Pharm Exam 3 Flashcards
A patient is taking propranolol and has diabetes. What are the major concerns?
Propranolol can mask symptoms of diabetes
True or false: a pt with Primary HTN will need to take lifelong antihypertensives:
True
Which electrolyte is most important to assess prior to starting an ACE inhibitor
Potassium. Hyperkalemia is a problem with ACE inhibitors
Pregnant women should never take:
ACE inhibitors
True or false: Beta blockers are safe to take for a patient with a diagnosed AV block:
False. BB will worsen an AV block!!
Which of the following endings is relates to ACE inhibitors?
- pril
- lol
- sartan
-pril. think lisinopril
What drug has the ending -sartan?
ARBS. Think Losartan
Nitropress can cause toxic levels of ___
thiocyanate.
A patient taking both a beta blocker and a diuretic may experience:
Significant hypotension. They both lower your BP
If your patient is taking an ARB or ACE inhibitor, you want to educate them on:
Signs of orthostatic hypotension
Major concerns of an ACE inhibitor is:
persistent dry cough and hyperkalemia
Which of the following medication may rarely cause angioedema:
Losartan. ARBS rarely cause angioedema compared to ACEs
If a pt is taking Propranolol (beta blocker) and Nifedipine (calcium channel blocker. Check this), we should monitor
Heart rate for bradycardia.
Because they both lower the HR
Prior to administering Nitropress, we need to check the:
Blood pressure!! It is extremely potent
The nurse educated the pt that experiencing flushing and severe headaches after taking nitro is a:
Common transient side effect.
A pt has a severe peanut allergy. The provider orders propranolol ER 60mg. Would you question the order?
Yes, BB blocks epinephrine and this could be fatal in an allergic reaction.
Amlodipine (dihydropyridines) is known to cause:
reflex tachycardia
Prior to adminstering Digoxin to a pt with afib, the nurse should:
Take an apical pulse for 60 seconds.
Toxicity from Lasix (furosemide) is known to cause:
Ototoxicity. Tinnitus.
The nurse knows that a pt who takes lasix loop diuretic is at risk for.
Hypokalemia. It is not potassium sparing, it pushes everything out.
The nurse will hold propranolol if the pt’s systolic BP is below:
90
The nurse will hold propranolol if the patient’s HR is below:
60
Think normal heart rate.
A pt taking an ACE inhibitor and spironolactone is at risk for:
Hyperkalemia. Both are potassium sparing agents.
Spironolactone is a potassium sparing diuretic, so it holds K in the body. It prevents your body from absorbing too much salt and keeps your potassium levels from getting too low.
ACE inhibitor = hyperkalemia.
True or false: Chlorothiazide is contraindicated in pts with a Sulfa allergy
True
Lactulose is used to reduce ammonia levels:
True. Liver problems can cause high ammonia levels. Will need to take Lactulose in the hospital.
True or False: The positive inotropic action of digoxin improves symptoms such as edema and SOB:
True. If the heart beats less efficiently, heart failure.
Which diuretic decreases ICP:
Osmotic
Which of the following indicates Digoxin toxicity:
Yellow halos around lights.
What happens with low dose activation of dopamine receptors?
Dilates renal blood vessels.
If a patient has a low GFR, then the following medication class would not be beneficial:
Thiazide diuretics.
True or false: A pt taking a combo of digoxin and lasix is not at risk for dysrhythmias:
False, they ARE at risk for dysrhythmias. Digoxin can cause toxicity. Lasix pushes things out of body, lowers BP, K+ and Mg+. Digoxin toxicity= neurological, and is common due to the small therapeutic window.
-parin is associated with anticoagulants
True
Which of the following endings is associated with HMG CoA reductase inhibitors?
-Statin
They work on cholesterol/triglycerides
The risk of serious bleeding is associated with
Thrombolytics
Which of the following would be a meal high in Vitamin K
wheat sandwich loaded with spinach with a side of broccoli and cabbage. KNOW ALL OF THESE.
Not corn, no sweet potatoes
Which of the following patients would Warfarin be contraindicated for?
A 31 year old woman who is preggers.
The nurse educates the patient to stop aspirin ____ days before a major surgery.
7 days
A therapeutic INR would be….
2.5
Therapeutic range is 2-3.
Bile-acid sequestrates are known to inhibit absorption of ___
Vitamin A, D, E and K
KNOW THIS !!!! :)
The nurse knows that statins are used for blood pressure true or false
False. Statins are used for cholesterol/triglycerides.
What time of day should a stain be administered
Evening.
Review this to understand why. Some statins work best when they’re taken at night. This is because the cholesterol-making enzyme is more active at night.
Gemfibrozil (Lopid) is known to treat ____
High triglycerides
Cholesterol screenings should be administered every ____
5 years
Unless you’re on a med or have high cholesterol
A common side effect of niacin is…..
facial flushing
Aspirin can reduce facial flushing by niacin
True.
On niacin, adjunct med is aspirin to prevent it.
SQ heparin admin. sites need to be rotated frequently in the lower abdomen.
True.
2 inches from umbilicus. Rotate site frequently.
Which of the following symptoms in a pt taking a statin should cause the nurse to be concerned?
Muscle tenderness.
Most concerning bc indication of a significant adverse effect.
Lovaza (omega 3 fatty acids) reduces ____
triglycerides
Increase HDL (good thing), decrease triglycerides.
True or False: Statins are appropriate for patients with hepatitis
False
Contraindication.
Psyllium (metamucil) is _____
bulk forming laxative which helps to improve fecal size.
Used for constipation
True or False: Milk of Mag is contraindicated in renal disease
True!
Ezetimibe (Zetia) blocks the absorption of biliary/dietary cholesterol
True. That is is purpose
Therapeutic aPTT levels should be ___x the control value
1.5-2x
True or False: Heparin assists antithrombin to activate clotting factors
False
Which of the following is the antidote to a heparin overdose
Protamine sulfate
What is the AD for warfarin? Vitamin K
Warfarin works by interfering with ___
Vitamin K dependent clotting factors in the liver
Liver=blood and metabolism and platelets
What allergy do you want to monitor for if the patient is getting a thiazide diuretic?
Sulfonamide
