Unit 2 Exam Review Flashcards
What color is Oxygen-Rich Blood?
Red
What color is Oxygen-Poor Blood?
Blue
What is the purpose of Inhaled Corticosteroids?
Exert anti-inflammatory action by inhibiting the response of many different kinds of cells.
What are the side effects of Corticosteroids?
- Weight Gain
- Increased Blood Sugar
- Decreased Immunity
What are Corticosteroids used for?
- Rhinitis
- Nasal Polyps
- Chronic Sinusitis
True/False: Do not give corticosteroids to children due to the cause of slow growth. Use caution if patient is on other steroids.
TRUE.
What is the purpose of Anti-Histamines?
Reduces histamine activity by blocking histamine receptor sites.
What is the brand name for “Diphenhydramine” ?
Benadryl
What are the 2 types of Antihistamine Receptors?
- H1 Receptors Antagonist (Control symptoms)
- H2 Receptors (Primarily on GI tract)
What are the common side effects of Anti-Histamines?
- Sedation
- Drowsiness
- Dry Nose
- Dry Mouth
- Blurred Vision
- Hypotension
What are the 2 generations of Anti-Histamines?
- 1st Generation: Dyphenhydramine (Benadryl)
- 2nd Generation: Ceterizine (Zyrtec)
What is the purpose of Decongestants?
- Reduce swelling of the nasal passages
- Clogged nasal passages
- Enhances drainage of the sinuses
What are Decongestants used for?
Temporary relief of nasal congestion; associated with common cold, hay fever, sinusitis, and ellergic rhinitis.
What is an example of a Decongestant?
- Phenylephrine (Neo-Synephrine)
- Oxymetazoline (Afrin)
What are the side effects of Decongestants?
- Nasal Burning
- Stinging
- Dryness
- Cardiac Arrythmias
What should the nurse assess for prior to giving a decongestant?
- Patient history for Thyroid disease
- Prostate Problems
- Glaucoma
True/False: Children under 12 years of age should not be given a decongestant.
TRUE.
True/False: You must be cautious when giving a decongestant to patients taking MAOI’s.
TRUE.
What is an Antitussive?
A drug that stops coughing
What is an example of an Antitussive?
Codeine (central acting)
What are Antitussives used for?
- Treatment of nonproductive coughs
- Acute broncopulmonary diseases (pneumonia, bronchitis)
- Cystic Fibrosis
- Acetaminophine overdose
What are the side effects of Antitussives?
- Drowsiness
- Dizziness
- Respiratory depression
True/False: Make sure the patient’s call light is in reach if they need to get out of bed while dizzy. They will need assistance.
TRUE.
What are some precautions for Antitussives?
- Use with caution in pregnant patients
- Acute asthmatic attack
- Acute abdominal conditions
- Head Inury
What is the purpose of Expectorants?
Increases respiratory tract fluids which reduces viscosity of secretions (mucus) in the lungs.
What is an example of an Expectorant?
Guaifenesin (Robitussin)
True/False: Expectorants have very minimal effects.
TRUE.
What is the purpose of Mucolytics?
Reduces viscosity of mucus in the bronchial tree (lower lung).
What are Mucolytics used for?
Cystic Fibrosis, Acute Bronchopulmonary Diseases
What are the side effects of Mucolytics?
- Broncospasm in asthamtic patients
- Nausea
- Vomiting
As a Nurse, what should you look for/should do on a mucolytic patient?
- Suction equipment available
- “Rotten Egg” Smell
- Rinse mouth after treatment
True/False: Beta 1 Blockers affect the heart; Beta 2 Blockers affect the lungs.
TRUE.
What is Asthma consists of?
Swelling of airway, mucus present
What is the purpose of Adrenergic Broncodilators?
Causes bronchodilation (relaxation of smooth muscles cells).
What are Adrenergic Broncodilators used for?
Bronchospasm associated with acute/chronic asthma, emphysema.
What are some effects of Andrenergic Broncodilators?
Tachycardia, palpitations, nervousness, anxiety
What medication is used in Broncodilators?
Theophylline (Xanthine Derivative)
What is the action of Broncodilators/Antiasthma Drugs?
Stimulates the CNS to promote bronchodilation.
What are Bronchodilators used for?
- Emphysema
- Chronic Bronchitis
- Asthma
What are the side effects of Asthma?
- Irritability
- Nervousness
- Flushing
True/False: Patients should avoid excessive caffeine use. As a Nurse, do not crush time released or EC pills.
TRUE.
What are Inhaled Corticosteroids?
Decreases inflammation in the airways; blocks reaction to allergens.
What are Inhaled Corticosteroids used for?
Management and prophylactic treatment of Chronic Asthma, Nasal polyps, and rhinitis.
True/False: You must monitor Theophylline Level; Ranges between 10-20 mcg per mL.
TRUE.
What are the reactions when taking Inhaled Corticosteroids?
Throat irritation, hoarseness, URI, fungal infection of mouth and throat.
True/False: Never combine with other corticosteroids, never give if pt has compromised immune system, and always be cautious in pt’s liver and kidney failure, seizures and diabetics.
TRUE.
True/False: The Central Nervous System (CNS) effects respiration.
TRUE.
What is a “Mast Cell Stabilizer” ?
Drug that acts on lung mucosa to prevent histamine release.
What are the side effects of Mast Cell Stabilizers?
- Throat Irritation
- Dryness
- Cough
- Wheeze
- Unpleasant taste
What are Mast Cell Stabilizers used for?
Reduce the number of asthma attacks prophylactically; not used for acute asthma attacks.
