The action of which drug is known to be increased by thyroid hormone replacement drugs - ANSWER-Warfarin (Coumadin)
Therapeutic INR range for a patient
... [Show More] taking an oral anticoagulant - ANSWER-2.0 - 3.0
A nurse is talking with a client who says she knows someone who takes metoprolol for blood pressure and asks if the medication would be appropriate for her as well. Which of the following data from the client's medical record should the nurse identify as a contraindication - ANSWER-History of sinus bradycardia
You are preparing to give an injection of heparin to a patient. Which of the following steps represent the correct procedure? (SATA) - ANSWER--Use a 25-gauge needle to give heparin subQ
-Draw up the heparin and check the dose with another nurse
-Do not massage the injection site after injecting the heparin
Why is it important to warn a patient prescribed to take finasteride (Proscar) for benign prostatic hyperplasia to wear a condom when having sex with a pregnant woman or one who could become pregnant - ANSWER-Drug can be absorbed by the pregnant woman and cause birth defects in the fetus
A nurse is reinforcing teaching about the manifestations of hyperglycemia with a client who has diabetes mellitus. Which of the following statements by the client indicates an understanding of the teaching - ANSWER-More thirsty than usual
A nurse is reinforcing teaching for a client who has type 2 diabetes mellitus and is prescribed glipizide. The client should be taught that glipizide works in which of the following ways - ANSWER-Stimulates the pancreas to release adequate insulin
A nurse is reinforcing teaching with a client who has a prescription for simvastatin. Which of the following instructions should the nurse provide - ANSWER-Take this medication in the evening
What precaution is most important to teach patients who are taking any "statin" drugs - ANSWER-Avoid drinking alcohol and taking acetaminophen
A nurse is collecting data from a client who takes metformin for type 2 diabetes. Which of the following medications is contraindicated for this client due to its effect on blood glucose levels - ANSWER-Prednisone
A nurse is caring for a client who has deep vein thrombosis, who received IV heparin for the past 5 days, and now has a new prescription for oral warfarin in addition to the heparin. The client asks the nurse is both medications are necessary. Which of the following is an appropriate response by the nurse - ANSWER-Heparin will be continued until the warfarin reaches a therapeutic level
A nurse is reinforcing teaching with a client who has a prescription for transdermal nitroglycerin to treat angina pectoris. The nurse should include which of the following instructions in the teaching? (SATA) - ANSWER--Remove the patch for 10 to 12 hr. daily
-Apply the patch to a hairless area
-Apply a new patch each morning
A nurse is reinforcing teaching with a client who has diabetes mellitus and a new prescription for lispro and Lantus Insulins. Which of the following statements by the client indicated an understand of the teaching - ANSWER-Unopened vials of insulin should be kept in my refrigerator
A patient with atrial fibrillation has been prescribed the drug dabigatran (Pradaxa). The patient asks you what the advantage of this drug may be over warfarin (Coumadin). What is your best response - ANSWER-This drug does not require frequent laboratory testing
A nurse is collecting data from a client who has a prescription for several daily medications and reports she also uses a variety of herbal supplements, including garlic, ginger root, and ginkgo biloba. The nurse should inform the client that these three herbal preparations can cause which of the following medication interactions - ANSWER-Increased effects of oral anticoagulants
A nurse is caring for a client who has atrial fibrillation and is receiving heparin. Which of the following findings is the nurse's priority - ANSWER-Slurred speech
A nurse is reinforcing teaching with a 55-year-old client who is experiencing menopause and is prescribed estrogen/progestin therapy (EPT). The nurse should tell the client that which of the following is a benefit of estrogen/progestin therapy in women who are postmenopausal - ANSWER-Estrogen prevents fractures from osteoporosis
