NURS 133 Final Exam Part 1

jasmine's version from 2016-06-16 06:26

Section 1

Question Answer
Estrogen Suppress release of FSH to suppress ovulation
Estrogen side effects Endometrial hyperplasia and cancer, breast cancer, ovarian cancer, thromboembolism, nausea, gallbladder disease, jaundice, headache, chloasma, stroke, hepatic adenoma, breast tenderness, edema
Estrogen interventions Assess BP, asses for pregnancy, monitor blood glucose, cholesterol, hepatic function, clotting
Progestin Can be used without disrupting lactation
Progestin action Alters endometrium, thickens cervical fluid
Progestin adverse effects Abnormal bleeding, amenorrhea, birth defects, breast cancer, breast tenderness, bloating, depression, thromboembolism
Progestin interventions Assess menstrual history, monitor I/O and , weight, BP, hepatic function
Diaphrams/Spermicide Leave in 6 hours after sex
Plan B Levanorgestrel
Plan B Action Inhibit ovulation, alter tubal transport
Plan B side effects Heavy bleeding, nausea, abd pain, headache, dizziness
Plan B interventions Assess for pregnancy, educate about contraception. Instruct to take within 96 hours. 1 pill or 1 pill and 2nd pill 12 hours later
Mifepristone action Antagonize effects of progesterone, sensitize uterus to prostaglandins,
Mifepristone side effects Headache, dizziness, fainting, weekness, abd pain, uterine bleeding and cramping, ruptured ectopic pregnancy
Mifepristone interventions Assess gestational age, assess for ectopic pregnancy, assess bleeding and cramping, confirm termination by ultrasound. Instruct 1 dose followed 3 days later by Misoprostol
Methotrexate action Toxic to rapidly dividing cells of trophoblast
Methotrexate side effects n/v, diarrhea, headache, dizziness, hot flashes
Methotrexate interventions Assess bleeding and cramping, assess for complete termination. Inform IM followed 4-8 days later by vaginal misoprostol
Pitocin action Stimulate uterine smooth muscle
Pitocin side effects Maternal- coma, seizure, hypotension, hypochloremia, hyponatremia, water intoxication, abruption, decreased uterine blood flow, tachysystole; Fetal- intracranial hemorrhage, asphyxia, hypoxia, arrhythmia
Pitocin interventions Assess gestational age and fetal presentation, assess pelvic adequacy and strength/frequency of contraction, assess FHR, maternal BP and pulse, monitor elctrolytes and signs of water intoxication
Clomiphene action Stimulate pituitary to release FSH and LH to stimulate ovulation
Clomiphene side effects Headache, blurred vision, photophobia, visual disturbance, hot flashes, abd pain, n/v, elevated liver enzymes, ovarian cysts, breast discomfort, multiple births, spotting, abnormal menstrual flow, weight gain
Clomiphene interventions Assess ovarian size and presence of cysts, endometrial biopsy/cause of infertility, assess for abdominal pain. Instruct start on 5th day of menstrual cycle. Take for 5 days. Have sex q 1-2 days on 5-10 days after last dose
Sildenafil action Enhance effects of nitric oxide to relax muscle of corpus cavernosm
Sildenafil side effects Headache, dizziness, insomnia, epistaxis, hearing/vision loss, MI, hypotension, veno-occlusive crisis, dyspepsia, priapism, UTI, flushing, myalgia, parasthesia
Sildenafil interventions Assess for cardiac issues, assess causes of ED. Instruct to take 1 hour before sex
Finasteride BPH and hair loss
Finasteride action Inhibit activation of testosterone
Finasteride side effects Gynecomastia, prostate cancer, decreased libido, sexual dysfunction, angioedema, breast cancer
Finasteride interventions Assess symptoms of BPH, rectal exam of prostate size
Terazosin action Blocks alpha adrenergic receptors to dilate smooth muscle of prostate
Terazosin side effects Dizziness, headache, weakness, nasal congestion, conjunctivitis, floppy iris, dyspnea, ortho hypotension, arrhythmia, palpitations, edema, tachycardia, n/v, ED, urinary freq, pruritis, weight gain, arthralgia, parasthesia
Terazosin interventions Assess for orthostatic hypotension, monitos I/O and edema, monito BP and pulse, assess BPH symptoms; Instruct to take at bedtime

