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for test 3

Quiz yourself by thinking what should be in each of the black spaces below before clicking on it to display the answer.
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Question
Answer
Is PUD & GERD affect the upper GI system?   Yes  
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PUD may occur in the...   Esophagus, stomach, or upper part of the duodenum  
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When does GERD occur?   When the stomach contents leak into te esophagus  
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When a peptic ulcer occurs in the stomach it is called?   A gastric ulcer  
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When an ulcer is formed in the duodenum it is called a ....   Duodenal ulcer  
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80-90% of gastric ulcers are caused by an infection with...   Helicobacter pylori (H-Pylori)  
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State the s/s of an ulcer that is getting worse   Blood in stools, black tarry stools, continuing nausea or repeated vomiting, feeling cold or clammy, feeling weak or dizzy, losing wt, pain that doesn't go away with meds, pain that radiates into the back, vomiting blood or food eaten hours or days ago  
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Gasatroespohageal reflux disease is a condition in which the liquid contents of the....   Stomach back up into the esopagus  
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State four risk factors for GERD development   Over wt, pregnant, certain medical conditions, certain medications (NSAIDS), alcohol, eating foods with high acid content, fatty & spicy foods, lying down too soon after meals, smoking  
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State the most common s/s of GERD   Dyspepsia (heartburn)  
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Chronic GERD can cause changes in the cells of the esophagus, leading to precancerous cells and cancer. This condition is called   Barrett's Esophagus  
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State the four substances that increase the risk for ulcer development   Alcohol, NSAID's, Aspiring-containing products, foods  
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Waht is the action of H2 Blockers   Decrease stimulation of H2 receptors in the gastric cells that secrete hydrochloric acid  
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State the most common side effect of H2 Blockers   Confusion  
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If a PT, is recommended to take an H2 Blocker once per day, when should the Pt be advised to take the medication & why   Hour of sleep (HS) to prolong its effects, when there is no food in the stomach & reflux may be worse.  
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Does examples of H2 Blockers include Ranitidine (Zantac), Cimetidine (Tagamet)   Yes  
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Rantitidine (Zantac) can cause what color change in the mouth & elimination?   Black tongue & dark stools  
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How do PPI's (Proton pump inhibitors) work?   Completely block the production/secretion of stomach acid  
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Are PPI's (Proton Pump Inhibitors) the most powerful medications used for treatment of PUD/GERD?   Yes, the are also used in combiination with antibiotics to treat H-Pylori  
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Are common examples of OTC PPI's include espmeprazole (Nexium) & Iansoprazole (Prevacid)   Yes, other med examples include Prilosec, Aciphex, & Protonix  
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How do antacids work?   They neutralize the stomach acid  
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Common s/e of antacids containing aluminum is...   Constipation  
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Common s/e of antacids containing calcium include...   Constipation  
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Common s/e of antacids containing magnesium include..   diarrhea  
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Antacids should be administered...   One hr after or 2 hr before any other medications  
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Pt. with heart failure should not take sodium containing antacids like Alka-Seltzer... Why?   They increase the NA & water retension, increasing the workload of the heart & can make the heart failure worse.  
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Are Maalox & Mild of Magnesia examples of antacids?   Yes  
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How do cytoprotective medications work?    
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What is the most common side effect of Sucralfate (Carafate)   Constipation  
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Bismuth subsalicylate (PeptoBismol) should not be used in children due to what condition?   Reye's syndrome (children should only use children's Pepto)  
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How do promotility drugs work?   Increase the LES (lower esophageal sphintcher) tone & speed up the emptying of food from the stomach  
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Can metoclopramide (Reglan) cause Neuroleptic malignant syndrome   Yes, this can be life threatening. Fever, resp distress, tachycardia, seizures, b/p changes, severe muscle stiffness, loss of bladder control, etc.  
