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Final exam
FINAL
| Question | Answer |
|---|---|
| For perfusion, what are the Anti-HTN Drugs & MOA | Diuretics, they reduce fluid volume in the vessels |
| Examples of diuretics | Furosimide, hydrochlorothiazide, Spironolactone, Metolzone |
| What are Statins for ? | < Cholesterol Biosynthesis |
| Nursing considerations for Statins | Monitor Liver function, do NOT consume alcohol, look for Muscle pain, tenderness, and weakness |
| Anti-Cholinergics MOA | prevent bronchoconstriction = bronchiole smooth muscle |
| Examples of SABA's | albuterol, bitolterol, pirbuterol, terbutaline |
| AE of SABA's | tachycardia & muscle tremors |
| What is Theophylline? | Class of Methylxanthine, relaxes bronchiole smooth muscle, inhibits inflammation mediators |
| Nursing considerations for Theophylline? | Monitor Serum theophylline |
| What might be given for severe exacerbation (increase of symptoms) ? | Aminophylline IV |
| What would be adminned for severe asthma attack? | Beclomethasone (corticosteroid) |
| What are Epinephrine, albuterol, iportropium, and "OL" endings examples of? | adrenergic agonists (dilate the bronchiole) |
| AE of Adrenergic's | headache, tachycardia, tremors, angina, allergic reaction, paradoxical bronchospasm |
| What are the main categories of bronchodilators? | Adrenergic agonists, methylxanthinesm anticholinergics |
| What manifestations would be present for toxicity of corticosteroids? | Dry mouth, taste change, hoarseness |
| What asthma med interferes with inflammatory process and preventing airway edema | Leukotrine modifiers --> Montelukast (Singulair) |
| What asthma med inhibits inflammatory process in the airway | Mast cell stabilizers --> Cromoyln |
| AE of Mast Cell Stabilizers | Stinging, burning of nasal mucosa, Throat irritation, nasal congestion, bronchospasm, anaphylaxis |
| AE for corticosteroids | Glaucoma, fluid retention, HTN, Mood swings, weight gain, cataracts, hyperglycemia, osteoporosis, delayed wound healing |
| Factors that effect the pulse | Age, gender, exercise, weight, fever, meds, stress, hypovolemia, position change, pathology |
| Nasal cannula and oxymizer gives how many L/min | 1-6 L/min |
| Vapotherm gives how many L/min | 1-40 L/min |
| Face mask gives how many L/min | 5-10 L/min, extra resivoir |
| Non-rebreather mask gives how many L/min | 10-15 L/min w/one way valve |
| Venturi Mask | can be specifically set at L/min due to jet adapter |
| Most prescribed anticholinergic for respiratory function | Ipotroprium Bromide inhaler |
| How long should the patient wait IN BETWEEN PUFFS for inhaler | 1-2 minutes |
| What are the steps of the nursing process? | 1. Assessment 2. Diagnosis 3. Planning 4. Implementation 5. Evaluation |
| High pitch, heard over trachea/Larynx, suggest narrowing of tracheal passage | Stridor |
| High pitch popping sounds, heard on inspiration, associated w/fluid, inflammation, exudate | Crackles |
| Long low pitch, heard through inspiration, suggests block of large airway, may sometimes be cleared w/cough | Ronchi |
| High pitch, heard on expiration/inspiration, suggests narrowing of bronchi | Wheezing |
| What are Promethazine and Phenothiazine | Antiemetics |
| What is an EPS of Promethazine and phenothiazine | Ticks |
| Other examples of anti-emetics | cannabinoids, Benzos (Lorazepam), Ondansetron, Corticosteroids (dexamanthsone) |
| Hard/dry/no stool, caused by staying in the large intestine too long and the H2O being reabsorbed by the LI | Constipation |
| Examples of bulk laxatives | Pysillum Mucilloid |
| Nursing considerations for Bulk Laxatives | 16 oz water total, take 2 hours before/after other meds, Not for long term use |
| 5 primary constipation drugs | Osmotic, Bulk, Saline, Stool softeners, Herbals |
| Adds form and increases size , promotes passing of stool | Bulk Lax |
