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Nursing > Pharmacology Exam 3 > Flashcards

Pharmacology Exam 3 Flashcards

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1
Q

When monitoring a patient who is taking a systemically administered glucocorticoid, the nurse should monitor for signs of:

A

Hypokalemia

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2
Q

A patient is receiving aminoglutethimide (Cytadren) therapy. The nurse knows that this medication is used for which condition?

A

Cushing’s Syndrome

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3
Q

A patient is taking fludrocortisone for Addison’s disease, and his wife is concerned about all the problems that may occur with his therapy. When teaching them about therapy with this drug, the nurse should include which information?

A

It should be taken with food or milk to minimize GI upset

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4
Q

A patient is concerned about the body changes that have resulted from long-term prednisone therapy for the treatment of lupus erythematosus. Which of the following effects of this drug therapy would be present to support the nursing diagnosis of disturbed body image?

A

Weight gain

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5
Q

When starting drug therapy with corticosteroids, the nurse is aware that some drugs can have adverse interactions with corticosteroids, such as:

A

NSAIDs

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6
Q

The nurse is administering lispro insulin, and should keep in mind that this insulin is:

A

a rapid-acting insulin

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7
Q

When teaching about hypoglycemia, the nurse should make sure that the patient is aware of the early signs of hypoglycemia, which are:

A

irritability and confusion

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8
Q

The nurse is teaching a group of patients about self-administration of insulin. What teaching is important to include?

A

when mixing insulins, the clear (such as Regular) insulin should be drawn up into the syringe first

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9
Q

A patient who has type II diabetes is scheduled for a laparoscopy and has been NPO since midnight. She is concerned about her medications being held. What is the best action regarding the administration of her oral anti diabetic drug?

A

contact the Physician for further orders

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10
Q

When taking a rapid-acting insulin such as insulin aspart, which of the following is correct regarding administration?

A

It should be taken within 15 minutes of beginning a meal

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11
Q

A patient has been prescribed warfarin (Coumadin) in addition to a heparin infusion. The nurse recognizes that the reason for the two anticoagulants is which of the following?

A

Heparin is often used to initiate therapy when oral anticoagulants are prescribed until laboratory tests indicate an adequate therapeutic response

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12
Q

During thrombolytic therapy, the nurse monitors the patient for adverse effects. What is the most frequent undesirable effect of thrombolytic therapy?

A

Internal and superficial bleeding

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13
Q

A patient has received too much warfarin. The nurse would expect to give which antidote for wafarin toxicity?

A

Vitamin K

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14
Q

Which of the following is true for the patient receiving long-term aspirin therapy?

A

Laboratory studies should be done to monitor liver, renal, and clotting functions

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15
Q

A patient is receiving an intravenous infusion of heparin. Which of the following laboratory studies will be used to adjust and monitor the dose of heparin?

A

aPTT (activated partial thromboplastin time)

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16
Q

A patient arrives in the emergency department with sever chest pain. She says she has had pain off and on for a week now. Which assessment finding would indicate the need for cautious use of nitrates and nitrites?

A

Blood Pressure of 98/68 mm Hg

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17
Q

A calcium channel blocker (CCB) is prescribed for patient , and the nurse provides instructions to the patient about the medication. What does the nurse tell the patient?

A

A high-fiber diet with plenty of fluids will help prevent the constipation that may occur

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18
Q

A patient about to receive his morning does of digoxin has an apical pulse of 70 bpm. What will the nurse do?

A

Administer the dose

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19
Q

A patient has been taking digoxin at home but has taken an accidental overdose and has developed toxicity. He has been admitted to the telemetry unit where the physician has ordered digoxin immune Fad (Digibind). The patient asks the nurse why the medication is ordered. What us the nurse’s best response?

A

“This drug is an antidote to digoxin and will help to lower the blood levels.”

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20
Q

While assessing a patient who is taking a beta-blocker for angina, the nurse knows to monitor for which adverse effect?

