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Final exam

FINAL

QuestionAnswer
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