Exam 3 Flashcards
1
Q
What type of angina occurs during rest?
A
Variant (prinzmetal, vasospastic) angina
2
Q
What is heart failure?
A
Its when the heart muscle weakens and enlarges, it loses its ability to pump blood through the heart and into the systemic circulation.
3
Q
What are commonly used Statin’s?
A
atorvastatin calcium, fluvastatin sodium, lovastatin, pravastatin sodium, rosuvastatin calcium, simvastatin, pitavastatin
4
Q
Loop diuretic drug
A
Furosemide (lasix)
5
Q
What labs need to be monitored with calcium channel blockers?
A
Liver enzymes
6
Q
Define badykinesia
A
slow movement
7
Q
What type of diuretic is spironolactone?
A
potassium sparing diuretic. Does not deplete potassium!!
8
Q
What is the most prevalent type of URI?
A
the common cold
9
Q
Digoxin nursing interventions
A
check apical pulse rate before administering
check for peripheral & pulmonary edema
monitor digoxin levels & potassium
10
Q
What labs do you monitor for heparin?
A
PTT
11
Q
Explain the mechanisms of action of medication used to treat Parkinson’s disease.
DOPAMINE AGONISTS
A
stimulate dopamine receptors
12
Q
Define antifungal drugs
A
agents that are used to treat fungal infections
13
Q
What is Hypercapnia?
A
Increased carbon dioxide in the blood
14
Q
What is COPD?
A
a restrictive pulmonary disease that is caused by airway obstruction with increased airway resistance of air flow to the lung tissue
15
Q
What do Beta blocker drug names end in?
A
“LOL”
little old lady needs a beta blocker!
16
Q
Define central nervous system
A
system that involves the brain and spinal cord that regulates body functions.
17
Q
Metered-dose inhaler: Do you shake the inhaler before administering dose?
A
YES
18
Q
What are statins used to treat?
A
High cholesterol
19
Q
What type of angina occurs frequently with progressive severity unrelated to activity; unpredictable regarding stress/ exertion and intensity?
A
Unstable (preinfarction) angina
20
Q
Define ADHD
A
thought to be caused by a dysregulation of the transmitters serotonin, epinephrine, and dopamine.
21
Q
What lab values are monitored with hyperlipidemia?
A
Homocysteine, hsCRPs, LDL, HDL and triglycerides
22
Q
Define nystagmus
A
constant, involuntary, cyclical movement of the eyeball.
23
Q
Short acting nitrate drug name?
A
Nitroglycerin
24
Q
What are signs and symptoms of hypokolemia?
A
Muscle weakness, leg cramps, cardiac dysrhythmias.
25
Define gingival hyperplasia
overgrowth of the gum tissues or reddened gums that bleed easily.
26
How long does it take to wean off of Beta blockers?
1-2 weeks
27
What can anticholinergic drugs help prevent in LRI?
bronchospasm
28
Which generation of antihistamines are not sedative?
second generation
29
Cardiac Glycoside Drug
Digoxin
30
What are expectorants?
agents that loosen bronchial secretions so they can be eliminated by coughing
31
True/False: Antiparkinsonism drugs can cause dark urine and perspiration to be dark as well.
TRUE!
32
PTT Cation
60-70
33
Define seizure threshold
level at which seizure may be induced
34
Digoxin + quinidine or fecainide or verapamil =
increased digoxin serum level
35
Thiazide side effects include:
dizziness, vertigo, weakness, nausea, vomiting, diarrhea, abdominal pain, hyperglycemia, constipation, rash, photo sensitivity, blurred vision
36
What is sudafed used for?
congestion!!
37
Thiazide adverse reactions include:
severe dehydration, hypotension, gout, severe potassium depletion, aplstic anemia, hemolytic anemia, thrombocytopenia, agranulocytosis, renal failure
38
Define restrictive lung disease
a decrease in total lung capacity as a result of fluid accumulation or loss of elasticity of the lung
39
Define convulsion
involuntary paroxysmal muscular contractions
40
pitavastatin brand name is
Livalo
41
Anti parkinsonism side effects
Anorexia, nausea, vomiting, dysphagia, fatigue, dizziness, headache, dry mouth, bitter taste, twitching, blurred vision, insomnia, dark urine
42
Explain the effects of stimulants on the central nervous system related to the increased release of specific neurotransmitters.
causes euphoria and alertness
43
What are antianginal drugs used for?