A

Bradycardia (under 60 bpm)

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21
Q

Break down clots

A

Thrombolytic Drugs

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22
Q

activate plasminogen & convert it to plasmin, which can digest fibrin

A

Thrombolytic Drugs

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23
Q

alteplase (Activase)

A

Thrombolytic Drug

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24
Q

an enzyme that naturally occurs in the blood stream

A

alteplase (Activase)

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25
Q

“t-PA”

A

alteplase (Activase)

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26
Q

Half life of alteplase (Activase)

A

5 minutes –> constant infusion

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27
Q

main treatment of alteplase (Activase)

A

stroke

acute MI, pulmonary embolism, acute ischemic stroke, clogged arterial lines [Cathflo-Activase]

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28
Q

2 Types of strokes

A
  1. Clot

2. Blow out of blood vessel

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29
Q

streptokinase (Streptase)

A

Thrombolytic Drug

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30
Q

produced from beta-hemolytic strep

A

streptokinase (Streptase)

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31
Q

main treatment of streptokinase (Streptase)

A

DVT

acute MI, pulmonary embolism

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32
Q

Prevents platelet adhesion at the site of blood vessel injury

A

Anti-Platelets

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33
Q

Once injury occurs –> platelets change shape

A

Anti-Platelets

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34
Q

aspirin (Acetylsalicylic Acid)

A

Anti-Platelet

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35
Q

The most common dose of this drug is 81mg/day

A

aspirin (Acetylsalicylic Acid)

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36
Q

Long-term use of this drug requires monitoring of liver, renal, and clotting function

A

aspirin (Acetylsalicylic Acid)

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37
Q

DO NOT give this drug to children, it can result in Reyes Syndrome

A

aspirin (Acetylsalicylic Acid)

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38
Q

This drug has the following adverse effects:
GI Bleeding, Diarrhea, Flushing, Dizziness
(heart burn, bleeding)

A

aspirin (Acetylsalicylic Acid)

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39
Q

main treatment of aspirin (Acetylsalicylic Acid)

A

MI –> 81 mg/day
stroke –> 325 mg/day

(anti-inflammatory, analgesic, antipyretic)

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40
Q

clopidogrel (Plavix)

A

Anti-Platelet

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41
Q

This drug has the following adverse effects:

chest pain, flulike symptoms, dyspepsia (heart burn), abdominal pain, epistaxis (nose bleeds), bleeding, chills

A

clopidogrel (Plavix)

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42
Q

main treatment for clopidogrel (Plavix)

A
  • arthrosclerotic events (stiff joints) –>75 mg/day
  • post stent replacement –> 300 mg/day
  • stroke
  • transient ischemic attack
  • post MT (thrombi-prevention)
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43
Q

eptifibatide (Intergrillin)

A

Anti-Platelet Drug given IV

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44
Q

An Antiplatelet drug only given in an ICU setting

A

eptifibatide (Intergrillin)

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45
Q

When administering eptifibatide (Intergrillin) you must monitor:

A

heart monitor at all times

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46
Q

Main treatment for eptifibatide (Intergrillin)

A

unstable angina or cardiac catheterization lab

MI

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47
Q

inhibits formation of clotting factors but not on a clot that has already formed

A

anticoagulants

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48
Q

Indications that an anticoagulant drug is needed:

A
  • MI
  • Unstable angina
  • A-Fib (pooling in R atrium [sometimes in L])
  • indwelling devices (heart valve)
  • major ortho surgery (femur/hip fracture)
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49
Q

Heparin

A

Anticoagulant

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50
Q

Concentrations of this drug can vary from 10 units to 40,000 units

A

Heparin

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51
Q

Half life of Heparin

A

1 - 2 hours

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52
Q

Monitoring of aPTT or PTT is a must with this drug

A

Heparin

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53
Q

antidote of this drug is protomine sulfate

A

Heparin

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54
Q

warfarin (Coumadin)

A

Anticoagulant

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55
Q

this anti-coagulant is the most commonly prescribed

A

warfarin (Coumadin)

