final exam ;( Flashcards by Morgan Nugent

Urinary/Reproductive Lecture-
What are the MOAs for urinary tract analgesics?

common meds

URINARY TRACT ANALGESICS: local anesthetic on the mucosa of the urinary tract

meds: Phenazopyridine (Pyridium)

How well did you know this?

Not at all

Perfectly

Urinary/Reproductive Lecture-

What are the MOAs for urinary tract antiseptics?
common meds

broad-spectrum urinary antiseptic with bacteriostatic and bactericidal action. It injures bacteria by damaging its DNA

Common Meds: nitrofurantoin and methenamine

How well did you know this?

Not at all

Perfectly

Urinary/Reproductive Lecture-

What possible interactions can happen using spironolactone and Angiotensin II receptor blockers or ACE inhibitors together?

Increased risk of hyperkalemia

How well did you know this?

Not at all

Perfectly

Urinary/Reproductive Lecture-

What are the signs and symptoms of hypokalemia (what lab values will be present with each)?

HYPOkalemia: 3.5-5mEq/L

Lethargic, low, shallow respirations, lethal cardiac dysrhythmias, lots of urine, leg cramps, limp muscles, low BP

How well did you know this?

Not at all

Perfectly

Urinary/Reproductive Lecture-

What are the signs and symptoms of hyperkalemia (what lab values will be present with each)?

HYPERkalemia: 3.5-5mEq/L

Muscle weakness, urine output little or none, respiratory failure, decreased cardiac contractility, early muscle twitches/cramps, rhythm changes

How well did you know this?

Not at all

Perfectly

Urinary/Reproductive Lecture-

What are the complications of loop diuretics (which are their common meds)?

Dehydration, hyponatremia, hypochloremia, hypotension, ototoxicity, hypokalemia, loss of other electrolyte levels

How well did you know this?

Not at all

Perfectly

Urinary/Reproductive Lecture-

What are the loop diuretics common meds?

furosemide (lasix)
ethacrynic acid (edecrin)
bumetanide (bumex)
Toresemide (dytor)

How well did you know this?

Not at all

Perfectly

Urinary/Reproductive Lecture-

What are the complications of potassium-sparing diuretics (which are their common meds)?

Hyperkalemia, endocrine effects, drowsiness, metabolic acidosis

How well did you know this?

Not at all

Perfectly

Urinary/Reproductive Lecture-

What are the contraindications for oral contraceptives?

Smokers over the age 35
Hx of thrombophlebitis and cardiovascular events
family history of breast cancer
experiencing abnormal vaginal bleeding
caution in hypertension
DM
gall bladder disease, uterine leiomyoma
seizure
migraine headaches

How well did you know this?

Not at all

Perfectly

Urinary/Reproductive Lecture-

What important patient teaching do we give to give patients of child-bearing age when taking antibiotics?

extra contraceptive protection

How well did you know this?

Not at all

Perfectly

(musculoskeletal medication classifications) Which are the MOAs of DMARDS

slow joint degeneration and progression of rheumatoid arthritis

How well did you know this?

Not at all

Perfectly

musculoskeletal medication classifications:

Which are the MOAs of (Selective estrogen receptor modulator) SERM

works as an endogenous estrogen in bone, lipid, metabolism, and blood coagulation

How well did you know this?

Not at all

Perfectly

(musculoskeletal medication classifications) Which are the MOAs of bisphosphonates

decrease the number and action of osteoclasts, and inhibits bone resorption

How well did you know this?

Not at all

Perfectly

(musculoskeletal medication classifications) Which are the MOAs of calcitonin

decreases bone resorption by inhibiting the activity of osteoclasts in osteoporosis, and increases renal calcium excretion by inhibiting tubular resorption

How well did you know this?

Not at all

Perfectly

(musculoskeletal medication classifications) Which are the MOAs of calcium supplements

maintenance of musculoskeletal, neurologic, and cardiovascular function

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture-

What are the signs/symptoms of hypercalcemia?

Hypercalcemia: bone pain, arrythmias, cardiac arrest, kidney stones, muscle weakness, excessive urination

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture-

What are the complications of calcium supplements?

hypercalcemia

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture-

Which common medications belong to the biphosphonate classification?

Alendronate, Ibandronate, Risedronate

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture-

What are the nursing implications of giving DMARDs?

Let clients know that DMARDS can take 3-6 weeks to start to take effect, several months for full
Monitor for side effects/adverse effects
Monitor potassium levels and blood glucose levels
Get baseline CBC, and monitor platelet counts periodically
Monitor liver enzymes
Monitor closely for infections
Obtain baseline eye exam and follow-up eye exam q6 months

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture-

What are the complications of methotrexate (DMARD)? What kinds of signs and symptoms would patients complain about if they had these complications?

Increased risk of infection
hepatic fibrosis and toxicity
bone marrow suppression
GI ulcerations

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture-

What medications/drinks interact with methotrexate (DMARD)?