To treat angina pectoris
44
Define opportunistic infections
infections that occur in the immunocompromised or debilitated population
45
What labs should be monitored with ARBs?
potassium
46
Montelukast (singular) -- Lower respiratory disorders
| ADVERSE REACTIONS
Angioedema, bleeding, vasculitis, seizures, edema, anaphylaxis, suicidal ideation, stevens-johnson syndrome
47
ARB adverse reactions include:
Orthostatic hypotension, hypoglycemia, hyperkalemia, renal dysfunction
48
What is diazapam used for?
Seizures!
49
Determine nursing care for patients receiving prescribed medication that stimulates the central nervous system.
Monitoring weight, height and growth (for children).
Observe for withdrawal symptoms
Monitor for side effects
50
Loop diuretic adverse reactions?
severe dehydration, marked hypotension, hyperglycemia, gout, hearing loss, renal failure, thrombocytopenia, agranulocytosis
51
Define cluster headaches
Headaches that occur 1 to 3 times a day in a period lasting from about 2 weeks to 3 months.
52
Labs to monitor with ACE inhibitors
Potassium
53
Tiotropium (spiriva) -- Lower respiratory disorders
| ADVERSE REACTIONS
Anaphylaxis, dehydration, hyperglycemia, cardiac dysrhythmias, cardiac arrest, paradoxical bronchocontriction
54
True/ False: Tolerance to nitroglycerin can occur.
TRUE!
55
How long should you hold your breath for after administering a dose from a Metered-dose inhaler? Whats next?
Just a few seconds and exhale slowly through pursed lips.
56
Is benedryl an antihistamine?
YES!
57
Why diuretics are used to treat hypertension?
Because they promote sodium and water loss by blocking sodium and chloride reabsorption.
58
What is bronchospasm?
the result when the lung tissue is exposed to extrinsic or intrinsic factors that stimulate a bronchoconstrictive response.
59
What vital signs should be closely monitored with antianginals?
Blood pressure
60
What is the difference between cardio-selective and non cardio-selective beta blockers?
Cardio selective beta bockers act mainly on beta1 receptors & brochoconstriction is less likely to occur.
61
Adverse reactions of Nitroglycerin
Hypotension, reflex tachycardia, paradoxical bradycardia.
62
Define myathenia gravis
a chronic autoimmune neuromuscular disease that affects approximately 14 in 100000 persons.
63
How long do you wait if you need to administer a second dose from Metered-dose inhaler?
2 minutes
64
Define antitubercular drugs
agents that are used to treat tuberculosis
65
What are the dietary restrictions for a patient who is on Loop diuretics?
Patient needs to avoid licorice because it may increase potassium loss!
66
What labs do we monitor on patients taking thiazides
calcium, glucose, potassium, magnesium, sodium
67
What is the mode of action of nitrates?
Nitrates cause generalized vascular and coronary vasodilation which increases blood flow through the coronary arteries to the myocardial cells.
68
What are calcium channel blockers used for?
Treatment of stable and variant angina pectoris, certain dysrhythmias and hypertension
69
What is amiodarone used for?
Life threatening dysrhythmias
70
Explain the mechanisms of action of medication used to treat Parkinson’s disease
COMT INHIBITORS
inhibits the catechol O-methyltransferase enzyme that inactivates dopamine
71
Loop diuretic mode of action
inhibits sodium and water reabsorption from loop of Henle and distal renal tubules; can also excrete potassium, magnesium and calcium
72
What is alberatrol?
A beta blocker used to treat lower respiratory infections
73
Define muscle relaxants
relieve muscular spasms and pain associated with traumatic injuries and spasticity from chronic debilitating disorders
74
Side effects of Nitroglycerin
Nausea, vomiting, headache, blurred vision, dizziness, syncope, weakness, diaphoresis, flushing, confusion, pallor, rash, dry mouth, palpitations, tolerance
75
Define multiple sclerosis
an autoimmune disorder that attacks the myelin sheath of nerve fibers in the brain and spinal cord, causing lesions that are called plaques.