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56
Q

This anti-coagulant is only given PO

A

warfarin (Coumadin)

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57
Q

monitoring of PT and INR is a must with this drug

A

warfarin (Coumadin)

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58
Q

goal of Heparin is:

A

aPTT 1.5 - 2.5 times the normal value

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59
Q

aPTT normal times are:

A

30 - 40 seconds

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60
Q

PTT normal times are:

A

50 - 70 seconds

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61
Q

PT normal times:

A

11 - 13 seconds

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62
Q

INR (international normalized ratio):

A

2 - 3

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63
Q

Goal on warfarin (Coumadin)

A

INR = 3.5

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64
Q

Antidote of warfarin (Coumadin)

A

Vitamin K

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65
Q

enoxaparin (Lovenox)

A

Anticoagulant

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66
Q

aka: low molecular weight heparin (LMWH)

A

enoxaparin (Lovenox)

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67
Q

this drug is fractionated heparin –> the smaller fragments have higher a attraction (affinity)

A

enoxaparin (Lovenox)

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68
Q

a pt can go home on this fractionated form of heparin

A

enoxaparin (Lovenox)

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69
Q

enoxaparin (Lovenox) has a longer half-life than heparin does, why is this beneficial?

A

enoxaparin (Lovenox) has a more predictable anticoagulant response

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70
Q

Anticoagulants

A

Coagulation Modifier Drug

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71
Q

Antiplatelets

A

Coagulation Modifier Drug

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72
Q

Thrombolytic Drugs

A

Coagulation Modifier Drug

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73
Q

Baseline vitals will ________ on Coagulation Modifier Drug

A

decrease

HR will increase

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74
Q

Platelet counts are important with this drug:

A

aspirin (Acetylsalicylic Acid)

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75
Q

During Assessment History of abnormal bleeding is important with which type of drugs?

A

Coagulation Modifier Drugs

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76
Q

Coagulation Modifier Drugs are what kind of medication

A

High Alert!

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77
Q

With high alert medications what 3 things should a nurse do with another nurse?

A
  1. Check Medication
  2. Check Calculation
  3. Check Pump
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78
Q

What drug is involved in NOT aspirating before administration?

A

Heparin

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79
Q

What drug do you NOT massage into muscle after aspiration?

A

Heparin

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80
Q

While administering what drug do you NOT want to pinch the muscle?

A

Heparin

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81
Q

What should a nurse do after drawing up Heparin?

A

Change the needle

82
Q

What type of needle should be used while administering Heparin?

A

High Gauge, Short Length

83
Q

When on Coagulation Modifier Drugs a pt should have labs on:

A

a regular basis

84
Q

Signs/Sympotms of bleeding (with not pain) may occur with these drugs:

A

Coagulation Modifier Drug

85
Q

A pt must wear a Med Alert Bracelet when on these types of drugs

A

Coagulation Modifier Drug

86
Q

A patient should not have foods high is Vitamin K if on these types of drugs

A

Coagulation Modifier Drug

87
Q

vasopressin (Pitressin)

A

Posterior Pituitary Drug

88
Q

vasopressin tannate means

A

vasopressin in peanut oil

89
Q 
this drug is stored in the fridge: 
before administration nurse must -->
-put into warm water
-shake vigorously (brown speckled dots should appear)
-repeat until dots appear
A

vasopressin tannate

90
Q

an advantage of this posterior pituitary drugs is it lasts 48 - 72 hours

A

vasopressin (Pitressin)

91
Q

adverse effects of this drug are water intoxication and excessive vasoconstriction

A

vasopressin (Pitressin)

92
Q

main treatment of vasopressin (Pitressin)

A

diabetes insipidus = pee & drink excessively

CPR, Cardiac Arrest

93
Q

this drug increases ADH activity, which promotes conservation of water, which reduces urine production

A

vasopressin (Pitressin)

94
Q

desmopressin (DDAVP)

A

Posterior Pituitary Drug

95
Q

Routes of desmopressin (DDAVP)

