NUR 372 Exam 3 Medications Flashcards
1
Q
CATEGORY CLASS: Humalog
A
- anti-diabetic
2
Q
THERAPEUTIC USE: Humalog
A
- diabetes mellitus (type I, II, gestational)
- control of hyperglycemia
3
Q
ADVERSE EFFECTS: Humalog
A
- hypoglycemia
- lipohypertrophy
- hypokalemia
4
Q
MECHANISM OF ACTION: Humalog
A
- lowers BG by stimulating glucose uptake in skeletal muscle and fat, inhibiting hepatic glucose production
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
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
7
Q
CATEGORY CLASS: Heparin
A
- anticoagulant
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
9
Q
ADVERSE EFFECTS: Heparin
A
- hemorrhage
- thrombocytopenia
- hypersensitivity
- neurological injury (from hematoma formation during lumbar puncture, epidural anesthesia)
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
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
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
13
Q
CATEGORY CLASS: Nitroglycerin
A
- nitrate
14
Q
THERAPEUTIC USE: Nitroglycerin
A
- acute management of angina pectoris
15
Q
MECHANISM OF ACTION: Nitroglycerin
A
- increases coronary blood flow by dilating coronary arteries and improving collateral flow to ischemic organs
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
