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Know your stuff!
NCLEX
Let's be rationale
Be a Davis Drug Guide
Know your drugs!
100
- prolonged immobility - major trauma - lower extremity surgery - hypercoagulability states -estrogen therapy
What are risk factors for both DVT and PE?
100
A client will be receiving lepirudin (Refludan). Which of the following is true concerning this drug therapy? Select all that apply. 1.Ginger, garlic, and green tea may increase the risk of bleeding. 2. Vitamin B 12 is used to augment this drug’s response. 3. Refludan is used for heparin-induced thrombocytopenia. 4. Activated partial thromboplastin time is monitored to determine effectiveness. 5. This drug is contraindicated for clients with severe hypertension.
What is 1, 3, 4, 5 Rationale: Ginger, garlic, and green tea may all increase the risk of bleeding. Lepirudin is used for heparin-induced thrombocytopenia (HIT) and is monitored by aPTT, similar to heparin. The drug is contraindicated in clients with severe HTN. Option 2 is incorrect. Vitamin B 12 does not enhance the response of lepirudin.
100
Monitored for therapeutic effectiveness for a client with DVT being treated with a heparin infusion.
What is aPTT?
100
Inhibits platelet aggregation to prevent clot formation.
What is Clopidogrel ( Plavix)?
100
- Anticoagulant - Indirect thrombin inhibitor - Activates antithrombin III - Pregnancy Category C
What is Heparin?
200
Stimulates production of RBCs and is used to treat anemia
What is Erythropoietin?
200
A statement the nurse would include in the care plan for a client receiving epoetin alfa? 1. Avoid fresh fruit and vegetables, or partially cooked meats. 2. Encourage frequent rest periods to minimize fatigue. 3. Limit exposure to direct sunlight and use sunscreen when outdoors. 4. Protect tissues and mucous membranes from traumatic injury.
What is # 2?
200
A client who regularly consumes significant amounts of alcohol is prescribed cyanocobalamin (Nascobal) and states, “I don’t understand why my health care provider has prescribed B 12 injections.” The nurse’s response would be based on which physiological concept? 1. Clients who regularly consume large amounts of alcohol are often deficient in this nutrient. 2. Alcohol facilitates folate metabolism in the liver, which destroys vitamin B 12 . 3. Clients who regularly consume large amounts of alcohol are at high risk for neutropenia, a condition that develops from vitamin B 12 loss. 4. Liver cirrhosis caused by large amounts of alcohol inges tion diminishes natural physiological deposits of B 12
What is # 1
200
- Thrombolytic/ fibrinolytic - Pregnancy Category C - Converts plasminogen to plasmin - Dissolve c lots that have already formed
What is Alteplase (Activase)?
200
Treatment of overdose of heparin
What is protamine sulfate?
300
Used to dissolve existing intravascular clots in patients with myocardial infarction and stroke
What are thrombolytics?
300
Darbepoetin (Aranesp) is prescribed for each of the following clients. A nurse should question the order for which condition? 1. A client with HIV who is receiving zidovudine 2. A client with uncontrolled hypertension 3. A client with chronic renal failure 4. A client with chemotherapy-induced anemia
What is # 2?
300
The nurse is teaching the client about ferrous sulfate (Feosol). Which statement should be included in the teaching plan? Select all that apply. 1. This drug should be taken on an empty stomach at least 1 hour before or 2 hours after a meal. 2. Getting liquid iron on teeth should be avoided because the drug can cause brown stains. 3. Iron preparation may darken stools and cause constipation. 4. Vitamin E is added to many oral iron supplements because it enhances iron absorption. 5. This drug can be taken with caffeinated beverages.
What is # 1, 2, 3
300
- Hematopoietic growth factor for anemia - Erthropoietin -Pregnancy Category C -Stimulates the division and differentiation of stem cells in the bone marrow
What is Epoetin Alpha ( Epogen, Procrit)?
300
-Anticoagulant -Vitamin K antagonist -Inhibits two enzymes involved in formation of activated vitamin K - Inhibits synthesis of new clotting factors - Category X
What is Warfarin?
400
Therapy based on etiology and severity A) oral iron supplements B) parenteral iron therapy C) increase in iron rich foods
What is A) moderate anemia B) severe anemia C) mild anemia
400
The client is being treated with filgrastim (Neupogen). Which of the following would the nurse monitor to determine the effectiveness of this drug? 1. Red blood cell counts 2. Platelet counts 3. White blood cell counts 4. Reticulocyte count and mean cell volume (MCV)
What is # 3?
400
A client will be receiving lepirudin (Refludan). Which of the following is true concerning this drug therapy? Select all that apply. 1. Ginger, garlic, and green tea may increase the risk of bleeding. 2. Vitamin B 12 is used to augment this drug’s response. 3. Refludan is used for heparin-induced thrombocytopenia. 4. Activated partial thromboplastin time is monitored to determine effectiveness. 5. This drug is contraindicated for clients with severe hypertension.
What is # 1,3,4,5
400
- Colony stimulating factor - Pregnancy Category C - increases neutrophil production in the bone marrow - Nurse is responsible in monitoring temperature every 4 hrs
What is Filgrastim ( Neupogen)?
400
Treatment of Warfarin overdose
What is Vitamin K?
500
Causes of anemia ( ALL 3)
What is *Blood loss due to hemorrhage *increase erythrocyte destruction *decreased erythrocyte production
500
The nurse is teaching the client about oprelvekin (Neumega). Which statement, if made by the client, indicates additional health teaching is needed? 1. “This drug stimulates the production of platelets.” 2. “I should weigh myself and watch for fluid retention.” 3. “I will report vision changes to my health care provider.” 4.“I will add more iron-rich foods to my diet.”
What is #4?
500
A client who is taking warfarin (Coumadin) states, “I wake up every morning with arthritis pain and I always take aspirin or ibuprofen.” The nurse’s response would be based on which physiological concepts? 1. Aspirin and ibuprofen (Motrin) will counteract the therapeutic effects of many anticoagulants. 2. Anticoagulants will reduce the half-life of drugs such as aspirin and ibuprofen. 3. Many substances such as aspirin and ibuprofen will increase the risk of bleeding. 4. The combination of aspirin products with anticoagulants will worsen arthritis pain.
What is # 3?
500
- Agent for anemia - iron supplement - pregnancy category A - desferal deferoxamine treats overdose
What is Ferrous sulfate?
500
- SQ only -10x less heparin- induced thrombocytopenia -More expensive -No aPTT monitoring
What are Low-Molecular-Weight Heparins?