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N450 Med Quiz (1).
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Exam of 21 pages for the course N450 - Ch. 3 - Principles of Geriatrics at N450 - Ch. 3 - Principles of Geriatrics (N450 Med Quiz (1).)
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N450 Med QuizAtorvastatin (Lipitor) - ANS-Therapeutic class: lipid-lowering agent
Pharm. class: Hmg CoA reductase inhibitor
Atorvastatin (lipitor) common indications - ANS-Adjunct mgmt of primary high cholesterol and
dyslipidemia
Atorvastatin (lipitor) critical nursing responsibilities - ANS-- diet history (fat consumption)
- serum cholesterol and triglyceride levels before start and at 2-4 weeks after starting lipitor
- liver function testing (increases bilirubin)
- Cannot take with Grapefruit
- watch for muscle pain, tenderness or weakness (common side effect or rhabdomyolysis
what is the trade name for atorvastatin? - ANS-Lipitor
What contraindications are for atorvastatin? - ANS-NO grape fruit
No macrolide antibiotics (ex. erythromycin)
No azole antifungals
No fibric-acid agents
Some immunosuppressants.
What is the trade name of Aspart? - ANS-Novorapid
What ther. and pharm. class of Aspart? - ANS-ther: antidiabetic, hormones
pharm: pancreatics
what are common indications of Aspart? - ANS-Control of hyperglycemia for pt's with t1 or t2
DM
Is Aspart rapid or long acting insulin? - ANS-rapid-acting insulin
rapid onset and shorter duration than human regular insulin and should be used with an
intermediate or long acting insulin.
Aspart critical nursing responsibilities? - ANS-- BGM q6hr and A1C q3months
- S&S hypoglycemia (anxiety, tingling in extremities, cool, pale skin, hunger, headache)
- clarify all orders and double sign doses (HIGH ALERT MED)
- Pt. should carry glucose tabs
instruct pt. on S&S of hypo and hyperglycemia
What is the therapeutic and pharmacologic class of Amlodipine? - ANS-ther: antihypertensive
pharm: calcium channel blocker
,what is the indication of amlodipine? - ANS-Mgmt of hypertension
angina pectoris
vasospastic (Prinzmetal's) angina
critical nursing responsibilities for amlodipine? - ANS-- monitor BP and pulse, monitor ECG
- monitor intake and output
- instruct pt to watch for swelling of hands and feet
- watch for signs of HF (peripheral edema, crackles/rales, dyspnea, weight gain)
- for angina, assess location, duration and intensity and precipitating factors of PAIN. (think
PQRSTU?)
What is Budesonide's trade name? - ANS-pulmicort neb
what is the therapeutic and pharm. class for budesonide? - ANS-ther: anti-inflammatory
pharm: corticosteroid
Common indications of budesonide? - ANS-maintenance and prophylaxis of asthma
critical nursing responsibilities for budesonide? - ANS-- monitor resp status and lung sounds
- after clinical effect obtained should decrease dose to lowest possible for relief
(corticosteroid=immunosuppression)
- should not be used for an acute asthma attack but can be used
AFTER bronchodilator
- watch for adrenal insufficiency (anorexia, nausea, weakness, fatigue, hypotension,
hypoglycemia) during initial therapy and periods of stress (LIFE THREATENING).
- Labs: adrenal function tests to assess degree of hypothalamic-pituitary-adrenal (HPA) axis
suppression
Albuterol (salbutamol and ventolin) neb - ANS-ther: bronchodilator
Pharm: adrenergics
common indication: albuterol neb - ANS-treatment or prevention of bronchospasm in asthma
and COPD
critical nursing responsibilities for albuterol neb? - ANS-assess lung sounds, pulse, BP, note
potential for high HR.
note sputum
monitor for paradoxical bronchospasm (wheezing)
rinse mouth (min. dry mouth and clean mouth piece 1x/wk)
use air flow at 6-10 L/min and breathe normally
Calcium gluconate therapeutic class? - ANS-mineral and electrolyte replacement/supplement
, common indications for calcium gluconate - ANS-treatment and prevention of hypocalcemia
emergency treatment of hyperkalemia and hypomagnesemia
and adjunct in cardiac arrest
critical nursing responsibilities for calcium gluconate? - ANS-- observe for S&S of hypocalcemia
(paresthesia "pins and needles", muscle twitching, cardiac arrthymias, laryngospasm, colic,
Chvostek's or Trousseau's sign)
- monitor BP, Pulse, ECG
- vasodilation= hypotension, bradycardia, arrhythmias, and cardiac arrest
- IV should be warmed and given through small bore needle to minimize phlebitis
- may cause burning (administer slowly to avoid cardiac arrest)
- Patient should remain recumbent for 30-60 min after IV administration.
therapeutic and pharm. class of captopril? - ANS-ther: antihypertensives
Pharm: ACE-inhibitor
common indications for captopril? - ANS-- Treatment/mgmt of HTN
- Mgmt of HF
Critical nursing responsibilities for Captopril? - ANS-Monitor BP and pulse
Assess for angioedema (swelling of face, extremities, difficult breathing/swallowing)
Give 1 hr BEFORE meals or 2 hrs AFTER meals
Encourage pt to comply with additional interventions (wt. reduction, low sodium diet, exercise).
For HF, watch wt. and assess for fluid overload reduction.
Cefazolin Trade Name - ANS-Ancef
Therapeutic and pharm. class for cefazolin? - ANS-ther: anti-infective
pharm: cephalosporin
Common indications for cefazolin? - ANS-- treatment of infection d/t skin infection, pneumonia,
UTI, bone/joint infection.
- bacterial endocarditis prophylaxis (dental and upper resp. procedures).
- Perioperative prophylaxis
critical nursing responsibilities for cefazolin? - ANS-Assess for infection (increase WBC, VS)
History of reactions to penicillins (Observe for anaphylaxis)
Obtain C&S specimen (can give 1st dose prior to results)
Monitor bowels (diarrhea, abd. cramping, fever, and bloody stools)
Watch for rash frequently (stevens-johnson syndrome)
Change sites every 48-72 hr to prevent phlebitis
Therapeutic and Pharm. class of ceftriaxone? - ANS-ther: anti-infective
pharm: 3rd generation cephalosporin
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