
Q

fluoxetine moa

A

inhibits serotonin reuptake at nerve endings
more serotonin

116
Q

fluoxetine side effects

A

weight gain
gi upset
sexual dysfunction
suicide risk
serotonin syndrome
withdraw symptoms

117
Q

fluoxetine neonatal effect

A

risk or pulmonary HTN and abstinence syndrome in baby

118
Q

serotonin syndrome

A

altered mental status 2-72 hours after med treatment

119
Q

venlafaxine class

A

SNRI

120
Q

venlafaxine moa

A

blocks neuronal activity of norepinephrine and serotonin

121
Q

venlafaxine side effects

A

withdraw
sexual dysfunction
blurred vision
increased LFTs

122
Q

amitrytaline class

A

tricyclic antidepressants

123
Q

amitrytaline moa

A

blocks reuptake of norepinephrine and serotonin

124
Q

amitrytaline indication

A

anxiety/depression
neuropathic pain
nocturnal enuresis

125
Q

amitrytaline side effects

A

too hot
dry mouth
blurred vision
red skin
confusion

126
Q

amitrytaline nursing considerations

A

FATAL overdose (HTN crisis)

127
Q

phenelzine class

A

monoamine oxidase inhibitor

128
Q

MAOI moa

A

inhibits MAO, increasing neurotransmitters at nerve endings

129
Q

MAO normal function

A

inactivates norepinephrine, serotonin, dopamine

130
Q

MAOI indication

A

atypical / refractory depression

131
Q

MAOI side effects

A

HTN crisis when taken with tyramine (aged cheese, smoked meats, yeast, wine)
drug interactions

132
Q

burproprion moa

A

unclear
stimulant effect
decreases appetite
similar structure to amphetamines

133
Q

burproprion side effects

A

seizures, agitation, tremor

134
Q

ketamine indications

A

extreme pain
rapid help with suicidal thoughts

135
Q

ketamine side effects

A

perceptual disturbances
dissociation

136
Q

ketamine nursing considerations

A

low dose intranasally

137
Q

trazadone moa

A

blockade of serotonin reuptake

138
Q

trazadone indications

A

anxiety
insomnia
not depression

139
Q

benzodiazepines

A

alprazolam
diazepam
lorazepam

140
Q

benzodiazepines moa

A

enhance inhibitory effects of GABA in the CNS

141
Q

benzodiazepines indications

A

GAD
panic disorder

142
Q

benzodiazepines side effects

A

cns depression (decreased loc)
withdraw effects
respiratory depression

143
Q

benzodiazepines nursing considerations

A

teratogen
do not mix with other meds that decrease loc
short term use only

144
Q

benzodiazepines antidote

A

flumazenil

145
Q

methadone moa

A

synthetic opioid
analgesic and mu agonist

146
Q

methadone indication

A

medication assisted treatment
for symptoms associated with opioid withdraw

147
Q

methadone side effects

A

light headedness
hives
chest pain
tachycardia

148
Q

methadone nursing considerations

A

lower potential for abuse than other opioids
dosed daily from a “methadone clinic”

149
Q

Suboxone

A

buprenorphine and naloxone

150
Q

buprenorphine moa

A

blocks receptors to prevent cravings

151
Q

naloxone moa

A

opioid antagonist

152
Q

Suboxone indications

A

help patients recover more quickly from addiction

153
Q

Suboxone nursing indications

A

some potential for abuse but lowest of the meds we talk about

154
Q

suboxone route

A

sublingual or buccal

NUR 330 (4 decks)

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