100 Questions
What is the antidote to cholinergic drugs?
Atropine
Which drug is used before surgery to prevent aspiration?
Anti-Cholinergics
What are the adverse effects associated with ACE inhibitors?
Dry, Non-productive cough
How do Clonidine and Methaladopa lower blood pressure?
By vasodilation
What is the mechanism of action of dobutamine?
It increases cardiac output by increasing contractility
In what situation would you administer dobutamine to a patient?
When the patient is experiencing cardiac decompensation
What is the primary effect of positive inotropes on the heart?
Increases the force of contraction on the heart
What distinguishes dobutamine from other positive inotropes?
It increases cardiac output by increasing contractility
Which of the following is a potential adverse effect of ARBs?
Hyperkalemia
What is the recommended patient education related to adrenergic drugs to prevent adverse effects?
Educating patients about the high risk of fainting with the first dose
What is the general dietary recommendation for all hypertensive patients?
Low sodium diet
What is SLUDGE a toxic effect of?
Cholinergic drugs
What is the antidote to cholinergic drugs?
Atropine
Which of the following describes the effects of cholinergic drugs?
Inducing sweating, urination, and diarrhea
What are potential adverse effects of cholinergic drugs?
muscle weakness, abdominal cramps, diarrhea, or difficulty breathing
What is a potential risk associated with the use of anti-cholinergic drugs?
Heat stroke
What is an important consideration for patient education regarding adrenic drugs?
Sit and dangle
Why is it important to establish baseline vital signs for a patient receiving nonselective adrenic blockers?
To monitor for side effects such as changes in heart rate and blood pressure
Which of the following is a potential adverse effect of beta blockers?
Hypoglycemia
In what situation would you administer dobutamine to a patient?
Acute heart failure with severe hypotension
What distinguishes dobutamine from other positive inotropes?
It has less effect on blood pressure
What is the primary action of beta blockers on the body?
Decrease heart rate and vasodilate
What is the mechanism through which Clonidine and Methaladopa lower blood pressure?
Decreasing heart rate and causing vasodilation
Which adverse effect should a nurse specifically educate a patient about when using beta blockers for hypertension?
Dry and Non-productive cough
What is the mechanism of action of beta blockers?
They lower blood pressure, heart rate, and myocardial contractility and constrict bronchioles
Which medication is an example of a beta blocker?
Propranolol
What distinguishes beta blockers from alpha blockers?
Beta blockers lower blood pressure, while alpha blockers raise blood pressure
What is a potential adverse effect associated with beta blockers?
Excessive vasodilation and hypotension
What is the potential adverse effect associated with ARBs?
Hyperkalemia
Which patient is most likely to be prescribed diuretics for hypertension?
A patient with no kidney disease, no heart problems, but with risk factors for heart disease
What is the primary education for patients taking aspirin for hypertension?
Take with food and water
Which medication is an example of a nonselective beta blocker?
Propranolol
What distinguishes alpha blockers from beta blockers?
Beta blockers constrict bronchioles and lower blood pressure
What is the primary therapeutic indication of dobutamine?
Increasing cardiac output in cardiac decompensation
What is the primary reason for being cautious when administering nonselective beta blockers to a patient with hypertension?
They can result in a slow heart rate and low blood pressure
Which medication is commonly used to reduce heart rate and vasodilate in patients with hypertension?
Clonidine
What distinguishes ACE inhibitors from ARBs in the treatment of hypertension?
ACE inhibitors are associated with a dry, non-productive cough, while ARBs are not
What is the primary mechanism through which Clonidine and Methyldopa lower blood pressure?
By reducing the release of norepinephrine from the nerve endings
Positive inotropes increase the force of contraction on the heart.
True
Cholinergic drugs decrease sweating, urination, and diarrhea.
False
Atropine is the antidote for the toxic effects of cholinergic drugs.
True
if you overdose a patient on anti-cholinergics, the antidote is PHYSOSTIGMINE.
True
Antidote for atropine overdose is physostigmine
True
Diuretics are the first line of defense for hypertensive patients. Thiazide diuretics are the most commonly used diuretics for hypertension.
True
which of the following are used to reverse anticholinergic poisoning? (antidote)
all of the above
What are catecholamines?
all of the above
Ad drugs are sympathomimetic…..they mimic…..and effect SNS.
