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NURS 104 Final Exam > Exam 4 Green Packet > Flashcards

Exam 4 Green Packet Flashcards

1
Q

What are the contraindications for anticoagulants, antiplatelets and thrombolytics? (6)

A

Excessive blood loss
Hemorrhage
Closed head injury
Hemorrhagic stroke
Prior to surgery
Pregnancy/lactation*

*Genetic conditions only

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2
Q

What is the purpose of antiplatelet drugs?

A

To prevent thrombosis by inhibiting platelet aggregations or clumping

May decrease CVA/MI

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3
Q

Clopidogrel (Plavix) is what type of medication?

A

Antiplatelet (~grel)

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4
Q

What is the purpose of anticoagulants?

A

Reduce clotting by interfering with clotting factors. Fibrinogen to fibrin.

Inhibit further clot formation

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5
Q

What are some uses of Heparin? (7)

A

DVT - thrombosis clot
PE - blood clot
MI - heart attach
heart valve devices
Thrombotic stroke
Orthopedic surgeries
Post-op

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6
Q

What are the side effects/adverse reactions to heparin? (3)

A

Itching
Burning
Bleeding

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7
Q

What is the antidote of heparing?

A

Protamine Sulfate IV - not a sulfonamide

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8
Q

When is heparin given SQ?

A

Post-op
Knee/bone manipulation surgeries

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9
Q

When is heparin given IV?

A

Acute MI
Acute stroke (CVA)

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10
Q

What are you monitoring when your patient is on heparin?

A

PTT

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11
Q

What is the therapeutic range for PTT?

A

60-90

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12
Q

What is Enoxaparin (Lovenox)?

A

Low molecular weight heparin

~parin

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13
Q

What is the antidote for LMWH Enoxaparin (Lovenox)?

A

Protamine sulfate

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14
Q

What drug is typically sent home with patients in a pre-filled syringe given once per day?

A

Enoxaparin (Lovenox)

Leave air bubble in!
Based on body weight

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15
Q

What are you monitoring when giving warfarin?

A

PT
INR

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16
Q

What is the therapeutic range of INR for those on coumadin?

A

2.0-3.0

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17
Q

What is the antidote for warfarin?

A

Vitamin K

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18
Q

What are some side effects/adverse reactions of warfarin? (3)

A

Anorexia
N/V/D
Bleeding

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18
Q

How long can it take for warfarin to become therapeutic?

A

3-7 days

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19
Q

What teaching will you provide a patient on coumadin?

A

Keep intake of vitamin K consistent.

Soft toothbrush

Electric razor

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20
Q

How quickly must a thrombolytic be given to be effective on current clots and prevent side effects?

A

3-4 hours

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20
Q

How long does it take to see results of statins?

A

2-3 weeks

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20
Q

What are the three new anticoagulant drugs that have less diet changes?

A

Dabigatran (Pradaxa)
Xa inhibitors - rivaroxaban (Xarelto) - Apixaban (Eliquis)

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20
Q

What is the first test a patient should get if a thrombolytic is to be given?

A

CT

Determine if clots are caused by aneurism

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21
Q

What is the one drug that can dissolve current clots?

A

Thrombolytics (~plase, ~kinase)

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22
Q

What are some adverse reactions of thrombolytics? (3)

A

Anaphylaxis
Hemorrhage
Arrythmias

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22
Q

What are three nonpharmacological ways to lower cholesterol?

A

Diet - <=30% fats, <=300 mg cholesterol
Exercise
No smoking

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22
Q

What is the use of antilipemics?

A

Lower abnormal blood lipid levels (cholesterol)

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23
Q

What are side effects of taking niacin for high cholesterol? (5)

A

GI upset
Flush/cramping
Hyperglycemia
Hyperuricemia
Abnormal liver function

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23
Q

What medication is a powder that must be taken with fluids and mixed with water or juice?

A

Questran - bile acid sequestrants

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23
Q

What major adverse reaction are you looking out for when on statins?

A

Rhabdomyolysis - muscle tenderness or weakness. Attacks the kidneys, hyperhydrate, dialysis.

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23
Q

What are the 3 most important teachings for a patient on statins?

A

Do not abruptly stop! Sever hypercholestemia leading to heart attack.

Monitor liver enzymes

Annual eye exam (cataract formation)

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23
Q

What is the most prescribed antilipidemic?

A

Vastatins or Statins
~statin

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23
Q

What are side effects of statins? (4)

A

GI upset
Headache
Muscle cramps
Tiredness

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24
Q

What is the biggest intervention for patients on peripheral vasodilators?

A

Safety! Low blood pressure, fall risk.

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24
Q

What is the blood force that stretches the LV?

A

Preload

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25
Q

What is the resistance to LV ejection of blood?

A

Afterload

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26
Q

When a patient is put on a cardiac glycoside, how does this affect their conduction, contraction HR, and SV?

A

Lowers conduction
Lowers HR
Increases SV
Increases myocardial contraction

27
Q

What is left sided heart failure?

A

LV fails to contract effectively, blood backs up in to lungs.

28
Q

What is right sided heart failure?

A

RA fails to contract effectively, blood backs up in to the periphery.

29
Q

What are some nonpharmacological ways to prevent heart failure? (5)

A

2gm salt intake a day
Avoid alcohol
Stop smoking
Lose weight
Mild exercise

30
Q

What are the two lab tests for HF, which is more reliable?

A

ANP - 20-77
BNP - <100 most reliable

We MUST know if the HF is cardiac or respiratory!

