Med Surg PHarm Quiz #1

jennraq2u's version from 2015-11-09 14:11


Question Answer
Epoetin/Procritform of human erythropoeitin=helps body make more RBCs/less transfusions
Epoetin (IV preferred or subQ) risk of tumor/MI/CVA( hgb 12-14)lowest dose just to avoid transfusion;
Epoetin (Assess Nsg Imp) evaluate labsbaseline vitals/baseline assesment b4 Rx admin
EpoetinOnset=less than 2mos; Peak=IV/SubQ=2months; Not for use w/ sensitivity to albumin
Epoetin (Assesing for Adverse S/E) Ck DeepVeinThrombus=swelling/pain/redCk BP/Nausea/Vomit/Diarrhea/Jt pain/Mental changs/chest pain r/t MI/CVA
Iron Supplement/Ferrous Sulfatebinds to transferrin/trans 2 bonemarrow for incorporation into hemoglobin
Iron Supplement (Adverse S/E) (liqiud=stained teeth)seizures,GI Discomfort/nausea/constipation/diarrhea/HyPOtension/black stools/ Iron OVerload=death
Iron Supplement (Asses Therapeutic Effect) improved appetitie/less fatigueCk Labs/asses for GI upset/black stools could b Melena
Iron Supplment (Patient Teaching) (w/ OR AFTER meals)Report stool constipation/ change in color/consistencty to PCP
Ferrous Gluconate (Fergon) S/ESeizures,nausea, constipation, epigastric pain, black and red tarry stools,HyPOtension
Ferrous Gluconate (Fergon) (Indication) Tx of iron deficiency anemia, prophylaxis for iron deficiency in pregnancy/Pt recieving hemoldyalisis & erithropoeitin
Ferrous Gluconate (Fergon) (Nsg Considerations)keep upright for 15-30 minutes= avoid esophageal corrosion/do not take 1 hour b4 or 2 hours after antacids, eggs, whole-grain bread or cereal, milk, coffee or tea
Ferrous Gluconate (Fergon) (Nsg Considerations II)take 1 hour before bedtime, do not substitue one iron salt for another because iron content differs
Iron DextranTx Iron Def anemia/PUD/IBD r/t PO Fe; Give a test dose 1hr b4 Therapy
Iron Dextran (Nsg Implications)Assess nutritional status/dietary Hx 2 determine possible cause of anemia/Ck Labs/Keep epinephrine/resuscitation close by
Iron Dextran (Nsg Implementation)Inject IM w/Ztrack; Change needles/After IV Keep Pt Recumbent 2 prevent Orth HTN; Pt takes missed w/in 12hrs or resume usual dose
K+Tx HypOK+; w/digoxin=HypOK+increases risk 4 dig toxicity; Pt recieving IV fluids r/t surg/GI disease/rep chloride in Pt w/ hypochloremic metabolic acidosis
K+ S/EN/V/Abd Pain/Diarrhea/Postinfusion Phlebitis @IV site;Overdose=heart block/card arrest/dysrrthmias/Resp paralysis
K+ Contra-IUse w/ ACE Inhibitors or K+Sparing diuretics/Salt Subs/Penicillin G K+=>HyperKalemia!!
K+(Nsg Implications)If unable to K+ PO=IV; Nurse meaures serum K+level & urine Output b4 starting IV K+Therapy
K+ (ONset)Less than 1 hour; Peak=1 -2HR
S/S HypokalemiaAbd Dist, polyuria, confusion, Palpitations, dizziness, muscle weakness
S/S HyperkalemiaSOB,slow pulse, fatigue, Muscle Weak, palpitations
Tylenol (Class)Analgesic/Antipyretic; Vasodilation/Sweating=reduces heat r/t act on Hypothalmic. Sometimes used Prophylactic on kids @ risk for seizures r/t Dtap Vaccine
Tylenol (Onset)Less than 0.5 Hr; Peak=0.5-2hr*S/E=Myocardial Damage/Hepatic Toxicity/Renal failure/Fever w/ Rash
Tylenol (Contra-i/Implications)Alcoholism*Impaired Hepatic* Evaluate Labs* assess pt’s ability to understand instructions, including family, caregivers
Tylenol (Nsg Intervention)Drug-Drug=w/ barbituates* rifampin * cabamazepine *
MorphineClass=Opiod Agonists* BBW=Schedule II Controlled Substance * O=less than 60min* P=PO/60min* R/20-60min* Sub-Q/50-90min*IM/30-60MIN* IV/20MIN
Morphine(Action/Use)causes euphoria/constriction of pupils & stim cardiac muscle. Tx SOB in Pt w/ HF. Causes peripheral vasodilation=> orthostatic hypotension
Morphine (S/E)hallucinations,dysphoria/Nausea & Constip. Over-D may result in respiratory depression. D-D=CNS depressants/MAO inhibitors– potentiate action of opiate; Resp Dep
Morphine (Contra-I)intensify/mask the pain of gallbladder disease, r/t biliary tract spasms. Not 4 acute/severe asthma, GI obstruction & severe hepatic/renal impairment
Morphine (NsgImp/Int)baseline ass't b4 administration* Assess Pain* Baseline V/S* Evaluate Labs*Pt/Family ability 2 understand instructions*
Tetracycline (Antbiotic)Bacteriostaic*Prevents cell replication by stopping bacteria from synthesizing protein. Tx STDs/Acne/Bronchitis/Helicobacter Pylori
Tetracycline (Con'd)O=less than 2hrs* P=2-4hrs* S/E=Uritcaria/ICP/Epigastric/enetrocolitis*Superinfections=Black Furry Tongue/Pseduomebranis Colitis*PHotosensitivity
Tetracycline (Contra-I)Under 8yrs bad teeth/bone growth*Hepatic/Renal impairment* incr Digoxin Absorption* w/oral anticoag enhances effect of VitK* Dairy reduces* Birth Control Effect
NeupogenClass=Colony Stimulating Factor. Increases neutrophil # @bone marrow r/t Pt w/ bone marrow transplant/chemotherapy neutropenia* Promotes arterioles Growth
Neupogen (Cont'd)SubQ/P=8Hr * IV/P= 2Hr * S/E=Aloplecia* N/V/D* Bone Pain* Stomatitis* Can b used for Harvesting
Neupogen (Cont-i) Hypersensitivy to E-Coli* Nsg Intv=>Evaluate Labs* No Rx w/in 24hrs of chemotherapy=>act as growth factor for tumor=>Ck 4 erythema @injection sites
Question Answer
HydromorphoneO=less than 30* P=30-60* S/E=Risk of Circulatory Depression
Naproxenanti-inflammatory* antipyretic* inhbitis prostaglandin synthesis* Tx ankylosing spondylitis* Monitor for CV events/Bleeding
NaproxenO=1hr P=2-4hr* S/E Headache/Dizziness/Somlennce/dyspepsia/GI Pain/bronchospasm* D-D w/ increases Litihium
AspirinO=5-30 min* P=15-120min* S/E=Aute aspirin toxicity=resp alkalosis/confusion/asterixis/tetany/met acidosis*Aspirin intolerance=exacerbation of bronchospasm/rhinits
AspirinSalicism=Dizzines/tinnitus/diffiuclty hearing/ N/V* D-D w/ Steroids=risk ulcerations*Asses 8th cranial nerve function* D-D w/ many drugs!