True
Catecholamines mimic so they are sympathomimetic
True
You have a patient who is 50 and is on a beta blocker, the nurse recognizes that this medication is used for ?
inhibiting the heart from working hard, Making it easier to pump with less blood pressure.
The patient has been diagnosed with BPH (benign prostatic hyperplasia) The nurse knows which of the following is primarily used to treat BPH?
Tamsulosin (flomax)
with ACE inhibitors and diuretics, your patient education should be on drinking water and preventing dehydration
True
A patient walks in and presents with no kidney disease, no heart problems but has a family history and has hypertension. The nurse should prescribe which of the following?
diuretics
ACE inhibitors are for renal and hypertension so they are used for diabetic patients
True
Match the following
Alpha blockers end in = SIN or MINE Betablockers end in = LOL PNS = rest and digest SNS = fight or flight
The mechanism of action for epi or epinephrine is increased hr, bp, and respirations and is used for a code.
True
The patient presents with dyspnea and is wheezing turning blue, and constricted lungs. What would the nurse give to this patient?
Albuterol
a patient comes in with acute cardiovascular instability, the nurse knows to administer which of the following immediately?
Epinephrine
Nursing implications for nasal spray can cause rebound congestion and is addictive.
True
Alpha1 in the heart and blood vessels cause vasoconstriction which causes BP, HR, and oxygen demand to increase.
True
match
Propanolol is used for = Hypertension, Anxiety & Headaches Timolol is used for = Interocular pressure and given optically Labatolol and Carval = reduce the Heart rate and vasodilate When you have high blood pressure = you run the risk for developing cardiovascular disease
The mechanism of action in alpha-blockers is used for Hypertension medication and vasodilation by arterial and venous dilation, reducing peripheral vascular resistance and blood pressure (BP)
True
a patient walks into the ER in shock because he accidentally took a week's worth of his Alzheimers (cholinergic medication ). The nurse would expect which treatment?
Atropine
The nurse recognizes that high blood pressure in a patient over 60 is:
150/90
The nurse recognizes that patients who have chronic kidney disease, diabetes or younger than 60 are to be considered high blood pressure when their bp reads:
greater than 140/90
Cholinergic-blocking drugs dry you out – decreased pooping, peeing, crying, sweating.
True
Albuterol is used for a more acute situation whereas Salmeterol is used for maintenance.
True
Respiratory indications for Adrenic drugs stimulate beta2-adrenergic receptors of bronchial smooth muscles, causing relaxation, resulting in bronchodilation
True
Cholinergic drugs stimulate pupils (miosis, reduced intraocular pressure), intestines & bladder (increased gastric secretions, increased gastric motility, and increased urinary frequency), and your sweat glands (increased salvation and sweating)
True
The nurse recognizes that Gingko is used for:
all of the above
Gingko may cause GI upset, headache, bleeding
True
Ginkgo may cause potential drug interactions with which of the following?
All of the above
The nurse is about to administer an anti-cholergenic, what is the most important a nurse should assess for?
a history of glaucoma
Patient with urinary retention and GI obstruction and glaucoma Should be careful taking this anti-cholinergics and should contact their doctor if muscle weakness, abdominal cramps, and diarrhea, or difficulty breathing. Slide 142
True
Cholinergic Drugs: Mechanism of Action: Mimic the effects of acetylcholine
True
if a patient comes in sweating due to nicotinic receptors from receiving high doses of Cholinergics, which would you
Topical application because of poor oral absorption
SLUDGE, which stands for salivation, lacrimation, urinary incontinence, diarrhea, GI cramps, and emesis
True
a patient is having difficulty peeing, or urinary retention, from post operative non obstruction the nurse knows to administer which medication?
Bethanechol (Urecholine)
Memantine (Namenda) is Not a cholinergic drug
True
Pyridostigmine For Myasthenia Gravis (an autoimmune disease)
True
match
cevimeline = Used to treat excessively dry mouth (xerostomia) succinylcholine = Used as a neuromuscular blocker in general anesthesia bethanechol = Increases tone and motility of bladder and Relaxes sphincters in bladder, allowing it to empty Used to reverse anticholinergic poisoning = physostigmine, pyridostigmine, neostigmine
These are used for treatment of mild to moderate Alzheimer’s disease Donepezil (Aricept) Galantamine (Razadyne) Rivastigmine (Exelon)
True
ATROPINE! LEARN IT!! IF A PATIENT IS COMING IN W SEVERE SINUS BRADYCARDIA THEN THE ANSWER IS ATROPINE TO GIVE.
