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NURS 104 Final Exam > Exam 3 Yellow Packet > Flashcards

Exam 3 Yellow Packet Flashcards

1
Q

MAOIsWhat are the two main cerebral centers that cause vomiting?

A

Vomiting center in medulla
CTZ

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2
Q

What are some nonpharmacological remedies to nausea and vomiting? (6)

A

Weak tea
Dry toast
Crackers
Gatorade
Pedialyte
IV fluids if severely dehydrated

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3
Q

What are some OTC drugs prescribed for nausea/vomiting? (4)

A

Diphenhydramine
Dramamine (motion sickness)
Meclizine - antihistamine
Pepto-bismol

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4
Q

What are some side effects that Antihistamines and Anticholinergics have in common?

A

Drowsiness
Dry mouth - can’t spit
Tachycardia
Blurred vision - can’t see
Constipation - can’t shit

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5
Q

You should avoid taking antihistamines and anticholinergics if you have what medical diagnosis?

A

Glaucoma

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6
Q

Very high doses of dopamine antagonists can treat what?

A

Psychiatric illness
Psychotic break
Schizophrenia

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7
Q

Dow do dopamine antagonists work?

A

Block dopamine 2 receptors in the CTZ

Promethazine
Prochlorperazine
Thorazine

IV or IM

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8
Q

What antiemetic is used for severe nausea from surgery, anesthesia, chemo, and radiation?

A

Phenothiazines

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9
Q

What are some common side effects/adverse reactions of dopamine antagonists? (7)

A

Hypotension
Sedation
EPS
CNS effects
Dry mouth
Constipation
Urinary retention

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10
Q

What is the most used Serotonin receptor antagonist used for nausea/vomiting?

A

Ondansetron (Zofran) - does not cause EPS

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11
Q

Benzodiazepines are a sedative hypnotic, but can indirectly be used as a what?

A

Antiemetic - not first choice

Indirectly control N/V with chemo - lorazepam, diazepam

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12
Q

What use do glucocorticoids and cannabinoids have in common?

A

N/V associated with cancer treatment

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13
Q

What are some side effects of cannabinoids?

DO NOT GIVE WITH PSYCHIATRIC DISORDERS

A

Mood changes
Euphoria
Drowsiness
Headache
Dry mouth
Confusion
Nightmares
Orthostatic hypotension

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14
Q

What is the antidote for acetaminophen overdose?

A

Mucomyst

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15
Q

When should you not take antidiarrheals?

A

You’ve already taken them for two days.
Fever is present

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16
Q

What do we use Somostatin Analog Sandostatin to treat?

A

Severe diarrhea r/t metastatic cancer

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17
Q

What is the use of adsorbents?

A

To coat the wall of the GI tract.

Kaopectate, Pepto-Bismol, Questran

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18
Q

What are some nonpharmaceutical solutions to constipation?

A

High fiber diet
Increased water intake
Exercise

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19
Q

When should you NOT use laxatives/cathartics? (4)

A

Intestinal obstruction
Appendicitis
Ulcerative colitis
Diverticulitis

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20
Q

What are the four types of laxatives?

A

Osmotics (saline) - Do not use if poor renal function or CHF
Stimulants (contact or irritant)
Bulk forming
Emollients (stool softeners)

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21
Q

Where in the GI tract can you get peptic ulcers?

A

Esophagus
Stomach (gastric)
Duodenum
Upper GI

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22
Q

What is the GMB?

A

Gastric Mucosal Barrier that helps to protect the lining against corrosive substances.

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23
Q

What are some nonpharmacological treatments for peptic ulcers/GERD? (7)

A

No smoking
Avoid alcohol
Weight loss
Avoid hot, spicy, greasy foods
NSAIDs/Glucocorticoids should be taken with food or decrease the dose
Avoid eating before hs
Loose fitting clothes

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24
Q

Name the seven antiulcer drugs.

A

Tranquilizers - decrease vagal activity
Anticholinergics - decrease acetylcholine
Antacids - neutralizes gastric acid
H2 Blockers - block h2 receptors
PPI’s - inhibits gastric acid secretion
Sucralfate - mucosal protectant
Prostaglandin E1 analogue misoprostol - inhibits gastric acid secretion and protects the mucosa

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25
Q

What are the pros and cons of antacids?

A

Pro: promote ulcer healing
Cons: decreases absorptions of all other medications/nutrients

Should take 1-3 hours after meals

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26
Q

What are you assessing with antacids? (3)

A

Calcium
Phosphate
Renal function

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27
Q

What ending to all protein pump inhibitors have?