| What is given for an overactive bladder | Oxybutynin |
| PTD for Cholinergic drugs | Bethanechol |
| Stimulates muscle contraction fo GU & GI Increased salivation, abdominal cramp, diaphoresis, hypotension | Cholinergic drug (bethanechol) |
| PTD for PPIs | Omeprazole |
| What are herbs that are contradicted in Omeprazole | Ginkgo, St. Johns Wart |
| Blocks the enzyme responsible for recreation of hydrochloric acid in the stomach | PPIs --> proton pump inhibitors |
| What are PPI's sometimes used to treat | GERD (4 weeks) |
| How long before relief is felt with PPI's | several weeks |
| Lactulose is an example of what laxative ? | Saline carthotic |
| Causes muscle contraction, stomach discomfort, cramps, | Lactulose |
| Saline carthotic/Osmotic laxatives MOA | pulls H2O into stool to make a more watery stool |
| What can saline carthotic/osmotic laxatives be used for | enemas, daily doses, bowel prep |
| Irritates the bowel mucosa to produce peristalsis, rapid acting, diarrhea/cramping | Bisacodyl |
| What is another use for Bisacodyl | Bowel prep |
| Adds moisture to the stool to promote passing | Stool softeners |
| Sodium colase | Stool softener "ASE or ATE" ending |
| Herbal laxative that irritates the bowel | Senna |
| Infections or poisons would make _______ contradictory | Anti-diarrheal meds |
| < acid secretion in the stomach also anti-ulcer drugs | H2 receptor antagonists |
| Ranitidine (antacid) | think wine & dine due to stomach acid after meals but may cause headache (liver/renal function monitoring) |
| What is the med of choice for sever or chronic diarrhea | Diphenoxylate w/atropine (Schedule V) |
| MOA od Diaphenoxylate w/atropine | works directly in the intention to slow peristalsis |
| Side effects of Diaphenoxylate w/atropine | CNS depression dizziness, drowsiness, only used short term |
| Another choice for Diarrhea | Imodium (Lomoti) --> low motility |
| What are antacids made of | minerals |
| Neutralize stomach acid | Antacids |
| Most common type of Antacid | Calcium Carbonate, Aluminum, Magnesium Hydroxide |
| Cause Constipation | Calcium carbonate and magnesium hydroxide |
| Causes diarrhea | Aluminum Hydroxide |
| What would you not give a bowel obstructed patient | Antacid |
| Nursing consideration for Antacids | give 2hrs before/after other drugs |
| Common AE of PPIs | NVD, headache, abdominal pain |
| PPI's treat | GERD and gastric ulcers |
| Examples of PPI's | Omeprazole and Lansoprazole |
| Thrombolytics are adminned for what | MI and Stroke |
| Dissolves clots and restores circulation in a quick manner | Thrombolytics (ASE ending, Alteplase) monitor cardiac rhythm |
| What is the time frame for Thrombolytics | 12 hrs after first symptoms, but max effect if given within 4 hrs |
| When are thrombolytics contradicted | If patient has had trauma within the last two weeks |
| Nitrates .... | Dilate the veins, arterial/venous/smooth muscle, reduce the preload, |
| Amylnitrite, Isosorbitide denitrate, nitroglycerine | For angina, have the patient lie down, if consumed with alcohol can cause cardiac collapse and hypotension (NITRATES) |
| No grapefruit juice, drowsiness, dizziness, visual disturbances, anorexia, N/V, serum potassium levels | Cardiac Gylcoside Nursing Considerations |
| Makes the heart beat forcefully but more slowly improving cardiac function | Digoxin (cardiac glycoside) |
| Nursing Considerations for Calcium Channel blockers | Obtain baseline ECG, HR, BP |
| If calcium channel blockers are adminned IV what is a possible AE | Tachycardia, hypotension |
| What is the class that treats angina, dysrhythmias, HTN, decreases the calcium level | Calcium channel blockers |
| MOA of Calcium | muscular contraction, peripheral vascular resistance, neuron transmission |
| Nursing considerations for Adrenergic antagonists | Hold med if HR < 90. BP < 90/60, vitals, potential orthostatic hypotension, hypoglycemia |
