P-col test HTN Flashcards
The nurse is providing care for a patient who is taking atenolol to treat hypertension
(HTN). Which physiologic action does this type of medication provide?
Beta-adrenergic blocker
A nursing student is reviewing pain management for pediatric patients who are also febrile.
Which medication should not be used for its antipyretic effect in children?
Salicylate
While studying for the medication exam, the nursing student determines that
norepinephrine, if given to a patient, would be contraindicated for which of the following
individuals?
A 52-year-old patient with a blood pressure of 186/94
The LPN is collecting history information for a patient planning outpatient surgery. Which of
the following statements by the patient would cause the nurse to contact the anesthesiologist?
“I used my pilocarpine eye drops this morning but didn’t take any of my pills.”
A nurse is reviewing a medication prescribed for moderate pain that is a combination-type
therapy—NSAID and narcotic. Which observation by the nurse warrants immediate
intervention?
The patient is taking additional ibuprofen for breakthrough pain.
The LPN is providing care for a patient who reports an allergy to acetaminophen and
penicillin. The patient has orders for morphine 1 mg intramuscular (IM) every 2 hours prn for
severe pain and Percocet two tablets every 4 hours prn for moderate pain. The patient reports
pain of 4 on a 10-point scale. Which of the following actions should the nurse take first?
Contact the RN so orders can be clarified
The LPN is monitoring a patient who has previously received morphine 4 mg intravenous
(IV) for pain relief. The patient appears drowsy and cannot respond in complete sentences.
Vital signs: Temperature 37.6 degrees, blood pressure (BP) 90/50, pulse 58, and respirations
12. Which action by the nurse is the priority?
Contact the RN to obtain an order for naloxone.
The LPN is caring for a patient being treated for clinical obesity. Phentermine has been
prescribed. What information should the LPN include in discharge teaching?
This medication is taken prior to eating meals.
The LPN is working with an elderly patient who reports difficulty sleeping and has been
prescribed eszopiclone. Which finding warrants immediate intervention?
The patient states that he has been speaking to his deceased wife.
While assisting with the care of a patient with a history of alcohol abuse, the LPN determines
that the patient’s withdrawal symptoms are worsening. Which of the following actions should
the nurse take next?
Determine if the patient has an order for prn diazepam.
An LPN working in a physician’s office receives a call from the parent of a child who recently
started taking dexmethylphenidate hydrochloride. The parent reports, “My son says
he hasn’t slept well for the past 3 days.” Which of the following responses by the nurse is
most appropriate?
“What time of day does he usually take the medication?”
While working with a patient who is taking selegiline, the LPN recognizes that the patient
understands the required dietary restrictions if the patient selects which of the following
lunches?
Hamburger with an onion bun, coleslaw, and a glass of milk
The LPN is working with a patient whose medication list includes lithium. The LPN would
be most concerned by which of the following?
The patient reports blurry vision and sensitivity to light.
An LPN is monitoring a patient diagnosed with Parkinson’s who is experiencing
extrapyramidal symptoms. Which of the following is the best nursing action?
Contact the health-care provider for a drug holiday.
The nurse is monitoring a patient who is being treated for alcohol dependence. Which vitamin
therapy should the nurse expect the health-care provider to order?
B vitamins
While passing out medications in a long-term care facility, the nurse recognizes that a
medication affecting the autonomic nervous system may cause which of the following
symptoms? (Select all that apply.)
Changes in pupil size, Altered heart rate, and Flushing of the skin
The peripheral nervous system is divided into:
Somatic and autonomic systems
This medication class mimics the sympathetic
system response:
Adrenergic agonists
Which of the following medications has no
effect on inflammation?
Acetaminophen
Acetaminophen fun facts
No anti-inflammatory effect
Opiod analgesics facts
supresses the central nervous system. Excess can cause decreassed blood pressure; this may lead to risk of falls or death, and decreased respirations.
Addiction potential with long-term use due to feelings of euphoria.
