Unit 11 - Oxygenation Flashcards
(116 cards)
1
Q
3 main mechanisms that contribute to bronchoconstriction
A
- bronchospasm
- secretion production
- edema
2
Q
Prototype of the Beta2 Adrenergic Agonists (Bronchodilators) (Selective) (fast acting)
A
albuterol
3
Q
first choice for asthma attacks
A
Beta2 Adrenergic Agonists (Bronchodilators) (Selective)
4
Q
T/F: more is better for albuterol
A
FALSE! (>12xd is not healthy = decreased lung function)
5
Q
route of albuterol
A
- inhalation (first choice)
- PO (more risk for systemic side effects)
6
Q
Expected therapeutic effects for albuterol
A
- Beta 2 Adrenergic Agonist, fast acting bronchodilator ->improved breathing
- exercise induced asthma
- drain mucous better
- decrease inflammation
7
Q
Contraindications/interactions of albuterol
A
- hypersensitivty
- caution: cardiovascular disorders
- beta blockers block effect
- MAOIs increase BP
- thyroid hormone increase CV effects
- CNS stimulants, caffeine, increase CNS & CV stimulation
8
Q
Side effects of albuterol
A
*- tremors (common)
9
Q
Nursing considerations/pt. teaching for albuterol
A
… no link slide 6
*- monitor for paridoxical syndrome
10
Q
Prototype for inhaled anticholinergics (bronchodilators)
A
iptratropium
11
Q
If a pt. had COPD and has an acute attack, what drug would they use
A
iptratropium, because of the COPD
12
Q
Therapeutic effects of iptratropium
A
acute attacks in pt. c COPD
13
Q
contraindications/interactions of iptratropium
A
*- watch out for pt. c allergies to soy beans, peanuts, atropine (allergic to ingrediant in propellent of inhalor)
14
Q
side effects of iptratropium
A
…
- cholinergic effects (dry mouth, cough, etc.)
15
Q
nursing considerations/pt. teaching of iptratropium
A
- do not confuse with alupent
- nebulizer (SVN): using in same nebulizer = goop it up & make it form a clumpy precipitate*- monitor for paridoxical syndrome
- teach to no use as rescue drug
- rinse mouth after use
- do not use in children under 12
16
Q
T/F: you should use your bronchodilator first for asthma
A
T
17
Q
prototype for inhaled corticosteroids (anti-inflammatory)
A
Beclomethasone
18
Q
drug of choice for prevention & maintenance of chronic respiratory problems
A
inhaled corticosteroids
- decrease mucous productions
- decrease edema
- steroids have NOTHING to do with bronchodilation (don’t prevent bronchoconstriction)
19
Q
T/F: steroids have everything to do with bronchodilation
A
FALSE! They don’t prevent bronchoconstriction
20
Q
drug of choice for long-term management of asthma or COPD
A
Beclamethasone
21
Q
Therapeutic effects of Beclamethasone
A
Decreased inflammation of respiratory tract alleviating the symptoms of asthma or allergic rhinitis
22
Q
Contraindications/interactions of Beclamethasone
A
*- DO NOT USE IN AN ACUTE ATTACK (not harmful nor helpful….use bronchodilator instead!)
23
Q
side effects of Beclamethasone
A
- osteoporosis (long-term use)
- cataracts (older adults)
24
Q
nursing considerations/pt. teaching for Beclamethasone
A
- avoid with active infections (decrease immune response = potential danger)
- monitor for infections
- assess for oral candidiasis (mouth yeast infection)
- effects might take 1-4 wks for benefit
- rinse mouth
- monitor for osteoporosis/vision changes (cataracts)
25
T/F: you should perform a resp. assessment (lung auscultation) with all respiratory drugs
T!
26
Prototype for Leukotriene Receptor Antagonists (anti-inflammatory)
Zafirlukast
27
T/F: you should use Zafirlukast for acute asthma attacks
NO!
28
Route for Zafirlukast
only PO
29
Can you use Zafirlukast in children
yes :)
30
Therapeutic effect of Zafirlukast
Prevent the signs and symptoms of asthma – blocks leukotriene receptors and decreases inflammation
31
contraindications/interactions for Zafirlukast
* - caution: liver dysfunction
| - may increase PT when taken c warfarin
32
side effects for Zafirlukast
* - HA
* - Chura-Strauss syndrome (fever, muscles aches & pains, weight loss)
- hepatic failure
33
nursing considerations/pt. teaching for Zafirlukast
- dangerous to use c liver dysfunction...can cause liver failure (monitor LFTs)
- report s/s of liver dysfunction (N,V, jaundice)
* - take even if not having s/s
* - food decreases rate/amt. of drug absorption = take on empty stomach ( 1 hr before or 2 hr after meals)
34
prototype for methylxanthines
theophylline (modest bronchodilators)
- similar side effects to caffeine
35
T/F: we have to assess whether pt's using methylxanthines are smokers or not
T
- smoking significantly increases metabolism = increase dosage
36
Therapeutic effects of theophylline
* - relaxes bronchiole smooth muscle
- Relieves bronchospasm for patients with asthma, chronic bronchitis and emphysema.