76
ACE inhibitors MAIN mode of action
Dilate venules and arterioles which improves renal blood flow and decreases blood fluid volume.
77
What are the five categories of diuretics that are effective in removing water and sodium?
Thiazides, Loop, Osmotic, Carbonic anyhydrase inhibitor, and Potassium sparing.
78
fluvastatin sodium brand name is
Lescol
79
Digibind onset is
30 minutes
80
Digoxin side effects
anorexia, nausea, vomiting, diarrhea, abdominal pain, headache, blurred vision, diplopia, photophobia, drowsiness, dizziness, fatigue, confusion
81
What is emphysema
a progressive lung disease caused by cigarette smoking or atmospheric contaminants.
82
What are the four classes of antidysrhythmic drugs?
Class I: Sodium channel blockers
Class II: Beta Blockers
Class III: Drugs that prolong repolarization
Class IV: Calcium channel blockers
83
True/ False: Patients can ingest alcohol while taking nitroglycerin.
FALSE!
84
Phenytoin therapeutic levels
10-20 mcg/mL
85
What are some dietary restrictions for a patient of ACE inhibitors
Avoid high potassium foods
86
Anticonvulsants half life
7-42 hours average is 24 hours
87
What are some dietary restrictions for the patient on ACE inhibitor’s?
Low sodium diet
88
What is the difference between beta blockers and anticholinergics used for lower respiratory infections?
Beta blockers open brochiole tubes while anticholinergics dry up!
89
What class of antidysrhthmic drug is amiodarone?
Class III
90
When giving Digoxin via IV what other equipment is important to have at patient bedside?
Cardiac monitor
91
What can ARB adverse reactions mask?
Hyperkolemia
92
Phenytoin side effects
```
headache
diplopia
confusion
dizziness
sluggish
decreased coordination
ataxia
slurred speech
rash
anorexia
nausea
vomiting
hypotension
pink/red/brown discoloration of urine
```
93
Define fasciculations
involuntary muscle twitching
94
What is angina pectoris?
a condition of acute cardiac pain caused by inadequate blood flow to the myocardium due to either plaque occlusions within or spasms of the coronary arteries.
95
Digoxin + loop diuretics or thiazide diuretics =
increase risk of digoxin toxicity
96
What are side effects of statins?
Headache, rash/pruitus, constipation, diarrhea
97
Define HIV
virus causing an infection characterized by profound immuno-suppression
98
Montelukast (singular) -- Lower respiratory disorders
| SIDE EFFECTS
fever, headache, drowsiness, dizziness, fatigue, restlessness, insomnia, confusion, depression, nasal congestion, cough, core throat, dental pain, influenza, dyspepsia, nausea, vomiting, abdominal pain, weight loss, rash
99
atorvastatin calcium brand name is
Lipitor
100
Explain the mechanisms of action of medication used to treat Parkinson’s disease.
ANTICHOLINERGICS
block cholineergic receptors
101
Tiotropium (spiriva) -- Lower respiratory disorders
| SIDE EFFECTS
insomnia, dizziness, depression, headache, nausea, vomiting, abdominal pain, constipation, urinary retention, hyperglycemia, muscle cramping in extremities, peripheral edema, blurred vision, oral ulceration
102
What lab values should be monitored when on Antiplatelet therapy?
Platelets
103
Nursing process for Anticonvulsants
| Assessment
Health history with current drugs and herbs being used
Check urinary output (needs to be >1500ML)
Determine lab values for BUN and creatinine and liver enzymes
104
Antihistamine mode of action?
compete with histamine receptor sites which prevent a histamine response
105
Side effects of calcium channel blockers?