Anxiolytic medications facts
Benzodiazepines: trat anxiety , seizures, alcohol withdrawal symptoms, and muscle relaxation.
Selective serotonoin reuptake inhibitors.
serotonin-norepinephrine reuptake inhibitors
Tricyclic antidepressants
CNS nervous system stimulants
ADD AND ADHD ; amphetamine dextroamphetamine (adderall) and methylphenidate (focalin/ ritalin)
Narcolepsy ; modafinil (provigil)
monoamine oxidase inhibitors-
requires dietary exclusion foods containg tyramine
Tricyclic antidepressants-
many anticholinergic side effects
Mood stabilizers-
Most common is Litium
narrow therapeutic index
-Lithium toxicity can be fatal
Dementia facts
Goal of therapy to prevent or slow down further deterioration; NO CURE
Parkinson’s disease
a degenerative disorder of CNS
-Drug holiday requires; with carbidoba/levodopa
Alcohol affects
prolonged used can permanently damage CNS and liver.
treatments; disulfiram
Adrenergic (sympathomimetics)-
Mimics the sympathetic system. used when the body needs to be “excited”, mimic sympathetic nervous system. Stimulates fight or flight EX: restores heart rhythm after cardiac arrest
Analgesic-
pain/fever reducers. Analgesics medications reduce pain without removing feeling or sensation. EX: Acetaminophen
Anxiolytics-
reduce intensity of fears, dangers and/or tension. Ex; benzodiazepines
aura-
body warning system ex; needing to sit down before migraine.
Automatic nervous system-
apart of the peripheral nervous system. involuntary system. ex; heart beating, contracts internal organs. breaks down into sympathetic and parasympathetic nervous systems.
Blood Brain Barrier-
natural protective membrane that prevents central nervous system from toxins and pathogens in blood, made of lipids. no one knows just where or how the blood brain barrier quite works.
Central nervous system-
includes the brain and spine. The brain receives and processes sensory information; initiates responses; stores memories; generates thoughts and emotions. The spine conducts signals to and from the brain; controls reflect activation.
Cholinergic-
nerve cell that releases (parasympathomemetic) acetylcholine, which relaxes the body.
Drug holiday-
taking a break from a drug this helps prevent t tolerance.
gamma-aminobutyric acid (GABA)
Naturally occuring neurotransmitter inhibitor increase presnecne, decreases seizure activity (stops receptors).
in other words its a chemical messenger in the brain thats involved in regulating mood and anxiety.
Hydantoins-
class of organic compounds with anticonvulsants(controls seizures) properties.
Monoamine oxidase inhibitors (MAOIS)-
inhibits enzymes that stops action of neurotransmitters.
Narcotic-
A drug or substance that affects mood or behavior and is consumed for nonmedical purposes, especially one sold legally.
Neuroleptic-
type of drug that used to treat symptoms of psychosis.
neuro transmitters-
chemicals that transmit signals between nerve cells, muscle, organs, and tissues.
Parasympathetic-
refers to parasympathetic system or drugs that activate the PSNS. responsible for rest and digest.
Peripheral Nervous system-
includes somatic and autonomic nervous system
Psychotorpic-
any drug capable of addicting the mind, emotions, and behaviors.
Selective serotonin reuptake inhibitors-
a class of drugs that treat depression and other mental health conditions.
Somatic nervous system-
voluntary muscles we have conscious control over
Static epilepticus-
a life-threatening neurological emergency characterized by a prolonged or recurrent seizure that does not stop on his own.
Sympathetic Nervous System-
controls fight or flight responses.
Synapse-
gaps between nerves to adjust transmission of message by neurotransmitters.
introductions to ANS: what are the primary fuctions of the autonomic nervous system?
ANS uses a balance between the sympathetic and parasympathetic nervous system that regulates the body’s involuntary functions.
Introduction to ANS: how do the sympathetic and parasympathetic nervous system work differ in their effects on the body?