A nurse is preparing to administer morning insulin to a client who has a prescription for 14 units of regular insulin and 28 units of NPH insulin subQ daily. What is the TOTAL number of units of insulin that the nurse should prepare in the insulin syringe - ANSWER-42 units
A nurse is reinforcing teaching with a young adult female client who has been prescribed lisinopril. Which of the following instructions should the nurse plan to include? (SATA) - ANSWER--Notify your doctor immediately if you become pregnant
-Report the development of a persistent dry cough
-Monitor your blood pressure on a regular basis
A nurse is collecting data from a client who has hypertension and a prescription for propranolol. A history of which of the following conditions should be reported to the provider - ANSWER-Heart failure
Which side effects are most common among women taking hormone replacement therapy for menopause - ANSWER-Breast tenderness and fluid retention
A nurse notes that a client's laboratory findings reveal agranulocytosis. The client is taking propylthiouracil to treat hyperthyroidism. The nurse should monitor the client who which of the following - ANSWER-Infection
Rapid-Acting Insulin Analogs > Examples - ANSWER--Insulin aspart injection
-Insulin glulisine injection
-Human lispro injection
-Insulin human inhalation powder
Rapid Acting Insulin: Onset? Peak? Duration? - ANSWER-Onset: 15 MINS
Peak: 1 hour
Duration: 3 hours
Give within 15 minutes of a meal
-Lispro (Humalog)
-Aspart (Novolog)
Long-acting Insulin: Onset? Peak? Duration? - ANSWER-Onset: 2 hours
Peak: no peak
Duration: 24 hr.
Acts as a basal insulin
Do not mix with other insulin
-Glargine (Lantus)
-Levemir
Thyroid Hormones > P/T - ANSWER-Take on an empty stomach
When should potassium levels be monitored - ANSWER-With loop diuretics and potassium-sparing diuretics
Diuretics > S/E & A/E - ANSWER--Urinary urgency, and frequency
-Dry mouth, increased thirst, lightheadedness
-Fluid and electrolyte imbalances
-Increased uric acid
-Dehydration-Hypotension
-Hypokalemia (loop diuretics)
-HYPERKALEMIA (K-SPARING DIURETICS)
Hypokalemia > S/S - ANSWER-"7 L's"
1. Lethargy (confusion)
2. Low, shallow respirations (decreased ability to use accessory muscles for breathing)
3. LETHAL CARDIAC DYSRHYTHMIAS
4. Lots of urine
5. Leg cramps
6. Limp muscles
7. Low BP and heart
HMG-CoA Reductase Inhibitors ("-STATIN") > S/E & A/E - ANSWER--Abd pain, HA, diarrhea, muscles and joint discomfort
-Elevation of BG
-Liver failure
-MYOPATHY
-Rhabdomyolysis (muscle breakdown): muscle pain, muscle weakness, stomach pain, and brown (tea-colored) urine
-Dangerous during pregnancy (cholesterol is needed for fetus's brain development). Don't take if you are breastfeeding too.
HMG-CoA reductase inhibitors ("-STATIN") > Examples - ANSWER--atorvastatin
-fluvastatin
-lovastatin
-pravastatin
-rosuvastatin
-simvastatin
THESE MEDICATIONS SHOULD BE TAKEN IN THE EVENING
Antihyperlipidemic Drugs > Niacin - ANSWER-Flushing of the face very common side effect
Hypertension Meds > P/T - ANSWER--Avoid sudden position changes
-MONITOR B/P ON NORMAL BASIS
-Avoid alcohol consumption
-Hold medication for systolic B/P less than 90
ACE-I ("-PRIL")/ ARBs ("-SARTAN") > P/T - ANSWER--DRY COUGH
-STOP TAKING IF YOU GET PREGNANT
-MONITOR B/P ON NORMAL BASIS
Calcium channel blockers ("-DIPINE") > P/T - ANSWER--Avoid in heart failure patients
-MONITOR FOR REFLEX TACHYCARDIA
Beta blockers ("-OLOL") > P/T - ANSWER--DON'T GIVE TO PATIENTS WITH HISTORY OF BRADYCARDIA
-Never administer if patients HR below 60
Antianginals > Nitrates MOA - ANSWER-Vasodilates by relaxing vascular smooth muscle in the peripheral venous system and reducing resistance to blood flow in the arterial system. These effects work together to help the heart get more oxygen and pump more easily
Vitamin K antagonist - ANSWER-warfarin
Indirect Thrombin Inhibitors > S/E - ANSWER--Bruising
-Minor bleeding (such as nosebleeds and bleeding from cuts)
-Major bleed
-Life-threatening bleed.
