CASE STUDY

Question 1

indications of morphine?

Answer 1

used for moderate-severe pain and should only be used in opioid tolerant patients

Question 2

indications of atorvastatin?

Answer 2

Adjunctive management of primary hypercholesterolemia and mixed dyslipidemia. Primary prevention of coronary heart disease (myocardial infarction, stroke, angina,
and coronary revascularization)

Question 3

indications of metoprolol?

Answer 3

for HTN, angina, prevention of MI

Question 4

indications of Hydrochlorothiazide?

Answer 4

management of mild to moderate HTN, treatment of edema

Question 5

indications of furosemide?

Answer 5

Edema due to heart failure, hepatic impairment or renal disease; HTN

Question 6

is insulin lispro (humalog) rapid, short or long acting?

Answer 6

rapid acting (10-15 min onset)

Question 7

is insulin glargine (lantus) rapid, short or long acting?

Answer 7

long acting (90 min onset)

Question 8

whats the duration of humalog?

Answer 8

3-5 hours

Question 9

what is the peak of humalog?

Answer 9

60-90 min

Question 10

whats the duration of lantus?

Answer 10

24 hours

Question 11

whats the peak of lantus?

Answer 11

there is no peak

Question 12

indications of warfarin?

Answer 12

anticoagulant. treatment of venous thrombosis and pulmonary embolism

Question 13

indications of ramipril?

Answer 13

used for HTN and reduction of risk of myocardial infarction, stroke, or death from cardiovascular causes

Question 14

indications of digoxin?

Answer 14

antiarrhythmics. Heart failure. Atrial fibrillation and atrial flutter (slows ventricular rate). Paroxysmal atrial tachycardia

Question 15

indications of Hydralazine?

Answer 15

moderate to severe HTN with a diuretic

Question 16

what is troponin?

Answer 16

a cardiac marker. will be elevated if there’s cardiac damage

Question 17

what is BNP and what does it stand for?

Answer 17

Brain natriuretic peptide (BNP) test is a blood test that is secreted by ventricles of heart in response to excessive stretching of cardiac muscle cells. DECREASES SYSTEMIC VASCULAR RESISTANCE AND CENTRAL VENOUS PRESSURE

Question 18

what is a D-Dimer test?

Answer 18

blood test. body’s natural reaction to clot development is fibrinolysis. D-dimer is produced by the action of plasmin on the fibrin polymer clot. If a D-dimer comes back positive, there is a clot

Question 19

what is hemglobin A1C?

Answer 19

A1C is a blood test that checks the amount of sugar (glucose) bound to hemoglobin. It shows an average BG control for the last 2-3 months

Question 20

normal range for hemo. A1C? whats the percentage for people with diabetes?

Answer 20

less than 6.0%. 6.5% and higher for diabetes.

Question 21

what is an ECG?

Answer 21

• Looks at electrical impulses in the heart
• They put 12 leads on you (different areas of your body and gives 12 different views of the heart and how the electrical impulses travel through the heart
• If a part of heart is not getting good blood supply, that electrical signal won’t work properly
-Can see where possible damage can be happening in the heart

Question 22

what is an echo?

Answer 22

Uses sound waves to produce an imagine of the heart (US of Heart)

Question 23

what is a chest xray?

Answer 23

xray of chest to detect possible infection in lungs, air collecting in space etc

Question 24

what do you do if a patient has mild-moderate hypoglycemia? and what is the range that you must be in?

Answer 24

2. 8-3.9mmol blood glucose range. You would give:
3. 16g carbohydrate (4 tablets) 1 tube of glucose gel if can’t swallow
4. repeat BG in 15 min
5. repeat steps 1 &2 until BG is greater than 4.0mmol
6. give meal or snack
7. inform physician
8. document hypoglycemia

Question 25

what do you do if a patient has severe conscious hypoglycemia? what is the range

Answer 25

anything less than 2.8mmol. you would give: 1. 20g carbohydrate (5 tablets) 1 tube of glucose gel if can't swallow 2. repeat BG in 15 min 3. repeat steps 1 &2 until BG is greater than 4.0mmol 4. give meal or snack 5. inform physician VERBALLY* 6. document hypoglycemia

Question 26

what do you do if a patient has severe unconscious hypoglycemia? what is the range

Answer 26

``` less than 2.8mmol. you would give: 1. IV glucose, 25g OR 1mg glucagon s/c or IM OR call 911 if in community 2. wait 10 minutes and then retest. If lower than 4, you can re give 25g IV or 1mg glucagon 3. inform physician VERBALLY* 4. document hypoglycemia ```

Question 27

what pre and post assessments would you want to do with ramipril?

Answer 27

BP pre and post and check potassium levels

Question 28

pre and post assessments for morphine?

Answer 28

RR before and after**

Question 29

pre and post assessments for atorvastatin?

Answer 29

evaluate serum cholesterol and triglyceride levels before and liver function and 3 months post admin

Question 30

pre and post assessments for metoprolol?

Answer 30

Take apical pulse before administering and BP

Question 31

pre and post assessments for hydrochlorothiazide?

Answer 31

monitor BP, intake and output, daily weight and assess feet, legs and sacral areas for edema

Question 32

pre and post assessments for furosemide?

Answer 32

assess fluid status, monitor BP and pulse before and during administration.

Question 33

pre and post assessments for insulin lispro (humalog)

Answer 33

Assess for symptoms of hypoglycemia (anxiety; restlessness; tingling in hands, feet, lips, or tongue; chills; cold sweats; confusion; cool, pale skin) etc

Question 34

pre and post assessment for glargine (lantus)

Answer 34

Assess for symptoms of hypoglycemia (anxiety; restlessness; tingling in hands, feet, lips, or tongue; chills; cold sweats; confusion; cool, pale skin) etc.

Question 35

pre and post for warfarin

Answer 35

Assess for signs of bleeding and hemorrhage, drop in hematocrit, BP, PT, INR,

Question 36

pre and post for digoxin

Answer 36

monitor apical pulse for 1 min before, BP, ECG throughout treatment

Question 37

pre and post for hydralazine

Answer 37

BP and pulse