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Final 1 Flashcards

1
Q

6 rights of medications

A

(1) right patient
(2) right drug
(3) right dose
(4)right route
(5) right time
(6) right documentation.

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2
Q

Metric system includes:

A

Gram
Liter
Meter
Celsius

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3
Q

1 teaspoon = ______ mL

A

5 mL

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4
Q

3 teaspoons = ?

A

1 Tablespoon

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5
Q

1 oz =?

A

30 mL

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6
Q

1 L = ? mL

A

1000 mL

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7
Q

1000 mL = ? mcg

A

1000,000 mcg

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8
Q

What are signs of fluid volume deficit (FVD)?

A

Signs include:
* Dehydration or shock
* GI fluid loss
* Concentrated urine
* Dry, brittle skin
* Changes in vital signs
* Changes in level of consciousness

Causes of FVD can include vomiting, diarrhea, laxatives, sweating, burns, and excessive diuresis.

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9
Q

What interventions should be taken for fluid volume deficit?

A

Interventions include:
* Treat with oral or IV fluids
* Monitor I&O
* Daily weights
* Report changes in urine patterns
* Report weight gain of over 2 lbs/day
* Monitor vital signs

Early recognition and treatment are essential to prevent serious complications.

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10
Q

What are the causes of fluid volume excess (FVE)?

A

Causes include:
* Excessive fluid intake
* Heart failure
* Renal failure
* Liver disease
* Excess sodium intake

FVE can lead to symptoms like edema and JVD.

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11
Q

What is the treatment for fluid volume excess?

A

Treatment includes:
* Diuretics
* Sodium restriction
* Monitoring lab values

Important lab values to monitor include Hgb, Hct, BUN, creatinine, and electrolytes.

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12
Q

What are the three types of IV solutions?

A

Types include:
* Crystalloids
* Colloids
* Hypertonic solutions

Crystalloids are further divided into isotonic, hypotonic, and hypertonic solutions.

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13
Q

What are isotonic crystalloids and examples?

A

Isotonic crystalloids include:
* Normal Saline (NS)
* Lactated Ringer’s (LR)
* D5W

They are used to expand IV volume and are compatible with most medications.

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14
Q

What does hypoosmolar mean?

A

Hypoosmolar solutions have more water than solutes

They cause water to move from ECF to ICF, expanding cells.

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15
Q

What is the normal range for potassium levels?

A

3.5-5 mEq/L

Potassium is critical for cardiac and muscle function.

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16
Q

What are signs of hypokalemia?

A

Signs include:
* Flat/inverted T waves
* Weakness
* Fatigue
* Cardiac arrhythmias

Hypokalemia can increase the risk of digoxin toxicity.

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17
Q

What is the management for mild hyperkalemia?

A

Management includes:
* K restriction
* Monitoring urine output
* Monitoring labs

It is important to check ECG for changes associated with hyperkalemia.

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18
Q

What are the symptoms of hypercalcemia?

A

Symptoms include:
* Nausea
* Vomiting
* Confusion
* Weakness
* Dehydration

Hypercalcemia can be caused by prolonged immobilization or excess vitamin D intake.

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19
Q

What is the normal range for calcium levels?

A

8.6-10.2 mg/dL

Calcium is essential for bone health and muscle function.

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20
Q

What are the signs of hypocalcemia?

A

Signs include:
* Trousseau’s sign
* Chvostek’s sign
* Muscle spasms

Hypocalcemia can result from vitamin D deficiency or hypoparathyroidism.

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21
Q

Fill in the blank: A gain of 1 kg (2.2 lbs) is equivalent to _______ of fluid.

A

1 liter

This relationship is crucial for assessing fluid balance.

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22
Q

What is the role of vitamin D in calcium absorption?

A

Vitamin D helps absorb calcium

Adequate vitamin D levels are necessary to maintain healthy calcium levels.

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23
Q

What are the main classes of diuretics?

A

Thiazides/like, Loop Diuretics, Osmotic Diuretics, Carbonic Anhydrase Inhibitors, Potassium-Sparing Diuretics

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24
Q

What is the prototype drug for thiazide diuretics?