A

~prazole

omeprazole
pantaprazole

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28
Q

What enzymes do you monitor for PPIs?

A

Liver

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29
Q

Which antiulcer drug decreases absorption of tetracyclines, dilantin, fat-soluble vitamins?

A

Sucralfate (Carafate) - Mucosal Protectant

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30
Q

Which antiulcer drug prevents NSAID induced gastric ulcers?

A

Prostaglandin Analogue (misoprostol)

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31
Q

Should oral hypoglycemic meds be taken by all diabetics?

A

No, they are for type 2 diabetics only

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32
Q

What are the two types of oral hypoglycemic medications?

A

Sulfonylureas
Nonsulfonylureas

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33
Q

What are common side effects of Glipizide (sulfonylurea)?

A

Insulin reaction (nervousness, tremors, confusion)
GI effects

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34
Q

What are common adverse effects of sulfonylureas (glipizide)?

A

Blood dyscrasias (anemia, leukopenia, thrombocytopenia)

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35
Q

What lab test will you order when taking oral hypoglycemic medication?

A

CBC - frequently

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36
Q

What type of medication is glucophage (metformin)?

A

Nonsulfonylurea

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37
Q

Which medication must be stopped prior to and two days after any radiological test using contrast?

A

Metformin (glucophage)

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38
Q

What is the criteria for use of oral hypoglycemic medication? (6)

A

Onset of diabetes mellites after adolescence
Diagnosed with diabetes for <5 years
Normal or overweight
Fasting glucose <=200mg/dl
<40 U insulin required per day
Normal renal and hepatic function

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39
Q

What are the four types of insulin?

A

Rapid (~log)
Short-Acting - Regular
Intermediate Acting - NPH or Lente
Long Acting - Glargine

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40
Q

When should rapid insulin be given?

A

Should be given within 5 minutes before eating, with the tray in front of them. Peak 30 minutes.

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41
Q

What is the only insulin given IV?

A

Regular/Short-Acting

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42
Q

What are the onset/peak times for short-acting insulin?

A

Onset - 30 minutes
Peak - 1-2 hours

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43
Q

What are the onset/peak times for intermediate acting insulin?

A

Onset - 2-4 hours
Peak - 4-6 hours

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44
Q

What are the onset/peak times for long acting insulin?

A

Onset - 4-6 hours
Peak - 6-8 hours

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45
Q

What are some common signs and symptoms of diabetes? (10)

A

Always tired
Always thirsty
Frequent urination
Always hungry
Unexplained weight loss
Blurred vision
Numbness/tingling
Wounds that won’t heal
Infections
Sexual dysfunction

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46
Q

Polyuria, polydipsia (thirst), polyphagia (hunger) are signs of?

A

Hyperglycemia

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47
Q

Glucagon is an IM injection used to treat?

A

Hypoglycemia

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48
Q

What nursing interventions are there for diabetes mellitis?

A

Monitor A1C 3-4 times a year
Monitor blood glucose
Periodic lipid profiles

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49
Q

What are the three pituitary hormones?

A

ADH - Antidiuretic Hormone
ACTH - Corticotropin
GH - Growth Hormone

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50
Q

What is caused when there is an excess of ADH (antidiuretic hormone)?

Demeclocycline

A

SIADH
Hypervolemia (excess fluid)

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51
Q

What is caused when there is a deficient amount of ADH (antidiuretic hormone)?

Desmopressin

A

Hypovolemia - Blood pressure bottoms out (check peripheral pulses and cap refill)
Diabetes insipidus

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52
Q

ACTH - corticotropin mimics steroids, so what is important to know?

A

Taper dose
Monitor electrolytes
Assess for weight gain, edema, hair growth

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53
Q

When would you NOT give medication for GH - growth hormone (~tropin)?

A

Already overweight
Already diabetic/hyperglycemic

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54
Q

Why do patients with hypothyroidism go to see the doctor?

A

Lethargy
Tough, dry skin
Memory problems
Myxedema
Weight gain

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55
Q

What are Levothyroxine (Synthroid, levothyroid) used to treat?

A

Hypothyroidism

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56
Q

What is another name for Hyperthyroidism?

A

Grave’s Disease

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57
Q

What are signs and symptoms of grave’s disease (hyperthyroidism)? (6)

A

Weight loss
Bulging eyes
Rapid pulse
Irritable
Nervous
Heat intolerance

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58
Q

Which thyroid disease can be fatal?

