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Pharm 2 exam
paharmacology exam 2
| Question | Answer |
|---|---|
| When teaching a patient who has been prescribed metoprolol( Lopressor) about side/adverse effects, which is the highest priority teaching point? | Instruct the patient how to take a pulse |
| Stimulation of which adrenergic receptor results in dilation of vessels and decrease in blood pressure? | Alpha2 |
| The nurse is teaching the patient about the side effects of atenolol ( Tenormin). These include | Bronchospasm. |
| A nurse is administering epinephrine to a patient during a cardiac arrest. The primary desired action of this medication to | Stimulate a heart rate. |
| A patient has been prescribed atenolol ( Tenormin). To ensure safe dosing, the nurse teaches the patient to frequently assess what parameter? | Heart rate |
| A patient is receiving dopamine ( Intropin) intravenously. Which drug should the nurse have available to treat extravasation and tissue necrosis? | Phentolamine mesylate Regitine) |
| What is Sympathetic known for? | Fight or flight |
| What is parasympathetic known for? | Rest and digest |
| What is another word sympathetic is known for? | Adrenergic |
| What is another word for parasympathetic? | Cholinergic |
| Drugs that stimulate the sympathetic nervous system are called? | adrenergic agonists, & adrenergics, |
| Parasympathetic constricts blood vessels. (T/F) | False |
| Sympathetic does not contrict the bladder. (T/F) | True |
| Sympathetic relaxes smooth muscles of gastrointestinal tract. (T/F) | True |
| Parasympathetic constrict bronchioles and increases secretions. (T/F) | True |
| Parasympathetic dilates pupils. (T/F) | False |
| What does Beta 2 do? | Dilates bronchioles, promotes gastrointestinal and uterine relaxtion. Promotes increase in blood glucose through glycogenolysis in the liver. |
| What does Beta1 do? | Increases heart rate and force of contraction; increases renin secretion, which increases blood pressure |
| What does Alpha2 do? | Inhibits release of norepinephrine; dilates blood vessels; produces hypotension; decreases gastrointestinal motility and tone |
| What does Alpha1 do? | Increases force of heart contraction; vasoconstriction increases blood pressure; mydriasis (dilation of pupils) occurs; secretion in salivary glands decreases; urinary bladder relaxation and urinary sphincter contraction increases |
| What is norepinephrine? | Stimulates Alpha 1 sites, Beta 1 receptors ( Increases cardiac output) |
| What is epinephrine? | Adrenaline. |
| What is epinephrine used for? | -Anaphylaxis, anaphylactic shock. -Bronchospasms. -Cardiogenic shock, cardiac arrest. |
| What is the nonselective action for epinephrine? | -Alpha 1 increases the blood pressure. -Beta 1 increases heart rate. -Beta 2 promotes bronchodilation |
| What is the drug interaction for epinephrine? | -Beta blockers. (blocks) -MAO's & Tricyclics. (antipsychotic need) -Digoxin. |
| What does Beta 1 receptors target? | -Heart -Kidney |
| Albuterol class and uses | Class- Beta 2 Adrenergic agonist Uses- Treats bronchospasm, astha, bronchitis, COPD |
| Albuterol side effects/adverse reactions | -Tremors, nervousness, restlessness, insonmia, dizziness, blurred vision, HA -Cardiac dysrhthmias, reflex tachycardia -hallucinations, hyperglycemia |
| Clonidine (Catapres) | -Essentially potent -Selective alpha 2-adrenergic agonist |
| Clonidine is at risk for? | Hypotension, (check BP) -Dizzy, cold=Fall risk |
| Methyldopa ( Aldomet) | -Alpha 2-adrenergic agonist that acts within the CNS. |
| Methyldopa is at risk for? | Causes vasodilation and decreased BP |
| What is Beta 1 stand for? | Heart -Reduces force of. contraction -decreases pulse |