A

intranasal, IV, subq, PO

96
Q

Advantage of desmopressin (DDAVP)

A

Painless route of intranasal

97
Q

Disadvantage of desmopressin (DDAVP)

A

repeat dose every 8 - 12 hours

98
Q

water intoxication leads to…

A

diluting electrolytes –> seize –> death

99
Q

Drug-to-Drug interactions with desmopressin (DDAVP)

A

lithium

100
Q

Preferred Drug for Diabetes Insipidus is…

A

desmopressin (DDAVP)

101
Q

Drug used to treat primary nocturnal enuresis (bed wetting)

A

desmopressin (DDAVP)

102
Q

ADH Activity

A
  • promotes renal conservation of water

- reduces urine output

103
Q

coticotropin (Adrenocorticotropic Hormone) (ACTH)

A

Anterior Pituitary Drug

104
Q

Diagnosis of adrenocortical insufficiency

A

Addison’s Disease

105
Q

Main treatment of coticotropin (Adrenocorticotropic Hormone) (ACTH)

A

Addison’s Disease

exacerbation of MS [helps with strength and muscle pain

106
Q

Adverse effects of coticotropin (Adrenocorticotropic Hormone) (ACTH)

A

increased blood glucose

107
Q

This drug stimulates the release of cortisol from the adrenal cortex

A

coticotropin (Adrenocorticotropic Hormone) (ACTH)

108
Q

octreotide (Sandostatin)

A

Anterior Pituitary Drug

109
Q

This drug inhibits growth hormone

A

octreotide (Sandostatin)

110
Q

Main treatments for octreotide (Sandostatin)

A

acomegaly and giganticism

111
Q

another word for hyperpituitarism

A

giganiticism

112
Q

over secreting of the pituitary gland results in this

A

hyperpituitarism

113
Q

when a tumor is on the pituitary gland ________ is most likely to happen

A

over secreting

114
Q

An annoying side effect of ACE inhibitors that may be minimized by switching to an angiotensin receptor blocking drug includes

A

a dry, nonproductive cough

115
Q

The following statement is said by a patient on __________________ drugs :
“I will include rest periods during the day to help me tolerate the fatigue my medicine may cause.”

A

Antihypertensive

116
Q

The following statement is said by a patient on __________________ drugs :

“I will change my position slowly to prevent feeling dizzy.”

A

Antihypertensive

117
Q

The following statement is said by a patient on __________________ drugs :

“I will not mow my lawn until I see how this medication makes me feel.”

A

Antihypertensive

118
Q

_____________ medications need to be taken routinely in order to maintain a normotensive state and prevent occurrence of complications. Many patients do not adhere to this regimen because hypertension itself does not cause symptoms, whereas the medication can cause some untoward effects. Patient teaching is essential.

A

Antihypertensive

119
Q

______________ prevent the breakdown of bradykinin, frequently causing a nonproductive cough. Angiotensin receptor blocking drugs do not block this breakdown, thus minimizing this annoying side effect.

A

ACE inhibitors

120
Q

What would the nurse question if ordered concurrently with ACE inhibitors?

A

potassium

121
Q

__________ block the conversion of angiotensin I to angiotensin II, thus also blocking the stimulus for aldosterone production. Aldosterone is responsible for potassium excretion—decreased aldosterone can result in increased serum potassium.

A

ACE inhibitors

122
Q

The nurse would plan to administer which calcium channel blocking drug to a patient with cerebral arterial spasms following a subarachnoid hemorrhage?

A

nimodipine (Nimotop)

123
Q

____________ crosses the blood-brain barrier and has a greater effect on the cerebral arteries than on other arteries in the body, thus it is indicated for the treatment of cerebral arterial spasm following subarachnoid hemorrhage.

A

nimodipine (Nimotop)

124
Q

The nurse would question an order for a calcium channel blocking drug in a patient with which condition?

A

Hypotension

125
Q

Which statement would be most appropriate during discharge teaching for a patient receiving transdermal clonidine (Catapres)?

