exam 1 Flashcards
(142 cards)
1
Q
feverfew reason for taking
A
arthritis, migraines
2
Q
feverfew contraindications
A
blood thinners, pregnancy, breastfeeding
3
Q
feverfew adverse reactions
A
allergy to ragweed
4
Q
feverfew route
A
PO
5
Q
feverfew takes up to ____ to work
A
months
6
Q
feverfew: why should pts not eat fresh leaves?
A
cause mouth sores or ulcers
7
Q
feverfew: the pt is a young married female, what do you tell her about this medication?
A
can cause contractions if pregnant, can cause menstrual cycle
8
Q
feverfew action
A
reduces prostaglandin release which decreases inflammation
9
Q
gingko action
A
protects neurons from oxidation
10
Q
gingko reason for taking
A
improves circulation
11
Q
gingko contraindications
A
bleeding disorders, seizure disorder
12
Q
gingko routes
A
po, tablets, teas
13
Q
gingko adverse reactions
A
headaches, dizziness, heart palpitations, constipation, upset stomach, skin irritation
14
Q
gingko: do not eat ___
A
raw leaves
15
Q
gingko: monitor for ___ and skin irritations
A
seizure and bleeding
16
Q
st johns worth action
A
decreases serotonin receptors which affects the area of the brain associated with depression
17
Q
st johns worth adverse reactions
A
agitation and anxiety, dizziness, dry mouth, photosensitivity, serotonin syndrome
18
Q
st johns worth reason for taking
A
depression, menopausal symptoms
19
Q
st johns worth contraindications
A
warfarin
20
Q
st johns worth routes
A
tablets, liquids
21
Q
st johns worth: when should pt notify their MD?
A
chronic or severe GI symptoms
22
Q
st johns worth: pt has muscle rigidity, dilated pupils, and confusion. what do you suspect is happening?
A
serotonin syndrome
23
Q
echinacea action
A
stimulates macrophages and other cells of the innate immune system, causing them to become activated and release cytokines
24
Q
echinacea adverse reactions
A
GI issues, jitteriness, tachycardia
25
echinacea reason for taking
common cold
26
echinacea contraindications
warfarin
27
echinacea routes
creams, liquids, mouthwash
28
echinacea: what do we tell our pts when they start this medication?
take at onset of cold
29
ginseng action
prostaglandin inhibitor
30
ginseng adverse reactions
nervousness, insomnia
31
ginseng reason for taking
reduces stress, builds immunity, increases memory
32
ginseng contraindications
warfarin
33
ginseng routes
po, topical
34
ginseng: what happens when women use ginseng regularly?
menstrual changes and possible allergic reactions
35
ginseng: what labs should be monitored and why?
serum glucose, can increase
36
ginseng: avoid ___
caffeine
37
ginseng: stop taking after ___ months. why?
3, long terms use can lead to headaches, dizziness, upset stomach, etc
38
ginger action
decreases serotonin receptors and releases antiemesis effects on the nausea center of the brain
39
ginger adverse reactions
belching, gi discomfort
40
ginger reason for taking
nausea, vomiting
41
ginger contraindications
bleeding disorders, warfarin
42
ginger route
po
43
ginger: why is this medication avoided in pts with bleeding disorders? what would i caution those pts about?
could slow blood clotting, could bleed out
44
ginger: pts who are to have ___ must tell their MD they are taking this med.
surgery
45
opioids drug names
morphine, hydromorphone, fentanyl, oxycodone, hydrocodone, codeine, acetaminophen, oxycodone
46
opioids action
binds to MU receptors in the central nervous system that slows down CNS
47
opioids adverse reactions
respiratory depressant, hypotension, bradycardia, pruritis, sedation, addiction, chronic constipation
48
opioids reason for taking
moderate to severe pain, sedation
49
opioids contraindications
decrease LOC, BP, or HR, severe asthma, mixing with other opioids or CNS depressants
50
opioids routes
po, patches, liquid, lollipops, iv, etc
51
opioid pt education: may cause ___. stand or change positions ____. caution when ___ or operating ____. may cause ____. recommend using a ____.
- dizziness, lightheaded
- slowly
- driving, heavy machinery
- constipation
- stool softener daily
52
opioid nursing implications: monitor ___. assess ___ level. check level of ___ before administering. monitor for s/s of ___.
- RR, BP, LOC
- pain
- consciousness
- overdose
53
opioids key notes: avoid ___ or ___. ___ is often used in surgical procedures. respiratory rate less than ___ hold and notify MD.
- alcohol, other CNS depressants
- fentanyl
- 10
54
opioids key notes: s/s of overdose ___ and ___. antidote is ___. ___ has a short half-life, and may need more than one dose. monitor how much ___ is given with Percocet.