| What does Beta 2 stand for? | Lungs -Bronchoconstriction (know patients history) -Contracts uterus -Inhibits glycogenolysis |
| What is Raynauds disease? | Too much vasol-constriction= always cold |
| What is BPH? | Benign prostetic hyperplasia- Difficult for them to pee. |
| Antidote to Betta 2 agonist | Phentolamine Mesylate (Regitine) |
| Antidote for Acetaminophen | Acetylcysteine |
| Antidote for Bensodiazepines | Flumazenil |
| Antidote for Digoxin | Digoxin immune fab |
| Antidote for Heparin | Protamine sulfate |
| Antidote for Magnesium | Calcium gluconate |
| Antidote for Opioids | Naloxone |
| Antidote for Warfarin | Vitamin K |
| Beta Blockers that block Beta 1 | -Attenolol (Tenormin); Acebutolol HCL ( Sectral) ---> Decreases BP & pulse -Metoprolol Tartrate (Lopressor) |
| What is the use for Beta blockers for Beta 1 | Hypertension, Angina Pectoris, MI |
| Nonselective Blocks Beta 1 & Beta 2 and action | -Propanolol HCL( inderal) -Sotolol(Betaspace) -Nadolol (Cagorard) -Timolol Maleate(Blocadren) Decreases BP and pulse |
| Contraindications for beta blockers for Beta 1 & Beta 2 | COPD |
| Uses and SE for Beta Blockers that block Beta 1 | HTN, angina and MI SE-Bradycardia, hypotention, orthostatic hypotention dysrhythmias, headaches, dizziness, N/V/D, hypoglycemia |
| Cholinergic receptors | -Muscarinic receptors (affect smooth muscles--->heart, GI, GU, Glands)-Direct and Indirect. -Nicotinic receptors (Affect skeletal muscles) Indirect only |
| Direct-acting Cholinergic Agonists ( located in smooth muscles)-->heart, GI, GU, glands. | Muscarinic receptors -Metoclopramide(reglan)->Used to increase gastric emptying. -Pilocarpine(Pilocar)/ Carbachol(Miostat)->Used to constrict pupils -****(PROTOTYPE DRUG) Bethanechol chloride (Urecholine)->Used to increase urination |
| BETHANECHOL-->Parasympathetic SE | -Hypotension, bradycardia, sweating, frequent urination. -Increased salivation & gastric acid, nausea, vomiting, diarrhea, abdominal cramps. -Blurred vision -Bronchoconstriction |
| Bethanechol contraindications | -Urinary obstruction -Bradycardia -Hypotension -COPD -Asthma -Peptic ulcer -Parkinsonism -Hyperthyroidism |
| Cholinergic Toxidrome = Mr. Pathetic | Extreme form of parasympathetic -Diarrhea -crying (lacrimation) -pin point pupils (miosis) -frothing at the mouth (salivation & bronchorrhea) -Vomiting (emesis) -Running nose (rhinorrhea) -Urination -Bradycardia |
| Reversible Cholinesterase inhibitors is and uses | Not long-acting->can be changed back to normal. -Uses: Pupil contriction in glaucoma, increase muscle strength in myasthenia gravis. |
| What is gravis? | Disorder of lack of communication between the muscle. |
| SE of Norepinephrine | -Hypertension -Arrhythmias -Digital necrosis with high doses. |
| Antidote for reversable cholinesterase inhibitors (parasympathetic) | Pralidoxime CL (Protopam) |
| Rapid acting insulin | Onset: 5-15min Peak: 30 min Duration: 6-8 hours |
| Short-acting insulin | Onset: 30-40 min Peak: 90-120 min Duration: 6-8 hours |
| Intermediate- acting insulin | Onset: 1-4 hours Peak: 4-8 hours Duration: 12hrs |
| Long-acting insulin | Onset: 1-2 hours Peak: None Duration: 12-24 hours |
| Vasopressin/Desmopressin | MOA:Reabsorption of water in the kidneys, leading to low urine output and high urine osmolality Treat: Used to treat diabetes insipidus SE: Fluid volume excess, pounding headache. |
| Somatropin | MOA: Stimulates growth and protein synthesis SE: Hypergylcemia, pancreatitis Uses: Growth hormone deficiencies. |
| Strong iodine solution | MOA: Inhibits thyroid hormone production and release. SE: GI upset, hypothyroidism, iodism Uses: Hyperthyroidism, thyrotoxicosis, preparation for thyroidectomy. |