Section 2

Question Answer
Penicillin action Binds bacterial cell wall to cause lysis
Penicillin side effects Seizure, diarrhea, n/v, c diff, nephritis, rash, pain at IM/IV site, anaphylaxis, serum sickness, superinfection
Penicillin Interventions Assess infection/superinfection, assess for allergy, kepp epi and resuscitation equipment nearby, monitor for hyperkalemia and hypernatremia
Cephalosporin action Disrupts cell wall synthesis
Cephalosporin side effects Allergy, anaphylaxis, bleeding, thrombophlebitis, anemia, c.diff, carnitine loss
Cephalosporin interventions Assess infection, monitor for bleeding, monitor bowel function, assess for allergy and anemia, assess for phlebitis at IV; Change IV site q 48 hours
Vancomycin action Binds/disrupts cell wall
Vancomycin side effects Ototoxic, hypotension, n/v, nephrotoxic, rash, phlebitis, anaphylaxis, Red Man syndrome
Vancomycin interventions assess signs of infection, IV site, 8th cranial nerve/otic damage, bowel function, kidney function, superinfection, anaphylaxis. Draw peak and trough levels; Slow infusion to prevent red man syndrome PO-ONLY for GI infection
Tetracycline action Inhibit protein synthesis
Tetracycline side effects Intracranian hypertension, dizziness, diarrhea, n/v, stained teeth (in in children and baby if taken during pregnancy), photosensitivity, blood dyscrasia, allergy, superinfection
Tetracycline interventions Assess infection and superinfection, monitor hepatic and renal function, monitor CBC; Inform to take on empty stomach. Wait 3 hours before/after to give antacids, magnesium, sodium bicarbonate, or iron
Erythromycin action Suppress protein synthesis
Erythromycin side effects Seizure, ototoxic, cardio-toxic, n/v nephritis, rash, phlebitis, allergy, superinfection
Erythromycin interventions Assess infection, assess for phlebitis, bowel function, liver function, superinfection, kidney function; Instruct to take with water, coated tabs on empty stomach, ethylsuccinate can be taken with food. IV- slow infusion, Topical
Aminoglycosides (gentamicin, tobramycin, amikacin) action Inhibit protein synthesis
Aminoglycoside side effects Nephrotoxic, ototoxic, neuromuscular blockade, blood dyscrasia, paresthesia, superinfection
Aminoglycoside interventions Monitor infection, monitor otic and renal function, draw peak and trough serum levels; IV- slow infusion, IM, topical, PO- not absorbed, only for GI infection
Sulfonamides action Inhibit synthesis of folic acid
Sulfonamides side effects Allergy- rash, photosensitivity, fever. Steven Johnson, anemia, kernicticus, renal damage
Sulfonamides interventions Assess for allergy and infection, monito I/O, encourage high fluid intake, monitor urinalysis and CBC
Trimethoprim action Interfere with folic acid synthesis
Trimethoprim side effects Altered taste, epigastric pain, glossitis, n/v, hepatitis, rash, anemia, neutropenia, thrombocytopenia, fever
Trimethoprim interventions Assess infection, monitor I/O, CBC, urinalysis; Instruct to take with water on empty stomach
Metronidazole action Disrupts protein and DNA synthesis
Metronidazole side effects Seizure, dizziness, headache, meningitis, encephalopathy, optic and peripheral neuropathy, abd pain, anorexia, n/v, steven-johnson, leukopenia, superinfection, phlebitis
Metronidazole interventions Signs of infection, monitor neuro status, I/O, sodium restriction, monitor for rash/steven Johnson; Instruct to take on empty stomach, topical, vaginal
Rifaximin action Inhibit RNA synthesis
Rifaximin side effects Dizziness, peripheral edema, c.diff, neutropenia
Rifaximin interventions Assess s/s of original infection (diarrhea, mental status, IBS), monitor for diarrhea/ c.diff
Bacitracin action Inhibit cell wall synthesis
Bacitracin side effects Rash, pseudomembranous colitis, n/v, renal failure
Bacitracin interventions Assess infection, bowel function, renal function, CBC

Section 3

Question Answer
Insulin action Increase glucose uptake in skeletal muscle and fat, decrease hepatic production of glucose, decrease lipolysis and proteolysis, increase protein synthesis; Long acting for both type 1 and 2 diabetes; Short acting used for both type 1 and 2 diabetes in conjunction with an intermediate or long acting agent
Insulin side effects Hypoglycemia, hypokalemia, lipodystrophy, pruritiis, swelling, allergy
Insulin interventions Assess for hypo/hyperglycemia, monitor blood glucose and a1c, monitor serum potassium, treat overdose with glucose or glucagon; Administer 45 mins before meal
Sulfonylureas action Stimulate release of insulin, increase receptor sensitivity to insulin, decrease hepatic glucose production
Sulfonylureas side effects Dizziness, drowsiness, headache, constipation, cramping, diarrhea, hepatitis, increases appetite, n/v, photosensitivity, hypoglycemia, hyponatremia, anemia, thrombocytopenia
Sulfonylureas interventions Assess for hypoglycemia, assess allergy to sulfa drugs, monitor blood glucose, a1c, CBC, renal and liver function, may need insulin during stress or sickness; Instruct once daily with meal
Metformin action Decrease hepatic glucose production, decrease glucose absorption in gut, increase sensitivity to insulin
Metformin side effects Bloating, diarrhea, n/v, lactic acidosis, decrease Vit B12 level, flatulence
Metformin interventions Assess for hypoglycemia and acidosis, monitor BG and a1c, monitor renal function and B12 level; Instruct with meals. Withhold if NPO or for contrast imaging