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NUR 106 > Mod 3 > Flashcards

Mod 3 Flashcards

1
Q

How are ulcers diagnosed?

A

BMP
stomach acid analysis
endoscopy

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2
Q

What is ZES?

A

Tumors develop in pancreas or duodenum that produce hormone gastrin which makes your stomach produce acid

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3
Q

How do ulcers feel?

A 
Heartburn
Upper abdominal pain
Nausea
Vomiting
Bloating
Bloody emesis or stool
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4
Q

How do antacids work?

A

Neutralize gastric acid

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5
Q

How do H2RAs work?

A

Decrease acid secretion by inhibiting action of histamine at H2 receptor site

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6
Q

How do PPIs work?

A

Inhibit parietal cells from producing acid by preventing transport of hydrogen into gastric lumen

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7
Q

What is ranitidine?

A

H2RA

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8
Q

What is ranitidine indicated for?

A

Short term and maintenance of EE

Treatment of ZES

Relief of GERD

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9
Q

What are routes of ranitidine?

A

Oral, IM, IV

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10
Q

What type of drug is magnesium/aluminum hydroxide?

A

Maalox/Mylanta

Antacid

Neutralizes gastric acid and inactivates pepsin

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11
Q

What is administration of magnesium/aluminum hydroxide?

A

PO only

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12
Q

Which anti-ulcer should not be taken with a sugar allergy?

A

Magnesium/aluminum hydroxide

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13
Q

In combination therapy of magnesium/aluminum hydroxide, what causes diarrhea and what causes constipation?

A

Aluminum-constipation

Magnesium-diarrhea

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14
Q

Which PPI potentiates effects of Coumadin?

A

Esomeprazole

Lansoprazole

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15
Q

When should patients take Esomeprazole?

A

One hour before meals

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16
Q

What is administration of Esomeprazole?

A

PO and IV

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17
Q

What is administration of omeprazole?

A

PO only

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18
Q

Which PPI potentiates effects of digoxin and Coumadin?

A

Omeprazole

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19
Q

Which PPI is contraindicated in breastfeeding?

A

Pantoprazole

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20
Q

What is administration of Pantoprazole?

A

PO and IV

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21
Q

Which PPI can cause hyperglycemia?

A

Pantoprazole

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22
Q

What is administration of lansoprazole?

A

PO only

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23
Q

Which PPI causes headache, diarrhea, and dizziness

A

Lansoprazole

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24
Q

What are nursing implications for PPIs?