Salicylates/ other NSAIDS, sulfonamides, PCN, tetracyclines, Folic Acid

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture-

What are the nursing implications of calcium supplements?

Nursing Implications: chewable tablets are preferred, monitor calcium levels, observe for signs of hypercalcemia

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture-

What are the patient teaching of calcium supplements?

Patient Teaching: take at least 1 hour apart from glucocorticoids and tetracyclines and at least 4 hours apart from thyroid hormone, take with 8oz of water

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture-

Which medication belongs to SERM classification?

Raloxifene

How well did you know this?

Not at all

Perfectly

Musculoskeletal lecture- | What are the complications of SERM medications?

Increased risk for pulmonary embolism and deep vein thrombosis, hot flashes

Musculoskeletal lecture- What are the nursing implications of Calcitonin meds?

- Can be given SQ, IM, or intranasally - keep the container in an upright position - monitor for hypocalcemia - monitor bone density scans periodically

Neurologic lecture- | What are the MOAs for Benzodiazepines

enhance the inhibitory effects of gamma-aminobutyric acid in the CNS

Neurologic lecture- | What are the MOAs for Muscle Relaxants

acts in the CNS to enhance GABA, produce sedative effects, and depress hyperactive spasticity of muscles

Neurologic lecture- What are the MOAs for Anticonvulsants: & meds

control seizure disorder by slowing the entracne sodium and calcium back into the neuron, suppressing neuronal firing, and enhancing the inhibitory effects of gamma butyric acid (GABA) Phenobarbital, Phenytoin, Carbamazepine, Valproic Acid

Neurologic lecture- | What are the MOAs for Antiparkinsons Agents:

relief of dyskinesias and ability to perform ADLs by maintaining the balance between dopamine and acetylcholine in the extrapyramidal nervous system

Neurologic lecture- | What are the MOAs for Antidementia Agent:

prevent the enzyme cholinesterase from inactivating acetylcholine thereby increasing the amount of acetylcholine available at receptor sites

Neurologic lecture- | What are the MOAs for Migraine:

prevent inflammation and dilation of the intracranial blood vessels, thereby relieving migraine pain

Neurologic lecture- | Benzodiazepines meds

Alprazolam, Diazepam, Lorazepam, Clonazepam

Neurologic lecture- Muscle Relaxants meds (b,c,d

Diazepam, Baclofen, Cyclobenzaprine

Neurologic lecture- | Anticonvulsants meds

Phenobarbital (Solfoton) Phenytoin (Dilantin) Carbamazepine (Tegretol) Valproic acid (Depakote)

Neurologic lecture- | Antiparkinsons Agents meds

Levodopa/Carbidopa

Neurologic lecture- | Antidementia Agent med

Donepezil

Neurologic lecture- | Migraine meds

Serotonin receptor agonists, ergot alkaloids (ergotamine, dihydroergotamine), aspirin-like NSAIDS/acetaminophen

Neurologic lecture- | What is the patient teaching points for antiparkinsons agents?

- Take as directed, do not adjust dosage without consulting with provider - May cause sleepiness/drowsiness, avoid activities that require alertness - May cause harmless darkening of saliva, urine, or sweat - Notify your provider if you experience any GI distress, palpitations, involuntary movements or behavioral changes

Neurologic lecture- | What is the patient teaching points for anticonvulsants?

- Take medications as prescribed - you will need periodic blood work - avoid activities that require alertness until seizures are fully controlled and medication effects are known - avoid pregnancy - do not stop medication without consulting your provider

Neurologic lecture- | Which medications are given for migraines?

Serotonin receptor agonists, ergot alkaloids (ergotamine, dihydroergotamine), aspirin-like NSAIDS/acetaminophen

Neurologic lecture- What are the complications of antidementia agents? Which signs/symptoms will the patient complain of if they are experiencing them?

- Excessive muscarinic stimulation (increased GI motility, secretions, diaphoresis, increased salivation) - Cholinergic crisis (respiratory depression, paralysis of the respiratory muscles can be fatal)

intro lecture: | What is the difference between generic names and brand names of medications?

Generic is the official name of the drug and Brand is the company created name

intro lecture: | Pharmacodynamics:

what the drug or medication does to the body

intro lecture: | Pharmacokinetics

how medications travel through the body

intro lecture: | What is genomic medicine and how can it help diverse populations?

Personalize medications for a specific group or person

Safety/Dosage Calc lecture: What are the steps to performing a safe medication administration?

Three checks of 6 rights

Safety/Dosage Calc lecture: | What are the six rights of medication administration?

Patient, Medication, Dose, Time, Route, Documentation

Pain/Inflammation lecture: Which are common medications that belong to the NSAID classification?