| Propythiouracil (PTU) | MOA: Blocks synthesis of thyroid hormones. SE: Agranulocytosis, GI upset, rash. When dose is too high, hypothyroidism. Uses: Grave's disease, preparation for thyroidectomy. |
| Levothyroxine, Lithyronine | MOA: Acts as a synthetic form of thyroid hormones. SE: When dose is too high, hyperthyroidism. Uses: Hypothyroidism. |
| Glucagon | MAO: Stimulates breakdown of glycogen into glucose. SE: Gi upset. Uses: Severe hypoglycemia when patient is unable to take oral glucose. |
| Acarbose | MAO: Inhibits glucose absorption in the GI tract. SE: GI upset, hepatotoxicity.. Uses: Type 2 diabetes |
| Pioglitazone | MAO: Low insulin resistance and glucose production. High glucose uptake. SE: Fluid retention, edema, elevated LDL's, hepatotoxicity. Uses: Type 2 diabetes |
| Metformin | MAO: Low glucose production in liver, low intestinal absorption of glucose, high insulin sensitivity. SE: Gi upset, metallic taste, lactic acidosis. Uses: Type 2 diabetes. |
| Repaglinide | MAO:Increases insulin release from pancreas. SE:Hypoglycemia, angina Uses: Type 2 diabetes |
| Glipizide, glyburide | MAO: Increases insulin release from pancreas. SE: Hypoglycemia, photosensitivity, GI upset. Uses: Type 2 diabetes. |
| Cacitonin salmon | MAO: Prevents bone reabsorption by inhibiting osteoclast activity. Increases renal excretion of calcium. SE: Gi upset, nasal irritation/dryness. Uses:Postmenopausal osteoporosis and hypercalcemia. |
| Albuterol | MAO: Bind to Beta 2 receptors in the lungs, causing bronchodilation. SE: Chest pain, tachycardia, palpations, tremors, anxiety. Uses: Asthma, COPD |
| Benztropine (parkinsonism) | MAO: Low ACh in the CNS SE: Anticholinergic effects Uses: Parkinson's disease to decrease tremors and muscle rigidity. |
| Albumin | MAO: Maintains osmotic pressure in the plasma. SE: Fluid overload. Uses: Shock, hemorrhage, burns. |
| Atropine | Action: Increases pulse, decreases motility and peristalsis, decreases salivary secretions=going into surgery. SE: tachycardia, excitement, confusion, dry mouth and skin, urinary retention, photophobia, blurred vision. (Dries you out) |
| Anticholinergics for motion sickness | -Scopolamine(Transderm scop): transdermal patch; placed behind ear. -Meclizine hydrochloride(Antivert): Dimenhydrinate(Dramamine);Cyclizine (Marzine) SE: Dry mouth, constipation, urinary retention, muscle weakness, tachycardia |
| A patient has received atropine. It is most important for the nurse to assess the patient for which effect? | Urinary retention |
| A nurse has jsut administered atropine to a patient. It is most important for the nurse to assess the patient for the development of which effect? | Tachycardia |
| A patient is ordered to receive bethanechol chloride (Urecholine) for urinary retention. Which health condition would serve as a contraindication for this medication? | Asthma |
| A patient received atropine as a preoperative medication 30 minutes ago/ The nurse evaluates the medication as effective if the patient states, | "My mouth feels dry" |
| A patient is prescribed scopolamine ( Transderm scop). It is most important for the nurse to assess the patient for a history of which condition? | Glaucoma |
| Atropine is most useful in the treatment of which cardiovascular condition? | Sinus bradycardia |
| Benzodiazepines( end in lam/pam) | Action: Interacts with neurotransmitter ( sleep hygiene= avoid phone, shower.) Uses: Reduce anxiety, stress. Interactions: Alcohol, CNS depressants. ( knowing what your patients are taking) Take 15 to 45 minutes before bedtime, report hangover effect |