A

Monitor liver function

Access and monitor abdominal pain

Monitor PT/INR when applicable

Monitor administration before meals

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25
What is the patient teaching for anti-ulcers?
Take as directed Report dark, tarry stools and diarrhea Avoid alcohol Avoid with aspirin and NSAIDS report worsening of symptoms
26
What is action of bronchodilators?
They treat only reversible airway obstruction Act by dilating the bronchi or bronchioles in lungs
27
What do bronchodilators treat?
Reversible airway obstruction such as bronchospasms, inflammation, mucus accumulation
28
What are the symptoms of airway obstruction?
Coughing, wheezing, SOB
29
Who is at risk for ulcers?
``` Anyone over 50 People who consume too much alcohol Chronic NSAID users Family history H. Pylori Poor diet ```
30
If patient is experiencing vasoconstriction what does this mean for broncho?
Bronchodilation
31
If patient experiencing bronchodilation what does this mean for vaso?
Vasoconstriction
32
What does acteylcholine cause?
Vasodilation and bronchoconstriction
33
Which drugs are the beta-adrengeric agonists?
Levabuterol, albuterol, salmeterol
34
What are the anticholinergic drugs?
Ipratropium, tiatropium
35
What are the nursing considerations for bronchodilators?
Use cautiously in cardiac and hormone disorders May inversely interact with beta blockers
36
What are the nursing management considerations ? There are 3
Cardiac monitoring during therapy Respiratory assessment and monitoring Side effects include nervousness, tremors, restlessness, palpitations, and dry mouth
37
What is the patient education for bronchodilators?
Proper inhaler use Indications for and proper use of spacers Avoid xanthine products Avoid respiratory irritants Increase fluid intake Oral care
38
What products contain xanthine?
Caffeine, coffee, tea, colas, chocolate
39
Which class of drugs should be avoided if patient consumes xanthine?
Bronchodilators
40
Which bronchodilators are used for acute exerbations?
Beta-Agonists Albuterol Levalbuterol Fluticasone/salmeterol (corticosteroid/bronchodilator combo)
41
Which two drugs are used for chronic maintenance of airway obstruction disorders?
Anti-cholergenics ``` Tiotropium Ipratropium bromide (Atrovent) ```
42
What are the diagnostics for bronchodilators?
Chest x Ray
43
What do corticosteroids do and what are they?
Hormone used to treat inflammatory and allergic conditions by modifying the immune response
44
What is the action of corticosteroids?
Mimic hormones produced by the adrenal glands (cortisol and sex)
45
Which two hormones are produced by the adrenal glands?
Cortisol and sex hormones
46
What would you need to know if you are getting ready to administer corticosteroids?
If there are any known hormone deficiencies
47
Patients taking steroids are at risk for what?
Hyperglycemia
48
What are the 3 nursing considerations for corticosteroids?
Avoid live vaccines because steroids alter immune system Avoid serious infections May increase blood glucose
49
What are the side effects for corticosteroids?
``` Nausea Peptic ulcers Bruising Hirsutism (abnormal hair growth) Muscle wasting Osteoporosis Cushingoid appearance Adrenal suppression Delayed wound healing ```
50
What are signs of adrenal suppression?
BP drop, weight loss, weakness, nausea, confusion
51
Name the two corticosteroids.
Methylprednisolone Prednisone
52
What are opioids used to treat?
Moderate to severe pain
53
Where are opiate receptors found?
Only in the brain
54
What do opiate receptors in the brain do?
Elicit euphoric effect
55
What are the signs of withdrawal from opioids?
``` Runny nose Goosebumps Yawning Teary eyes Muscle aches and pains Abdominal pain and cramping Irritability Insomnia ```
56
What are the signs of an opioid overdose?
Muscle spasms | Seizures as the CNS depresses, body trying to wake itself up
57
What are the nursing considerations for opioids?
Use smaller doses for the elderly Avoid use with alcohol, antihistamines, antidepressants, sedatives, MAOIs May cause respiratory depression Gradual discontinuation
58
How are opioids administered?
PO, IM, IV, transdermal
59
What is the antidote for opioid overdose?
Naloxone (Narcan) To all 7 opioids
60
Do opioids cause urinary retention?
Yes
61
What are side effects of opioids?
Dizziness, euphoria, dysphoria, constipation, confusion, hypotension, sedation, nausea, dry mouth
62
What do pupils look like when opioid overdose is expected?
Pinpoint
63
What is the patient teaching for opioids?
Avoid alcohol and CNS depressants Turn, cough, deep breathing every 2 hours Increase fluid intake Activities with caution Avoid MAOI Mgmt of transdermal patches--must remove old one!
64
How do opioids effect pain?
They effect perception of pain, not localized to the source to eliminate pain
65
Name the opioids.
Meperidine-Demerol Hydromorphone-Diluadid Oxycodone/Acetaminophen-Percocet Hydrocodone/Acetaminophen-Lortab, Vicodin, Norco Oxycodone-OxyContin Fentanyl-Duragesic Codeine
66
What do non-opioid analgesics treat?
Mild to moderate pain, they have a peripheral action
67
What are the two effects of non opioid analgesics?
Antipyretic Prostaglandin inhibition
68
How does prostaglandin inhibition work?
Pain is thought to be a protective mechanism, prostaglandins are released and cause the pain, fever, and swelling to the effected area which are essentially the ways tbe body uses to heal itself, this is all due to prostaglandins so non-opioid analgesics inhibit the prostaglandins therefore reducing pain, fever, and swelling and inhibiting the healing process
69
What effects the efficacy of non opioid analgesics?
Blood flow because this medication works peripherally it depends on blood flow
70
What are the nursing considerations for nonopiod analgesics?
Avoid in severe liver and kidney disease Alcohol caution-liver Interacts with NSAIDS causing renal dysfunction Hepatoxicity may occur with acetaminophen Aspirin interacts with warfarin and acts as a blood thinner
71
What are the two non opioid analgesics?
Tylenol-acetaminophen Aspirin ASA
72
If the liver or brain is swelling do you give Tylenol or aspirin?
NO
73
What are NSAIDS used to treat?
Mild to moderate pain due to inflammation Is also a anti-pyretic
74
Which NSAID should not be used for more than 5 days?
Ketorolac
75
What are the side effects of NSAIDS?
Constipation, dizziness, headache, dyspepsia, nausea, Stevens Johnson syndrome
76
What are the NSAIDS
Ibuprofen Naproxen Ketorolac (Torodol, Sprix)
77
Which NSAID is not anti-pyre tic?
Ketorolac

NUR 106 (6 decks)

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