A

Hydrochlorothiazide (HCTZ)

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25
List three uses of Hydrochlorothiazide (HCTZ).
* Hypertension * Heart failure * Peripheral edema
26
What are common side effects of Hydrochlorothiazide (HCTZ)?
* Dizziness * Headache * Weakness * Hypotension * GI distress / constipation * Hyperglycemia * Electrolyte imbalances
27
What contraindication is associated with Hydrochlorothiazide (HCTZ)?
Renal Failure
28
What condition may be exacerbated by the use of Hydrochlorothiazide (HCTZ) in patients with a sulfa allergy?
Caution due to potential allergic reaction
29
What vital signs and labs should be assessed when administering Hydrochlorothiazide (HCTZ)?
* Vital Signs * Daily weight * Urine output * Calcium * Glucose * Uric Acid * Potassium * Magnesium
30
What is the action of thiazide diuretics?
Act on distal convoluted renal tubule to promote sodium, chloride, potassium, magnesium, and water excretion
31
True or False: Thiazide diuretics promote calcium reabsorption.
True
32
What is the onset and duration of action for thiazide diuretics?
Onset ~2hrs, lasts ~6-24hrs
33
What is the prototype drug for loop diuretics?
Furosemide
34
List two uses of Furosemide.
* Edema related to heart failure * Hypertension
35
What side effects are associated with Furosemide?
* Dizziness * Headache * Weakness * Dry mouth * Hyperglycemia * Electrolyte imbalances
36
What baseline assessments should be performed before administering Furosemide?
* Drug history * Allergy to sulfa * Vital signs * Baseline weight * Urine output
37
What nursing intervention should be taken to prevent hypotension in patients taking Furosemide?
Change positions from lying to standing slowly
38
Fill in the blank: Furosemide is contraindicated in patients with _______.
anuria
39
What should be monitored to assess fluid volume status?
* Weight (baseline & daily) * Input and Output (I&O) * Edema
40
What is the common side effect of rapid or high-dose IV administration of Furosemide?
Hearing loss
41
What is the main action of potassium-sparing diuretics?
They help retain potassium while promoting sodium and water excretion
42
What are the signs and symptoms that may warrant a diuretic?
* Orthopnea * Cough * Crackles * Pulmonary edema * Peripheral edema * Tachypnea * Dyspnea * Decreased O2 * Weight gain * Increased urine output with normal kidneys
43
What should be done to minimize gastric irritation when taking diuretics?
Take with food or milk
44
What are the effects of NSAIDs when taken with diuretics?
They may inhibit diuretic activity
45
What should patients be instructed regarding the timing of diuretic administration?
Take early in the morning to avoid sleep disturbance from nocturia
46
What are the main classes of antihypertensives?
Diuretics, Sympatholytics, Direct acting arteriolar vasodilators, ACE inhibitors, Angiotensin II-receptor blockers, Direct renin inhibitors, Calcium channel blockers.
47
What is the action of Alpha 1- and beta 1-adrenergic blockers?
Blocks alpha 1 and beta 1 receptors.
48
What are common side effects of Alpha 1- and beta 1-adrenergic blockers?
Hypotension, bradycardia, paresthesia, depression, nasal congestion, nausea, erectile dysfunction.
49
Name some Angiotensin II Receptor Blockers (ARBs).
Losartan, valsartan, irbesartan, eprosartan, candesartan, olmesartan, telmisartan, azilsartan.
50
What is the primary action of Angiotensin II Receptor Blockers (ARBs)?
Prevent release of aldosterone, act on renin-angiotensin-aldosterone system, block angiotensin II from angiotensin I receptors.
51
List the side effects associated with Angiotensin II Receptor Blockers (ARBs).
Dizziness, hypotension, headache, weakness, fatigue, edema, hyperkalemia, hyperglycemia.
52
What is the action of Calcium Channel Blockers?
Block calcium channels in vascular smooth muscle cells promoting vasodilation.
53
What are some common side effects of Calcium Channel Blockers?
