Summary NR 566 Midterm exam study guide / NR566 midterm guide (latest 2020/2021) complete
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NR 566 (NR566)
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CHAMBERLAIN COLLEGE OF NURSING
Summary NR 566 Midterm exam study guide / NR566 midterm guide (latest 2020/2021) completeMITERM- NR566 1 Know what meds you would give for asthma and COPD (LABA and intermittent use) • LABA- indacaterol (Arcapta). Indacaterol is a once-daily long-acting bronchodilator that has an onset of 5 minu...
miterm nr566 1 know what meds you would give for asthma and copd laba and intermittent use • laba indacaterol arcapta indacaterol is a once daily
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MITERM- NR566
1 Know what meds you would give for asthma and COPD (LABA and intermittent use)
LABA- indacaterol (Arcapta). Indacaterol is a once-daily long-acting bronchodilator
that has an onset of 5 minutes and a duration of 24 hours
FORMOTEROL/ SALMETEROL/ INDACATEROL
3 What to do when a patient calls you with hypoglycemia
4 How many gms of carb is needed during hypoglycemic episode- 15 what to tell patient to do for
low blood sugar
5 how many mcg of dietary intake of iodine
Dietary iodine of about 100 to 150 mcg/d is required for normal thyroid hormone
production.
6 alendronate (Fosamax) patient education- osteoporosis
PO meds should be taken first thing in the morning, at least 30 mins prior to
medications.
Take it with 8oz plain water
Mineral water, coffee, OJ, and other beverages greatly reduce absorption.
Remain upright for least 30 mins after taking meds, which allows for passage out of
the stomach and minimizes the risk for esophageal irritation.
GI distress and dyspepsia are the most common s/e's. if needed take aluminum and
magnesium containing anatacids may be taken more than 2 hours fosomax.
Patients should eat a diet that has calcium and vitamin D
7 what medication decreases the T4 and the answer was Carbamazepime/ drug increases t4
(carbamazepine)
8 First choice for hypertension – which diuretic
thiazide-type diuretic has been typically chosen because in the landmark
Chlorothiazide (Diuril)
Chlorthalidone.
Hydrochlorothiazide (Microzide)
Indapamide.
Metolazone.
9 Besides hypertension, BB are indicated for (I selected MI)
Angina/ HTN/ MI prophylaxis/ glaucoma / migraine prophylaxis
10 Mechanism of action of Theophylline
Treats asthma (bronchodilator)
Work directly by an unknown mechanism believed to be mediated by selective
inhibition of specific phosphodiesterases. This, in turn, produces an increase in
cAMP, which then leads to bronchial smooth muscle and pulmonary vessel
relaxation.
Theophylline and caffeine have an impact on most of the major body systems. They
are powerful CNS stimulants, often causing insomnia and excitability. Although both
drugs have cardiovascular effects, theophylline has a greater effect on the
cardiovascular system. Theophylline directly stimulates the myocardium and
increases myocardial contractility and heart rate. By relaxing vascular smooth
muscle, theophylline dilates the coronary, pulmonary, and systemic blood vessels.
11 What should you test a patient c/o muscle pain, on atorvastatin
For all reductase inhibitors, muscle tenderness or pain may indicate a serious
problem that may require discontinuance of the drug.
patient C/O muscle pain on atorvastin: check cK level.
,12- 7 yo with pneumonia, what to give if already on amoxicillin
high-dose amoxicillin (90 mg/kg daily, divided in two doses) is the drug of choice for
7 to 10 days of outpatient treatment (Bradley et al, 2011)). If highly resistant
pneumococci are in the community, the practitioner may choose between IV or IM
ceftriaxone (50 mg/kg in one daily dose) or cefotaxime (150 mg/kg/d every 8
hours) followed by appropriate oral therapy after 1 or 2 doses
13 What to give for high cholesterol if cannot take statins – name of medication
Nicotinic acid (niacin) was always touted as effective in lowering total cholesterol
and triglyceride levels and raising HDL levels
14 Which inhaler to give on asthma exacerbation
Ipratropium is an inhaled anticholinergic that may be used in combination with
albuterol to treat asthma exacerbation in the emergency department (NAEPP,
2007). Hospital admission may be avoided by the addition of ipratropium to the
treatment regimen in cases of exacerbation seen in the clinic or emergency
department
15 Nicotine replacement drugs– bupropion should be avoided with what?
Bupropion is contraindicated in patients with seizure disorders, bulimia, and
anorexia nervosa and within 14 days of the use of monoamine oxidase inhibitors
(MAOIs).
