NUR 325 exam 4 Flashcards
(154 cards)
1
Q
biggest concern with anticoagulants
A
bleeding
2
Q
how to monitor for bleeding
A
H&H, vitals (increased HR, decreased BP)
3
Q
anticoagulants moa
A
inhibits action or formation of clotting factors
prevents clots
4
Q
antiplatelet moa
A
inhibit platelet aggregation
prevents the platelet plug from forming
5
Q
antiplatelet indications
A
prevent stoke and heart attack
6
Q
heparin moa
A
activates antithrombin
inactivates thrombin and factors Xa
inhibits fibrin formation
7
Q
heparin indication
A
prompt anticoagulation activity
(stoke, pe, massive dot, open heart surgery, dialysis, disseminated intravascular coagulation)
8
Q
heparin side effects
A
bleeding, hematoma, thrombocytopenia
9
Q
how we dose heparin
A
based on clotting time labs (anti-Xa and aPTT)
10
Q
heparin routes
A
IV or subQ
11
Q
heparin onset
A
quickly
12
Q
heparin antidote
A
protamine sulfate
13
Q
heparin nursing considerations
A
caution in spinal epidural anesthesia
14
Q
enoxaparin class
A
low molecular weight heparin
15
Q
enoxaparin moa
A
only inactivates factor Xa (not thrombin)
16
Q
enoxaparin indications
A
prophylaxis and treatment
17
Q
enoxaparin nursing considerations
A
don’t need labs
slower onset, longer 1/2 life
leave air bubble in syringe
caution in spinal epidural anesthesia
18
Q
enoxaparin side effects
A
bleeding, thrombocytopenia, HIT
19
Q
enoxaparin route
A
subQ
can be given at home
20
Q
enoxaparin antidote
A
protamine
21
Q
warfarin class
A
vitamin k inhibitor
22
Q
warfarin moa
A
prevents synthesis of 4 coagulation factors (VII, IX, X, prothrombin)
23
Q
warfarin indications
A
prevent DVT/VTE/PE, thrombotic events with afib, heart valves, MI, TIA
24
Q
warfarin side effects
A
bleeding, lethargy, muscle pain, purple toes
25
warfarin nursing considerations
given PO at 5pm
hold before surgery
many drug, alcohol, food (vitamin K) interactions
26
warfarin onset
24hr onset, 2-5 day duration
27
warfarin lab monitoring
PT/INR
normal range- 1
therapeutic for warfarin- 2-3.5
monitor monthly after therapeutic
28
heparin induced cytopenia
decreased platelet and increased thrombi
caused by antibody development
monitor platelet labs
stop heparin if platelet <100,000
29
apixaban / rivaroxaban moa
directly inhibits factor Xa
30
apixaban / rivaroxaban indications
prevents strokes with afib
postop thromboprophylaxis
DVT/PE
31
apixaban / rivaroxaban side effects
bleeding, hematoma, dizziness, rash, gi upset, peripheral edema
32
apixaban / rivaroxaban bbw
spinal hematoma with epidural
risk of thrombosis if stopped abruptly
33
apixaban / rivaroxaban nursing considerations
many drug interactions
no routine monitoring
monitor liver function
34
apixaban / rivaroxaban antidote
andexxa
35
aspirin moa
blocks prostaglandin synthesis through cox enzyme pathway
prevents platelet aggregation
36
aspirin indication
prevent MI / ischemic stoke
37
aspirin side effects
bleeding, nausea, vomiting, drowsiness, confusion
38
aspirin nursing considerations
chew baby aspirin for acute event
Reye's syndrome (not for children with viruses)
39
aspirin antidote
DDAVP
40
clopidogrel / ticagrelor class
anti platelet ADP inhibitor
41
clopidogrel / ticagrelor moa
alter platelet membrane so it can't receive the signal to aggregate
42
clopidogrel / ticagrelor indications
risk of stroke, prophylaxis of TIA, post MI
43
clopidogrel / ticagrelor side effects
chest pain, edema, flu-like symptoms, gi upset, rash, itching, nosebleed
44
clopidogrel bbw
increases cardiovascular event risk with genetic abnormalities
45
ticagelor bbw
risk for bleeding with aspirin over 100mg
46
clopidogrel nursing consideration
decreased effectiveness with certain other drugs
47
clopidogrel / ticagrelor antidote
