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NUR 334: Pharmacology > Exam 1 Review Packet (new) > Flashcards

Exam 1 Review Packet (new) Flashcards

1
Q

what 6 drugs are used for inflammation (NSAIDs)

A

o ibuprofen
o ketorolac
o meloxicam
o naproxen
o indomethacin
o aspirin

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2
Q

what enzyme results in inflammation?

A

cyclooxygenase

o COX 1
o COX 2

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3
Q

what was the highest priority for the nurse to monitor for/anticipate in one taking opioids?

A

respiratory assessment

o resp. rate
o resp. depth
o SpO2
o lung sounds

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4
Q

what causes something to be placed on the list of controlled substances

A

risk for abuse and dependency

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5
Q

ASA?

A

acetylsalicylic Acid

o another word for Aspirin

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6
Q

what are four roles of ASA (aspirin)?

A

o anti-inflammatory
o antipyretic
o analgesia
o anti-platelet/anti-coagulant

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7
Q

what is the primary organ of metabolism?

A

liver

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8
Q

what is the most common complication of using NSAIDs?

A

GI Bleed

i.e S/S:
o indigestion
o low blood count
o bloody stool
o anything w/Gi

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9
Q

what drugs can be used as first line treatment for acute migraines?

A

serotonin 5-HT agonist (drug class)

o sumatriptan (drug)

(other drug class for this disease are ERGOT ALKALOIDS)

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10
Q

a nurse is teaching a patient about their new medication that has a narrow therapeutic index.
what should the nurse teach the patient to expect?

A

o start slowly and increase slowly
o routine lab work

o must take meds as prescribed (exact dose and time)
o notify provider of adverse effects

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11
Q

stimulates or activates

A

agonists

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12
Q

inhibits or blocks

A

antagonist

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13
Q

what is the primary organ of excretion and why is it important

A

kidney

o filters waste products, excess water and other substance from bloodstream to produce urine.

o help maintain body’s fluid balance, regulate electrolyte

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14
Q

routes from fastest onset to slowest onset?

A

IV, IM, SubQ, Transdermal, Oral

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15
Q

what would be signs of hepatotoxicity?

A

o hepatomegaly (enlarged liver)
o elevated AST and ALT

o jaundice, fatigue, N/V, abdominal pain, edema, loss appetite

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16
Q

which patients should not receive a nephrotoxic drug?

A

o patients with pre-existing kidney disease
o elevated BUN & creatinine (means kidney issues)
o elderly patients
o individuals w/concurrent medical conditions (diarrhea, HBP)
o pregnant women

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17
Q

what medication blocks the opioid receptors?

A

naloxone

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18
Q

a patient that is taking ibuprofen must be educated about what signs or symptoms related to its primary adverse effect?

A

o jaundice
o abdominal pain
o N/V
o stomach pain
o black/tarry stools

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19
Q

treats physical signs of opioid OD

A

methadone

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20
Q

what OTC pain medication would be preferred in a patient that is in the hospital for rhabdomyolysis (disease of the muscles)?

A

acetaminophen

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21
Q

allows a nurse to administer medication to a patient provided that the parameters for administration have been met

A

standing orders

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22
Q

what must a nurse monitor for in all patients receiving an IV medication

A

patency of medication

23
Q

name four adverse effects of long term steroid use

A

o hyperglycemia
o decrease in bone mass
o hypertension
o immunocompromise

24
Q

what is the term for the difference between the minimum effective concentration and the toxic concentration

A

therapeutic range

25
Q

what are signs of opioid toxicity?

A

o euphoria
o sedation
o constricted pupils
o SOB
o decrease LOC
o impaired motor coordination and speech

26
Q

a patient tells their nurse that they are on a medication that is teratogenic and just found out they are pregnant. what is the correct nursing action?

A

o notify provider immediately

27
Q

what condition in a patient’s hx might exclude them from taking sumatriptan?

A

o cardiac disease
o uncontrolled hypertension
o and if they are pregnant

28
Q

what does cyclooxygenase do in the body?

A

it is an enzyme that plays a crucial role in our body’s inflammatory response

COX 1 prostaglandins are involved in the regulation o blood flow to organs, protects gastric mucosa and maintain platelet aggregation

COX 2 produces prostaglandins that mediate pain, fever, and inflammation

29
Q

how would nurse assess their patient for any adverse effects relating to a medication that is nephrotoxic?

A

o oliguria (low urine output)
o blood in urine
o lower back pain
o elevated BUN & increased serum creatinine level

30
Q

why can we not administer aspirin to children?