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Does Ducralfate (Carafate) cause Tardive Dyskinesia   No, Metoclopramide (Reglan) does  
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Antibiotics are used to treat what infection?   Bacterial infection, H-Pylori  
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acute pain...   has a sudden onset, an identifiable cause, and a limited duration; triggers physiologic changes; and improves with time even when it is not treated  
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addiction   is the psychologic need or craving for the "high" feeling that results from using opioids when pain is not present  
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analgesics Drugs that   provide pain relief by either changing the perception of pain or reducing its source  
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antihistamines   Drugs used to treat allergies and allergic reactions  
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benzodiazepine receptor agonists are   drugs that depress the CNS and induce sleep by binding with gamma-aminobutyric acid (GABA) receptors  
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benzodiazepines   a class of psychotropic drugs with hypnotic and sedative effects, used mainly as tranquilizers to control symptoms of anxiety or stress and as sleeping aids for insomnia  
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chronicpain...   has a long duration, may not have an identifiable cause, does not trigger physiologic changes, and persists or increases with time  
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controlled substance   a drug containing ingredients known to be addictive that is regulated by the Federal Controlled Substances Act of 1970  
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dependence is   Physical changes in autonomic nervous system function that can occur when opioids are used long term  
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insomnia   is the inability to sleep or to remain asleep throughout the night  
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narcolepsy is   a sleep problem with sudden, uncontrollable urges to sleep, causing the person to fall asleep at inappropriate times  
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nonopioid analgesics are....   drugs that reduce a person's perception of pain; it is not similar to opium and has little potential for psychologic or physical dependende  
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nociceptors are   free sensory nerve endings that, when activated, trigger a message sent to the brain that allows the perception of pain  
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opioid analgesic are drugs containing any ingredient derived from   the poppy plant (or a similar synthetic chemical) that changes a person's perception of pain and has a potential for psychologic or physical dependence (also called narcotics)  
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pain is   an unpleasant sensory and emotional experience associated with acute  
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pain tolerance is   a person's ability to endure or stand pain intensity  
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sedatives are a drug that   promotes sleep by targeting signals in the brain to produce calm and ease agitation  
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sleep is...   a natural and necessary periodic state of rest for the mind and body, in which consciousness is partly or completely lost, eyes close, metabolism slows, body movements decrease, and responsiveness to external stimuli declines  
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tolerance is....   the adjustment of the body to long-term opioid use that increases the rate that a drug is eliminated and reduces the main effects (pain relief) and side effects of the drug. More drug is needed to achieve the same degree of pain relief  
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withdrawal is...   the autonomic nervous system symptoms occurring when long-term opioid therapy is stopped suddenly after physical dependence is present. Symptoms include nausea, vomiting, abdominal cramping, sweating, delirium, and seizures  
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Schedule I drugs have....   a high potential for abuse with no acceptable medical use in the US. Lack of accepted safety for use of the drug or other substance under medical supervision  
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Schedule II drugs have....   high potential for abuse but are currently accepted for use in the US. Abuse may lead to severe psychological or physical dependence  
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Schedule II drugs have   the potential for abuse but is less than drugs or substances in the previous classes. They are currently used in the US for treatment of medical conditions. Abuse may lead to moderate or low physical dependence or high psychological dependence  
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Schedule IV drugs have   a low potential for abuse relative to drugs in previous classes. They are used in the US for medical purposes. Abuse may lead to limited physical dependence or psychologic dependence relative to previous drug class. Valium is in this class  
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Schedule V drugs have   low potential for abuse relative to the drugs in previous class. They are used for medicine in the US. Abuse may lead to limited physical dependence or psychologic dependence relative to previous drug class. Lomotil is in this class  
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absence seizure is a...   generalized seizure usually lasting less than 20 seconds characterized by a blank stare and sometimes blinking, eye rolling, or chewing movements; also called petit mal seizure  
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atonic seizure is a seizure characterized by...   sudden loss of muscle tone for a few seconds followed by confusion  
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aura is   the strange sensation such as tingling, smell, or emotional changes that occur before a seizure  
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complex partial seizure is a seizure that....   involves only part of the brain and impairs consciousness; often preceded by a simple partial seizure, aura, or warning  
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epilepsy is...   a disorder of the brain that causes recurrent, unprovoked seizures  
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generalized is a seizure that...   involves the entire brain; caused by electrical discharges originating from both sides of the brain  
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myoclonic seizure is a...   brief muscle jerk resulting from an abnormal discharge of brain electrical activity; usually involves muscles on both sides of the body, most often the shoulders or upper arms  
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partial seizure is...   one that starts in one part of the brain. The abnormal electrical activity may remain confined to one area or spread to the entire brain; also called a focal or local seizure  
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postictal phase is..   "After the seizure" phase often characterized by confusion, headache, sore muscles, and fatigue  
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seizure is..   uncontrolled electrical activity in the brain that may produce a physical convulsion, minor physical signs, thought disturbances, or a combination of symptoms  
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seizure disorder is...   a pathologic condition resulting in a sudden episode of uncontrolled electrical activity in the brain  
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status epilepticus is....   a prolonged seizure (usually defined as lasting longer than 20 min) or a series of repeated seizures; a continuous state of seizure activity that may occur in almost any seizure type  
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tonic-clonic seizure...   lasts 2-5 minutes with stiffening or rigidity o fthe arm and leg muscles and immediate loss of consciousness; also called a grand mal seizure  
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For a generalized or complex partial seizure,   remove anything that could cause injury to the patient and turn him to one side to prevent aspiration and let secretion drain  
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Do not attempt to put anything into the person's mouth during a seizure to prevent   them biting their tongue. If they break off pieces of whatever you put in there, or break off their teeth, they may aspirate those  
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Most anti-seizure drug treatments consists of...   more than one drug  
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Anti-seizure drug treatments start   with only 1 drug at a time to determine its effects  
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Because multiple drugs are given for seizure control,   the primary drug given for control is called the 1st-line drug. The next drug is called the 2nd-line drug.  
