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Flashcards in Meds Deck (8):
1

Warfarin MOA; indication; BBW; ASE; Contra

Anticoag MOA = prolongs bleeding time by interfering w/V. K dependent clotting factors

Warfarin is indicated: maintenance/PPX in suppressing formation of clots post MI/valve surgery/Afib/A flutter/DVT/PE

BBW: Bleeding risk

ASE: hemorrhage/necrosis/cholesterol embolism/hepatits

Contra: pregnancy/eclampsia/hepatic/renal dz/recent neuro/ocular/traumatic surgery

Antidote: V. K

2

Low-molecular weight heparin MOA; indication; BBW; ASE; Contra:

LMW ex: dalteparin (fragmin 2500-5000), enoxaparin (Lovenox 40 mg)

heparin MOA: blocks action of factor Xa/IIa

LMW-Heparin is indicated: ppx against thromboembolic DO associated w/surgery & bedrest

BBW: epidural/spinal hematoma

ASE: hemorrhage/thrombocytopenia

Contra: allergy to pork/epidural/spinal anesthesia; active bleeding; thrombocytopenia

3

Toxic side effects of digoxin:

bradycardia, dysrhythmia, nausea, vomiting, anorexia, dizziness, headache, weakness and fatigue.

4

A client is about to have an intravenous pyelogram (IVP). After the contrast material is injected, which client reaction should be acted upon immediately by a nurse?

A: Feelings of excessive warmth
B: Hives w/severe itching over the body
C: Excessive salty taste in the mouth
D: Face turning a deep ruddy red color

B: Hives/severe itching

Hives over the body with severe itching is a sign of anaphylaxis and should be acted upon with the administration of epinephrine (adrenaline) immediately. The other reactions are considered normal after the dye injection. Prior to any dye injection procedure clients should be informed that these symptoms may occur.

5

A client on warfarin (Coumadin) therapy after coronary artery stent placement calls the clinic to ask: "Can I take Alka-Seltzer for an upset stomach?" What is the best response by the nurse?

A: "Select another antacid that does not inactivate warfarin (Coumadin)."
B: "Take Alka-Seltzer at a different time of day than you take the warfarin (Coumadin)."
C: "Use about half the recommended dose of Alka-Seltzer."
D: "Avoid Alka-Seltzer because it contains aspirin."

D: "Avoid Alka-Seltzer because it contains aspirin."

Alka-Seltzer is an over-the-counter aspirin-antacid combination. Aspirin is an antiplatelet drug and taking this with warfarin will potentiate the anticoagulant effects of the medication, which may increase the risk of bleeding.

6

A client has been taking alprazolam (Xanax) for three days. The nurse should expect to find which intended effect of this drug?

Increased coordination and ability to concentrate

Relief of insomnia and phobias

Tranquilization and calming effects

Sedation and long-term analgesia

Tranquilization and calming effects

Alprazolam is a benzodiazepine used in the treatment of anxiety, panic disorder, and anxiety associated with depression; it is also beneficial to those suffering from sleep disorders. This medication is a central nervous system depressant, producing a drowsy or calming effect; it may cause a lack of coordination. Alprazolam has a very short half-life and produces immediate symptom relief. It does not cause analgesia nor is it used to treat phobias.

7

How long should it take for the nurse to administer 100 mg of phenytoin IV push to an elderly client? (Use a whole number to answer the question and write only the number.)

4

Phenytoin is safe to give IV push at a rate of 25 mg per minute to an elderly client, so 4 minutes is the correct time frame. Phenytoin may be given IV at 25-50 mg per minute, but it should be given at the slowest rate to older adults.

8

A client reports taking lithium (Eskalith, Lithobid) as prescribed. Which of these findings indicate early signs of lithium toxicity?

Pruritus, rash and photosensitivity

Electrolyte imbalance, tinnitus and cardiac arrhythmias

Vomiting, diarrhea and lethargy

Ataxia, agnosia and course hand tremors

Vomiting, diarrhea and lethargy

Serum lithium levels should be between 0.8 - 1.2 mEq/L (remember, the exact numbers may vary slightly depending on the lab). Diarrhea, vomiting, drowsiness, muscular weakness and lack of coordination may be early signs of lithium toxicity. Toxicity increases with increasing serum lithium levels, but clients may exhibit toxic finding at lithium levels below 2.0 mEq/L. Dehydration, other medications and other conditions can interfere with lithium levels.