-Stroke symptoms (Weak, SLURRED SPEECH)
-HIT (Heparin induced thrombocytopenia)
Hypoglycemia symptoms - ANSWER--Anxiety
-Weakness fatigue
-Dizziness
-TACHYCARDIA
-Headache
-BLURRY VISION
-DIAPHORESIS (excessive sweating)
-Shakiness
-Irritability
-Hunger
Hyperglycemia symptoms - ANSWER--Stomach pain
-Irritability
-VERY THIRSTY
-Need to urinate often
Short-Acting Insulin > Examples - ANSWER--Regular human insulin injection
-Humulin R
Short-acting Insulin: Onset? Peak? Duration? - ANSWER-Onset: 30 min.
Peak: 2 hours
Duration: 8 hours
(May be given IV)
Most common used in hospital for low BS
-Regular insulin
Intermediate-acting Insulin: Onset? Peak? Duration? - ANSWER-Onset: 2 HOURS
Peak: 8 hr.
Duration: 16 hrs
Not to be given IV
-NPH
Short-acting insulin > How to prevent hypoglycemia - ANSWER-Patient will need to eat the meal within 15 mins of receiving the injection
Which diuretic drug exert on the collecting duct - ANSWER-Thiazides
Phenazopyridine (Pyridium) > Action - ANSWER-Excreted into the urine and act as a local anesthetic on the mucous membranes of the urinary tract
Phenazopyridine (Pyridium) > P/T - ANSWER-Will turn the urine an orange-red color that can stain the toilet and clothing. (Only take it for maximum of 2 days. Notify MD after 2 days)
Digoxin toxicity > S/S - ANSWER--Fatigue
-Weakness
-Vision changes
-GI effects
Common drugs for thyroid problems - ANSWER--Methimazole
-Propylthiouracil
Alendronate > P/T - ANSWER--Take 30 min before you eat or drink anything
-After administration, do not eat, drink, or take any medications for at least 30 minutes
-Sit upright or stand upright for at least 30 minutes have passed
-Swallow the tablet with a full glass of water (do not split, chew, or crush)
What do you not take with Amitriptyline - ANSWER-Valerian
What drug category is useful in promoting sleep for insomnia - ANSWER-Sedatives
What do we tell patients that we are treating with monoclonal antibodies or other neurological drugs to do - ANSWER-Avoid large crowds
Cholinesterase Inhibitors > Examples - ANSWER--donepezil
-rivastigmine
-galantamine
Buspirone is an example of... - ANSWER-miscellaneous nonbenzodiazepine agonist
P/T > Xanax - ANSWER-Can get addicted
What does acetaminophen destroy - ANSWER-Liver
Haloperidol S/E - ANSWER-Tardive dyskinesia
P/T > Diazepam - ANSWER-It will make you drowsy (make sure they don't drive)
Patient is given lorazepam (benzo). What do we report to the provider immediately - ANSWER-Anxiety increases
Cyclobenzaprine > MOA - ANSWER-Muscle relaxant, decreases muscle spasms
Hydromorphone > A/E - ANSWER-Vomiting
What can carbamazepine cause - ANSWER-bone marrow suppression, patient may have BRUISES
What increases phenytoin (Dilantin) toxicity - ANSWER-Alcohol
Selegiline > MOA - ANSWER-Decrease tremors
What can Narcan (naloxone) cause when giving - ANSWER-tremors that look like seizures
What is carbamazepine for - ANSWER-Seizures
Who can't take zovirax (acyclovir) - ANSWER-people allergic to milk
S/s of acyclovir (SATA) - ANSWER-back pain (or flank pain)
mood changes
dizziness [Show Less]