- Reduces responsiveness to airway irritants
37
contraindications/interactions of theophylline
* - IV: incompatible with many other IV drugs
| * - interacts c many other drugs (antibiotics & antianxieties)
38
side effects of theophylline
...
39
nursing considerations/pt. teaching for theophylline
- monitor LFTs because of significant metabolism
* - give PO = give c extra glass of water to decrease stomach upset
- give at same times every day
* - Avoid charcoal broiled foods (because if increased excretion = decreased effects)
* - limit caffeine = increase adverse effects
* **- therapeutic range: 10-15 mcg/mL
* **- toxic range: > 20 mcg/mL
- report s/s toxicity: anorexia, N, V, dizziness, shakiness, restlessness, irritability, hypotension, cardica arrhythmias, tachycardia
40
List 2 meds that prevent allergic/cold symptoms
antihystamines & steroids
41
List 4 meds that help relieve allergic/cold symptoms
- decongestants
- antitussives
- expectorants
- mucolytics
42
What type of antihistamine:
- used for allergies, insomnia, nausea/motion sickness, urticaria, Parkinson's
- found in resp. tract
H1
43
What type of antihistamine:
- used for GERD & peptic ulcer disease
- found in GI tract
H2
44
What type of antihistamine:
| - cause drowsiness
1st generation
45
What type of antihistamine:
| - less likely to cause drowsiness (doesn't cross BBB)
2nd generation
46
Classify Diphenhydramine
1st generation antihistamine
47
Classify Texotenadine
2nd generation antihistamine
48
T/F: Diphenhydramine crosses the BBB
T, so it causes drowsiness
49
T/F: Diphenhydramine blocks cholinergic receptors
T, so it causes anticholinergic side effects
50
Therapeutic effects of Diphenhydramine
...
- Has anticholinergic, antihistamine, and antiemetic effects
- Decreased N&V, sedation, decreased itching and hives
51
contraindications/interactions of Diphenhydramine
- MAOIs (antidepressent = hypertensive crisis potential)
52
side effects of Diphenhydramine
anticholinergic effects (dry mouth, etc.)
53
nursing considerations/pt. teaching for Diphenhydramine
- monitor for falls (drowsiness)
* - avoid alcohol & other CNS depressants
- increase fluids = help c dry mucous membranes
- chew gum
54
Therapeutic effects of Fexofenadine
- H1 receptor antagonist
| - Reduces nasal congestion, sneezing, teary eyes, urticaria
55
contraindications/interactions of Fexofenadine
* - pregnancy
* - caution: severe renal disease
- interactions: CNS depressants increase sedative effects, antacids decrease absorption, erythromycin increase serum levels, absorption decreased c apple, orange or grapefruit juice
56
side effects of Fexofenadine
*- HA
57
nursing considerations/pt. teaching for Fexofenadine
* - avoid other OTC cold meds
- drowsiness = avoid driving
- avoid alcohol
* - do NOT take with apple, orange, or grapefruit juice
58
Prototype for allergic rhinitis/cold corticosteroid
fluticasone
59
T/F: we like to use PO corticosteroids
FALSE! We use inhaled first because you want to avoid systemic side effects
60
T/F: corticosteroids are for immediate problems
F, used long-term therapy
61
Therapeutic effect of Fluticasone
Anti-inflammatory action that improves breathing
62
Contraindications/interactions for Fluticasone
contraindication: - active infection
63
side effects of Fluticasone
* - HA
* - local burning
* - drying of nasal mucosa = epistaxis, irritation
64
Nursing considerations/pt. teaching for Fluticasone
- tell people not to share these meds: increase spread of virus (used in nose)
- use for only one illness (throw away after done using)
- rinse mouth if used in mouth, avoid swallowing
- therapeutic results take 1-3 wks
- take decongestants first before steroids
- can use a humidifier = help with nasal dryness
65
Prototype for Decongestants (alpha adrenergic agonists - intranasal & sympathomimetic)
Pseudoephedrine
66
nasal mucosa is controlled by the _____
ANS
67
The SNS causes arteriole vasoconstriction which causes ____ congestion
decreased
68
The PNS causes arteriole dilation which causes ____ congestion & ______ mucous production
increased, increased
69
Therapeutic effect of pseudoephedrine
Causes vasoconstriction that relieves congestion of nasal passages and eustachian tubes
70
contraindications/interactions of pseudoephedrine
...