| Barbiturates ( end in barbital) | agents: -phenobarbital( Luminal) Long-acting(seuizures) -mephobarbital9Mebaral) -butabarbital(Butisol) -secobarbital(seconal) -pentobarbital(Nembutal)Short-acting( procedure sedation) -thiopental sodium(Phentothal) |
| Nonbenzodiazepine, Nonbarbiturate CNS Depressants | Zolpidem tartrate ( Ambien), eszopiclone ( Lunesta), zaleplon(sonata). Use: Binds to GABA receptors Adverse effects: Mild nausea, dizziness, diarrhea, daytime drowsiness, amnesia, sleepwalking. Contraindicated in lactating women. |
| Hydantoins | Phenytoin (Dilation) -Contraindications: Pregnancy (teratogenic) -SE: Gingival hyperplasia, nystagmus, headache, diplopia, dizziness, slurred speech, decreased coordination, alopecia, thrombocytopenia, stevens-johnson syndrome, hirsutism |
| Succinimides | Ethosuximide(Zarontin) Action: suppress calcium influx Use: for petit mal (absense) seizures. AE: Adverse effects include blood dyscrasias, renal and liver impairment, and systemic lupus erythematosus, gastric irritation common, take w/ food |
| Valproate | Valporic acid ( Depakene, Depakote) -Used: treat absence, paritial, tonic-clonic, mixed types of seuizures. (not for children younger than 2 years, bc of it possible hypertotoxicity) -Range: 50-150 mcg/ml Anti-depressant( suicide risk) |
| (SSIRI's)Serotonin reuptake inhibitors | Action: Blocks the reuptake of neurotranmitter serotonin into presynaptic terminal, increasing the levels of serotonin. Uses: major depression, anxiety disorders, prevent migraines SE: headache, nervousness, restlessness, suicidal ideation, weight gain |
| SSRI's stands for | Serotonin reuptake inhibitor |
| SSRI's list | -fluvoxamine ( Luvox) -citalopram (Celexa) -escitalopram (Lexapro) -fluoxetine ( Prozac) -paroxetine ( Paxil) -sertraline (Zoloft) ALL HAVE INTERACTIONS WITH GRAPEFRUIT JUICE TOXICITY. |
| Serotonin syndrome (SES) | Confusion, anxiety restlessness, HTN, tremors, sweating, hyperpyrexia, ataxia |
| (SNRI's) Serotonin norepinephrine reuptake inhibitors | Action: Inhibit the reuptake of serotonin and norepinephrine, increasing these subtances in nerve fibers. Use: Major depression as well as generalized anxiety disorder and social anxiety disorder. SE: Drowsiness, dizziness, insonmia, headache, euphoria |
| (MAOI) Monoamine oxidase inhibitors | Inactivates NE, epinephrine and dopamine at the adrenergic synapse. -Low therapeutic index (higher risk of toxicity) Agents: Phenelzine ( Nardil), tranyclpromine (parnate), isocarboxazid (Marplan), selegiline (Emsam) |
| Atypical antidepressants agents | -Amoxapine ( Asendin) -Maprotiline ( Ludiomil) -Wellburtin ( Bupropion) -Remeron ( Mirtazapine) -Desyrel ( Trazodone) |
| Atypical antidepressants action | Their chemical structures do not fit into any of the other antidepressants. |
| Antipsychotic agents | -schizophrenia -schizoaffective disorder |
| Antipsychotic | Believed to be a disorder related to overactive dopaminergic pathway. |
| Dopamine pathways functions | -Reward (motivations) -Pleasure, euphoria -Motor function ( fine tuning) -Compulsion -Perserveration |
| Serotonin( sleep) pathways functions | -Mood -Memory processing -Sleep -Cognition |
| Phenothiazines list (end in zine) | -chlorpronazine (thorazine) -fluphenazine (prolixin) -perphenazine -prochlorperazine (compazine) -trifluoperazine |
| Non phenothiazines list | -haloperidol (Haldol) -loxapine (loxitane) -pimozide ( orap) -thiothixene (navane) |
| Tardive dyskinesia | Appears late, serious adverse effect protrusion and rolling of the tongue, sucking and smacking movt. of the lips, chewing motion. |
| Acute dystonia | Occur early, within days, muscle spasms, particular in the back, neck, tongue and face, abnormal involuntary upward eye movt., facial grimacing. |
| Akathisia | Most common, inability to rest and relax, patient cannot stand still, paces back & forth. |