Weakness, headache, dizziness, peripheral edema, fatigue, blurred vision, nausea, constipation, erectile dysfunction, bradycardia, hypotension, pharyngitis, rhinitis.
54
Fill in the blank: Labetalol is an example of _______.
Alpha 1- and beta 1-adrenergic blockers.
55
True or False: Calcium Channel Blockers can cause hyperkalemia.
False.
56
What is a potential side effect of both Alpha 1- and beta 1-adrenergic blockers and Calcium Channel Blockers?
Hypotension.
57
What are the therapeutic effects of Pentoxifylline?
Improves tissue perfusion by decreasing blood viscosity Reduces blood viscosity to maintain flow during intermittent claudication Improves the flexibility of erythrocytes which improves perfusion Decreases aggregation of platelets
58
What is the antidote for Warfarin?
Vitamin K (phytonadione)
59
Contraindications for thrombolytic therapy?
Intracranial bleeding Active GI bleeding Brain tumor Brain attack (stroke) within 3 months
60
Drug that counteracts bleeding caused by thrombolytic therapy?
Aminocaproic Acid
61
Pts taking antihyperlipidemic treatment?
Health, diet, and exercise is important Stop smoking You may still need it if your levels return to normal
62
What is the antidote for Acetaminophen overdose?
Acetylcysteine (Mucomyst)
63
What are the side effects of Acetaminophen?
* Rash * Hepatotoxicity * Renal failure
64
Fill in the blank: The maximum daily dose of Acetaminophen is _______.
4 g/day
65
What is a common side/adverse effect of opioid therapy?
Nausea/vomiting/Constipation Decrease BP/orthostatic Urinary retention respiratory depression Cough suppression Miosis Pruritus Dependency
66
What is the drug used for growth hormone deficiency?
Somatropin
67
List side effects of growth hormone excess treatment.
* Hyperhidrosis/ cephalgia/ fatigue * Chest pain/ htn/Bradycardia/dysrhythmias elevated hepatic transaminases * Gi distress/ Constipation/ weightloss/ flatulence
68
What is the drug of choice for hypothyroidism replacement therapy?
Levothyroxine sodium
69
What is the action of glucocorticoids?
Affect inflammatory response, growth
70
True or False: Levothyroxine sodium is used to treat chronic lymphocytic thyroiditis.
True
71
What is the effect of glucocorticoid therapy on blood glucose?
Can cause hyperglycemia
72
What is the function of insulin?
Promotes uptake of glucose, amino acids, and fatty acids; converts glucose to glycogen in liver and muscle for future needs.
73
What are the types of insulin based on duration?
* Rapid-acting * Short-acting * Intermediate-acting * Long-acting * Combinations
74
What is rapid-acting insulin?
Insulin lispro, insulin aspart, insulin glulisine, oral inhalation insulin.
75
What are common side effects of insulin?
* Hypoglycemia * Allergic reactions * Insulin resistance
76
What are the criteria for using oral antidiabetic drugs?
* Onset of diabetes at age 40 or older * Diagnosis of diabetes for less than 5 years * Normal weight or overweight * Fasting blood glucose 200 mg/dL or less * Less than 40 units of insulin required per day * Normal renal and hepatic function
77
Levothroxine does what
Increase T4 Treats simple goiter Treats lymphocytic thyroiditis Increases metabolism
78
Levothyroxine
Avoid broccoli, cabbage, coffee, soy, salt , shellfish Take on empty stomach Synthetic T3 (increase T4) Replaces hormone naturally prod by thyroid Regulates energy and metabolism Watch for thyroid storm/thyroid crisis Treat hypothyroidism
79
Growth hormone
No oral ingestion (gi enzymes inactivate)/Not for athletes Targets body tissue and bone Long term use causes hyperglycemia Given before epiphyses are fused Linear growth with deficiency
80
What is a common use for furosemide?
* Edema related to heart failure * Hypertension * Edema related to renal disease * Acute pulmonary and peripheral edema
81
What are common side effects of thiazide diuretics?
* Dizziness * Headache * Weakness * Hypotension * GI distress * Hyperglycemia * Electrolyte imbalances * Hyperuricemia * Renal failure
82