Headache, hypotension, dizziness, and flushing of the skin
106
Define rhinorrhea
watery nasal discharge
107
What does peripheral refer to?
the extremities
108
Nursing process for Anticonvulsants
| Patient teaching
No driving or performing other hazardous activities
Avoid alcohol
Advise not to abruptly stop but to rather gradually stop under medical supervision
109
Nursing process for Anticonvulsants
| Interventions
monitor serum drug levels to determine therapeutic range (10-20 mcg/mL)
monitor CBC for early detection of blood dyscrasias
use precautions (environmental protection from sharp objects) for all patients at risk for seizures
watch nutritional intake
females need to use backup contraceptives
110
True/False: Metered-dose inhaler.
| Breathe out through nose. Open mouth wide and hold inhaler 1-2 inches from mouth.
FALSE. Breath out through mouth**
111
What are peripheral vasodilators used for?
poor circulation, decrease edema
112
Define anticonvulsants
drugs that stabilize nerve cell membranes and suppress the abnormal electric impulses in the cerebral cortex.
113
Anti parkinsonism dietary restrictions
Administer with low protein foods -- high protein foods can interfere with drug transport to CNS
114
What type of diet should patients taking thiazides be on?
High potassium
115
True/ False: For Amiodarone, the initial dose is usually greater and then it decreases over time.
TRUE!
116
What are some non-pharmacological measure to help the patient with heart failure
```
Limit salt intake to 2 g/day
Decrease alcohol to one drink a day or completely avoid it
No smoking
Obese patients should diet
Mild exercise
```
117
Digibind (digoxin antidote) mode of action is
binding with digoxin to form complex molecules which prohibits digoxin from attaching to cellular side of action
118
Define cholinergic crisis
an acute exacerbation of symptoms
119
If symptoms do not clear up after 3-5 days while on sudafed, what should you do?
call the doctor.
120
What medication is use for dysrhythmia?
Antidysrhythmias--
Beta1 blocker: cardioselective beta-adrenergic antagonis
Acebutotol HCl
121
What is Diltiazem (cardizem) used for?
to increase blood pressure
122
Furosemide (lasix)
| ADVERSE REACTIONS
severe dehydration, marked hypotension, hyperglycemia, gout, hearing loss, renal failure, thrombocytopenia
123
What do anginal attacks usually lead to?
MI (heart attack)
124
Define analeptics
CNS stimulants that mostly affect the brain stem and spinal cord and sometimes the cerebral cortex
125
Define narcolepsy
falling asleep during normal waking activities such as driving a car or talking with someone.
126
Which generation of antihistamines are very sedative?
first generation
127
Adverse reaction of calcium channel blockers?
Reflex tachycardia & peripheral edema
128
How long do you wait to administer a steroid after administering a bronchdilater?
five minutes
129
Define miosis
abnormal pupil constriction
130
True/ False: Patient should take thiazides on an empty stomach.
FALSE!
131
How fast is Digoxin administered through IV?
give dose over 5 minute time span
132
What labs should be monitored for patients on Anticoagulant therapy?
PT, PTT, INR, Platelets
133
Can prednisone be immediately stopped?
No, it needs to be tapered and weaned off.
134
pravastatin sodium brand name is
Pravachol
135
Define seizure
abnormal electric discharges from the cerebral neurons
136
Can mannitol be given to patients who have heart failure or heart disease?
NO
137
If a patients heart rate is greater than 100, can you give alberatrol?
NO!
138
What is hypoxia?
Lack of oxygen to body tissues
139
Define migraine headaches
headaches that cause severe throbbing pain. Often preceded by an aura (visuals, smells, tingling, vertigo, warning)
140
Digoxin cation
0.8-2
141
What are some first generation drugs used to treat URI?
Benedryl
142
True/ False: All diuretics are potassium wasters.
FALSE!
143
What is Protamine Sulfate used for?
Antidote for heparin
144
Digoxin + antacids or colestipol =
decrease in digoxin absorption
145
Anti parkinsonism adverse reactions
involuntary movements, palpitations, orthostatic hypotension, urinary rentention, priapism, psychosis, severe depression with suicidal ideation, hallucinations, agranulocytosis, hemolytic anemia, thrombocytopenia, cardiac dysrhythmias, neuroleptic malignant syndrome
146
True/False: It is okay for patients to immediately discontinue antiparkinsonism drugs.