| Examples of Adrenergic antagonists | Doxazosin, guandrel, atenolol |
| Diazoxide, minoxidil, hydralazine, nitroprusside | Vasodilators |
| What has reflex tachycardia, angina, NA+ and water retention | Vasodilators |
| Nitroprusside | IV choice drug for emergency HTN |
| First dose is given @ bedtime and may cause hypotension | Ace Inhibitor |
| Nursing considerations for Ace Inhibitors | Vitals, LOC, angioedema (life threatening), CBC levels |
| ACE inhibitors and Angiotensin II receptor blockers | Prils and sartans |
| Treat acute asthma --> bronchodilation | Anticholinergics |
| What manages the asthma and pulmonary disease by realizing the bronchial smooth muscle | Beta 2 adrenergic agonists |
| How are Beta adrenergic classified | Duration (short or long acting) |
| albuterol (conspire ER) | long acting |
| albuterol (prosit HFA) | short acting |
| What is the dosing for Montelukast | 1x daily, 1 hour before/after meals, Headache, N/D |
| What occurs in the body when It becomes acidic ( < 7.35) | CNS depression and coma |
| CNS stimulation and convulsions occur when the body becomes ____ | alkolotic @ > 7.45 |
| Sodium bicarb and phosphate are what | Buffers |
| Lungs and Kidneys have what function | removing acid |
| hypoventilation and severe diarrhea | 2 ways to become acidic |
| 2 ways to become alkolotic | hyperventilation and constiaption |
| NACL & KCL | Treat alkalosis |
| What is a quick way to treat severe alkalosis | Hydrochloric acid and ammonium chloride |
| Sodium is what | the most abundant ECF cation |
| Neutromuscular activity, acid-base balance, water balance | Sodium main roles |
| Thirst fatigue, muscle twitch | Hypernatremia manifestations |
| Sodium bicarb is used to treat what | Acidosis and hyperK+ |
| Renal _____ may be given to eliminate excess K+ | Polystyrene sulfate |
| What is the normal PH value for plasma and body fluid | 7.35-7.45 |
| What system would need a range outside of the normal PH | digestive tract |
| Patient presents with a low BP, what would be adminned? | NS (0.9% NACL) |
| Normal serum albumin is ______ | the most common colloid |
| PTD for colloids | Dextran 40 |
| Nerve conduction, membrane permeability, muscle contraction, water balance, bone regrowth and remodel | Roles of electrolytes |
| Hey Cal, give me the 411 | Normal Calcium value: 4-11 |
| Chloride normal value | 95-112 |
| I only need half the mag | Normal Magnesium level 0.4-8 |
| Normal Phosphate value | 1-6 |
| Sodium level | 135-145 |
| Normal Potassium level | 3.5-5 |
| If there is an electrolyte imbalance, there is an underlying cause, what is the most common? | Renal impairment |
| What contains electrolytes that mimic the ECF, replace fluid, and promote output | Crystalloids |
| Isotonics | 0.9% NACL, Lactated ringers, Plasma 148, D5W |
| Hypertonics | 3% NACL |
| Hypotonic | Plasma 56, 0.45% NACL |
| What is one of the most important questions to ask during assessment | Do you have any drug allergies |
| What relieves cellular edema (cerebral edema) | hypertonic crystalloids (3% and 0.45% NACL) |
| Hypernatremia and cellular dehydration is treated with | Hypotonic crystalloids ( plasma lyte 56 and 0.45% NACL) |
| Patient presents with normal BP, what kind of solution is given | hypotonic crystalloids Plasma 56, 0.45% NACL |
| Why is sodium the greatest contributor to Osmolality | it is abundant in body fluids |
| Tonicity | ability to cause change in water movement across a membrane due to osmotic forces |
| Causes sodium and water retention | Aldosterone |
| IV fluid therapy supports | blood volume and BP |
| Suctioning, vomit, diarrhea, sweat, hemorrhage, burns, excessive diuresis | causes of FVD |
| FVE, pulmonary edema, cardiac stress are the results of | rapid fluid replacement |
| 2 types of fluid replacement | Crystalloid and Colloid |