The sympathetic nervous system works as Fight or flight, while the parasympathetic nervous system works as “rest and digest”. sns increases production of the body’s organs while pns does the opposite and they both work together to create homeostasis.
Basic concepts: describe the structure and function of the central nervous system,
Parasympathetic slows and constricts the body functions while sympathetic system increase production and accelerates bodily functions.
Basic concepts: what roles do sensory, and motor neurons play in the nervous system?
sensory neurons sense the environment and conducts signals to the brain that became a conscious perception of that stimulus. motor neurons consist of somatic nervous system that stimulates voluntary movement of muscles and the autonomic nervous system that controls involuntary movements.
SNS and PNS functions: what physiological changes occur in the body during the “fight or flight” response?
for flight a person’s body will change to produce more oxygen and glucose to be delivered to skeletal muscle. more oxygen, more blood flow, more blood in muscles.
SNS and PNS functions: how does the parasympathetic nervous system contribute to homeostasis?
it helps to counteract the SNS and lower heart rate and oxygen intake in order to match the body’s need and to maintain homeostasis.
Chemical signaling explain the roles of preganglionic and postganglionic neurons in the ANS.
Preganglionic releases Ach- acetylcholine that gets delivered to the postganglionic neurons, that can then produce norepinephrine.
Chemical signaling: what are the primary neurotransmitters involved in the sympathetic and parasympathetic nervous system?
Sympathetic is norepinephrine and parasympathetic is acetylcholine
ANS neuroreceptors: what are the effects of stimulating alpha1, alpha 2, beta1, and beta 2 receptors in the sympathetic nervous system?
alpha 1 and 2 stimulates the secretion of epinephrine and norepinephrine (peripheral vasoconstriction). Beta 1 activation accelerate heart rate, contractility. Beta-2 activation dilates bronchioles in the lungs.
ANS neuroreceptors: how do adrenergic agonists and antagonists affect these receptors?
adrenergic agonists simulate alpha-1, alpha-2, beta-1, and/or beta-2 receptors has different effects. adrenergic antagonists block the effects of the SNS receptors.
Adrenergic agonists and antagonists: provide examples of medications that act as adrenergic agonists and their clinical uses.
alpha-1 medication- pseudoephedrine or phenylephrine are used to treat nasal congestion and cardiac arrest. Albuterol- bronchial dilation
Adrenergic agonists and antagonists: what are the potential side effects of beta-2 receptors against like albuterol?
albuterol can cause tachycardia by stimulating B-2 receptors in the heart. simulation of B2 receptors can also cause hyperglycemia in clients with diabetes because of activation of B-2 in the liver glycogenolysis.
Parasympathetic nervous system: what are the effects of stimulating nicotinic and muscarinic receptors in the parasympathetic nervous system?
cholinergic are drugs that stimulate nicotinic and muscarinic receptors, they can prevent the breakdown of acetylcholine. making their more acetylcholine to bind to the body.
Parasympathetic nervous system: how do muscarinic agonists and antagonists differ in their mechanisms and clinical applications?
anticholinergic cause the body to relax/stop reducing. for example, salvations decreased, lacrimation decreased, urinary retention etc…..
Clinical applications: discuss the use of anticholinergic medications and their common side effects.
oxybutynin- relaxes overactive bladder (can cause constipation, headache, dizziness, drowsiness, diarrhea.
Benztropine-reduces tremors and muscle rigidity.
Clinical applications: how do medications like atropine and oxybutynin work, and what conditions are they used to treat?
atropine: anticholinergic, dilates pupils, inhibits salivary glands and bronchial secretion.
Oxybutynin: anticholinergic used to treat overactive bladders.
Parasympathetic division :
rests and digests, constricts pupil(miosis), stimulates salvation, slows heart rate contractility, constricts bronchioles, stimulates digestion, stimulated gallbladder function, constricts bladder, stimulates erection or vaginal lubrication.
