Respiratory
Give an example of an short acting beta2 agonist and how it works.
Albuterol, levalbuterol, pirbuterol
Works by bronchodilating the bronchioles
Heparin is what drug class?
Anticoagulant
Name the classes for the following: Lisinopril, Losartan, Propranolol, Verapamil
Lisinopril: ACE inhibitor
Losartan: ARB
Propranolol: Beta blocker
Verapamil: Calcium channel blocker
A client with CHF is experiencing is exacerbation. He currently has SOB and +3 pitting edema. What medication would the RN except?
Loop diuretics such as furosemide
What labs should be check prior to given a HMG-CoA reductase inhibitor?
Cholesterol levels: LDL, HDL
Liver panel: AST, ALT
What are common side effects of short acting beta2 agonists?
Tremors, anxiety, hyperglycemia, insomnia
Name the labs needed to check therapeutic range for coumadin, heparin, and enoxaparin
coumadin: PT/INR
heparin: aPTT
enoxaparin: None
A client taking doxazosin decides to take his medication in the morning. Explain why this is dangerous and when he should have taken it.
Doxazosin used for HTN and BPH has the risk of orthostatic hypotension. It is best to take it at night to prevent this.
Name the s/s of hypokalemia
Alkalosis
Shallow respirations
Irritability
Confusion
Weakness
Arrhythmias
Lethargy
Thready pulse
A client has been on atorvastatin for 2 weeks. A couple of days ago, the client starts to have muscle cramping. What should the client do? What could be happening?
The should call the provider
This may be s/s of rhabdomyolysis
A client is on theophylline for management of his COPD. What education should the RN provide regarding SE and foods?
This medication may cause palpations and if occurs call the provider. Avoid foods with caffeine such as coffee, tea, and chocolate
A 55 year old female is 1 day post op from a total knee replacement. The RN receives orders for heparin and enoxaparin subq.
What is the priority next step?
Name the steps to give a prefilled enoxaparin injection.
Call the provider for clarification.
Clean site with alcohol, pinch skin, insert needle, inject medication, remove needle and observe for bleeding
What are the side effects of ACE inhibitors and ARBS?
Is there anything clients can do to decrease the effects of the side effects?
non-productive cough, hyperkalemia, angioedema
ARBs do not cause the cough
non-productive coughs are common, if it bothers clients they can switch to ARBs
A client has been on 20mg of furosemide IV for 3 days. What are some SE that could be seen after 3 days?
What are some things that can be done to counter the SE?
Hyponatremia and hypokalemia
Contact provider for KCL supplements or switch to a potassium sparing diuretic
Adenosine is administered when client's rate and rhythm cannot be controlled. What is a common SE of this medication?
Asystole
A 30 year female was recently dx with acute sinusitis and prescribed guaifenesin and decongestant nasal spray. What nursing education needs to be provided? What's the difference between a local and systemic decongestant?
Guaifenesin is an expectorant works by pulling fluid into the respiratory tract to help loosen phlegm. Clients should increase fluids.
Decongestant spray should be use no more than up to 3 days. More than 5 days can cause rebound congestion. Local only works in a single location while systemic effects the whole body
A 45 year old client with PMHX of PUD tells his nurse that he is taking aspirin for his pain. What should the RN do and why? What types of clients should not have aspirin and why?
Aspirin is an antiplatelet that will increase the risk for GI bleeds for clients with PUD. The RN should tell the client to stop use of aspirin.
Children and young teens should not take aspirin due to the risk of Reye's Syndrome
A client with PMHX of HTN has been newly prescribed amlodipine. The client is already on HCTZ and is told to take both. What education should be provided regarding both medications and its SE?
Amlodipine is a CCB and cause constipation. Clients should increase fiber and fluid intake. Grapefruit juice should also be avoided.
HCTZ can cause hyponatremia and hypokalemia. This medication will increase urine output
A client is experiencing chest pains after mowing the lawn. After a few the pain is still there. Please name the steps in order how the client should take his nitroglycerin. How would he know that it's working?
1. Place the first tablet under the tongue at the first sign of chest pain.
2. Call 911
3. After 5 mins take another if pain persist
4. After another 5 mins take the last tablet
Burning or tingling under the tongue means the medication is working
Name an antihistamine that can be used for allergies. What are common SE? How can these SE be managed?
diphenhydramine
anticholinergic effects can be managed by chewing sugarless gum. To decrease sedation effects, take most of the dose at time.
What is Montelukast used for, how should it be taken, and and how would they know it's working?
Name the antidotes for the following: coumadin, heparin
What do these medications do?
What are the dietary and supplement education need to be provided for coumadin?
Antidote: vitamin K, protamine sulfate
They prevent the formation of future clots. They do NOT break existing clots.
Clients should keep greens consistent and avoid St. John wort
Beta blocker can be used for HTN. Name the other reasons they are used for and common side effects.
What types of clients should not be on beta blockers?
Migraines, CHF, antidysrhythmic, MI
SE: bradycardia, hypotension, bronchospasm, mask s/s of hypoglycemia
Asthma and COPD client should NOT take this medication
A client has been admitted for a CHF exacerbation. The client exclaims that he's tired and that the lights are bothering him. The RN has orders below:
atenolol 50mg PO now
digoxin 10mcg PO now
What should the RN do first? What is happening? How should digoxin be given? What is the antidote?
RN should check potassium levels first because hyperkalemia can cause toxicity.
The client is most likely having digoxin toxicity
VS and an apical pulse should be should be check prior to administration
Digoxin immune fab
An ESRD client is prescribed iron and Epogen for anemia. What are side effects of iron PO and IV? What labs should be checked prior to Epogen administration?
What do pregnant women take folic acid?
Iron PO can cause dark tarry stools, IV may lead to anaphylactic reaction
Hemoglobin should be checked. It should not be given if Hgt is greater than 11
Folic acid is used to prevent neural tube defects