Units 7-9
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| What is an anticoagulant? | They prevent new clots from forming and prevent existing clots from becoming larger.
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| What must the nurse teach a patient on anticoagulants long term to avoid? | Avoid activities that can traumatize tissue and lead to bleeding.
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| What do antiplatelet drugs do? | Prevent platelets from clumping together (aggregating).
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| What do thrombin inhibitors and clotting factor synthesis inhibitors do? | Prevent new clots from forming and existing clots from getting larger.
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| What type of drug is given to persons exhibiting stroke symptoms? | A thrombolytic drug (clot buster)
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| A thrombolytic drug must be administered within how many hours of the onset of symptoms? | These drugs must be administered within 3 hours of the onset of symptoms of a stroke.
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| After receiving a thrombolytlic drug the patient is at risk for what effect? | High risk for bleeding with any invasive procedures.
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| On what factor is the initial heparin bolus based? | The patient's weight.
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| What is the goal of continuous heparin therapy? | To keep the aPTT within a therapeutic range of 1.5 to 2.5 times greater than the laboratory established control value.
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| What is a major advantage of prescribing enoxaparin? | Patients are not required to have laboratory work done to guide their therapy.
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| What is the normal platelet range? | 200,000 to 400,000/mm3
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| What does a low platelet count mean for someone on heparin? | It is an indication of an adverse reaction to heparin known as heparin-induces thrombocytopenia.
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| What vitamin counteracts the therapeutic effects of warfarin? | Vitamin K
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| In what foods is vitamin K found? | Green leafy vegatables
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| What is the therapeutic warfarin level for INR? | Therapeutic warfarin levels should maintain the INR between 2.0 and 3.0.
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| What is the normal range for INR? | 0.7 to 1.8 is the normal INR range
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| What are common side effects of anticoagulant therapy? | Bleeding from the gums, oozing from cuts or wounds, nosebleeds, and heavier than usual menstrual bleeding.
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| What effect does darbepoetin alfa have on a patient? | Darbepoetin alfa increases blood cell production, the blood becomes more viscous (thicker).
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| What effect does viscous blood have on a patient's vascular system? | This raises blood pressure, increases clot formation and slows blood movement through small vessels.
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| What is the action of oprelvekin? | Oprelvekin is a thrombpoietic colony-stimulating factor that increases production of platelets to at least 50,000/mm3
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| What is the purpose of short acting but rapid acting beta2 agonists (albuterol)? | Reduce the severity or stop an asthma attack.
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| What is the purpose of a long acting beta2 agonist (salmeterol)? | Can prevent attacks when taken daily.
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| For what purpose might a short acting beta2 adrenergic agonist be prescribed for a COPD patient? | Extra doses might be needed to open airways whenever the patient feels especially breathless.
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| What is the advantage of inhaled drugs? | Inhaled drugs go more to the site where the intended responses are needed and less drug is absorbed systemically; there are fewer side effects.
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| What must you teach a patient using a dry powder inhaler? | Washing the DPI may cause the medication in the inhaler to clump together.
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| What is the therapeutic range for theophylline? | A very narrow 10 to 20 mcg/mL.
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| What is the recommended loading dose of IV aminophylline? | 5 to 7 mg/kg
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| What is the intended action of bronchodilators? | To widen the airways to improve breathing.
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| What does aminophylline do? | Stimulates the sympathetic nervous system.
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| What are signs and symptoms of aminophylline toxicity? | CNS irritability, restlessness, temperature elevation, tremors, tachycardia, nausea and vomiting, palpitations and dizziness.
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| Which side effect reported by the patient taking Brethine should the nurse report to the prescriber? | Chest pain. This may mean constriction of the coronary arteries.
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| What is a patient at risk for when using a steroid inhaler excessively? | Excessive use reduces the local immune function and increases the patient's risk for infection.
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| What is a side effect of leukotriene inhibitors? | They can cause liver impairment.
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| What lab value indicates liver impairment? | Lactate dehydrogenase.
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| What is the purpose of cromolyn sodium? | It is a prophylactic drug that stabilizes mast cell membranes.
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| What is the pregnancy warning for benzodiazepines? | Have caused birth defects when used during the first trimester and can cause the fetus to become dependent and experience withdrawal symptoms after birth.
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| What is ondansetron? | An antinausea drug.
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| What is a contraindication to prescribing metoclopramide? | A history of depression
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| What is the action of metoclopramide? | Increases stomach and small intestine peristalsis which helps move food through the GI system.
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| What are the effects of promethazine? | It is an antiemetic drug which induces sedation and confusion; some patients have reduced memory about events occurring within a few hours after receiving the drug.
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| What effect do antiemetic drugs have on the central nervous system? | All of the antiemetic drugs cause some degree of central nervous system depression.
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| Scopolamine is what type of drug? | Anticholinergic
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| What is a side effect of an anticholinergic drug? | Urinary retention
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| What is a rare and life threatening side effect of prochlorperazine? | Neuroleptic malignant syndrome in which dangerously high body temperatures can occur.
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| What is a dangerous side effect of bisacodyl? | Hypokalemia
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| What are the symptoms of toxic megacolon, a serious complication of diarrhea therapy? | Increasing abdominal size, fever, abdominal pain, rapid heart rate and dehydration.
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| What are cholinergic antagonists? | Anticholinergic
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| What do anticholinergic drugs do? | Block the parasympathetic nervous system
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| What are systemic effects of bronchodilators? | Rapid heart rate, increased blood pressure, a feeling of nervousness and difficulty sleeping
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| What are the actions of a mucolytic? | Reduce the thickness of mucus, allowing the mucus to more easily move out of the airways.
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| Name a mucolytic. | Guaifenesin
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| What is the major mucolytic drug for COPD? | Acetylcysteine
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| What are common side effects of antiemetic drugs? | Dizziness, fatigue, headache, blurred vision, constipation and drowsiness
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| What is a side effect of Reglan? | May cause mild to severe depression. Should not be prescribed to patients with a history of depression.
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| What instruction do you give patients taking antiemetic drugs for chemotherapy? | Take 30 minutes before meals
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| What are the 3 types of antidiarrheal drugs? | Antimobility, Adsorbent/absorbent, and antisecretory
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| What are signs and symptoms of hypokalemia? | Cardiac dysrhythmias, muscle pain, general discomfort or irritability, weakness and paralysis
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| What are common side effects of antidiarrheal drugs? | Constipation, abdominal discomfort. dizziness and dry mouth
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| What is an alert for Pepto Bismol? | It contains aspirin and can increase the effects of the anticoagulant warfarin.
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| What foods should patients with GERD avoid? | Chocolate, peppermint, alcohol and caffeinated drinks
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| For best effects when should PPIs be given? | Before meals, preferably in the morning
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| What are characteristics of a complex partial seizure? | Loss of consciousness for 1 to 3 minutes and automatisms such as lip smacking, patting or picking at clothes.
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| What is a pediatric consideration with phenytoin? | Excessive growth of gum tissue (gingival hyperplasia)
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| What are common side effects of first line drugs for generalized and partial seizures? | Dizziness, drowsiness, nausea/vomiting and ataxia (loss of coordination)
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| What is the effect of drugs for partial and generalized seizures on anticoagulant drugs? | Can increase the effects. Watch for abnormal bleeding.
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| What is the effect of drugs for partial and generalized seizures on oral contraceptive drugs? | They interfere with the effects. An additional form of contraception should be used.
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| TRUE or FALSE: Absorption of phenytoin is decreased by antacids | TRUE
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| TRUE or FALSE: Grapefruit and grapefruit juice increase the action of carbamazepine | TRUE
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