A

Hyperthyroidism

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59
Q

What is the main purpose of the parathyroid?

A

Maintains calcium levels

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60
Q

Which parathyroid disease can cause renal failure?

A

Hyperparathyroid = hypercalcemia

~dronate, calcitonin, biphosphonates

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61
Q

Which parathyroid disease can cause lock jaw?

A

Hypoparathyroid = hypocalcemia

Calcium, Calcitrol, Vitamin D

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62
Q

Cushings is an adrenal disorder, what would you expect to see?

A

High cortisol, high Na, low K
Too much steroids
Moon face
Hair growth
Hump back
Excess fluid volume
Hyperglycemia

63
Q

Addison’s is an adrenal disorder, what would you expect to see?

Mineralcorticoids (florinef) maintain electrolytes
Hydrocortisone to restore

A

Low cortisol, low NA, high K
Decreased fluid volume
Hypoglycemia
Withdrawal of steroids

64
Q

Herbal remedies can be marketed, but they cannot….?

A

Claim to cure.

65
Q

What are some uses for aloe vera? (5)

A

Burns
Insect bites
Sunburn
Laxative - if ingested
Increased menstral flow - if ingested

66
Q

What are two uses for Black Cohosh? (2)

A

Menopause symptoms (hot flashes, irritability)
Heart palpitations

67
Q

What herbal remedy should you avoid if allergic to daisy and ragweed?

A

Chamomile - causes bronchoconstriction

68
Q

What are two uses of chamomile?

A

GI relief (IBS and colic)
Sedative (sleepy time tea)

69
Q

What are two uses of Dong quai?

A

Treatment of menstrual cramps
Regulates menstrual cycle

70
Q

What are the two rare adverse reactions to dong quai?

A

Fever
Excessive menstrual bleeding

71
Q

You should NOT use echinacea if you have these three diagnosed diseases?

A

HIV
AIDS
TB

72
Q

What are the three uses for Echinacea?

A

Immune enhancer
Leaf - respiratory and UTI
Root - flu-like symptoms

73
Q

What are the six uses of Evening Primrose?

A

Cirrhosis
Eczema
PMS
Hypertension
Hardening of the arteries - may lower cholesterol
Heart Disease

74
Q

You should not use this herbal remedy if pregnant or lactating?

Also, use cautiously with anticonvulsants?

A

Evening Primrose

75
Q

What are the two uses of feverfew?

A

Migraines - seratonin antagonist
N/V from headache/migraines

76
Q

What are the five uses of the “herb of endurance” Garlic?

A

Lower cholesterol
Decrease BP
Antibiotic to treat wounds
Earache - warmed
Lower triglyceride levels

77
Q

What two herbs act as an immune system booster?

A

Echinacea and Ginger

78
Q

What are the five uses of Ginger?

A

Immune booster
GI disorders
Motion sickness
Nausea
Relief of pain from OA and RA

79
Q

What are the four uses of gingko?

A

Dementia syndromes - improves cognition
Intermittent Claudication
Vertigo
Tinnitus

80
Q

What are the three uses of ginseng?

A

Short term relief of stress
Energy boost
Digestive support

81
Q

What are the two uses of Goldenseal?

A

Ward off infection/promote wound healing
Congestion

82
Q

What herb can be used in combo with Goldenseal?

A

Echinacea

83
Q

What are the two uses for Kava Kava?

A

Promotes sleep
Muscle relaxation

84
Q

What are the four uses of Licorice?

A

Chronic fatigue syndrome
Ulcers
Heartburn
Indigestion

85
Q

What is the main use of Milk Thistle?

A

Prevent damage of liver cells and regenerate liver cells

86
Q

What are the uses of peppermint internally? (3)

A

Stimulates appetite
Aids in digestion
Treats bowel disorders

87
Q

What are the uses of peppermint in tea? (4)

A

Stimulates circulation
Reduces fever
Clears congestion
Restores energy

88
Q

What is the main use of peppermint oil?

A

Tension Headache

89
Q

What are the three uses of the “herbal prozac” St. John’s Wort?

A

Mild depression
Anxiety
Insomnia

90
Q

Which herb has the potential side effect of seratonin syndrome (massive diarrhea)?

A

St. John’s Wort

91
Q

What are the 7 uses of the “plant catheter” Saw Palmetto?