Bupropion should not be used in patients with a history of stroke, brain tumor, brain
surgery, or history of closed head injury.
Bupropion should be used with caution in patients with hepatic cirrhosis, with the
dose decreased to 150 mg every other day.
The concurrent use of bupropion (Zyban) and Wellbutrin is contraindicated. Risk of
suicide ideation and suicidality in children, adolescents, and young adults. Zyban is
not approved for smoking cessation in children under 18 years of age. Patients
prescribed Zyban should be monitored closely for signs of suicide ideation when
treatment is started.
16 INH - risk for liver toxicity
INH has a Black-Box Warning regarding the development of severe and sometimes
fatal hepatitis, even after many months of treatment.
.Increased risk for hepatitis is associated with daily alcohol use, chronic liver disease,
and IV drug use. Black and Hispanic women, as well as any woman during the
postpartum period who takes INH, may have increased risk of developing fatal
hepatitis. nitro sublingual
All patients taking INH should have monthly symptom reviews to screen for
hepatitis. Symptoms to screen for include unexplained anorexia, nausea, vomiting,
dark urine, icterus, rash, persistent paresthesias of hands or feet, fatigue, weakness,
fever longer than 3 days, or abdominal tenderness especially in the right upper
quadrant.
Liver enzymes should be measured in patients over age 35 years prior to starting
INH and then periodically throughout treatment.
They should report all flu-like illness immediately and see their health-care provider
at least monthly during treatment.
17 Angina patient should be on ASA- aspirin
Atenolol, metoprolol, nadolol, and propranolol are indicated for long-term
management of angina
18 Angina and diabetic should be on what
, 19 Which medication to take for SVT
Verapamil might be chosen for patients with supraventricular tachycardia who also
have angina.
Type 1 CCBs (calcium channel blockers) are useful in treating selected
supraventricular tachycardias because they slow AV nodal conduction. Verapamil
(80 to 120 mg orally) can be used to terminate the rhythm. Conversion usually
occurs in about 1 hour. Diltiazem (40 to 80 mg orally) can also be tried. Prophylaxis
with verapamil (240 to 480 mg/d) is effective for patients with paroxysmal
supraventricular tachycardia (PSVT)
20 MOA of nitroglycerine sublingual
Nitroglycerin (NTG) and its analogues act largely by providing more nitric oxide (NO)
to vascular endothelium and arterial smooth muscle, resulting in vasodilation (Fig.
16-5). All parts of the vascular system, from larger arteries to large veins, relax in
response to nitrates.
Sublingual absorption is dependent on salivary secretion. Dry mouth (including
drug-induced) decreases absorption.
The sublingual route avoids hepatic first-pass effect and is preferred for achieving a
rapid blood level.
21 Goal for HgA1C when on tx; 7mg/dL
22 Glucagon route; How glucagon is given
Glucagon is well absorbed after parenteral administration. (IM)
23 MOA of insulin
once insulin arrives to the receptors, it creates changes within the cell membrane
that result in translocation of certain proteins, such as glucose transporters from
sequestered sites within the cell to the cell surface.
Insulin promotes the storage of fat as well as glucose and influences cell growth and
metabolic functions in a wide variety of tissues.
Insulin acts on the liver to increase storage of glucose as glycogen and resets the
liver after food intake by reversing the amt of catabolic activity.
Insulin reduces the circulation of free fatty acids and promotes storage of
triglycerides in adipose tissue, done by the suppression of cAMP production and
dephospherylation of the lipases in fat cells.
24 stages of asthma adults (>12yrs)
1. Mild intermittent asthma: Symptoms occur less often than twice a week and the patient
is asymptomatic between exacerbations; nighttime symptoms occur less than twice a
month; and peak expiratory flow (PEF) is greater than 80% predicted. The use of short-
acting beta2 agonists (SABA) should be less than twice a week, unless used for exercise-
induced bronchospasm (EIB).
2. Mild persistent asthma: Symptoms occur more often than twice a week but less often
than once a day and exacerbations may affect activity; nighttime symptoms occur 3 to 4
times a month; and PEF is greater than 80% predicted. Patients with mild persistent asthma
may use their short-acting beta2 agonists more than twice a week but not daily, and not
more than once daily.
3. Moderate persistent asthma: The patient is having daily symptoms; requires daily use of
a beta2 agonist; exacerbations affect normal activity; nighttime symptoms occur more often
than once a week; and PEF is greater than 60% to less than 80%.
4. Severe persistent asthma: The patient has some degree of symptoms all the time;
extremely limited physical activity and frequent exacerbations; frequent nighttime
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