| - caution: HTN, cardiac disease, diabetes, glaucoma, hyperthyroidism, prostate enlargement
71
side effects of pseudoephedrine
* - rebound congestion: when stop using it
| * - insomnia
72
nursing considerations/pt. teaching for pseudoephedrine
- monitor for nasal irritation & bleeding
- monitor VS: HR, BP = in case of systemic effect
* - encourage to not use longer than 2-5 days (especially nasal)
- discourage sharing
- DO NOT USE IN CHILDREN UNDER 2
73
prototype for antitussives (stop coughing = suppress cough reflex)
dextromethorphan
74
is dextromethorphan a narcotic antitussive?
NO. It's non-narcotic, however there are other antitussives that are narcotics (codeine, hydrocodone)
75
contraindications/interactions for dextromethorphan
* - pt. c a lot of secretions/mucous: we need them to be able to cough it out
- caution: immobilized pt's
- MAOIs, SSRIs
76
side effects of dextromethorphan
* - drowsiness
- dizziness
- N, V
- stomach pain
77
nursing considerations/pt. teaching for dextromethorphan
* - only use on pt. who don't need to cough/have non-productive cough
- increase liquids in order to liquify secretions
- encourage good pt. positioning (head of bed up)
- humidify room
* - encourage avoidance of pulmonary irritants: smoking (discourage smoking around pt.)
- monitor pt. c lung disease
* - avoid alcohol
- report s/s resp. infections
78
therapeutic effect of dextromethorphan
treat non-productive cough
79
prototype for expectorant
guaifenesin
80
therapeutic effects of guaifenesin
- expectorant: do NOT break down mucous, just help them thin out = more easily removed
81
contraindications/interactions of guaifenesin
*- caution: pregnancy/breast feeding
82
side effects of guaifenesin
- drowsiness
- dizziness
- N, V, D
- stomach pain
83
nursing considerations/pt. teaching for guaifenesin
*- increase fluids to liquify secretions (drink whole glass of water before and after the dose: trick to encourage pt. to get more fluid intake)
84
prototype for Mucolytic
acetylcysteine
85
therapeutic effect of acetylcysteine
- DOES breakdown mucous
| - changes chemical structure of respiratory secretions
86
contraindications/interactions of acetylcysteine
...
87
side effects of acetylcysteine
...
88
nursing considerations/pt. teaching for acetylcysteine
- nausea c unpleasant odor lessons over time
- when treating acetaminophen overdose must be used within 24 hrs of ingestion - give immediately - do not wait for serum drug levels to get back
89
is acetylcysteine an OTC
NO! Only prescription
90
what medication can we use for tylenol (acetominaphen) overdose
acetylcysteine
91
drug used for TB
Isoniazid
- mechanism of action: breaking up the synthesis of particular acid that's only used with microbacteria (TB)
92
Therapeutic effect of Isoniazid
Used for treatment and prophylaxis of tuberculosis infections
93
Contraindications/interactions of Isoniazid
*- caution: liver or renal disease, seizure disorders
94
side effects of Isoniazid
* - hard on liver = elevated liver enzymes: have LFTs monitored
* - CNS effects: put on perodoxine to prevent/minimize CNS effects
- rash
- fever
- parasthesias
- peripheral neuropathy
95
nursing considerations of Isoniazid
*- LFTs...discourage alcohol use: because of effect on liver
- report s/s liver dysfunction: excessive N,V, dark urine, light colored stools, jaundice
*- neurotoxic effects: to minimize be put on B6 or parodoxine
- report to doc. about neuro problems: numbness, tingling
-
96
```
Q: What is the drug of choice for acute respiratory distress?
A. ipratropium, an anti-cholinergic
B. albuterol, a beta 2 agonist
C. beclomethasone, an inhaled steroid
D. acetylcysteine, a mucolytic
```
B. albuterol, a beta 2 agonist
97
Q: What is an important teaching point about inhaled beclomethasone?
A. use for an acute asthma attack
B. prime the inhaler prior to every inhaled dose
C. rinse out the mouth after taking the inhaled med
D. store the inhaler in the refrigerator
C. rinse out the mouth after taking the inhaled med
98
Q: If a smoker uses throphylline, how will the dose need to be adjusted?