A

BPH
Urinary conditions
Expectorant
Colds
Asthma
Bronchitis
Thyroid deficiency

92
Q

What are the two uses of the “herbal valium” Valerian?

A

Mild sedative
Sleep inducing agent

93
Q

The following herbs interfere with what medications?

Bilberry, cats claw, chamomile, dong quai, feverfew, garlic, ginseng, ginger, gingko, licorice

A

Anticoagulants

94
Q

What does the label of herbal supplements require?

A

Scientific name
Manufacturer’s name & address
Batch and lot number
Date of manufacture & expiration

95
Q

Describe the adverse effect of antipsychotic meds called neuroleptic malignant syndrome?

A

Malignant hyperthermia - a fever that will not go away. Can be fatal.

Can also be caused by ‘miracle cures’

Stop meds

96
Q

What are the three types of antipsychotic agents?

A

Phenothiazines
Non-phenothiazines
Atypical (seratonin-dopamine antagonists)

97
Q

What are signs of positive psychosis?

A

Lose contact with reality
Delusions
Hallucinations
Aggressive or violent behaviors
Schizophrenia

98
Q

What are signs of negative psychosis?

A

Withdrawal
Depression
Catatonic
Poor self-care

99
Q

What hormone do antipsychotics interfere with?

A

Dopamine

100
Q

What is the maid side effect of antipsychotic drugs?

A

EPS - Extrapyramidal symptoms

“Parkinsonsism”

101
Q

What is EPS (Extrapyramidal symptoms)

A

Parkinsonism
Shuffling gait
mask-like facial expression
Tremors
Rigidity in extremity movement

102
Q

What is the adverse effect of antipsychotic drugs that include restless, pacing, rocking back and forth called?

A

Akasthisia

Treat with Beta Blockers or benzos

103
Q

What is the adverse effect of antipsychotic drugs that include gum smacking, tongue rolling, chewing motion, involuntary movements called?

A

Tardive Dyskinesia

104
Q

How long can it take for Tardive Dyskinesia to show up?

A

Up to a year or later after treatment initiation.

Will have to stop meds

105
Q

What is the adverse effect of antipsychotic drugs that include facial grimacing, upward eye movement, muscle spasms of next, back, trunk, face and tongue?

A

Acute Dystonia

Treat with Cogentin (Antiparkinsons/anticholinergic)

106
Q

What type of antipsychotic medication is Thorazine?

A

Phenothiazine

107
Q

What type of antipsychotic medication is Haldol?

A

Non-phenothiazine

Very large dose needed.

108
Q

What are the side effects of phenothiazines and nonphenothiazines?

A

Low blood pressure
EPS
Sedation

109
Q

Which antipsychotic is less likely to cause EPS or Tardive Dyskinesia?

A

Atypical

Clozapine
Risperdone

110
Q

What may someone taking antipsychotics use to help dry mouth?

A

Lozenges

111
Q

What is the small therapeutic range of lithium, which is used for bipolar disorder?

A

0.5-1.5mEq/L

112
Q

How much fluid should you be taking when on lithium?

A

1-2L daily

113
Q

Are isolated seizures permanent?

A

Typically they are not. They are caused by an underlying issue like fever, hypoglycemia, electrolyte imbalance, acid-base imbalance, alcohol/drug withdrawal. Correct the problem and the seizures cease.

114
Q

How long do patients need to take anticonvulsants?

A

Usually lifelong, may possibly stop after 3-5 years seizure free

115
Q

What are the two phases of a Grand Mal seizure?

A

Tonic - back raised
Clonic - clenched

116
Q

Suppressing sodium influx, suppressing calcium influx, and increasing action of GABA are the 3 ways to prevent what?

A

Seizures

117
Q

What are the common anticonvulsant medications? (6)

A

Phenytoin
Barbituates
Benzodiazepines
Valproate
Gabapentin
Levetiracetam

118
Q

Phenytoin is the most commonly used medication for seizures, why is that? (2)

A

Least addictive
Least toxic effects

119
Q

What are some common side effects of phenytoin? (5)

A

Gingival hyperplasia
Neurologic/psychiatric effects
Leukopenia
Hyperglycemia
Teratogenic

120
Q

Phenytoin is highly protein bound, so what other medications will it interact with? (6)

A

Anticoagulants
ASA
Sulfonamides
Tagamet
Antacids
Antineoplastics

121
Q

What barbituate is also used for seizures?