- decrease LOC, decreased respirations
- naloxone (Narcan)
- naloxone
- Tylenol
55
non opioid analgesics drug names
acetaminophen (tylenol)
tramadol (ultram)
56
non opioid analgesics action:
acetaminophen (tylenol)
tramadol (ultram)
decreases prostaglandin synthesis=blocks pain impulses
57
non opioid analgesics adverse reactions:
acetaminophen (tylenol)
tramadol (ultram)
hepatotoxicity, gi upset
58
non opioid analgesics reason for taking:
acetaminophen (tylenol)
tramadol (ultram)
mild to moderate pain, tylenol is also a fever reducer
59
non opioid analgesics contraindications:
acetaminophen (tylenol)
tramadol (ultram)
liver disease, tramadol avoided with pts taking SSRI or MAOI's
60
non opioid analgesics routes:
acetaminophen (tylenol)
tramadol (ultram)
po, rectal, iv
61
non opioid analgesics nursing implications: acetaminophen (tylenol)
tramadol (ultram)
assess ___ pain level ___ to administering and ___ minutes after. Monitor the amount of ___ given in a ___ hour period. (no more than ___ grams in ___ hour period)
assess
prior
30
tylenol
24
3
24
62
non opioid analgesics pt education: acetaminophen (tylenol)
tramadol (ultram)
take as ___. caution if you have ___ or ___ problems. take with ___. avoid ___. no more than ___ grams in a ___ hour period.
directed
renal
liver
food
alcohol
3
24
63
non opioid analgesics
acetaminophen (tylenol)
tramadol (ultram): antidote for acetaminophen is ___.
tramadol is considered a (____) opioid in some literature- inhibits the reuptake of ___.
tramadol can cause ___ if taken with an MAOI or SSRI's.
acetylcysteine
weak
serotonin
serotonin toxicity
64
nsaids drug names
salicylate acid (aspirin)
ibuprofen (motrin)
ketorolac (tordal)
cox 2 inhibitor: celecoxib (celebrex)
65
nsaids action:
salicylate acid (aspirin)
ibuprofen (motrin)
ketorolac (tordal)
cox 2 inhibitor: celecoxib (celebrex)
decreases production of prostaglandin release by blocking the COX enzyme
66
nsaids adverse reactions:
salicylate acid (aspirin)
ibuprofen (motrin)
ketorolac (tordal)
cox 2 inhibitor: celecoxib (celebrex)
hepatotoxicity, GI bleeding, stomach ulcers, nephrotoxicity with toradol
67
nsaids reason for taking: salicylate acid (aspirin)
ibuprofen (motrin)
ketorolac (tordal)
cox 2 inhibitor: celecoxib (celebrex)
analgesic, inflammatory, antipyretic, antiplatelet(aspirin)
68
nsaids contraindications: salicylate acid (aspirin)
ibuprofen (motrin)
ketorolac (tordal)
cox 2 inhibitor: celecoxib (celebrex)
peptic ulcer disease, GI bleeding, vit K deficiency
69
nsaids routes: salicylate acid (aspirin)
ibuprofen (motrin)
ketorolac (tordal)
cox 2 inhibitor: celecoxib (celebrex)
po, iv, rectal
70
nsaids pt education
salicylate acid (aspirin)
ibuprofen (motrin)
ketorolac (tordal)
cox 2 inhibitor: celecoxib (celebrex): take with ___ or milk. avoid ___ and other ___. report any black ___ or noticeable bleeding to MD. may cause ___ damage.
food
alcohol
hepatoxic drugs
stools
kidney
71
nsaids nursing implications
salicylate acid (aspirin)
ibuprofen (motrin)
ketorolac (tordal)
cox 2 inhibitor: celecoxib (celebrex):
aspirin can cause ___ in children. monitor for unusual ___. assess ___ level before and ___ minutes after administration. monitor ___ and ___ if taking toradol.
reye syndrome
bleeding
pain
30
ALT/AST and BUN
creat
72
nsaids
salicylate acid (aspirin)
ibuprofen (motrin)
ketorolac (tordal)
cox 2 inhibitor: celecoxib (celebrex): do not give ___ to children. do not crush ___ aspirin. ___ is also used as an antiplatelet. s/s of reye syndrome- ____, ___, ___, and ___.
aspirin
enteric coated
aspirin
bleeding
tachycardia
seizures
coma
73
all cns depressants pt teaching: caution while ___ or operating heavy machinery. avoid ___ and other CNS depressants. do not stop ___. take ___ due to high abuse rate.