| Lithium | Mood stabilizer, |
| Pituitary | ( testes of the brain) -> connected to the hypothalamus |
| ACTH adrenocorticotropic hormone | effect: |
| Dopamine pathways functions | -Reward (motivations) -Pleasure, euphoria -Motor function ( fine tuning) -Compulsion -Perserveration |
| Serotonin( sleep) pathways functions | -Mood -Memory processing -Sleep -Cognition |
| Phenothiazines list (end in zine) | -chlorpronazine (thorazine) -fluphenazine (prolixin) -perphenazine -prochlorperazine (compazine) -trifluoperazine |
| Non phenothiazines list | -haloperidol (Haldol) -loxapine (loxitane) -pimozide ( orap) -thiothixene (navane) |
| Tardive dyskinesia | Appears late, serious adverse effect protrusion and rolling of the tongue, sucking and smacking movt. of the lips, chewing motion. |
| Acute dystonia | Occur early, within days, muscle spasms, particular in the back, neck, tongue and face, abnormal involuntary upward eye movt., facial grimacing. |
| Akathisia | Most common, inability to rest and relax, patient cannot stand still, paces back & forth. |
| Lithium | Mood stabilizer, |
| Pituitary | ( testes of the brain) -> connected to the hypothalamus |
| ACTH adrenocorticotropic hormone (AP) | effect: stimulates adrenal cortex to release aldosterone & cortisol. stimulus: stress |
| FSH follicle-stimulating hormone (AP) | Effect: Men-sperm production, women-ovarian follicles for eggs stimulus: GNRH ( Gonadotropic-releasing hormone) -> in the hypothalamus. |
| LH Lutenizing hormone (AP) | Effect: Men-testicular, women-ovulation (release of the egg) stimulus: GNRH ( Gonadotropic-releasing hormone)-> in the hypothalamus |
| GH Growth hormone (AP) | Effect: Increased during anabolic metabolism, cartilage growth & catabolism of fat. Blood glucose & insulin effects. stimulus: Normal growth & development. |
| PRL Prolactin "lactose" (AP) | Effect: Stimulates production of milk in the breast.( also secreted by the uterus) stimulus: Estrogen, pregnancy & nursing. |
| TSH Thyroid-stimulating hormone (AP) | Effect: Stimulates thyroid to release T3 & T4 stimulus: Thyroid needs |
| ADH Antidiuretic hormone (PP) | "Add Da H20" Effect: Add water back into the body by telling the kidneys to reabsorb water. stimulus: Decreased BP, pain, high osmolality of the blood. |
| Anterior pituitary | Largest part of the pituitary gland, synthesis & release of most pituitary hormones. |
| Posterior pituitary | Does not produce hormones directly, stores & secretes hormones produced by the hypothalamus. |
| Osmolality | Really thick blood-> More water needs to be added back to the body to dilute the blood. |
| Oxytocin (maternity) | effect: Stimulates uterine contractions & lactation of breast milk. stimulus: Labor & delivery of newborn or infant breast feeding. |
| 1. Steps to stimulate the thyroid, Hypothalamus releases what? | TRH Thyrotropin-releasing hormone. |
| 2. Steps to stimulate the thyroid, Tells the anterior pituitary to release what? | TSH thyroid stimulating hormone. |
| Triifothyronin | stored & secreted by thyroid. |
| 3. Steps to stimulate the thyroid, The stimulate pops out 3 key players | 1. T3 (active thyroid hormone) 2. T4 (thyroid hormone) 3. Calcitonin ( puts a "ton" of Ca IN bone) |
| Calcitonin | Tone's down the calcium in the blood, by putting a ton of calcium into the bone. |
| Hyo-thyroid | Low T3 & T4 Cause: Iodine defficiency Ex: -HashimOtos -low dietary iodine -Pituitary tumor -Thyroidectomy ( body can't produce any thyroids at all) scenerios: -low BP -Constipated -cold Body can't produce any thyroid hormones AT ALL. |
