NUR 372 EXAM 2 MEDICATIONS

Question 1

CLASS: ALBUTEROL

Answer 1

• beta2-adrenergic agonist

Question 2

THERAPEUTIC USE: ALBUTEROL

Answer 2

• long-term management of asthma
• prevention of exercise-induced asthma
• treatment of ongoing asthma exacerbations

Question 3

SIDE/ADVERSE EFFECTS: ALBUTEROL

Answer 3

• tachycardia
• heart palpitations
• angina
• tremors

Question 4

NURSING INTERVENTIONS: ALBUTEROL

Answer 4

• monitor and report tachycardia, heart palpitations, and chest pain
• monitor and report tremors

Question 5

PATIENT INSTRUCTIONS: ALBUTEROL

Answer 5

• report chest pain and palpitations
• report increase in pulse rate
• avoid caffeine
• notify provider if tremors interfere with ADLs

Question 6

MECHANISM OF ACTION: ALBUTEROL

Answer 6

• acts by selectively activating the beta2-receptors in the bronchial smooth muscle, resulting in bronchodilation and decreased airway resistance

Question 7

CLASS: FUROSEMIDE

Answer 7

• loop diuretic

Question 8

THERAPEUTIC USE: FUROSEMIDE

Answer 8

• treats pulmonary edema in heart failure
• treats edema caused by renal, hepatic or cardiac failure not affected by other diuretics
• treats hypertension not controlled by other diuretics

Question 9

ADVERSE EFFECTS: FUROSEMIDE

Answer 9

• hypotension
• electrolyte imbalance (hyponatremia, hypochloremia, dehydration, hypokalemia)
• ototoxicity
• hyperglycemia
• increased uric acid levels with gouty arthritis

Question 10

NURSING INTERVENTIONS: FUROSEMIDE

Answer 10

• monitor serum electrolyte levels; notify provider of abnormal levels
• monitor for signs of electrolyte imbalance
• if hypokalemia occurs, monitor for cardiac dysdysrhythmias
• if hypokalemia is a risk, furosemide can be combined with a potassium-sparing diuretic
• monitor blood glucose
• ensure patient does not take other ototoxic drugs
• monitor for hearing loss, tinnitus, vertigo
• monitor uric acid levels

Question 11

PATIENT INSTRUCTIONS: FUROSEMIDE

Answer 11

• eat foods rich in potassium
• report signs of electrolyte imbalance: confusion, muscle twitching, weakness, nausea
• teach patient to have BP monitored
• report dizziness, syncope
• report new onset of hearing loss, ringing in ears, or vertigo
• carefully monitor blood glucose
• patients who have history of gout need to report symptom onset to provider

Question 12

MECHANISM OF ACTION: FUROSEMIDE

Answer 12

• inhibit reabsorption of Na+ and Cl- in ascending limb of the loop of Henle to prevent reabsorption of water

Question 13

CLASS: BISACODYL

Answer 13

• stimulant laxatives

Question 14

THERAPEUTIC USES: BISACODYL

Answer 14

• constipation from opioid use or from slow intestinal transit
• colon evacuation prior to elective procedures

Question 15

ADVERSE EFFECTS: BISACODYL

Answer 15

• diarrhea
• abdominal cramps
• burning sensation (suppositories)
• prostates (prolonged use)
• laxative abuse

Question 16

NURSING INTERVENTIONS: BISACODYL

Answer 16

• monitor for severe diarrhea and dehydration
• tell patients to expect rectal/anal burning
• monitor for rectal discomfort, bleeding, or discharge of mucus or pus
• discourage long-term use
• monitor I&O
• monitor BM pattern

Question 17

PATIENT INSTRUCTIONS: BISACODYL

Answer 17

• report severe diarrhea and stop taking drugs
• drink fluids
• expect burning sensation with suppository use
• report rectal discomfort, bleeding, or discharge
• do not use repeatedly or for extended periods
• increase in fluid intake and add high-fiber foods slowly

Question 18

MECHANISM OF ACTION: BISACODYL

Answer 18

• stimulation of intestinal peristalsis

Question 19

CLASS: COLACE

Answer 19

• stool softener

Question 20

THERAPEUTIC USE: COLACE

Answer 20

• constipation

- prevention of fecal impaction, straining during defecation, painful elimination of hard stools

Question 21

ADVERSE EFFECTS: COLACE

Answer 21

• diarrhea

- mild abdominal cramps

Question 22

NURSING INTERVENTIONS: COLACE

Answer 22

• monitor for severe diarrhea and dehydration

Question 23

PATIENT INSTRUCTIONS: COLACE

Answer 23

• report severe diarrhea and stop taking drug
• drink fluids
• increase exercise, fluid intake, and consume high-fiber foods

Question 24

MECHANISM OF ACTION: COLACE

Answer 24

• lower surface tension of the stool to allow penetration of water

Question 25

CLASS: FLUTICASONE

Answer 25

- glucocorticoid

Question 26

THERAPEUTIC USES: FLUTICASONE

Answer 26

- long-term prophylaxis

Question 27

ADVERSE EFFECTS: FLUTICASONE

Answer 27

- URI - cough - sinusitis - sinus infection - throat irritation - oral thrush - headache

Question 28

PATIENT TEACHING: FLUTICASONE

Answer 28

- decrease strength of immune system and mask signs of infection - administer on a fixed schedule - oral care after administration

Question 29

MECHANISM OF ACTION: FLUTICASONE

Answer 29

- decrease inflammation and swelling of airways, suppress mucus production, promote responsiveness of beta2-receptors

Question 30

CLASS: SPIRINOLACTONE

Answer 30

- potassium-sparing diuretics

Question 31

THERAPEUTIC USE: SPIRINOLACTONE

Answer 31

- hypertension - edema caused by HF - cirrhosis of the liver - nephrotic syndrome - hypokalemia

Question 32

ADVERSE EFFECTS: SPIRINOLACTONE

Answer 32

- hyperkalemia - menstrual irregularities - abnormal hair growth - deepening of voice in women - gyenocomastia in men

Question 33

NURSING INTERVENTIONS: SPIRINOLACTONE

Answer 33

- monitor serum potassium levels - monitor for cardiac dysrhythmias if hyperkalemia occurs - may be combined with thiazide or loop diuretic to maintain normal potassium level - report endocrine effects

Question 34

PATIENT INSTRUCTIONS: SPIRINOLACTONE

Answer 34

- report palpitations, irregular pulse, or signs of hyperkalemia - avoid potassium supplements or large amounts of foods high in potassium and salt substitutes - report endocrine symptoms

Question 35

MECHANISM OF ACTION: SPIRINOLACTONE

Answer 35

- block the effect of aldosterone on renal tubules resulting in the loss of sodium and water and retaining potassium