A

reye’s syndrome

31
Q

why can’t enteric coated pills be crushed?

A

designed to be resistant to stomach acid so that it can be dissolved in intestine.
prevents it from being destroyed by stomach acid
(shield stomach from pill)

32
Q

why can’t sustained release and extended release pills not be released

A

designed to be released slowly and consistently over extended period of time.

crushing and breaking pill can disrupt their specific formulation and alter their intended release mechanism

33
Q

when assessing for an overdose of what drug this module would you monitor for tinnitus?

A

aspirin

34
Q

what are five CAMs and their uses?

A

o echinacea = cold/flu
o chamomile = anxiety, insomnia
o gingko biloba = memory/cognition
o ginger = GI upset/nausea
o St. John’s Wort = mental health/depression
o cranberry juice = prevent UTI (not treat)

35
Q

what are some mild side effects that most patients can address on their own?

A

o headache
o N/V
o muscle aches
o drowsiness
o pyrexia (fever)
o upset stomach/GI upset

36
Q

what are some potentially serious side effects that patients should report?

A

o allergic reactions
o severe persistent pain
o unusual bleeding or bruising
o rash
o difficulty breathing/SOB

37
Q

what are some S/S you would assess for in a person who took a drug that causes “CNS effects”?

A

o LOC
o bradypnea
o SOB
o N/V
o autonomic dysfunction
o changes in mental status
o mood and behavior changes
o motor abnormalities
o headache
o sleep disturbance
o dizziness
o usual disturbance

38
Q

what are some adverse effects to assess for in a patient that regularly receives subcutaneous injections?

A

o lipodystrophy (rare condition that causes a disproportionate distribution of fat in the body) - change sites
o injection site reactions
o bruising/hematoma
o infection
o allergic reaction
o pain/discomfort
o systemic side effects

39
Q

NEED TO KNOW THIS
what do we need to consider when giving medications to someone in kidney failure

A

o decrease patient’s dosage - if we dont, can lead to OD because kidney is filtering only half the pill and medication stays in and keeps adding on each pill causing OD

40
Q

what is the risk of combining a medications within a class?
i.e. taking 2 NSAIDs or 2 opioids

A

risk of OD

41
Q

how should a RN encourage a child to take a medication

A

o have mom or dad help to encourage child to take meds

NEVER FORCE

42
Q

assessments a nurse can perform to monitor for the primary adverse effect of fentanyl?

A

o SpO2
o chest rise & fall
o respiratory rate/depth
o LOC
o breathing pattern
o listen to lung sounds

43
Q

what is the difference between an expected outcome and desired effect?

A

(same thing - synonymous terms)
o predicted/anticipated results or intentions one aims to get from a medication

44
Q

what would you teach a patient about a PCA pump?

A

PCA pump is a programmable electronic device that connects to an IV line or other route of medication delivery that allows patients to self administer through a hand help device.

PCA has a lockout feature that determines the minimum time between doses to prevent OD and maximum dose limit over a specific timeframe

45
Q

what is the most common side effect of opioids?

A

constipation

o patient education would be to increase fiber, fluid, and activity (move around more).

46
Q

what IM has the smallest volume limit?

A

deltoid muscles (only 1-2 mL)

47
Q

what would the nurse expect to find in a patient that received an opioid antagonist?

A

o reversal of opioid effects
o aggression
o improved breathing
o symptoms of opioid withdrawal such as sweating, N/V, tremors, anxiety, increased heart rate, increased BP, dizziness, abdominal cramping, headache

48
Q

provide two examples of a BBW and the drug that it goes with from this module?

A

o GI bleed -> ketorolac (NSAIDs)
o hepatoxicity -> acetaminophen (central acting antagonist)

49
Q

what is polypharmacy and who is most at risk?

A

o taking multiple medications simultaneously

o geriatric or patients with chronic genetic diseases

50
Q

how must morphine be given?

A

via IV push (2-5 minutes)

51
Q

types of pain

A

o neuropathic - nerves
o visceral - organs
o simple - i.e. paper cut, punch, kicked

52
Q

what type of pain is easiest to treat?

A

simple pain

53
Q

what type of pain is not treated with analgesics?

A

neuropathic pain is not treated with analgesics

54
Q

what meds are used for neuropathic pain?

A

adjuvant medications (adjuvant therapy)

o gabapentin
o pregabalin (lyrica)

adjuvant have nothing to do with analgesics (organ pain) but do work for neuropathic pain

NUR 334: Pharmacology (13 decks)

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