False; abruptly discontinuing these medications can lease to rebound parkinsonism
147
Signs & Symptoms of Digoxin Toxicity
Anorexia, diarrhea, nausea and vomiting, bradycardia, premature ventricular contractions, cardiac dysrhythmias, headache, malaise, blurred vision, visual illusions, confusion, and delirium.
148
Define dopamine agonists
agent that stimulates dopamine receptors
149
Long acting nitrate drug name?
Isosorbide dinitrate
150
What type of medication is commonly used to treat hyperlipidemia?
Statins
151
True/false: Metered-dose inhaler.
| The medication canister is inserted into plastic mouthpiece
TRUE!
152
What are ACE inhibitors used for?
Heart failure
153
Explain the mechanisms of action of medication used to treat Parkinson’s disease.
MAO-B INHIBITORS
inhibits the monoamine oxidase b enzyme that interferes with dopamine
154
When are ARB’s used?
When a patient doe not respond to or tolerate an ACE inhibitor.
155
selegiline food restrictions
Avoid foods high in tyramine -- aged cheese, yogurt, chocolate, bananas, red wine, cream, raisins
156
Hydantoins mode of action
reduces motor cortex activity by alerting ion transport
157
What type of angina occurs with predictable stress or exertion
Classic (stable) angina
158
What are the three types of Antianginal drugs?
Nitrates
Beta Blockers
Calcium channel blockers
159
True/ False: A patient does not need to check their pulse rate before administering digoxin.
FALSE!
160
What are 3 vitamins that lower homocysteine?
Vit b6, Vit b12, folic acid
161
What do ARB drugs usually end in?
"sartans"
162
What position do you place a patient in if hypotension results from SL nitroglycerin?
Supine position with legs elevated
163
Anticonvulsants drug name
Phenytoin (dilantin)
164
Anticonvulsants excretion
Small amounts in urine, moderate amounts in bile and feces
165
What is a sign of peripheral edema and poor circulation?
a cap refill greater than 3 seconds
166
Digoxin adverse reactions
Bradycardia, visual disturbances
167
What is pseudoparkinsonism?
an adverse reaction that occurs with antipsychotic drugs
168
What are adverse reactions of statins?
Rhabdomyolusis, myalgia, photosensitivity, hyperglycemia, elevated liver, enzymes.
169
Anticonvulsants adverse reactions
```
leukopenia
hepatitis
depression
gingival hyperplasia
nystagmus
hirsutism
osteoporosis
aplastic anemia
thrombocytopenia
agranulocytosis
stevens-johnsons syndrome
hypotension
ventricular fibrillation
encephalopathy
suicidal ideation
```
170
True/ False: It is important to advise the patient to avoid adverse drug interactions with digoxin by not taking OTC drugs without first consulting health care provider
TRUE!
171
What do beta blocker drugs usually end in
"lol"
172
What type of diuretic is hydrochlorothiazide?
Thiazide diuretic
173
What is the antidote for Coumadin?
Vitamin K
174
What are side effects of loop diuretics?
Nausea, diarrhea, electrolyte imbalances, vertigo, abdominal cramping, constipation, rash, headache, weakness, ECG changes, blurred vision, photo sensitivity, muscle cramping
175
Define dystonic movement
involuntary abnormal movement
176
True/False: Continuing to monitor pulse rate while on digoxin is part of the nursing process.
TRUE!
177
Furosemide (lasix)
| SIDE EFFECTS
Nausea, diarrhea, electrolyte imbalances, vertigo, abdominal cramping, constipation, rash, headache, weakness, ECG changes, blurred vision, photosensitivity, muscle cramping
178
Which ACE inhibitors spares potassium?
Spironolactone
179
What are signs and symptoms of heart failure?
fatigue, shortness of breath, edema, decrease in physical activity
180
Define acute rhinitis
acute inflammation of the mucous membranes of the nose
181
What labs do you monitor for coumadin?
INR
182
Difference between digoxin & digitoxin
digoxin half life is 36 hours while digitoxin half life is 4-9 days,
183
What is thrombocytopenia?
low platelet count
184
Define Parkinsonism
a chronic neurologic disorder that affects the extrapyramidal motor tract
185
Digoxin therapeutic use
Treat heart failure, atrial fibrillation
186
Anticonvulsants excretion
Small amounts in urine, moderate amounts in bile and feces
187
What is important to teach patients about regarding transderm nitro patch?
