NURS 309 final exam Questions And Answers With
Complete Solutions
- admin BEFORE MEALS
- may open capsule and sprinkle granules in pudding or
applesauce
- DO NOT CHEW GRANULES
- Omeprazole must be SWALLOWED WHOLE
- if ordered, antacids may be given concurrently Correct
Answers PPIs implementation
- administer NSAIDs as directed with food or milk to dec
harshness on the stomach
- IBUPROFEN --> MAX 24 HR DOSE - 3200 mg!!!!!
- do not give aspirin or salicylates to children < 16 y/o
- administer Colchisine on an empty stomach, if tolerated
- administer Allopurinol with meals
- with gout treatments, INC FLUIDS TO 3 L PER DAY!!!!
- educate pt on s/s of bleeding (coffee ground emesis), MI,
stroke, and salicylism
- avoid alcohol
- dietary restrictions to prevent gout: 3L fluids daily, AVOID
***ALCOHOL/RED MEAT/SEAFOOD*** Correct Answers
anti-inflammatory and antigout medication implementation
- administer OTHER MEDS 2 HOURS BEFORE OR AFTER
antacid - for if they require a lower gastric pH
- chewables - chew thoroughly, do not swallow
- liquids - shake well
- FOLLOW WITH 8 OZ. OF WATER
,- may take with/in addition to PPIs for breakthrough symptoms
- separate from H2 antagonists by 1-2 HOURS
dietary measures:
- avoid spices, caffeine, alcohol, and extremes in food
temperature --> trigger foods that cause GERD/heartburn
- weight loss - for GERD
- no heavy meals - do not overfill stomach
- DO NOT LIE DOWN FOR 2 HOURS AFTER EATING!!!
Correct Answers antacid implementation
- amphotericin B: severe systemic fungal infections (ex:
jiroveci) - most potent and toxic
- fluconazole - crosses the BB barrier, useful fro cryptococcal
meningitis
- nystatin - not well absorbed in the GI tract!!!!!, useful in oral
fungal infections (ex: magic mouthwash)
- topical antifungals - used for skin and vaginal fungal infections
Correct Answers different types of antifungal drugs and what
they tx
- angina - chest pain bc heart is not getting enough O2 d/t
vasoconstriction or plaque
- cardioprotective effects: inhibits stimulation from circulating
catecholamines - protect heart from SNS activity
- dysrhythmias - controls rate
- migraine HA
- HTN
- HF - reduce amount of work the pump has to do, so it's not
strained
,- glaucoma (topical use) - dec IOP Correct Answers what are
some indications for beta-adrenergic blockers?
- antacids - raises the pH and makes it more alkaline, work
extremely quickly but does not last long because it leaves the
stomach
- H2 antagonists (H2RBs) - H2 receptors help produce stomach
acid, so by blocking them you will have less acid - don't work as
quickly as antacids (so take them ahead of time), but last longer
- proton pump inhibitors (PPIs) - turn off the pumps that make
the acid - short term use bc they inhibit the nl flora Correct
Answers types of acid controlling drugs
- anticholinergics - clash
- antihistamines - work like anticholinergics
- adrenergic agonists - clash
^^^all 3 of these antagonize cholinergic drugs, resulting in dec
responses
- other cholinergic agonist drugs - additive Correct Answers
interactions with cholinergic agonists
- CNS stimulation (nervousness, insomnia, euphoria, HA d/t
vasoconstriction, tremors, seizures)
- CV stimulation (HTN, tachycardia, reflex bradycardia after
constant stimulation, dysrhythmias)
- GI (NV, dry mouth)
- sweating, hyperglycemia d/t glycogenolysis, muscle cramps
Correct Answers what are the major AEs of adrenergic agonist
drugs?
, - CV (palpitations, orthostatic hypotension, tachycardia, edema,
chest pain) - all deal with drop in BP
- CNS (dizziness, HA, anxiety, depression, weakness,
numbness, fatigue) - the CNS trying to correct mess ups
- GI (NVD, constipation, abd pain - why to not give to a pt with
PUD) Correct Answers other than first-dose phenomenon, what
are other AEs of alpha-adrenergic blockers?
- dec muscle rigidity and muscle tremors - PARKINSON'S
disease
- drug-induced extrapyramidal reactions such as those associated
with antipsychotic drugs - when the brain loses control of
muscles and there is no control of movement Correct Answers
CNS indications for using anticholinergics
- dec secretions from the nose, mouth, pharynx, and bronchi
- relaxes smooth muscles in the bronchi and bronchioles -->
expansion
- dec airways resistance
- bronchodilation - inc diameter
anticholinergics are used to tx:
- asthma
- exercise-induces bronchospams
- chronic bronchitis
- COPD Correct Answers respiratory indications for using
anticholinergics
- dermatophytic infections are difficult to eradicate
- esp toenail fungus