Aspirin, Ibuprofen, Naproxen, Indomethacin, Diclofenac, Ketorolac, Meloxicam, Celecoxib

Pain/Inflammation lecture: | What are the contraindications for opioids?

``` Pregnancy Cat D Biliary tract surgery preemies during/after delivery kidney failure head injuries extremely obese hepatic or renal disease hypotension ```

Pain/Inflammation lecture: | What are the antidotes for opioids and non-opioid analgesics?

Naloxone

Cardiovascular lecture: What are the complications of beta blockers?

- Bradycardia - orthostatic hypotension - decreased cardiac output - heart block; nonselective: bronchoconstriction - inhibited glycogenesis

Cardiovascular lecture: What are the therapeutic effects of ACE inhibitors?

- Vasodilation - excretion of sodium and water and retention of potassium by actions in the kidneys - reduction in pathological changes - in the blood vessels and heart that result from the presence of angiotensin II and aldosterone

Cardiovascular lecture: What are expected side effects for organic nitrates?

orthostatic hypotension headache reflex tachycardia tolerance

Cardiovascular lecture: Which are common medications belonging to ARBs?

losartan, irbesartan, candesartan, Olmesartan

Respiratory lecture: | What is the patient teaching for antihistamines?

- Take before bed - don’t operate heavy machinery/drive while on meds - increase fluids and fiber - suck on sugar free hard candy to avoid dry mouth

Respiratory lecture: | What are the complications of antihistamines?

Sedation, anticholinergic effects, GI discomfort, respiratory depression

Respiratory lecture: | What is the patient teaching when giving an inhaled glucocorticoid?

Use with a spacer as directed, rinse mouth after each use

Respiratory lecture: | What is the MOA of expectorants?

Promotes increased cough production by increasing and thinning mucous secretions

Hematology/Immune lecture: Which lab values would indicate that epoetin alfa is therapeutic?

Hg 10-11 g/dL | Hct 33%

Hematology/Immune lecture: | What is the patient teaching for Vitamin K inhibitors?

- Take in evening - avoid alcohol or NSAIDS - avoid high vitamin K foods - watch for bruising - bleeding gums - use soft toothbrush and safety razor - regular blood tests

Hematology/Immune lecture: | ptt normally and on heparin

normal: 30-40 sec heparin: 60-80 sc

Hematology/Immune lecture: | platelet count

150,000-450,000

Hematology/Immune lecture: | hematocrit

38%- 54%

Hematology/Immune lecture: | hemoglobin

12-18

Hematology/Immune lecture: pt normally pt on warfarin

normal: 9.5-11.8 sec warfarin: 18-24 sec

Hematology/Immune lecture: INR normal INR on warfarin

normal: 0-1.1 | warfarin 2-3

Hematology/Immune lecture: | AST

7-46

Hematology/Immune lecture: | ALT

10-30

Hematology/Immune lecture: | total billrubin

.3- 1.2

Antimicrobials lecture: | What are the complications of antifungal medications?

- IV infusion reactions - thrombophlebitis - nephrotoxicity - electrolyte imbalance - bone marrow suppression

Antimicrobials lecture: | What is the general patient teaching for all antibiotics?

Finish entire course, take back up BC methods

Antimicrobials lecture: | When are peak and trough levels drawn?

Trough is draw immediately before the next dose of the drug and peak is drawn 1-several hours after admin

GI lecture: | What is the patient teaching for Mucosal protectants?

- Take therapy for 4-8 weeks even if feeling better - increase fluid intake - fiber and dietary bulk to prevent constipation - follow up with GI specialist

GI lecture: | What are the nursing implications for Antacids?

- Admin 1-3 hours before meals or at bedtime - shake the suspension well before admin - monitor for hypercalcemia and hypermagnesemia - use caution with antacids that contain sodium with hypertension or heart failure patients

GI lecture: | potassium level

3.5-5.1

GI lecture: | sodium level

135-145

GI lecture: | calcium level

8.5-10.5

GI lecture: | magnesium

1.8-2.2

endocrine lecture: Rapid acting: Insulin Lispro: ONSET & PEAK

ONSET: 15-30 min PEAK: 0.5-2.5 hours

endocrine lecture: Rapid acting: Insulin Aspart: ONSET & PEAK

ONSET: 10-20 min PEAK: 1-3 hours

endocrine lecture: Rapid acting: Insulin Glulisine: ONSET and peak

ONSET: 10-15 min PEAK: 1-1.5 hours

endocrine lecture: short acting: Regular Insulin: ONSET and PEAK

ONSET: 30-60 min | PEAK: 1-5 hours

endocrine lecture: Intermediate acting: NPH Insulin: ONSET and PEAK

ONSET: 1-2 hours PEAK: 6-14 hours

endocrine lecture: Long acting: Insulin Glargine: ONSET & PEAK

ONSET: 70 min | PEAK: none

endocrine lecture: Long acting: Insulin Detemir: ONSET and peak

ONSET: 1-2 hours PEAK: 12-24 hours

endocrine lecture: Which food/drink interactions are there with patients taking oral antidiabetic medications?

ALCOHOL