A

Phenobarbital

Grand mal and acute episodes of status epilepticus, meningitis, toxic reactions, eclampsia

Gradual discontinuance

122
Q

Diazepam (valium) is used to treat acute status epilepticus - IV

Clonazepam is used to treat absence (petit mal) seizures.

What drug category do these fall in?

A

Benzodiazepines

123
Q

Valproate treats petit mal, grand mal, and mixed types of seizures. What is the one main adverse effect from it?

A

Hepatotoxicity

Monitor liver enzymes

DO NOT give to children

124
Q

What is the narrow therapeutic range of phenytoin?

A

10-20ug/ml

125
Q

What are some risks for pregnant women that have epilepsy? (7)

A

Seizures increase 25%
Hypoxia
Teratogenic properties of meds
Decreases folate
Inhibits vitamin K
Cardiac defects, cleft lip/palate - phenytoin/carbamazapine
Neural tube defects - valproic

126
Q

What is status epilepticus?

A

Continuous seizure state

127
Q

Diazepam (Valium) or lorazepam (Ativan) followed by Phenytoin should be given IV for status epilepticus. Over what time should you push the IV meds?

A

2 minutes to avoid respiratory depression

128
Q

What are some symptoms of Parkinson’s disease?

A

Involuntary tremors
Rigidity of muscles
Slow movement (bradykinesia)

129
Q

What is happening pathologically for Parkinson’s disease?

A

Increased Gaba
Decreased dopamine

130
Q

What are the five agents for Parkinson’s?

A

Anticholinergics
Dopaminergics
Dopamine agonists
MAO-B inhibitors (~gilline)
COMT inhibitors (~capone)

131
Q

When it comes to seizures, when would you take anticholinergics?

A

Drug induced or pseudo-parkinsons

132
Q

Why must you take Carbidopa and Levadopa together when taking dopaminergics

A

Carbidopa helps the medication get to the brain.

133
Q

What is a common side effect of dopaminergics that you would want to educate your patient about so they do not worry?

A

It can discolor your urine

134
Q

What foods would you administer dopaminergics with?

A

Low protein

135
Q

The CNS Stimulant Methylphenidate has a black box warning, why?

A

Very high abuse potential!

These calm people with ADD/ADHD

136
Q

What are some common side effects of methylphenidate (parkinsons agent)? (7)

A

Weight loss
Unsteadiness
High heart rate
High blood pressure
Decreased growth
Priapism - long erection
Psychiatric episodes

137
Q

Which herbal remedies should you avoid if taking antidepressants?

A

St. John’s Wort
Ginseng

Can lead to seratonin syndrome when taking SSRI’s

138
Q

What do all Tricyclic antidepressants have in their name?

A

~triptyline

139
Q

Which two antidepressants can cause insomnia?

A

SSRI
MAOI

140
Q

Most SSRIs end in ~xetine, what is one exception?

paroxetine paxil
fluoxetine - prozac
duloxetine - cymbalta

A

Sertraline (zoloft)

141
Q

What antidepressant has major food interactions including caffeine, aged cured meats, aged cheese, wine, beer, bread with yeast?

A

MAOIs

142
Q

Which antidepressants cause orthostatic hypotension?

A

Tricyclic
MAOIs

143
Q

Which antidepressent can be used to help with hot flashes?

A

Atypical

144
Q

Which antidepressent should you avoid grapefruit juice?

A

SSRIs

145
Q

Buspirone, bupropion, and venlafaxine are all what type of medication?

A

Atypical antidepressant

146
Q

Marplan, nardil, and parnate are all what type of medication?

A

MAOI Antidepressent

147
Q

Which antidepressent has the most interactions? Including OTC cold medicines, cns stimulants, and vasoconstrictors?

A

MAOIs

148
Q

Which antidepressants should NOT be taken at the same time as MAOIs?

A

Tricyclic
Atypical

149
Q

What side effect do all antidepressants have?

A

Dry mouth

150
Q

Which antidepressant is used for neuropathic pain?

A

Tricyclic

151
Q

Which antidepressant is used for OCD and migraine headache prevention?

A

SSRIs

152
Q

Which antidepressants are also used to treat anxiety?

A

SSRI
Atypical

153
Q

Which antidepressant should you watch for an increase in suicidal thoughts?

A

SSRIs

154
Q

What is the typical timeframe until antidepressants are therapeutic?

A

1-4 weeks

NURS 104 Final Exam (5 decks)

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