| What are some possible causes to fevers | Meds and Infections |
| What meds can cause a Lethal fever | Anti-infectives (penicillin G), SSRI's (paroxetine) Conventional anti-spychiotic (chlorpromazine) |
| HTN, CHF, Peripheral edema are caused by | Unmanaged FVE |
| What are the compartments of ECF | intravascular space & interstitial spaces |
| Fluid that is measured by # of dissolved particles or solutes in 1L of H20 | Osmolality |
| 3 Components of Osmolality | Sodium, Glucose, Urea |
| Salicylates class, kind to COX 1 & 2 making inhibitons longer in platelets, when taken in small doses daily it can help prevent abnormal clotting r/t MI and stroke..What am I? | Aspirin |
| Nursing consideration for aspirin | monitor bleeding due to high anti-platelet ratio |
| Tinnitus, dizzy, headache, excessive diaphoresis can all be summed up to what syndrome | Salicylism which is an AE of aspirin |
| For what reasons would you not give a 19 and under aspirin | flu symptoms, fever, chickenpox, all r/t Reye's syndrome |
| Most common side effect of NSAIDs | N/V |
| BLACKBOX for NSAID's | increased risk for thrombembolytic events, stroke, MI, may cause/worsen HTN |
| I am the only Cox2 inhibitor, because of that, I help save the GI and effects on coagulation. I can also help treat polyps | Celecoxib |
| Besides treating severe inflammation, what else does corticosteroids treat | Asthma, arthritis, neoplasia, corticosteroid deficiency |
| Inhibits the prostaglandins, histamine release, phagocytes, lymphocytes. Due to the multi factor of function, I am the most effective for severe inflammation | Corticosteroids (ONE ending) |
| How are corticosteroids supposed to be taken | Every other day @ the same time in the AM, w/food or milk, must be tapered down |
| Cushing's syndrome is an effect of | over-treatment of steroids |
| High fevers in children are dangerous because | they can cause febrile seizures |
| High fevers in adults are dangerous why? | can lead to coma, death, tissue break down, < mental acuity, delirium |
| What are the 5 steps to inflammation | 1. Vasodilation = redness & heat 2. Vascular Permeability = edema 3. Cellular filtration = pus 4. Thrombosis = clots 5. Stimulated Nerve endings = pain |
| Non-pharm interventions for inflammation | RICE and rest |
| Common diseases that benefit from anti-inflamm medication | Allergic rhinnitis, anaphylaxis, contact dermatitis, Crohns Disease, Hashimoto, PUD |
| What are the two main types of anti-inflamm meds | NSAIDS and corticosteroids |
| When the pain is disabling and severe due to inflammation, what would be prescribed for a short term? | Corticosteroids |
| NSAIDS inhibit COX 1 and 2. Cox 1 protects the stomach, due to it being blocked, what is the possible outcome | GI upset and stomach bleeding |
| What med should be taken 4-6x daily to not effectivity of terminating acute asthma attacks | Mast cell stabilizers (cromolyn) |
| What can be given subcu for allergic rhinitis and moderate to severe persistent asthma | Omalizumab every 2-4 weeks |
| COPD is what stage of emphysema | Chronic obstructive pulmonary disease; terminal |
| What are the causes of COPS | chronic bronchitis (excess mucus in LRT) and/or emphysema |
| If a patient has COPD, what meds are contradictories | beta-adrenergic agonists, opioids, barbiturates |
| Main purpose of inflammation | to contain the injury, and destroy the microorganisms |
| How long does it take for inflammation to resolve and and repair to start | 8-10 days |
| If the inflammation doesn't contain and resolve it, what is the result? | Chronic inflammation |
| Histamine and mast cells = | the main chemical mediators of inflammation |
| 2 examples of autoimmune diseases | Systemic Lupus Erythrematosus (SLE) and rheumatoid arthritis |
| What can be checked as a key sign for inflammation | C-reactive protein |