driving
alcohol
abruptly
as directed
74
all cns depressants nursing considerations: assess ___ and ___ before and after administering. caution in ___ and sleep ___. caution in pts with ___ or ___ problems. caution with other ___.
vitals
LOC
elderly
apnea
kidney
liver
cns depressants
75
benzodiazepines
(-azepam or -azolam) drug names
- alprazolam (xanax)
- midazolam (versed)
- clonazepam (klonopin)
- diazepam (valium)
76
benzodiazepines endings
-azepam
-azolam
77
benzodiazepines action
thought to enhance GABA
78
benzodiazepines adverse reactions
drowsiness, loss of coordination, dry mouth, constipation
79
benzodiazepines reasons for taking
anxiety, alcohol withdrawl, panic disorder, sedation, seizure activity
80
benzodiazepines contraindications
pregnancy, narrow-angled glaucoma
81
benzodiazepines routes
po, iv
82
benzodiazepines: what do you need to monitor before and after administering? pt is lethargic with shallow respirations, what medication are you anticipating administering? what is the caution with the medication to the last question?
- vitals and LOC
- flumazenil
- seizure disorder
83
benzodiazepines: how do you know the pt is going through withdrawal? what is difference between midazolam (versed) and the other benzodiazepines?
- confusion, tremors, irritable, increase HR and BP
- shorter lasting, faster acting
84
benzodiazepines:reasons for each medication
- alprazolam (xanax)
- midazolam (versed)
- clonazepam (klonopin)
- diazepam (valium)
- alprazolam (xanax) and diazepam (valium) are used for alcohol withdrawal
- midazolam (versed) for sedation
- clonazepam (klonopin) for panic disorder, anxiety
85
non-benzodiazepine drug
zolpidem (ambien)- sleep aid
86
non-benzodiazepine zolpidem (ambien): action
binds to neuroreceptors that slows brain activity
87
non-benzodiazepine zolpidem (ambien): adverse reactions
decreased LOC, confusion, short term memory loss
88
non-benzodiazepine zolpidem (ambien): reason for taking
insomnia
89
non-benzodiazepine zolpidem (ambien): contraindications
- kidney disease
- other cns depressants (opioids, benzodiazepines, alcohol)
90
non- benzodiazepine zolpidem (ambien): routes
po
91
non-benzodiazepine zolpidem (ambien): usual does is ___ and can titrate up to ___. what is different about zolpidem(ambien) CR?
5mg, 10mg
controlled release
92
non-benzodiazepine zolpidem (ambien): what do you need to teach your pt before discharge? what should you assess before and after administering?
- only use 7-10 days, regular bedtime, can cause sleep walking (somnambulant), avoid large meals
- vitals, LOC, risk for injury
93
muscle relaxant drug name
cyclobenzaprine (flexeril)
94
muscle relaxant
cyclobenzaprine (flexeril): action
relaxes skeletal muscles to help alleviate pain d/t muscle tension or spasms
95
muscle relaxant
cyclobenzaprine (flexeril): adverse reactions
weakness, fatigue, drowsiness
96
muscle relaxant
cyclobenzaprine (flexeril): reason for taking
several skeletal muscle conditions like strains, sprains, celebral palsy, ortho surgeries
97
muscle relaxant
cyclobenzaprine (flexeril): contraindications
- hypersensitivity
- cardiovascular disease
- hyperthyroidism
- cautions with other cns depressants
98
muscle relaxant
cyclobenzaprine (flexeril): route
po
99
muscle relaxant
cyclobenzaprine (flexeril): works better along the side of ___. how do you treat an overdose and what do you monitor?
- physical therapy
- find something to counteract the drug, enduce vomiting/pump stomach, monitor: fluids, monitor airway, BP, LOC, fluids, EKG
100
muscle relaxant
cyclobenzaprine (flexeril): increase fluids to avoid ___. what are you assessing/monitoring as the nurse? what are you teaching your pt at discharge?
- crystalloid
- ambulation, LOC, coordination
- take as same time every day, do not stop abruptly, avoid alcohol, increase fluids
101
cns stimulants endings
triptans (-triptan)
102
cns stimulants drug name
sumatriptan (imitrex)
103
cns stimulants sumatriptan (imitrex): action
stimulates 5-HT1 receptors in cerebral arteries causing vasoconstrictions
104
cns stimulants sumatriptan (imitrex): adverse reactions
chest tightness, abdominal discomfort, muscle cramps, dizziness, anxiety, fatigue, headache
105
cns stimulants sumatriptan (imitrex): reason for taking
migraine
106
cns stimulants sumatriptan (imitrex): contraindications
pregnant
107
cns stimulants sumatriptan (imitrex): routes
po, intranasal, sublingual
108
cns stimulants sumatriptan (imitrex): what are you going to assess as the nurse? what are you going to teach your pt before discharge about this medication?