A

“The patch should be applied to a nonhairy site, and abrupt withdrawal should be avoided.”

126
Q

When explaining different medication regimens to treat hypertension during a community education program, it would be accurate to state that African Americans probably respond best to which combination of medications?

A

Diuretics and calcium channel blockers

127
Q

Research has demonstrated that _____________ do not typically respond therapeutically to beta-blockers or ACE inhibitors. They respond better to diuretics and calcium channel blockers.

A

African Americans

128
Q

Carvedilol (Coreg) is classified as a

A

Dual action alpha1 and beta-receptor blocker

129
Q

____________ blocks both the alpha1 and beta-receptors of the adrenergic nervous system.

A

Carvedilol (Coreg)

130
Q

Signs and symptoms of ___________ toxicity include extreme hypotension, abdominal pain, apprehension, diaphoresis, dizziness, muscle twitching, nausea, irregular pulse rates, vomiting, and pain behind the sternal area of the chest.

A

nitroprusside (Nipride)

131
Q

The nurse would monitor for reflex tachycardia in a patient receiving which classification of antihypertensive drugs?

A

Direct-acting vasodilators

132
Q

____________ decrease blood pressure but have no effect on myocardial conduction, thus allowing for reflex tachycardia.

A

Direct-acting vasodilators

133
Q

_______ and _________ both have a negative chronotropic effect that negates the reflex tachycardia.

A

Calcium channel blockers and beta-blockers

134
Q

A patient prescribed prazosin (Minipress) does not have a history of hypertension. The nurse would assess for what disorder for which this medication is also used?

A

Obstructive benign prostatic hyperplasia

135
Q

ACE inhibitors and angiotensin receptor blockers both work to decrease blood pressure by

A

preventing aldosterone secretion.

136
Q

ACE inhibitors block the formation of

A

angiotensin II

137
Q

angiotensin receptor blockers allow the formation of __________ but block its effect at the receptors

A

angiotensin II

138
Q

Which is a priority nursing diagnosis for a patient taking an antihypertensive medication?

A

Ineffective tissue perfusion related to disease process and/or medication

139
Q

Patients taking ____________ medication are at risk for ineffective cerebral, renal, and cardiac perfusion.

A

antihypertensive

140
Q

__________ has the dual antihypertensive effects of reducing heart rate (beta1 receptor blockade) and also vasodilation (alpha1-receptor blockade).

A

Carvedilol (Coreg)

141
Q

Which is an expected outcome associated with the administration of digoxin?

A

Decreased heart rate

142
Q

Therapeutic serum digoxin levels are

A

0.5 to 2 ng/mL

143
Q

A patient is taking digoxin 0.25 mg and furosemide (Lasix) 40 mg. When the nurse enters the room, the patient states, “There are nice yellow halos around the lights.” Which action will the nurse take?

A

Evaluate the patient for other symptoms of digoxin toxicity

144
Q

which drug results in the following therapeutic effects?

Positive inotropic, negative chronotropic, and negative dromotropic

A

digoxin

145
Q

Which effect(s) would alert the nurse to suspect early digitalis toxicity?

A

anorexia, nausea and vomiting (related to the gastrointestinal tract), fatigue, headache, depression, weakness, drowsiness, confusion, and nightmares

146
Q

Phosphodiesterase inhibitors have an added advantage in treating heart failure because they cause a positive inotropic effect and

A

vasodilation

147
Q

Assessment of a patient receiving a positive inotropic drug would include reviewing which values?

A
  • lung sounds
  • daily weights
  • apical pulse
  • serum electrolytes
148
Q

The nurse would question the use of milrinone (Primacor) in a patient with which disorder?

A

Systolic heart failure

149
Q

When teaching a patient regarding the administration of digoxin, the nurse instructs the patient not to take this medication with which food?

A

Wheat Bran

150
Q

Which is an indication for use of the antidysrhythmic drug lidocaine?

A

Ventricular arrhythmias

151
Q

When giving adenosine, it is important to remember to

A

give it as a fast intravenous push.

