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pharm II > summer exam 1 > Flashcards

summer exam 1 Flashcards

1
Q

a nurse knows which neurotransmitters are involved in Parkinson’s disease?

A

dopamine and acetylcholine

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2
Q

dopamine

A

-inhibitory neurotransmitter
-helps control muscle movement, rewards, and motivation

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3
Q

acetylcholine

A

-excitatory neurotransmitter
-enhances senses, stimulates muscle movement, and sustains attention

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4
Q

side effects of carbidopa/levodopa

A

excess peripheral dopamine= dysrhythmia/palpitations, orthostatic hypotension, involuntary movements, hallucinations, GI distress

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5
Q

classification of Benztropine

A

anticholinergic

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6
Q

Benztropine’s classification causes the side effect of. . .

A

dry up - drowsiness, constipation, urinary retention, dry mouth

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7
Q

how would a nurse educate the client to combat the side effects they might experience from benztropine?

A
  • chew on sugar-free gum or candy to combat dry mouth
  • report urinary retention and constipation
  • increase fluids
  • do not participate in activities where falling may take place (use caution and/or assistive devices)
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8
Q

what should a nurse educate the client to do before taking an anticholinergic medication?

A
  • increases fall risk
  • do not take if you have a GI/GU obstruction
  • increase fluids
  • have sugar-free gum or candy to treat dry mouth
  • report constipation and urinary retention
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9
Q

muscle relaxers cause what major side effect? ___________________.

A

sedation

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10
Q

what nursing considerations would be a priority to address as a nurse caring for a client newly prescribed Cyclobenzaprine?

A
  • avoid activities that require alertness
  • other CNS depressants will increase sedation
  • taper off to d/c
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11
Q

what are the properties of acetylsalicylic acid?

A

antipyretic, anti-inflammatory & analgesic, antiplatelet aggregate

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12
Q

when would a nurse not want to give acetylsalicylic acid to her adult client?

A

when the child has a viral infection, which could pose as a risk for Reye’s Syndrome

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13
Q

what assessment finding would a nurse observe with toxicity to acetylsalicylic acid in an adult?

A

tinnitus, hearing loss

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14
Q

what assessment finding would a nurse observe with toxicity to acetylsalicylic acid in a child?

A

behavioral changes, dizziness, drowsiness, hypoventilation

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15
Q

why should infants not receive acetylsalicylic acid?

A

Reye’s Syndrome

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16
Q

NSAIDS target prostaglandins synthesis. If we stop prostaglandins synthesis the patient will experience a decrease in ___________________.

A

inflammation

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17
Q

prostaglandins protects what in the body? ______________. Therefore, what nursing interventions are needed for a client on this medication?

A
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18
Q

Ibuprofen and acetylsalicylic acid are both ___________ (classification).

A

NSAIDS

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19
Q

what are the 4 properties of these medications?

A

analgesic, anti-inflammatory, antipyretic, antiplatelet aggregate

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20
Q

a priority assessment for adverse effect a nurse should be making while a client is on any NSAID is __________.

A

bleeding? (black, tarry stool)

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21
Q

where would the nurse most likely see this complication manifest?

A

in the stool

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22
Q

a nurse knows that a client with osteoarthritis benefits from taking Celecoxib due the decrease in ____________ ________.

A

COX-2 (anti-inflammatory)

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23
Q

but the nurse would consider an allergy to ___________ and any history of ________ _________ when planning the client’s medication administration.

A

sulfa, cardiac disease or stroke

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24
Q

a client comes into the clinic with a suspected infection. What risk factors place the client at risk for infection?

A
  • infants
  • high stress
  • malnourishment/underweight
  • immunocompromised
  • HIV/AIDs, cancer, autoimmune pts on meds
  • elderly
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25
Q

what are the 2 different actions of antibiotics? (How do they work?)

A
  • bactericidal: kills bacteria
  • bacteriostatic: inhibits/slows growth of bacteria, eventually leading to bacterial death
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26
Q

what would a nurse teach clients to prevent bacterial resistance to antibiotics?

A

finish taking all prescribed antibiotics, even if feeling better

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27
Q

what is an early sign of adverse effect of antibiotics?

A

pruritus, urticaria

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28
Q

antibiotics are great to treat bacterial infections but they are dumb. -What does Dr. Snider mean when she says this?

A
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29
Q

since antibiotics are dumb, how would you intervene if a client began having loose stools? (What would be your priority?)

A
30
Q

an elderly client is prescribed nitrofurantoin long term. The nurse understands this is for _____ ___________.

A

UTI prophylaxis

31
Q

a nurse knows that sulfonamides are primarily used to treat what type of infections?

A

UTI, otitis media (bacterial)

32
Q

what would a nurse teach clients about hydration while on antibiotics?

A

hydration enhances antibiotic absorption

33
Q

when reading an order for the medication trimethoprim/ sulfamethoxone the nurse understands this is a ____________ drug most commonly used to treat ____________.

A

sulfa, UTIs

34
Q

Tetracycline has a strong affinity for _________. Therefore should not be used in children because of ______________ ______________.

A
  • calcium
  • teeth staining
35
Q

a major adverse effect of fluoroquinolones is _____________ _____________. A nurse knows that due to this the medication would be held when ____________________________.