| Hyper-thyroid | Your body needs dietary iodine found in salt Causes: -Graves: Gains-"High" -Iodine excess -levothyroxine excess ex: -high BP -enlarged thyroid -hot Treatment: -Propylthouracil w/ potassium iodine -Methimazole-> contraindicated if pregnant |
| Methimazole | stops thyroid gland from making too much thyroid hormone |
| Thyroid contains (Ca+) | T4 & T3 (active thyroid hormone) |
| Parathyroid (Ca+) | For regulation of blood calcium "PC"->like a computer P: Parathyroid C: Calcium (9.0-10.5 mg IDL) |
| PTH Parathyroid hormone | "Puts The calcium High"-> inside the blood Ca+ high-> PTH Shuts OFF Ca+ low->PTH Turns ON |
| Calcium (ca+) is increased in the blood by 3 ways: | R: Renals reabsorb (calcium from urine) I: Intestines (GI) absorption form food, & help with Vit D (activation) B: Bone (into the bone) |
| Hyper-parathyroidism | "Too MUCH calcium in the blood" 1. Stones= Kindey stones (renal calculi) 2. Moans= Fractured bones 3. Groans = Constipation (hyper-calcemia) Everything swollen & slow |
| Hypo-parathyroidism | "Too LITTLE Ca= in the blood" -less than 9.0 calcium |
| Adrenal cortex | The outer region of the adrenal gland, divided into 3 separate zones. |
| Adrenal cortex zones | 1. Zona glomerulosa 2. Zona fasciculata 3. Zona reticularis |
| Adrenals location | Sit ON TOP of the kidneys-> helps the body adapt to stress. By MACC hormones, like Mac computers-> looks like the apple logo. |
| MACC hormones | M: Mineral-corticoids steroids. Aldosterone " salt water hormone." A: Androgen steroids ( sex) & ( hair) C: Cortisol steroid (Glucocortioid) "stress hormone" C: Catecholamines -epi & norepi (adrenaline)-> increases HR & BP -Fight or flight |
| Aldosterone | Blocks release of Na+H20. A: Adds sodium & water In ( to balance BP) L: Lets Potassium out (& into the potty) |
| Adrenal functions | -Maintain potassium excretion through kidneys. -Stimulate the sympathetic nervous system. -Promote sodium & water absorption. -Increase metabolic activities. |
| Taper off | steroids |
| Idiosyncratic effect | Response to a drug that is unexpected & may be Unique to that client. "i" & "u"= singular |
| Teratogenic effect | Any substance that is capable of causing Harm to a fetus |
| Cumulative effect | Metabolism & Excretion fails to keep pace with the repeated intake of medication. "Cumul"=Multiple fail |
| Synergistic effect | Two drugs are used together, and the result has greater impact than if two were separated. "syn"="sync"->two together |
| Endocrine function of the pancreas | To regulate glucose levels in the body system. |
| Potassium iodine | Affects synthesize of the thyroid hormone |
| Dexamethasone | w/breakfast, prevents stomach upset. |
| Grave's disease ( hyperthyroidism) | Propythiouraci (antithyroid) |
| Prolonged use of steroids cause | Cataracts-> opacity or cloudiness of the lens of the eyes. |
| Steroids at risk for | reduce body inability to absorb Ca+-->osteoporosis |
| Taking glyburide avoid | -increased risk of sunburns outdoors, use sunscreen. -Avoid skipping meals to prevent hypoglycemia. -Notify HCP immediately if they develop chest pain or discomfort. |
| A nurse has been teaching a patient about levothyroxine ( Synthroid). Which side effect should the nurse teach the patient to observe for? | Nervousness |
| A patient has adrenocortical insufficiency and was taking hydrocortisone (Solu-Cortef) 240 mg every 12 hr Iv. Before discharge the drug was switched to prednisone (Deltasone). Which is appropriate teaching for discharging a patient with oral prednisone? | The dose needs to be tapered off over 1 to 2 weeks. Steroids=taper off |
| The nurse will teach a patient taking levothyroxine (Synthroid) for hypothyroidism to notify the HCP if he or she experiences. | Nausea |