- assess pain location, intensity and duration and affect of drug
- take at first onset of headache, can take another one in 2 hours if headache hasn't subsided
109
all antiepileptics (anticonvulsants) pt teaching: notify MD if you start to have ___. caution with ___ bc it may cause ___. take at ___ time everyday. can decrease the effectiveness of ___. avoid ___.
- suicidal thoughts
- driving, drowsiness
- same
- with
- birth control
- alcohol
110
all antiepileptics (anticonvulsants) nursing considerations: assess/monitor ___. monitor for ___ activity. medication list for other cns ___.
- LOC
- seizure
- depressants
111
anticonvulsants ending
- toin
112
anticonvulsants drug name
phenytoin (dilantin)
113
anticonvulsants phenytoin (dilantin): action
thought to work on GABA to decrease impulses along the neuro pathway
114
anticonvulsants phenytoin (dilantin): adverse reactions
gingival hyperplasia, acne, hirsutism
115
anticonvulsants phenytoin (dilantin): reason for taking
seizure disorder
116
anticonvulsants phenytoin (dilantin): contraindications
teratogenic, possible drug interactions
117
anticonvulsants phenytoin (dilantin): routes
po, iv
118
anticonvulsants phenytoin (dilantin): push iv slowly over ___ to avoid ___. what lab values do we need to monitor?
- 50mg/min, cardiac arrest
- serum drug level, 10-20 mcg/mL
119
anticonvulsant carbamazepine (tegretol): action
thought to work on GABA to decrease impulses along the neuro pathway
120
anticonvulsant carbamazepine (tegretol): adverse reactions
blisters around mouth, aplastic anemia, anaphylactic reaction
121
anticonvulsant carbamazepine (tegretol): reason for taking
seizure disorders
122
anticonvulsant carbamazepine (tegretol): contraindications
multiple drug interactions
123
anticonvulsant carbamazepine (tegretol): routes
po, iv
124
anticonvulsant carbamazepine (tegretol): what labs are you going to monitor? inform pt to notify MD if they have ___. report ___ or sore throat to MD. Can be given for ____.
- WBC, RBC, platelets, serum drug levels 4-12 mcg/mL
- unusual bleeding
- fever
- neuropathic pain
125
anticonvulsants levetiracetam (keppra): action
thought to work on GABA to decrease impulses along the neuro pathway
126
anticonvulsants levetiracetam (keppra): adverse reactions
anemia, agression, anxiety, depression, fatigue, dizziness, suicidal thoughts
127
anticonvulsants levetiracetam (keppra): reason for taking
seizure disorders
128
anticonvulsants levetiracetam (keppra): contraindications
hypersensitivity, renal impairment, pregnancy/breastfeeding, well tolerated
129
anticonvulsants levetiracetam (keppra): routes
po, iv
130
anticonvulsants levetiracetam (keppra): must be ___ to an effective dose. what is the max dose of this medication?
- titrated
- 3000 mg/day
131
anticonvulsants GABA analogue gabapentin (neurontin): action
inhibits over excitement of brain activity by synthesizing GABA
132
anticonvulsants GABA analogue gabapentin (neurontin): adverse reactions
respiratory depression, drowsiness or dizziness, edema
133
anticonvulsants GABA analogue gabapentin (neurontin): reason for taking
seizure disorder
134
anticonvulsants GABA analogue gabapentin (neurontin): contraindications
alcohol, other cns depressants, pregnancy
135
anticonvulsants GABA analogue gabapentin (neurontin): route
po
136
anticonvulsants GABA analogue gabapentin (neurontin): gabapentin is used most often in pts with ___.
neuropathic pain (pain in legs in feet)
137
anticonvulsants valproic acid (depakote): action
inhibits over excitement of brain activity by synthesizing GABA
138
anticonvulsants valproic acid (depakote): adverse reactions
dizziness, hair loss, hepatotoxic, pancreatitis
139
anticonvulsants valproic acid (depakote): reason for taking
seizure disorder
140
anticonvulsants valproic acid (depakote): contraindications
liver disease, pancreatitis
141
anticonvulsants valproic acid (depakote): routes
po, iv
142
anticonvulsants valproic acid (depakote): also used to treat ___. what labs are you going to monitor? increase ___ when taking this medication.
- bipolar disorder
- ALT, AST, complete blood count, platelet count, bleeding, serum drug level= 50-100 mcg/mL
- protein
