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Med/Surg Nursing II

Pharm Exam 1

QuestionAnswer
Diprivan (Propofol) is used for? What is the Mechanism & Side effects (SE)? Sedation of a MV Pt. Mechanism: decrease anxiety -Produce amnesia NO PAIN RELIEF. SE: cardiac depression
What are the Nursing Activities for Diprivan (Propofol)? Monitor for SE and TE. Monitor level of sedation (Modified Ramsey Scale)
Pavulon (Pancuronium) is used for? What is the Mechanism & SE? Is a Neuromuscular Blocking Agent used for a Pt on a MV. Mechanism: non-depolarizing agent produces prolonged paralysis to prevent "bucking" of the ventilator ***Needs concomitant sedation & analgesia* SE: Prolonged skeletal muscle weakness
What are the Nursing Activities for Pavulon (Pancuronium)? Protect Pt from environment Monitor for TE/prevent side effects. Evaluate level of paralysis q4h w/peripheral nerve stimulator *"Train of Four" (ulnar nerve stimulator "how many times does thumb twitch?"
Name 3 bronchodilators & Adjuncts for Pt's on MV. Albuterol Atrovent (lpratropium) Mucomyst -KP says worst smell!!
What is the Mechanism and SE of Albuterol? Mechanism: relaxes smooth muscle SE: tachycardia, increased bp
What is the Mechanism and SE of Atrovent (lpratropium)? Mechanism: blocks constriction of smooth uscle SE: relatively few side effects
What is the Mechanism and SE of Mucomyst? Mechanism: Liquifies secretion SE: bronchospasm (usually given with bronchodilator)
What is Beciomethasone and how is it used? Inhaled corticosteroid
What is Beciomethasone Mechanism and SE? Mechanism: suppresses inflammatory response SE: increased risk for infection!!
What lab value is monitored when giving a Pt Heparin? PTT
What is the therapeutic level for Heparin? 1.5 X Control
What is the antidote for Heparin Protamine Sulfate (remember PMS)
What is monitored when giving Heparin? Monitor for HIT (Heparin Inudced Thrombocytopenia) Platelets <100,000
What is the average dose of LMWH lovenox ? 1mg/kg subq q12h profalxis would be 40mg every day
What lab value should be checked when giving coumadin? PT/INR Therapeutic PT 1.5 X control & INR 2-3
how long does coumadin take before it reaches the therapeutic leve? 36-72 hours.
What is the antidote for coumadin? Vitamin K (coumadin hard C sound)
Why would Morphine be used for pulmonary edema? It has vasodilating properties (decreases afterload)
Why would Dopamine be used for a PE? Vasoconstrictor. Inotropic agent to increase preload. Titrate and monitor BP. Give dopamine to increase BP if it falls under 90.
Name two vasodilators for a PE Nitroglycerine (venous vasodilator) Nitroprusside (arterial and venous vasodilator)
Which drug was once known as viagra? Think about what effects it would have on the body besides the first one that pops up. Used for PAH Pulmonary HTN Sildenafil (Revatio) Oral Phosphodiesterase inhibitor Selective pulmonary vasodilator
What does Epoprostenol (Flolan) do? relaxes smooth muscle in PAH
What does Bosentan (Tracleer) do? Vasodilator, Endothelin-receptor antagonist
What does Nitric Oxide do? Inhaled selective pulmonary vasodilator
Medication used during mechanical ventilation fall into four categories. What are they? Sedatives: benzodiazepines, barbituates, and propofol. Neuroleptics: Haldol Analgesics: Morphine (drug of choice)but if Pt can't tolerate hypotension use fentanyl (sublimaze) or hydromorphone (dilaudid). Paralytics: Succinylcholin (Anectine)
What is the method of testing the level of paralysis? single, tetanic, and train-of-four (TOF). TOF is most common and involves delivering four consecutive electrical stimul to the ulnar nerve (thumb twitches).
Created by: ashleydc1987
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