DDAVP or platelet transfusion
48
argatroban / bivalrudin class
direct thrombin inhibitors
49
argatroban / bivalrudin moa
inhibit thrombin (factor IIa)
50
argatroban / bivalrudin indications
treat HIT, procedures with high risk for HIT
51
argatroban / bivalrudin side effect
bleeding
52
argatroban / bivalrudin route
IV only
53
argatroban nursing considerations
not for patients with hepatic dysfunction
54
argatroban / bivalrudin labs
monitor anti-Xa, H&H, platelet
55
glucocorticoids
hydrocortisone, prednisone, dexamethasone
56
glucocorticoids moa
mimic cortisol
57
dexamethasone use
checks function of adrenal gland
58
glucocorticoids acute side effects
increased intraocular pressure
fluid retention
increased bp
mood swings
weight gain
cataracts
high blood sugar
59
glucocorticoids chronic side effects
risk of infection
osteoporosis
suppressed adrenal gland
slowed wound healing
60
glucocorticoids nursing considerations
don't stop abruptly
take at same time throughout the day
monitor weight and blood sugar
61
fludrocortisone class
mineralocorticoids
62
fludrocortisone indication
used with glucocorticoid replacement for salt wasting despite proper kidney function
63
adsorbents
bismuth subsalicylate
activated charcoal
64
adsorbants moa
coats wall of gi tract
binds to causative agent for elimination
65
adsorbants indications
diarrhea
66
bismuth subsalcicylate side effects
increased bleeding time (form of aspirin)
constipation
dark stools/dark tongue
67
anti motility drugs
loperamide
diphenoxylate
68
anti motility moa
slows peristalsis
drying effect
69
antimotility side effects
urinary retention
bradycardia, hypotension
flushing, dry skin
70
probiotics
lactobacillus organisms
saccharomyces boulardii
71
probiotics moa
replenish bacteria and restore normal flora
72
lactobacillus organisms indication
diarrhea from antibiotic use
73
saccharomyces boulardii indication
diarrhea from cdiff
74
psyllium class
bulk forming
75
psyllium moa
similar to dietary fiber
absorbs water into intestine, increasing bulk
distends bowel, initiating bowel movement
76
psyllium indication
constipation (ok for long term use)
77
psyllium side effects
impaction above strictures
fluid/electrolyte imbalances
gas formation
esophageal blockages
78
decussate sodium class
emollient
79
emollient moa
lubricates fecal wall and material
80
decussate sodium indication
opioid induced constipation
81
emollient side effects
rash
decreased vitamin absorption
82
mineral oil class
emollient
83
mineral oil indication
fecal impaction
84
mineral oil route
po or pr
85
hyperosmotics
glycerin
lactulose
polyethylene glycol
86
hyperosmotics moa
increases water content in feces
87
hyper osmotic indication
clean out bowel before diagnostic procedures
88
hyperosmotics side effects
abdominal bloating
rectal irritation
electrolyte imbalance
89
saline (a class of laxatives)
magnesium citrate
magnesium hydroxide
magnesium sulfate
fleet enema
90
saline (a class of laxatives) moa
increase osmotic pressure, drawing water into the colon
91
saline (a class of laxatives) side effects
magnesium toxicity
electrolyte imbalance
cramping/diarrhea
92
bisacodyl / Senna indication
constipation
total bowel evacuation
93
bisacodyl / Senna side effects
nutrient malabsorption
gastric irritation
electrolyte imbalance
94
epinephrine moa
inhibits the release of cell mediators from mast cells
95
epinephrine indications
severe allergic reactions
cardiac arrest
severe asthma attacks
96
epinephrine cardiac side effects
angina
arrhythmias
hypertension
tachycardia
97
epinephrine cns side effects
nervousness
restlessness
tremor
98
epinephrine route
usually subQ
anything but PO
99
epinephrine nursing considerations
overdose can be fatal
100
phenazopyridine class