What contraindication is associated with hydrochlorothiazide?
Renal failure
83
True or False: Thiazide diuretics are contraindicated in patients with sulfa allergies.
True
84
What are the signs and symptoms that may warrant the use of a diuretic?
* Orthopnea * Cough * Crackles * Pulmonary edema * Peripheral edema * Tachypnea * Dyspnea * Decreased O2 * Bounding pulse * Weight gain * Decreased osmolality
85
What is the typical onset time for hydrochlorothiazide?
Approximately 2 hours
86
What should be avoided when taking potassium-sparing diuretics?
Salt substitutes
87
What electrolyte imbalances should be monitored in patients receiving furosemide?
* Low potassium * Low sodium * Elevated calcium
88
Fill in the blank: A common side effect of Calcium Channel Blockers is _______.
Peripheral edema
89
What is the primary action of glucocorticoids?
Antiinflammatory effect
90
List the common administration routes for glucocorticoids.
* MDI inhaler * Tablet * Intravenous
91
What are common side effects of glucocorticoids?
* Dry mouth * Throat irritation * Hoarseness * Cough * Headache * Euphoria * Confusion * Depression * Hyperglycemia * GI distress * Hypertension * Insomnia * Weakness * Fluid retention * Diaphoresis * Osteoporosis * Psychosis * Superinfections * Menstrual irregularities * Electrolyte imbalance
92
What are the uses of Beclomethasone?
* Allergic Rhinitis * Nasal Polyps * Asthma
93
List side effects of Beclomethasone.
* Headache * Epistaxis * Nasopharyngitis * Ocular hypertension * Candidiasis * Dysphonia * Hoarseness
94
What is Mometasone primarily used for?
Allergic rhinitis prophylaxis
95
List the uses of Mometasone.
* Allergic rhinitis * Asthma * Nasal congestion * Nasal polyps
96
What are common side effects of Mometasone?
* Headache * Arthralgia * Candidiasis * Epistaxis * Pharyngitis * Cough * Fatigue * Sinusitis * Wheezing
97
What is Dextromethorphan used for?
Temporary cough relief
98
List the adverse effects of Dextromethorphan.
* Tachycardia * Respiratory depression * Serotonin syndrome * Dizziness/drowsiness * Confusion/fatigue * Ataxia * Nausea/vomiting/restlessness
99
Fill in the blank: The correct use of MDI requires shaking the inhaler well before _______.
use
100
What types of crystalloids are used for maintenance and replacement?
* Isotonic (NS, LR, D5W) * Hypotonic (0.45%, 0.33%) * Hypertonic (3% NaCl, D10W, D5 ½)
101
What is the primary function of Iron in the body?
Regeneration of hemoglobin
102
What are common food sources of Iron?
* Liver * Lean meats * Egg yolks * Dried beans * Green vegetables like spinach * Fruit
103
What are the side effects of Iron supplementation?
* Constipation * Nausea/vomiting * Diarrhea * Iron toxicity * Hemorrhage * Shock
104
What nursing interventions should be taken when administering Iron?
* Administer IM by the Z-track method * Advise to increase fluids, activity, and dietary bulk * Counsel on iron-rich foods * Educate on taking between meals with 8 oz of juice/water * Remain upright for 30 min after taking
105
What is the primary use of Heparin?
* Prevent thromboembolism (PE, MI) * Treat DVT/Acute coronary syndrome
106
What labs are monitored while on Heparin?
* PTT
107
List some adverse reactions of Heparin.
* Itching * Chills * Headache * Bleeding * Stroke * Hyperlipidemia
108
What are the side effects of Warfarin?
* Headache * Fever * Weakness
109
What is the treatment purpose of Alteplase?
* PE * Stroke
110
What should be monitored during Alteplase treatment?
* Bleeding * Neurological changes
111
What is the effect of Statins on LDL?
Decreases LDL
112
What should be monitored while a patient is on Statins?
* Liver * Eyes
113
What are the side effects of Statins?
* Headache * Muscle cramps
114
True or False: Heparin can be given orally.
False
115
Fill in the blank: Vitamin C _______ iron absorption.
increases
116
What should be avoided when taking Iron to prevent decreased absorption?
* Foods * Antacids

Pharmacology (6 decks)

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