Anemia
What is the drug action of Epoetin Alfa and when is it given?
It is used to stimulate erythropoiesis and is given to patients who are not able to produce erythropoietin (renal failure patients).
List the contraindications for Hormone Replacement Therapy.
Idiopathic vaginal bleeding
Breast or Cervical Cancer
Thromboembolic Events (DVT)
Patients who smoke
How do Adrenergic Blocking agents work and what are the nursing responsibilities?
Lower the BP, decrease the HR, and improve renal perfusion.
Used to treat cardiac-related conditions including hypertension.
Nursing Intervention: check HR prior to administration
Describe three different types of drugs that affect clotting formation.
Antiplatelets alter platelet aggregation and formation of the platelet plug.
Anticoagulants interfere with the clotting cascade and thrombin formation.
Thrombolytics break down the thrombus.
Therapeutic level for Heparin
WBCT of 2.5-3 times the control value or aPTT of 1.5-3
How should the nurse administer Iron preparations?
1. It should be given with food.
2. Liquid preparations should be administered through a straw.
3. Avoid administering with eggs, milk, coffee, tea, and Vitamin C.
When a patient is receiving Oxytocin what are the primary nursing interventions?
Monitor for adverse effects of the drug
Monitor the fetal heart rate and uterine activity
Obtain vital signs frequently
How do Adrenergic agonist work and what are the nursing responsibilities?
They stimulate receptors within the SNS.
Used to treat shock, cardiac arrest, ventricular arrhythmias, heart block, and prevention of bronchospasm.
Monitor the client for adverse reactions: tachycardia, angina, MI, and palpitations, SOB, cough, and bronchospasm, N/V, and anorexia.
What are anticoagulants used to treat?
Prevention of venous thrombosis and PE
Treatment of Atrial Fibrillation
Treatment of DIC
Adjunct treatment for MI and Stroke
Prevention of clotting in blood samples and heparin lock sets
List the Antidote for Heparin
List the Antidote for Warfarin (Coumadin)
Protamine Sulfate
Vitamin K
If a client is taking Ferrous Sulfate how can the nurse evaluate the client's compliance to drug therapy?
Labwork (HgB)
Risk factors associated with Oral Contraceptives.
Thromboembolic Events (DVT)
Ophthalmic Adrenergic Agonist
Used to treat elevated intraocular pressure in people with open-angle glaucoma or ocular hypertension. Patients are to place one drop in the affected eye(s) three times a day. Always perform hand hygiene prior to administration and instruct the client not to rub the eyeball after administration. The client should tilt the head or lie supine and drops are instilled into the lower conjunctival sac.
Most common side effects are allergic conjunctivitis, burning sensation in the eye, eye pruritus, ocular allergic reactions, and visual disturbances.
What education should the nurse provide to a patient starting on anticoagulant therapy?
Provide education on the importance of having coagulation studies (bloodwork).
Brush teeth with a soft bristle toothbrush
Use an electric razor
Avoid contact sports
Wear a MedicAlert bracelet
Monitor for signs of bleeding
How is Heparin administered?
Intravenously or Subcutaneously
What client's benefit from Folic Acid administration?
Patients planning to become pregnant, patients who are pregnant or lactating, patients with nutritional deficiencies, and patients with megaloblastic anemia.
For client's who are starting on oral contraceptive therapy what education should be provided?
They should continue to use a backup method for the next month.
Take the medication at the same time each day.
If they forget to take one dose they can take two doses the following day.
If they forget to take two doses they can take tablets daily for the next two days.
If they miss greater than 3 doses they need to begin a new cycle of tablets 7 days after the LMP.
What are the contraindications for anticoagulants?
Known allergy
Conditions that could be compromised by increased bleeding tendencies
Warfarin is contraindicated in pregnancy (Heparin is used during pregnancy)
Drug-Drug Interactions for Heparin
Any drugs that increase bleeding risk
Warfarin interacts with many drugs so it is safest practice to always check and ask the patient which medications they are currently taking in addition to herbal preparations.
List a common adverse effect of Iron preparations.
GI upset and dark green stool.
What is included in the "Black-Box Warning" for patients taking anabolic steroids?
Serious effects of liver tumors (Hepatic Carcinoma) and changes in lipid levels.
Inhibit the formation of clots.
What is the therapeutic level for Warfarin?
Prothrombin Time (PT) - 1.3 to 1.5 times the control value
International Normalized Ratio (INR) - 2 to 3.5