| During a diasnostic test for parathyroid function, a patient asks the nurse what the parathyroid gland does. The nurse correctly informs the patient that the parathyroid gland is responsible for.. | Regulating calcium levels |
| Which drug would the nurse administer for treatment of a patient with hyperthyroidism? | Methimazole (Tapazole) |
| PMP treatment for hyperthyroidism | P-> propythiouracil W/ potassium iodine M: methimazole ( stops thyroid gland from making too much thyroid hormone.)->contraindicated if pregnant. P:Potassium iodine w/ propylthouracil |
| The nurse identifies the drug of choice for the treatment of chronic lympocyte (Hashimoto) thyroiditis as-> | Levothyroxine sodium ( Synthroid) |
| A patient has hypoparathyroidism. The nurse anticipates administration of which medication? | Calcitriol |
| Hypothalamus | Regulates sleep, hunger, thirst, body temp. |
| Pineal Gland | Releases melatonin, which regulates sleep and wake cycle. |
| Pituitary gland | Releases energy, metabolism and growth. |
| Thyroid gland | Regulates enerygy, metabolism, and growth. Produces 3 hormones 1.Thyroxine T4 2.Triiodothyronine T3 3. Calcitonin ( ton of Ca) |
| Parathyroid gland | Helps regulate calcium & phorphorus in the blood. |
| Adrenal gland | Controls growth, sugar metabolism, kindey function & stress.-> epi * norepinephrine ( Fight or flight) |
| Pancreas | Aids in the digestion of protein, fats, and carbohydrates. Produces insulin to control blood sugar. |
| Ovaries | Produces female hormones 1. Estrogen 2. Progesterone |
| Testes | Produces male hormones->Testosterone |
| DM type 1 onset & treatment | Abrupt -Insulin only (insulin dependent for life) |
| DM type 2 onset & treatment | Gradual -Diet & exercise (Possibly insulin) |
| DM type 1 treatment | IV insulin- fluid replacement correction of electrolyte imbalances. |
| DM type 2 treatment | Fluid replacement correction of electrolyte imbalances, possible insulin administration. |
| Polydipsia (Hyperglycemia) | Excessive peeing |
| Polyphagia (Hyperglycemia) | Excessive hunger |
| Polyuria (Hyperglycemia) | Excessive peeing |
| Hyperglycemia (high BS) Causes 4 S's | 1. Sepsis ( infection) 2. Stress 3. Steroids 4. Skipping insulin or oral -hot & dry skin |
| Hyperglycemia treatment | -Administer insulin as needed. -Test urine for ketones |
| Glucose range | 70-110 mg/dL |
| Hypoglycemia ( low BS) causes/signs | -exercise -alcohol -peak times of insulin -cool & clammy -inability to arouse from sleep-->can lead to coma! |
| Hypoglycemia treatment | (15x15x15) -Oral intake of 15 grams of carbohydrates= juices, soda, low fat milk. -Recheck blood glucose in 15 min. -Give another of carbohydrates if needed. -unconscious patients-> do not put anything in their mouth! risk for ASPIRATE |
| Rapid insulin (acting) | -Lispro->Humalog -Apart->Novolog -Glulisine->Apidra Onset: 5-30min Peak: 30-90 min Duration: 3-5 hrs Highest risk for hyperglycemia |
| Short inslin (acting) | -regular->Humalin R, Novolin R Onset: 30-60 min Peak: 2-4 hrs Duration: 5-7 hrs Only insulin given IV " Regular goes Right into vein" |
| Intermediate insulin (acting) | NPH: Humulin N, Novolin N Onset: 1-2 hrs Peak: 4-12 hrs Duration: 18-24 hrs Never give IV "Too long duration" |
| Long insulin (acting) | -Glargine->Lantus -Detemir->Levenir Onset: 1-2 hrs Peak: None Duration 24+ hrs Lowest risk for hyperglycemia "Do not mix with any other insulin. |
| HbA1c range | Non-diabetic: 4-5.6% Pre-diabetic: 5.7-6.4% Diabetic: >6.5% Goal for diabetic: <6.5% |
| Albumin range (BMP) | 3.4-5.4g/dL |
| Creatinine range (BMP/renal) | 0.6-1.2mg/dL |
| Triglyceride (Lipid panel) | <150 mg/dL |
| Cholesterol range | <200 mg/dL |
| Calcium range (BMP/renal) | 9-11 mEq/L |
| WBC range (CBC) | 4,500-11,000 |