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Most of these anti-seizure drugs should or should not be taken with food   Should  
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Carbamazepine (Tegretol) should not be taken with...   grapefruit juice because it increases the action of the drug  
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neutropenia   Term for decrease in the number of WBC's  
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pancytopenia   Term for the reduction of all types of blood cells  
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aplastic anemia is   deficient RBC production by the bone marrow  
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laryngospasm   Term for closing of the larnyx; adverse effect of phenobarbitol  
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angiodema   Term for the swelling around the eyes and lips and sometimes of the hands; adverse effect of phenobarbitol  
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What is the normal Litium serum levels?   0.5 - 1.5 meq/L  
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Carbidopa - Levodopa (Sinemet)   Medication for Parkins Disease (PD) Blocks the conversion of levodopa to dopamine in the perigheral NS. Onset 15 min. Peak 1-3 hrs. Duration 5-12 hrs. Admin with low protein foods. Avoid excessive amounts of Vitamin B6 (Pyridoxine).  
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S/E of Carbidopa - Levodopa (Sinemet)   NUMEROUS!! Nausea, vomiting (dopamine stimulates the CTZ in the medulla) Cardio-orthostatic hypotension, increased HR, cardiac dysrhymias with dose changes, mental changes, nightmares, & suicide tendencies.  
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Is pain assessmetn considered the 5th vital sign?   Yes  
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name the division of the ANS that pain will trigger & identify three s/s that can result in the aactivation.   Sympathetic, Increased HR, Respitory, & Blood Pressure  
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Identify 3 barriers related to good pain management that affect health care workers..   Fear of addiction, belief that pain is an expected part of aging, fear of overdosing a PT.  
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What is the action of Analgesics?   Pain Control  
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Why is the assessment of the PT pain intensity & when the last dose of pain medication was administered necessary prior to any Analgesic medication?   Pain intensity may warrent a different medication route, PT intervention; Last medication dose determines if administration time is appropriate..(too long of interval, too early)  
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Opiods AKA?   Narcotics  
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Are Opiods controlled substances?   Yes  
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Identify three common s/e of Opioid administration   Constipation, Nausea, Vomiting  
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State two adverse effects of the use of Opioids   Respiration depression, Dependance, & Addiction  
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State the Opioid antidote   Narcan  
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Are Opioids used to manage severe pain?   Yes  
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NSAID's are used to ...   Reduce inflammation  
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State what each of the letters in NSAID stand for   Non Steriodal Anti - Inflammatory Drug  
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Headaches & kidney problems are associated with all NSAID's except...   Aspirin (ASA)  
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Can NSAID's cause bleeding?   Yes  
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What are 2 examples of Ibuprofen?   Motrin / Advil  
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Celecoxib (Celebrex) is a Cox-2 selective / inhibitor; What is the major advantage of a Cox-2 inhibitor?   Helps decrease inflammation, yet keep the lining of the stomach intact.  
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NSAID's can cause retention of NA & H2O, causing what vital sign change?   Increased blood pressure!!  
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Acetaminophen AKA?   Tylenol  
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State the max adult dose of Acetaminophen   4g / day  
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Identify three acute sleep problems   Stress, Use of stimulants, Use of alcohol, Minor illness  
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How do medications for insomnis work?   Cause general CNS depression, drowsiness, & mild sedation  
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Methylphenidate (Ritalin) can cause what two growth alterations in children?   Height & Weight  
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