NURS 615 Exam II/ Questions with Definitive Solutions.
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Course
NURS 615
Institution
NURS 615
NURS 615 Exam II/ Questions with Definitive Solutions. Terms like:
What instructions will you provide to a woman who wants to get pregnant and has a seizure disorder controlled with valproate? - Answer: Switch to another antiseizure medication such as Keppra
Use of these drugs during the fir...
NURS 615 Exam II/ Questions with Definitive
Solutions.
What instructions will you provide to a woman who wants to get pregnant and
has a seizure disorder controlled with valproate? - Answer: Switch to another
antiseizure medication such as Keppra
Use of these drugs during the first trimester of pregnancy is associated with
neural tube defects including spina bifida. Their use should be restricted to cases
in which a woman's life would be endangered without them and then only beyond
the first trimester. They should be used with caution during lactation.
What are the precautions and contraindications for the tricyclic antidepressants? -
Answer: •Most significant risks are cardiac conduction disorder. At highest risk are
children and the elderly therefore, baseline ECG and periodic monitoring should
be performed. The most common cardiovascular effect is sinus tachycardia due to
the inhibition of norepinephrine reuptake and anticholinergic action. Contribute
to the slowing of depolarization of the cardiac muscle, contributing to
prolongation of the QRS complex and the PR/QT intervals.
Can be cardiotoxic in overdose.
Page 1 of 14
, •TCAs have a direct alpha-adrenergic blocking effect and quindine-like effect on
the myocardium, they are contraindicated for those with cardiovascular disorders.
•Due to their acetycholine blocking effect they should be used with caution in
those who have glaucoma, prostatic hypertrophy, or urinary incontinence.
•Should not be prescribed in combination with MAOIs or individuals who have
demonstrated hypersensitivity in this class.
•Pregnancy category C and are excreted in low doses in breast milk. Safety of use
in pregnancy is unclear.
•Tardive dyskinesia and neuroleptic malignant syndrome have been reported, and
more likely with amoxapine use due to its dopaminergic effect.
•Should be titrated gradually in either direction. Nausea, headache, vertigo,
malaise, and nightmares have been noted following abrupt discontinuance of the
drug or after large dose decreases.
•Lower seizure thresholds in those with seizure disorder or those taking
medications that also decrease seizure threshold.
•Therapeutic and toxic level index is LOW. Great care needs to be taken when
prescribing for a person who is depressed and has suicidal ideas.
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