A

-tendonitis rupture
- . . .the pt reports tendon pain and inflammation is observed

36
Q

aminoglycosides cause what toxicities?

A

nephro, oto, neuro

37
Q

what are the s/s of each aminoglycoside toxicity?

A

nephro- hematuria, proteinuria, increased BUN/Creatinine, decreased urinary output
oto- tinnitus, dizziness/vertigo, partial hearing loss (may be permanent)
neuro- numbness, tremors, tingling, twitching, weakness, paralysis

38
Q

what is the advantage to being prescribed azithromycin?

A
  • only side effect is GI upset, which can be prevented by administering with food
  • bacteriostatic
39
Q

many antibiotics cause photosensitivity. Which ones did we discuss that causes this?

A

sulfonamides (trimethoprim/sulfamethoxazole (Bactrim))

40
Q

how would a nurse know a client has adequate pain control (besides using the pain scale). What would the nurse observe?

A
  • facial expression
  • mood
  • position
41
Q

a client has just returned from surgery and has requested a dose of an opioid. A nurse knows to combat respiratory issues the nurse should educate the client to ____________________________________.

A

administer narcan?

42
Q

other side effects of an opioid the nurse should monitor for are. . .

A
  • elevated temp
  • shallow respirations
  • agitation
  • decreased LOC
  • hyperglycemia
  • poor sleep
43
Q

what would a nurse teach a breast-feeding client about opioid use?

A

must wait 4-6 hours after opioid intake

44
Q

what 2 priority assessments would a nurse want to perform with a client on with a PCA?

A
  • pain level
  • respiratory status
45
Q

what organ does acetaminophen adversely affect?

A

liver

46
Q

what labs would tell you there is an adverse effect from acetaminophen?

A
  • AST/ALT
47
Q

what is the reversal agent for Opioids?

A

naloxone (narcan)

48
Q

how does the reversal agent work?

A

binds to opioid pain receptor and blocks the effect of agonist

49
Q

what a nurse should expect when giving the reversal agent?

A
  • onset is 1-2 min, wears off in 30 min-2 hr
50
Q

what should a client on immunosuppression avoid?

A

exposure to crowds

51
Q

what are the 4 main adverse effects of Steroids?

A
  • GI upset
  • osteoporosis (long-term use)
  • hyperglycemia
  • weight gain
  • mood changes (“roid rage”)
52
Q

what can happen if you d/c steroids abruptly?

A

may lead to shock

53
Q

Adalimumab (humira) works by causing __________________________. This places the client at high risk for ______________.

A

immunosuppression; infection

54
Q

how would a nurse expect to administer Adalimumab?

A

40mg every other week, may advance to 40mg weekly if indicated (Sub-Q)

55
Q

Methotrexate can suppress _________ ____________.

A

bone marrow

56
Q

what is the priority assessment with the suppression found with Methotrexate?

A
  • pallor
  • heart rate (tachycardia)
  • observing how tired the pt becomes upon minimal exertion
57
Q

Methotrexate can cause __________ and ___________ damage.

A

renal and liver damage

58
Q

which labs would the nurse monitor for the damage caused by Methotrexate consumption?

A

CBC, platelets, BUN/Creatinine, ALT/AST

59
Q

a client taking Hydroxychloroquine should be educated to report what adverse effect immediately?

A

vision changes (retinopathy)

60
Q

gold salts are used for ____________________ of arthritis.

A

treatment

61
Q

Auranofin is given ________ ___________ and can cause __________ _________ suppression and toxicity to the ___________.

A

long-term, bone marrow, kidneys

62
Q

what is the most common adverse effect of any anticoagulant?

A

bleeding

63
Q

how (what) should clients be educated to decrease the risk of the most common adverse effect of anticoagulation?

A
  • do not use razors
  • use soft toothbrush
  • avoid potentially dangerous activities that can cause injury
  • avoid alcohol
  • provide pressure to injection site if bleeding begins
64
Q

Heparin therapeutically is an anticoagulant. Explain how it works pharmacologically.

A

accelerates formation of antithrombin III-thrombin complex and deactivates thrombin, preventing conversion of fibrinogen to fibrin
inhibits new clots from forming

65
Q

how does alteplase work pharmacologically?

A

converts plasminogen to plasmin by directly cleaving peptide bonds at two sites, causing fibrinolysis
dissolves clot

66
Q

what lab values should be monitored with the administration of heparin?

A
  • platelets
  • aPTT (60-80 seconds)
  • PPT (120-140 seconds)
67
Q

what lab values should be monitored with the administration of lovenox?

A
  • platelets
  • PT/INR
68
Q

some drugs have interactions with certain foods. Which anticoagulants have interactions and to which foods?

A
  • warfarin: foods with vitamin K (eat consistently or limit to. keep PT/INR consistent)
  • apixaban (Eliquis): grapefruit juice (may increase drug level and risk of bleeding)
  • clopidogrel (Plavix): grapefruit, grapefruit juice (may reduce drug’s antiplatelet effects)
69
Q

what role does aspirin play in bleeding? (how does it work?)

A

prevents clot formation by inhibiting cox1&2, which prevents the production of thromboxane A (2)

70
Q

what lab should be monitored when administering aspirin in regards to bleeding?

A

aPTT, PT/INR

pharm II (11 decks)

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