Sympathetic division:
dilates pupil(mydriases), inhibits salvation, accelerates heart rate contractility, dilates bronchioles, inhibits digestion, stimulates release of glucose, secretes epinephrine (peripheral vasoconstriction), relaxes bladder, stimulates ejaculation or orgasm.
What is the definition of hypertension according to the video?
The amount of resistance of blood pumping through the body/arteries (narrowing).
How does the analogy of a water hose help explain hypertension?
It helps show that the arteries constrict causing the blood to increase pressure.
what are the acceptable blood pressure ranges according to the joint national committee?
Normal: less then 120/80, Pre HTN: 120-139/80-89, stage 1: 140-159/90-99, and stage 2 is more than 160/100,
Why is hypertension referred to as the “silent killer”?
patients can have hypertension for years without symptoms until it’s effecting other systems of the body ex: blurred vision.
what mnemonic does the speakers use to remember the body systems affected by hypertension, and what does each letter stand for?
” can’t eat your CAKE and have it too”
Cardiovascular Congestive heart failure (CHF), A:brAin (Stroke), Kidneys: renal failure, and Eyes: retina changes/
How does hypertension affect the cardiovascular system?
CHF- over working heart muscles making pumping less effective.
what are effects of hypertension on the brain?
Stroke- increase pressure in arteries cause them to weaken, leading to stroke.
How does hypertension effect the kidneys?
renal failure- too much blood at fast rate weakens arteries in kidneys making them less productive.
what are the consequences of hypertension in the eyes?
Visual changes: damages blood vessels to retina… blurred vision can’t focus objects.
what are the two types of hypertension?
primary/essential HTN and secondary HTN.
what mnemonic is used to remember the risk factors for hypertension and what does the letters represent?
RISK FACTORS: Race, Increase NA+ and ETOH intake, Smoking +Stress, K+ and vitamin D intake low, Family history, Advanced age, Cholesterol high, To much caffeine, Obese, Restricting activity, Sleep apnea.
what are secondary cause of HTN?
Pregnancy, crushing syndrome, chronic renal failure, diabetes, hypo/hyper thyroidsims.
what are common symptoms of HTN when it starts effecting the body systems?
Blurry vision, headache and chest pain.
what are the key aspects of nursing management of Patients with HTN?
Asses, Educate, Evaluate, Measure B.P. both arms 5 mins apart, get family history, sensory changes, BMI report, high BP reading alert physicians, look at meds; take them regularly.
what lifestyle changes are recommended with patients that have HTN?
Limiting Na+, ETOH, and caffeine intake, smoking cessation, exercise program, measure BP and keep records.
what is the first line of pharmacological treatment for HTN , how do the meds work?
Starts out with thiazide diuretics (-IAZIDE)- removes water a Na+ via kidneys-waste potassium not for renal issues pt’s watch lithium levels (if on lithium)
key points of pt education for taking thiazide diuretic?
Patients consume enough potassium need to protect skin due to photosensitivity.
what are ACE inhibitors? what are important patient education points for these medications?
end in -Pril, blocks angiotensin 1 and 2 receptors ex: lisinopril. let PT know -dry cough, avoid potassium substitutes, compliance (rebound HTN) takes hr or two before meals.
what are ARBS, how do they differ from ACE inhibitors?
angiotensin receptor blockers end in “-Satrans”, blocks aldosterone and angiotensin receptors. If PT can’t handle ACE inhibitors, they are a part of ARB’S.
how do calcium channel blockers work, and why should there be some precautions?
lower BP and work on the calcium from reaching the heart and arteries. Watch us for bradycardia and watch on CHF patients and AV heart blocks rhythm.
what are beta blockers, and why should they be used precariously in patients with asthma or COPD?
-Olol, blockers epinephrine blocking sympathetic nervous systems of the heart. don’t take with asthma or COPS because -olol blocks receptors bronchioles causing asthma attacks
why is it important for diabetics taking betablockers to monitor their glucose regularly?
masks symptoms of hypoglycemia