True/False: Patients should not use Mast Cell Stabilizer with aspirin or warfarin.
TRUE.
What are Leukotriene Modifiers?
Drugs that decreases formation of leukotrienes.
What are the side effects for Leukotrienes?
Headaches; Flu-like symptoms
What are the side effects for Immodulators?
Anaphylactic reactions
True/False: As a Nurse, you should not give Leukotriene Modifiers to patients with liver diseases/broncospasm in acute asthma attack.
TRUE.
True/False: As a Nurse, you should not give aspirin or warfarin to patients who are using Leukotriene Modifiers.
TRUE.
Which adverse effect is associated with the use of high doses of codeine as an antitussive?
Respiratory Depression
What is the purpose of pseudoephedrine?
To temporarily relieve sinus congestion and pressure.
What is the purpose of guaifenesin?
To relieve chest congestion; remove mucus.
What is the purpose of acetylcysteine?
To relieve chest congestion; remove mucus.
True/False: When caring for clients who might be under assessed and under treated, observe for behavioral signs that would indicate pain.
TRUE.
What is Acute Pain?
Short Duration; trauma, surgery; severe initially, eases as it heals and goes away.
What is Chronic Pain?
Last longer than 6 months.
3 Main Barriers to Proper Pain Management
- Primary healthcare providers do not prescribe proper pain medicine doses
- Nurses do not administer adequate medication for relief of pain
- Patients do not report accurate level of pain.
What are Analgesics?
Pain Medications
What are Salicylates?
Aspirin (acetylsalicylic acid)
Used to reduce fever, pain, inflammatory conditions.
What are Non-Salicylates?
acetaminophen (Tylenol)
What are NSAIDS?
ibuprofen (Advil, Motrin)
What are Antiplatelet Aggregation?
Inhibits the aggregation or “clumping” of platelets.
What are Antiplatelet Aggregation?
Inhibits the aggregation or “clumping” of platelets.
When can you use Salicylates?
- When having mild to moderate pain
- Control of fever
- Inflammatory conditions
- Reduce TIA (stroke) occurence (aspirin only)
- Reduce MI in men with unstable angina (aspirin only)
Adverse effects of Salicylates (Aspirin)
Tinnitus (ringing in ears)
- Drowsiness
- Epistaxis
- Bleeding
- Bruising
- Edema
- Hypotension
- Nausea
- Vomiting
- Diarrhea
- Gastritus
Nursing Implications for Aspirin
- History of nasal polyps, asthma, rhinitis, chronic unticaria
- History of diabetes-monitor glucose
- Interactions w/anti-coagulants
- Monitor CBC, Prothrombin Time, Kidney/Liver function studies for patients on long term therapy
- Stop therapy 1 week prior to surgery
Nursing Implications for Aspirin
- History of nasal polyps, asthma, rhinitis, chronic unticaria
- History of diabetes-monitor glucose
- Interactions w/anti-coagulants
- Monitor CBC, Prothrombin Time, Kidney/Liver function studies for patients on long term therapy
- Stop therapy 1 week prior to surgery
NSAID Related Drugs
ibuprofen (Motrin, Advil) naproxen ( Naprosyn) indomethacin (Indocin) ketorolac (Toradol) celecoxib (Celebrex)
What is Cyclooxygenase (COX)
COX 1 - Enzyme that helps to maintain stomach linen (ibuprofen & naproxen)
COX 2 - Enzyme that triggers pain and inflammatory
Acetaminophen actions/uses
- Analgesic
- Antipyretic
- No anti-inflammatory action
- Does not inhibit platelets aggregation
- Mild to moderate pain
- Fever reduction
- Arthritis pain
- Analgesic choice for bleeding tendencies
- Analgesic choice for past minor surgical procedures.
Acetaminophen actions/uses
- Analgesic
- Antipyretic
- No anti-inflammatory action
- Does not inhibit platelets aggregation
- Mild to moderate pain
- Fever reduction
- Arthritis pain
- Analgesic choice for bleeding tendencies
- Analgesic choice for past minor surgical procedures.
Tylenol Adverse Effects
Rash, liver toxicity
Nursing Implications for Tylenol
- Monitor liver/kidney, CBC
- Can cause psychological dependence
- Antidote: acetylcysteine (Mucomyst)
Discharge Teaching/Patient & Family Education
- Notify Doctor if no relief of symptoms within 5 days of therapy
- Do not drink alcohol with tylenol
Narcotic Analgesics
- Morphine Sulfate
Actions of Morphine
Acts on opiod receptors in the Central Nerve System and induces sedation, analgesia, and euphoria
Uses of Morphine
- Relief of moderate to severe pain
- Pain relief in MI
- Relief of dyspnea
- OB anesthesia
- Severe cough/diarrhea
- Conscious sedation
- Manage opiate dependence
Adverse effects for Narcotic Analgesics (pt.1)
- Sedation
- Confusion
- Euphoria
- Impaired coordination
- Dizziness
- Urinary retention
- Constipation
- Hyperglycemia
- Respiratory depression
Adverse effects for Narcotic Analgesics (pt.2)
- Hypertension
- Tachycardia
- Bradycardia
- Nausea/Vomiting
- Decreased uterine contractibility
- Allergic reactions
- Tolerance
- Physical/Psychological dependence
- Pupil constriction
Narcotic Drugs
- Codeine
- Hydromorphone (Dilaudid)
- Meperidine (Demerol)
- Methadone (Dolophine)
- Oxycodone (Percocet, Percodan)
Narcan
Only reverses narcotics