A. The dose will need to be increased above the usual dosage.
B. The dose will need to be lowered below the usual dosage.
A. The dose will need to be increased above the usual dosage.
99
Q: What is the advantage of 2nd generation H1 blockers over 1st generation H1 blockers?
A. 2nd generation H1 blockers are more effective
B. 2nd generation H1 blockers are less expensive
C. 2nd generation H1 blockers are less likely to cause an idiosyncratic anaphylactic reaction
D. 2nd generation H1 blockers are less likely to cause drowsiness
D. 2nd generation H1 blockers are less likely to cause drowsiness
100
```
Q: What is NOT a common adverse effect of diphenhydramine?
A. dry mouth
B. drowsiness
C. watery eyes
D. incoordination
```
C. watery eyes
101
Q: What is the main action of fluticasone that helps relieve the symptoms of seasonal allergies?
A. It stabilizes mast cells.
B. It blocks histamine from attaching to receptors on nasal mucosa.
C. It decreases inflammatory mediators.
D. It causes vasoconstriction of nasal mucosa blood vessels.
C. It decreases inflammatory mediators.
102
Q: When using an inhaled decongestant and an inhaled steroid together, which one should be used first?
A. the decongestant
B. the steroid
A. the decongestant
103
Q: What patient teaching should be included for a client using dextromethorphan, and anti-tussive.
A. decrease fluid intake to decrease secretions
B. don't drive until its effects are known
C. keep the bedroom as dry as possible to avoid lung irritants
D. take with alcohol to increase the absorption of the med
B. don't drive until its effects are known
104
Q: True or False: guaifenesin, an expectorant, breaks down the chemical structure of mucous.
A. True
B. False
B. False
105
```
Q: What disease is isoniazid used to treat?
A. tuberculosis
B. allergies
C. asthma
D. cystic fibrosis
```
A. tuberculosis
106
use of afrin nasal spray decongestant (not oral)
short term use (for asthma?)
*only use for a few days, switch over to nasal steroid for long term use
107
TQ: The nurse teaches a client about the use of corticosteroid nasal sprays for treating seasonal allergies. The nurse advises the client to limit the use of the spray container to one person and one episode of illness. What is the reason for this advice?
A. viruses may colonize at the tip of the container and increase the potential for spreading infection.
B. once the container is opened the medication reapidly loses its effectiveness
C. the pt. will develop a tolerance due to overuse.
D. all of the above
A. viruses may colonize at the tip of the container and increase the potential for spreading infection.
108
```
TQ: Which of the following physiologic processes does beclomethasone effect in treating the s/s of asthma?
Select all that apply:
A. tissue edema
B. mucous production
C. respiratory rate
D. bronchospams
```
A. tissue edema
| B. mucous production
109
```
TQ: Which of the following is NOT an important nursing consideration related to administration of the drug, isoniazid?
A. monitor for cardiac dysrhythmias
B. monitor LFTs
C. monitor for peripheral neuropathy
D. monitor for compliance
```
A. monitor for cardiac dysrhythmias
110
```
TQ: Which of the following pt. teaching points need to be included for the pt receiving isoniazid?
A. avoid foods high in potassium
B. avoid alcohol intake
C. avoid caffeine intake
D. avoid food in vitamin B6
```
B. avoid alcohol intake
111
TQ: A pt. is taking dabigatran. Which conidition is being preventing by this pt.s use of dabigatran
???
112
```
TQ: Which is NOT a first line drug for the treatment of early heart failure?
A. digoxin
B. furosemide
C. lisinopril
D. metoprolol
```
A. digoxin (last resort med)
113
```
TQ: A client is given a new prescription for metoprolol. Which of the following conditions could be complicated by taking metoprolol and would require additional teaching about the medication?
A. arthritis pain
B. diabetes
C. frequent urination
D. osteoporosis
```
B. diabetes
114
```
TQ: Which of the following symptoms are adverse effects of the corticosteroid, prednisone?
A. hypertension
B. increased risk for infection
C. weight loss
D. hypoglycemia
E. moodiness
```
A. hypertension
B. increased risk for infection
E. moodiness
115
```
TQ: A pt. has been on long-term prednisone for the treatment of Chrone's disease. Which medications might the nurse also expect ehe pt. to be taking?
A. levadopa
B. alendronate
C. ibuprofen
D. insulin
E. losarten
```
B. alendronate
D. insulin
E. losarten
116
```
TQ: Nursing diagnoses for pharmacotherapy are developed form what phase of the Nursing Process?
A. assessment
B. planning
C. implementation
D. evaluation
```
A. assessment