152
Q

To prevent the occurrence of cinchonism in a patient prescribed quinidine, the nurse emphasizes the importance of

A

avoiding ingestion of antacids.

153
Q

Adenosine is used to treat which condition?

A

Paroxysmal supraventricular tachycardia (PSVT)

154
Q

Sodium channel blockers are considered which class of antiarrhythmic drugs?

A

Class I

155
Q

Ibutilide (Corvert) is a class III antiarrhythmic drug that is used for

A

conversion of recent-onset atrial fibrillation and flutter.

156
Q

Potential side effects from __________ include photosensitivity, bluish skin discoloration, hyperthyroidism, hypothyroidism, and decreased libido

A

amiodarone

157
Q

Before administering a dose of an antiarrhythmic drug to an assigned patient, which assessments would be of highest priority?

A

Apical pulse and blood pressure

158
Q

Which classification of drugs is used to treat both hypertension and dysrhythmias?

A

Calcium channel blockers

159
Q

Calcium channel blockers have which pharmacodynamic effect?

A

Coronary vasodilation

160
Q

Amiodarone toxicity is evidenced in which body system?

A

pulmonary

161
Q

Which instruction should be included in the discharge teaching for a patient with a transdermal nitroglycerin patch?

A

“Apply the patch to a nonhairy, nonfatty area of the upper torso or arms.”

162
Q

Nitrates relieve angina pain by reducing preload, which is

A

blood volume within the heart.

163
Q

Common side effects of ________ include flushing, headache, and hypotension.

A

nitroglycerin

164
Q

The following statement is said by a patient on __________________:
“I should keep my medication in a cool, dry place.”

A

nitroglycerin

165
Q

Patients on this drug are taught to take up to three tablets 5 minutes apart. If no relief from chest pain is obtained after three tablets, they should seek medical assistance.

A

nitroglycerin

166
Q

Calcium channel blockers reduce myocardial oxygen demand by reducing afterload, which is

A

pressure against which the heart must pump

167
Q

Which nitrate preparation or dosage form has the longest duration of action?

A

Transdermal nitroglycerin patch

168
Q

In order to prevent the development of tolerance, the nurse instructs the patient to perform which action?

A

Tolerance can be prevented by maintaining an 8- to 12-hour nitrate-free period each day.

169
Q

Nitrates relieve angina pain by reducing afterload, which is:

A

pressure against which the heart must pump

170
Q

During patient teaching, the nurse explains that nitroglycerin relieves chest pain primarily by which action?

A

Decreasing the workload of the heart

171
Q

It is most important to instruct a patient prescribed nitroglycerin to avoid which substance(s)?

A

Erectile dysfunction medications

172
Q

When caring for a patient with angina, the nurse would question an order for a noncardioselective beta-blocker in a patient with coexisting

A

bronchial asthma

173
Q

Which laboratory value might indicate an adverse response to hydrochlorothiazide (HydroDIURIL)?

A

Glucose levels

174
Q

When teaching a patient why spironolactone (Aldactone) and furosemide (Lasix) are prescribed together, the nurse’s statements are based on knowledge that

A

this combination promotes diuresis but decreases the risk of hypokalemia.

175
Q

Which laboratory value depicts a known side effect of furosemide (Lasix)?

A

Hypokalemia

176
Q

A patient is admitted to the hospital with pneumonia and has a history of chronic renal insufficiency. The physician orders furosemide (Lasix) 40 mg twice a day because it

A

is effective in treating patients with renal insufficiency

177
Q

A patient taking spironolactone (Aldactone) requests assistance with dietary choices. The nurse would NOT recommend which food choices?

A

bananas

178
Q

This drug is used to treat high-altitude sickness, edema secondary to heart failure, and open-angle glaucoma

A

Acetazolamide (Diamox)

179
Q

When preparing to administer furosemide (Lasix) intravenously to a patient with renal dysfunction, the nurse plans implementation based on knowledge that the medication should be administered no faster than which rate?