urinary tract analgesics
101
phenazopyridine moa
unknowns
topical analgesic on urinary mucosa
102
phenazopyridine indication
uti pain relief
103
phenazopyridine side effect
reddish orange urine
104
mirabegrin class
urinary antispasmodic
105
mirabegron moa
stimulates beta 3 receptors, relaxing smooth muscle of the bladder
106
mirabegron indications
overactive bladder
107
mirabegron side effects
HTN
urinary retention / uti
108
oxybutynin class
anticholinergic
109
oxybutynin moa
blocks action of acetylcholine
110
acetylcholine normal function
activates smooth muscles to contract
111
oxybutynin indications
overactive bladder
incontinence
112
oxybutynin side effects
dry mouth
constipation
113
anxiety and depression meds nursing considerations
SSRIs and SNRIs are first line
assess for suicide risk
monitor for 4-8 weeks for efficacy
114
fluoxetine class
SSRI
115
fluoxetine moa
inhibits serotonin reuptake at nerve endings
more serotonin
116
fluoxetine side effects
weight gain
gi upset
sexual dysfunction
suicide risk
serotonin syndrome
withdraw symptoms
117
fluoxetine neonatal effect
risk or pulmonary HTN and abstinence syndrome in baby
118
serotonin syndrome
altered mental status 2-72 hours after med treatment
119
venlafaxine class
SNRI
120
venlafaxine moa
blocks neuronal activity of norepinephrine and serotonin
121
venlafaxine side effects
withdraw
sexual dysfunction
blurred vision
increased LFTs
122
amitrytaline class
tricyclic antidepressants
123
amitrytaline moa
blocks reuptake of norepinephrine and serotonin
124
amitrytaline indication
anxiety/depression
neuropathic pain
nocturnal enuresis
125
amitrytaline side effects
too hot
dry mouth
blurred vision
red skin
confusion
126
amitrytaline nursing considerations
FATAL overdose (HTN crisis)
127
phenelzine class
monoamine oxidase inhibitor
128
MAOI moa
inhibits MAO, increasing neurotransmitters at nerve endings
129
MAO normal function
inactivates norepinephrine, serotonin, dopamine
130
MAOI indication
atypical / refractory depression
131
MAOI side effects
HTN crisis when taken with tyramine (aged cheese, smoked meats, yeast, wine)
drug interactions
132
burproprion moa
unclear
stimulant effect
decreases appetite
similar structure to amphetamines
133
burproprion side effects
seizures, agitation, tremor
134
ketamine indications
extreme pain
rapid help with suicidal thoughts
135
ketamine side effects
perceptual disturbances
dissociation
136
ketamine nursing considerations
low dose intranasally
137
trazadone moa
blockade of serotonin reuptake
138
trazadone indications
anxiety
insomnia
not depression
139
benzodiazepines
alprazolam
diazepam
lorazepam
140
benzodiazepines moa
enhance inhibitory effects of GABA in the CNS
141
benzodiazepines indications
GAD
panic disorder
142
benzodiazepines side effects
cns depression (decreased loc)
withdraw effects
respiratory depression
143
benzodiazepines nursing considerations
teratogen
do not mix with other meds that decrease loc
short term use only
144
benzodiazepines antidote
flumazenil
145
methadone moa
synthetic opioid
analgesic and mu agonist
146
methadone indication
medication assisted treatment
for symptoms associated with opioid withdraw
147
methadone side effects
light headedness
hives
chest pain
tachycardia
148
methadone nursing considerations
lower potential for abuse than other opioids
dosed daily from a "methadone clinic"
149
Suboxone
buprenorphine and naloxone
150
buprenorphine moa
blocks receptors to prevent cravings
151
naloxone moa
opioid antagonist
152
Suboxone indications
help patients recover more quickly from addiction
153
Suboxone nursing indications
some potential for abuse but lowest of the meds we talk about
154
suboxone route
sublingual or buccal