| RBC range (CBC) | 4.5-5.5 |
| Female (Hgb) range | 12- 16 g/dL |
| Male (Hgb) range | 13-18 g/dL |
| BMI range | 18.5-24.9 |
| Dopamine | Influences movement, learning, attention, and emotion. |
| Acetylcholine | Enables muscle action, learning, and memory. |
| Glutamate | A major excitatory neurotransmitter. |
| Prednisone 40 mg IV is ordered for a pt with pneumonia. The pt will be D/C'ed soon. The RN knows. | The prescription for home will be tapered. |
| A new admit has an A1C of 9.6. The RN knows the pt has. | DM |
| (T/F) Insulin lispro is a long acting insulin | False |
| The RN gave the pt regular insulin 1 hr ago. TN assesses the pt and notes the pt is unconscious. The RN should: | Give D5O IV |
| The DM pt develops sepsis. The RN anticipates the MD will order what? | Increased insulin dose. |
| (T/F) Piogflitazone and metformin can be taken together | True |
| The RN is giving IV insulin. There is an order for IV K. The nurse should do what action? | Administer the medications as ordered |
| (T/F) The onset of action for regular insulin is 90 minutes. | False |
| The symptoms of hypoglycemia include | -headache -nervousness -tachycardia |
| (T/F) A pregnant pt has been started on metformin. The RN knows 500 mg po BID is the appropriate dose. | False |
| The pt has DM. The orders include insulin and oral anticoagulants. The RN should monitor for: | Increased hypoglycemia |
| A newly admitted pt with DKA is prescribed glyburide. The RN shoudl: | Call the HCP |
| RN has a pt on metformin. The pt is going to CT with contrast. The nurse should: | Make sure the pt stops the metformin bf the test. |
| A pt with status epilepticus should get which med? | diazepam |
| Cholinergic crisis S?S includes? | -Respiratory paralysis -Excess salivation -Sweating -Pupil constriction |
| Seuizure pt who wants to become pregnant. The nurse should advise the pt to: | Speak with provider about tx plan. |
| (T/F) The RN is mixing regular and NPH insulins. The Rn should draw up the NPH first. | False |
| Common SE of sedative hypnotics include | -hangover -dependence -resp deoression |
| The RN is assessing for EPS and will monitor for which S/S | -stooped posture -masklike face -shuffling gait -sucking and smacking |
| RN teaching about methylphenidate, pt should avoid which foods? | chocolate |
| RN administers alprazolam. takes vitals and RR is 10/min. The RN should give which med? | Flumazenil |
| The RN is giving valporic acid. The level is 135 mcg/ml. The RN should: | Hold medication and call provider. |
| (T/F) There are no S/S of depression | False |
| (T/F) TCA's can make seizure pts more prone to have seizures | True |
| Nexly dx DM type 1 pt is ordered for Regular Insulin and metformin 1000mg BID. The RN should: | question the orders |
| The RN should know the pt with DI is ordered which med? | Vasopressin |
| Pt started on calcitrol. The RN should know they have which dx? | Hypoparathyroidism |
| Diazepam (Benzodiazepine) | Long-acting benzodiazepine -has many uses, one of which is to relieve muscle spasms and spasticity associated with MS and other motor neuron diseases such as CP. |
| Diazepam causes | -sedation -memory impairment -urinary incontinence -urinary retention |
| Cerebyx | A hydantoin antiseizure drug, with Celebrex, a nonsteroidal antiinflamatory drug(NSAID) |
| Valporic acid | Prescribed for tonic-clonic, absence, and partial seizures, although the safety and efficacy of this drug has not been established for children younger than 2 years of age. |
| Phenytonin (antiseizure drug) | intracranial regulation |
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yolanda.olivera001
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