| What are some devices that can be used to deliver respiratory meds | Metered Dose Inhaler (MDI) Neb w/face mask, Dry powder inhaler (DPI) |
| What part of the LRT is affected by a DPI delivery | Bronchial tree |
| MDIs deliver meds to | the lungs |
| Chronic pulmonary disease w/inflammatory properties is known as ? | Asthma |
| Bronchoconstriction, secretions of histamines, increased mucus, edema in airways | What occurs in asthma attack |
| Air pollutants, allergens, chemicals, food, respiratory infections, stress, exercise are what ? | Asthma triggers |
| Acetylcysteine is an example of | Mucolytic |
| What are some diseases that produce which bronchial secretions | Cystic fibrosis, and chronic bronchitis |
| Acetylysteine is the antagonist to | acetaminophen |
| Blood pumped through the lungs is what | Perfusion |
| Sympathetic branche causes | Bronchodilation by relaxing smooth muscle in the bronchials |
| Parasympathetic branch causes what | Broncoconstriction by contraction of smooth muscle |
| How can a bronchospasm be fixed? | Aersol therapy; it relieves the gasping |
| Examples of mast cell stabilizers | Ipotropium, montelukast, cromoloyn |
| Largest side effect of intranasal meds | Rebound congestion that comes from use for more than 3-5 days |
| Nasal decongestant examples | Oxymetazoline (Zoloine and Rine ending) |
| What dampens the cough reflex | antitussive |
| For severe cough what could be adminned | Opioid (codine or hydrocodone) |
| Non-opioid antitussive | dextromethorphan |
| Meds that reduce thickness of bronchial secretions making it easier to remove them by coughing | expectorants |
| Most common expectorant | Mucinex (guigenesin) |
| What makes up the upper respiratory tract | nose, nasal cavity, pharynx, paranatal sinuses |
| What endings represent H1 receptor antagonist (antihistamines) | INE & ATE |
| What makes antihistamines most effective | if taken prophylactically (1-3 weeks) |
| What is the first line of treatment for allergic rhinitis | corticosteroids |
| Alternate for corticosteroids | Mast cell stabilizers |
| Unstable, severe, unresponsive to other meds asthma, what would be prescribed | oral prednisone 5-7 days |
| What would need monitoring if older adult is taking corticosteroids and is at risk for osteoporosis | bone mineral density tests |
| What are the second choice drugs that decrease inflammation, ease bronchoconstriction, alternate for asthma symptoms | leyukotrine modifiers (montelukast) |
| MOA of montelukast | inhibits leukotriene receptors to decrease inflammation |
| what inhibits mast cells from release histamines and other chemical agents and prevents asthma attacks | cromolyn |
| Tremors, tachycardia, dizziness, dry mouth, throat irritation, gi distress | Common AEs of asthma meds |
| Pharyngitis, bronchospasm, urinary retention | side effects to Ipotropium |
| MOA of anticholinergics | blocks parasympathetic NS from bronchoconstriciton |
| Used for longterm prophylaxis of asthma that does respond to the beta agonists or corticosteroids | methylxanthines (theophylline & aminophylline) |
| Long term prevention of asthma attacks | inhaled corticosteroids |
| Most potentate natural anti-inflammatory substance | Corticosteroids |
| SABAs, anti-cholinergic, systemic corticosteroids | Provide quick relief for asthma |
| Corticosteroids, mast cell stabilizers, leyukotrine modifiers, LABAs, methylxanthines are | Long acting |
| SABAs are considered PRN because | they only last 2-6 hours but due to rapid onset they're called emergency meds |
| Albuterol ProAir HFA, Levalbuterol, metaprotereol, terbutaline | make up the SABAs |
| Albuterol Vospire ER, Formoterol, Salmeterol | Make up LABAs that work for upto 12 hours |
| BLACKBOX for SABAs | increased risk for asthma related death |
| What wouldn't be used for acute bronchospasm | The LABAs |
Created by:
nghayes08
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