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U of R SCHOOL OF NURSING - 372 > NUR 372 Exam 3 Medications > Flashcards

NUR 372 Exam 3 Medications Flashcards

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1
Q

CATEGORY CLASS: Humalog

A
  • anti-diabetic
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2
Q

THERAPEUTIC USE: Humalog

A
  • diabetes mellitus (type I, II, gestational)

- control of hyperglycemia

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3
Q

ADVERSE EFFECTS: Humalog

A
  • hypoglycemia
  • lipohypertrophy
  • hypokalemia
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4
Q

MECHANISM OF ACTION: Humalog

A
  • lowers BG by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production
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5
Q

NURSING INTERVENTIONS: Humalog

A
  • monitor for signs of hypoglycemia
  • check BG level to confirm
  • for unconscious patients, admitted. glucose/glucagon parenterally
  • monitor skin for subcutaneous fat accumulation
  • monitor potassium levels
  • monitor EKG
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6
Q

CLIENT EDUCATION: Humalog

A
  • wear medical alert bracelet
  • watch for symptoms of hypoglycemia (tachycardia, palpitations, diaphoresis)
  • carry carbohydrate shake
  • rotate injection sites and space 1” apart
  • do not inject cold insulin
  • report weakness, nausea, palpitations, or paresthesias
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7
Q

CATEGORY CLASS: Heparin

A
  • anticoagulant
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8
Q

THERAPEUTIC USE: Heparin

A
  • prophylaxis for post-op venous thrombosis and PE
  • anticoagulant for evolving CVA, PE, DVT
  • adjunct therapy during angioplasty, open-heart surgery, hemodialysis, blood transfusion
  • ischemic complications of unstable angina and some dysrhythmias
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9
Q

ADVERSE EFFECTS: Heparin

A
  • hemorrhage
  • thrombocytopenia
  • hypersensitivity
  • neurological injury (from hematoma formation during lumbar puncture, epidural anesthesia)
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10
Q

MECHANISM OF ACTION: Heparin

A
  • potentiates the inhibitory effect of antithrombin on factor Xa and thrombin
  • prevents the conversion of prothrombin to thrombin by its effects on factor Xa
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11
Q

NURSING INTERVENTIONS: Heparin

A
  • monitor vital signs, checking for hypotension or tachycardia
  • monitor aPTT making sure it is no higher than twice the baseline value
  • for heparin overdose administer protein sulfate (no faster than 20 mg/min or 50 mg in 10 min)
  • monitor platelet count
  • monitor for itching and rash/hives
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12
Q

PATIENT EDUCATION: Heparin

A
  • report bruising, petechiae, hematoma, or black/tarry stools
  • report calf pain, tenderness, or swelling immediately
  • report SOB
  • report itching, rash, or hives
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13
Q

CATEGORY CLASS: Nitroglycerin

A
  • nitrate
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14
Q

THERAPEUTIC USE: Nitroglycerin

A
  • acute management of angina pectoris
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15
Q

MECHANISM OF ACTION: Nitroglycerin

A
  • increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic organs
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16
Q

ADVERSE EFFECTS: Nitroglycerin

A
  • dizziness
  • headache
  • hypotension
  • tachycardia
17
Q

NURSING INTERVENTIONS: Nitroglycerin

A
  • assess location, duration, intensity, and factors of anginal pain
  • may cause increased (false) serum cholesterol levels
  • monitor BP before and after administration
18
Q

PATIENT EDUCATION: Nitroglycerin

A
  • take medication as directed
  • change positions slowly
  • 3 x 5 min and call 911
  • avoid concurrent use of alcohol
  • advise patient that headache is common side effect and will go away continuing therapy
19
Q

CATEGORY CLASS: Digoxin

A
  • digitalis glycoside
20
Q

THERAPEUTIC USE: Digoxin

A
  • HF
  • Afib
  • atrial flutter
  • paroxysmal atrial tachycardia
21
Q

MECHANISM OF ACTION: Digoxin

A
  • increases force of myocardial contraction

- decreases conduction through SA & AV nodes

22
Q

ADVERSE EFFECTS: Digoxin

A
  • fatigue
  • headache
  • bradycardia
  • arrhythmias
  • anorexia
23
Q

NURSING INTERVENTIONS: Digoxin

A
  • monitor apical pulse for 1 min prior to administration
  • < 60 BPM notify provider
  • monitor EKG through IV administration and 6 hours after each dose
  • observe for s/s of toxicity: N/V, abdominal pain
  • correct electrolyte abnormalities
24
Q

PATIENT INSTRUCTIONS: Digoxin

A
  • take med at same time each day
  • take as directed
  • teach patient to take pulse and contact provider if pulse < 60 or > 100 BPM
  • teach patient that changes in HR, especially bradycardia are among signs of digoxin toxicity in infants and children
25
Q

CLASS OF: Humulin NPH/Regular

A
  • antidiabetic
26
Q

THERAPEUTIC USE: Humulin NPH/Regular

A
  • regulation of blood glucose levels in patients with DM
27
Q

ADVERSE EFFECTS: Humulin NPH/Regular

A
  • hypoglycemia
  • anaphylaxis
  • swelling
  • erythema
  • pain at injection site
28
Q

NURSING CONSIDERATIONS: Humulin NPH/Regular

A
  • alternate injection sites between arm and abdomen
  • thiazide diuretics and glucocorticoids may increase blood glucose levels
  • sulfonylureas, beta blockers and alcohol have additive hypoglycemic effects
29
Q

PATIENT EDUCATION: Humulin NPH/Regular

A
  • dosing may need to be adjusted for increased caloric intake, infection, stress, growth spurts
  • administer injections in one general area to have consistent absorption rates
  • absorption rates increase from thigh to upper arm to abdomen
  • enhance with proper diet and exercise
  • store vial in use at room temperature and discard after 1 month
30
Q

CATEGORY CLASS: Morphine

A
  • opioid agonist
31
Q

THERAPEUTIC USE: Morphine

A
  • management of moderate to severe chronic pain in patients requiring a use of continuous around-the-clock opioid analgesic for an extended period of time
32
Q

MECHANISM OF ACTION: Morphine

A
  • binds to opiate receptors in the CNS

- alters perception of and response to painful stimuli while producing generalized CNS depression

33
Q

ADVERSE EFFECTS: Morphine

A
  • confusion
  • sedation
  • hypotension
  • constipation
  • respiratory depression
34
Q

NURSING CONSIDERATIONS: Morphine

A
  • assess type, location, and intensity of pain prior to and 1 hour following administration, 20 min after IV administration
  • assess level of consciousness, BP, pulse, and respirations before and periodically during administration
  • if RR < 10 assess level of consciousness
  • assess bowel function
35
Q

PATIENT EDUCATION: Morphine

A
  • caution patient to call for assistance when ambulating or smoking
  • avoid driving or other activities requiring alertness
  • advise patient to change positions slowly to avoid orthostatic hypotension
  • avoid concurrent use of alcohol and CNS depressants
  • emphasize prevention of constipation with morphine

U of R SCHOOL OF NURSING - 372 (12 decks)

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