Apply once a day, usually in the morning. Rotate skin sites and avoid hairy areas.
188
Furosemide (lasix) labs to monitor
potassium & urinary intake & output
189
ACE inhibitors other mode of action
Decrease the release of aldosterone which reduces sodium and fluid retention
190
What vital sign should be checked after administering peripheral vasodilators?
Assess pain level!!
191
lovastatin brand name is
Mevacor
192
What do ace inhibitor drugs usually end in?
"prils"
193
What does a vasodilator do?
opens up the veins!
194
rosuvastatin calcium brand name is
Crestor
195
What is a cardiac dysrhythmia?
any deviation from the normal rate or pattern of the heartbeat.
196
Digoxin mode of action
Inhibits sodium-potassium ATPase, promoting increased force of cardiac contraction, cardiac output, and tissue perfusion; decreases ventricular rate.
197
What are some second generation antihistamine drugs?
clariton, allegra, zyrtec
198
What type of diet does a patient need to be on while taking digoxin?
high potassium diet (fresh and dried fruits, fruit juices, and vegetables, including potatoes)
199
What are the three types of seizures?
Grand mal, petit mal, psychomotor
200
What is amicor used for?
Help stop bleeding
201
True/False: African Americans have more than twice the rate of heart failure as whites.
TRUE!
202
Labs to monitor with Digoxin?
Potassium, magnesium, calcium, digoxin toxicity
203
Define EEG (electroencephalogram)
a machine that records abnormal electric discharges of the cerebral cortex
204
Define anorexiants
appetite suppressants
205
True/false: Do a test spray before administering the metered dose of a new inhaler or when the inhaler has not been used recently.
TRUE!
206
Name the three types of angina
Classic (stable)
Unstable (preinfarction)
Variant (prinzmetal, vasospastic)
207
Define anoxia
absence of oxygen
208
What is dyskinesia
Impaired voluntary movement
209
What can albertrol help prevent?
Acute asthma
210
What is status epilepticus seizures?
rapid succession of epileptic seizures
211
What is Alzheimer's disease
a chronic, progressive, neuro degenerative condition with marked cognitive dysfunction.
212
simvastatin brand name is
Zocor
213
INR Cation
2-3
214
How do we know if antidysrhythmics have been effective?
Comparing heart rate to baseline heart rate and assessing patient's response to drug
215
Define amphetamines
Stimulate the release of neurotransmitters (norepinephrine and dopamine) from the brain and symphathetic nervous system
216
Which type of antianginal drugs are non effective against variant (prinzmetal, vasospastic) anginas?
Beta Blockers
217
What are some nursing interventions for patients on thiazides?
Observe for hypokolemia
Monitor patients weight daily
Watch urine output to determine fluid loss or retention.
218
Define idiopathic
of unknown cause
219
Define AIDS
immune disorder characterized by opportunistic diseases.
220
Are anticholinergic drugs used for acute asthma?
NO!
221
Define tolerance
a condition in which larger and larger doses of a drug are needed to reproduce the initial response.
222
Antidote for digoxin
Ovine, digibind
223
Explain the mechanisms of action of medication used to treat Parkinson’s disease.
DOPAMINE REPLACEMENTS
stimulate dopamine receptors
224
Why does an African American need to be given a diuretic with ACE inhibitors?
to prevent coughing and angidema (swelling of the face)
225
Digibind duration of action is
3-4 days
226
Common side effects of ACE inhibitors
constant, irritated cough, nausea, vomiting, diarrhea, headache, dizziness, fatigue, insomnia, hyperkalemia and tachycardia.
227
What are the therapeutic uses for calcium channel blockers?
```
Relax peripheral arterioles
Decrease cardiac oxygen demand
Decrease cardiac contractility
Decrease afterload
Decrease peripheral resistance
Reduce the work load for the heart
```
228
When do we use osmotic diuretics?
to prevent kidney failure
to decrease intracranial pressure (ICP)
to decrease intraocular pressure (glaucoma)