A

4 mg/min

180
Q

Hyperkalemia, dizziness, and headache are common side effects associated with

A

potassium-sparing diuretics

181
Q

A patient asks about taking potassium supplements while taking spironolactone (Aldactone). What is the nurse’s best response?

A

“You are on a diuretic that is potassium-sparing, so there is no need for extra potassium.”

182
Q

the direct antagonist for aldosterone

A

spironolactone (Aldactone)

183
Q

The nurse prepares to administer which diuretic to treat a patient suffering from acute pulmonary edema?

A

furosemide (Lasix)

184
Q

an osmotic diuretic that pulls fluid from extravascular spaces into the bloodstream to be excreted in urine. This will decrease intracranial pressure, increase excretion of medications, decrease urine osmolality, and increase serum osmolality.

A

mannitol

185
Q

When assessing a patient on triamterene (Dyrenium), the nurse would specifically monitor for which adverse effect?

A

Hyperkalemia

186
Q

When teaching a patient about signs and symptoms of hypokalemia, the nurse will instruct the patient to notify the health care provider if which occurs?

A

Leg cramps

187
Q

The nurse would question the health care provider if which type of diuretics is prescribed to a patient with gout?

A

Thiazide diuretics –> can cause hyperuricemia

188
Q

A patient with severe trauma is admitted to the intensive care unit. The patient has received 5000 mL of normal saline, is exhibiting peripheral edema, and remains hypotensive. The nurse anticipates administering which substance to correct fluid balance?

A

hetastarch (Hespan)

189
Q

When caring for a patient with serum potassium of 2.8 mEq/L, which is a priority nursing intervention when administering intravenous replacement therapy?

A

Maintain infusion rate at no greater than 20 mEq/hour

190
Q

When planning administration of hypertonic saline solution to treat a patient with severe hyponatremia, the nurse monitors for signs and symptoms of overdose as manifested by

A

flushed skin and increased thirst.

191
Q

A patient receiving a unit of red blood cells suddenly develops shortness of breath, chills, and fever. Following patient assessment, the nurse’s initial action should be to

A

discontinue the infusion of packed cells

192
Q

The nurse is caring for a patient with an acute renal insufficiency and thrombocytopenia. Along with platelet transfusions, the nurse would expect to administer which substance to increase deficient clotting factors in this patient?

A

Fresh frozen plasma

193
Q

The nurse would assess which laboratory value to determine the effectiveness of intravenous heparin?

A

Activated partial thromboplastin time (aPTT)

194
Q

A patient who has been anticoagulated with warfarin (Coumadin) is admitted with gastrointestinal bleeding. The nurse will anticipate administering which substance?

A

vitamin K

195
Q

The nurse understands that a patient’s international normalized ratio (INR) value of 2.5 means that

A

the patient’s warfarin dose is therapeutic

196
Q

Enoxaparin sodium (Lovenox) is an anticoagulant used to prevent and treat deep vein thrombosis and pulmonary embolism. This drug is in which drug group?

A

Low molecular weight heparin

197
Q

The patient asks what the difference is between dalteparin (Fragmin) and heparin. What is the nurse’s best response?

A

“Dalteparin is a low molecular weight heparin that has a more predictable anticoagulant effect.”

198
Q

Before emergency surgery, the nurse would anticipate administering which medication to a patient receiving heparin?

A

protamine sulfate

199
Q

A patient is started on oral anticoagulant therapy while still receiving intravenous heparin. The patient is concerned about risk for bleeding. What is the nurse’s best response?

A

“It usually takes 4 to 5 days to achieve a full therapeutic effect for warfarin, so the heparin is continued to help prevent blood clots until the warfarin is working up to speed.”

200
Q

Before administering alteplase (Activase), it is important for the nurse to perform which action?

A

Perform all necessary venipunctures

201
Q

The nurse recognizes that patient teaching regarding warfarin (Coumadin) has been successful when the patient acknowledges an increased risk of bleeding with concurrent use of which herbal products?

A

Garlic, Ginkgo, Ginseng

Nursing (3 decks)

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