31
Q

What are signs of digoxin toxicity? (7)

A

Anorexia
N/V
Headache
Blurred vision
Green/yellow halos
Confusion
Flu-like symptoms

32
Q

What is the antidote for Digoxin?

A

Digibond

33
Q

What are side effects of Digoxin? (3)

A

Bradycardia
Heart blocks
Ventricular dysrhythmias

34
Q

What nursing interventions are appropriate for Digoxin? (3)

A

Check apical pulse for 1 min - if HR is less than 60 DO NOT GIVE!
Assess for HF - edema, congestion, daily weights
Monitor K+

35
Q

What is the therapeutic range of Digoxin (Lanoxin)?

A

0.5-2.0 ng/ml

36
Q

What are the three types of angina?

A

Classic (Stable)
Unstable
Variant (Prinzmetals)

36
Q

What are the three main antianginal drugs? NBC

A

Nitrates - emergent
Beta Blockers
Calcium channel blockers

37
Q

What is stable angina?

A

Pain from exertion/stress

38
Q

What is unstable angina?

A

Frequently, progressive

39
Q

What is variant angina?

A

Occurs at rest due to coronary artery spasm

40
Q

What are the side effects of nitroglycerine? (7)

A

N/V
Pounding headache
Dizzines
Weakness
Flush
Low BP
Tachycardia

41
Q

Nitroglycerine can increase hypotensive effects if given with what other medication?

A

Antihypertensives & alcohol

42
Q

What is the most common way nitroglycerin is administered?

A

Sublingual

43
Q

How often can you give SL nitroglycerin?

A

Up to 3 times, 5 minutes apart. If pain continues call 911

44
Q

How long is nitroglycerin good for?

A

6 months

45
Q

What medication comes in a small brown bottle stored away from light?

A

Nitroglycerin

46
Q

Where can the nitroglycerin patches be placed? (3)

A

Chest
Arms
Thighs
Avoid hair

47
Q

When should you remove NTG Transdermal patches?

A

At night to avoid bottoming out BP

48
Q

What are the two shockable ventricular arrhythmias?

A

V-fib (quivering)
V-tach

49
Q

What are the three main antiarrythmics? ABC

A

Amiodarone - emergent
Beta blockers
Calcium channel blockers

50
Q

You will not give antiarrythmics if the heart rate is below…?

A

60

51
Q

Phenytoin (dilantin) can help with what two diagnoses?

A

Dysrrythmias
Seizures

52
Q

What determines the potency of diuretics?

A

The proximity to Bowman’s capsule

53
Q

What are the purposes of diuretics? (5)

A

Lower blood pressure
Decrease edema
Decrease fluids due to liver/renal disease
Lower Na reabsorption

54
Q

What is the most common loop diuretic?

A

Furosemide (lasix)

55
Q

What is the main osmotic diuretic?

A

Mannitol

56
Q

What electrolytes do you lose when taking furosemide?

A

Na
K
Ca
Mg

57
Q

Would a patient with a sulfa allergy be able to take lasix?

A

No, furosemide is a sulfonamide derivative

58
Q

IV push furosemide to avoid what?

A

Ototoxicity

59
Q

What are some nursing interventions for loop diuretics and thiazides?

A

Monitor VS, U/O, weight
Monitor for hypokalemia
Monitor electrolytes
Suggest take in am with food

60
Q

What is the name of the most common thiazide?

A

Hydrochlorothiazide

61
Q

What is the name of potassium sparing diuretics?

A

Spironolactone

62
Q

What is the weakest diuretic?

A

Potassium sparing

63
Q

Potassium sparing is the only diuretic you will watch for…?

A

Hyperkolemia

64
Q

What is important to check before giving osmotic diuretics (mannitol)?

A

Check the solution to make sure there are no crystals!

65
Q

What are the side effects of mannitol?

A

Fluid/electrolyte imbalance
PE
N/V
Tachycardia
Acidosis

66
Q

What are some interventions for antihypertensives?

A

Check BP and HR - hold if below 100/60
Monitor for edema
Do not suddenly stop
Rise slowly
AA use diuretics or combos

67
Q

What are some nonpharmacological approaches to prevent hypertension?

A

Low sodium diet
Exercise
No smoking
No alcohol
Stress reduction

68
Q

What do all beta blockers have in their name?

A

~lol

69
Q

What do all calcium channel blockers have in their name?

A

~dipine

70
Q

What do all ACE inhibitors all have in their name?

A

~pril

71
Q

What do all Alpha adrenergic blockers have in their name?

A

~zosin

72
Q

What do all ARBs have in their name?

A

~sartan

73
Q

What two antihypertensives are also used for angina and arrythmias?

A

Beta blockers
Calcium channel blockers

74
Q

Native and african americans have the most succes with what two antihypertensives?

A

ARBs and ACE inhibitors

75
Q

Which antihypertensive is good to use with patients that have asthma/COPD?

A

ARBs

76
Q

Which antihypertensives can actually cause hypotension?

A

All of them

77
Q

Which antihypertensive should not be mixed with grapefruit juice?

A

Calcium channel blockers

78
Q

Which hypertensives should you not take when pregnant or with OTC drugs?

A

ACE inhibitors
ARBs

79
Q

Which antihypertensive should not be taken with potassium sparing diuretics?

A

ACE inhibitors

80
Q

Which antihypertensive should you monitor BUN creatinine?

A

Beta Blockers
ACE inhibitors
ARBs

NURS 104 Final Exam (5 decks)

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