True
PAY ATTENTION TO BOLD. IF EXAM HAS A PATIENT W COPD, W DIAGNOSED OR HAD CLASSIC SYMPTOMS -> GIVE A CHOLINERGIC BLOCKER.
True
match the cholinergic blocking drugs
Atropine = bradycardia, ventricular asystole, antidote for anticholinesterase inhibitor toxicity or poisoning, and preoperatively to reduce salivation and GI secretions Dicyclomine (Bentyl) = functional disturbances of GI motility such as irritable bowel syndrome Glycopyrrolate (Robinul) = Blocks receptor sites in the autonomic nervous system that control the production of secretions. Use: preoperatively to reduce salivation and excessive secretions in the respiratory and GI tracts Scopolamine = prevention of motion sickness and to help prevent postoperative, postanesthesia nausea and vomiting
match
Oxybutynin (Ditropan) = overactive bladder and antispasmodic for neurogenic bladder associated with spinal cord injuries and congenital conditions such as spina bifida Tolterodine (Detrol) = urinary frequency, urgency, and urge incontinence caused by bladder (detrusor) overactivity Sildenafil and Tadalafil = used for erectile dysfunction impotence means = sexual dysfunction
Angiotensin-Converting Enzyme (ACE) Inhibitors : Captopril (Capoten) Benazepril (Lotensin) Enalapril (Vasotec) Fosinopril (Monopril) Lisinopril (Prinivil) Perindopril (Aceon) Quinapril (Accupril) Ramipril (Altace) Trandolapril (Mavik)
ACE lowers blood volume so again they also give your kidneys a break. ACE inhibitors: reduce glomerular filtration pressure Who has a high risk of kidney injury? Diabetics.. A person w diabetes, can be on an ace inhibitors. They end in PRIL.
True
. A pt w diabetes has a new prescription for lisinopril she questioned this order because the physician has never told her she has high blood pressure. D- diabetic. 99.9% of diabetics will be on this even though they don’t have high blood pressure.
True
ACE inhibitors indications: Hypertension HF (either alone or in combination with diuretics or other drugs) Slow progression of left ventricular hypertrophy after myocardial infarction (MI) (cardioprotective) Renal protective effects in patients with diabetes
True
ACE Inhibitor patient education: Educate patients: may cause dizziness, stand up slow.
True
Heparin-induced thrombocytopenia (HIT) Type I Gradual reduction in platelets Heparin therapy can generally be continued. Type II Acute fall in the number of platelets (more than 50% reduction from baseline) Discontinue heparin.
True
a patient presents with hematuria, melena (blood in the stool), petechiae, ecchymoses, and gum or mucous membrane bleeding. The nurse finds a recent history of heparin and realizes these are toxic effects. What will the nurse administer?
Intravenous (IV) protamine sulfate: 1 mg of protamine can reverse the effects of 100 units of heparin.
The nurse notices that a patient is displaying toxic effects of warfarin. What should the nurse do first?
Discontinue the warfarin
When warfarin effects were treated previously treated with vitamin K, warfarin resistance will occur for up to 7 days.
True
Idarucizumab (Praxbind) is the Specific antidote for dabigatran Reverses the anticoagulant effects for dabigatran for emergency surgery or in life-threatening or uncontrolled bleeding
True
the patient asks why she has been put on two anticoagulants .. heparin and warfarin. how should the nurse respond?
This is because this is bridge therapy and warfarin takes about 7 days to kick in while heparin acts immediately. When those 7 days have passed, you will be taken off the heparin.
Argatroban is used for HIT, is only given intravenously and Used for active HIT and percutaneous coronary intervention procedures in patients at risk for HIT
True
Careful monitoring of the prothrombin time/international normalized ratio (PT/INR). normal (without warfarin) is 1.0 and with warfarin is 2.0-3.5
True
aspirin is a big no-no for children and teenagers, if they take it- they run the risk of Reyes syndrome which is swelling in the liver and brain.
True
Which can be given as an antidote in case of excessive anticoagulation.
protamine sulfate
a patient taking warfarin has a INR of 4.2. Does the nurse recognize this as?
its too high, give vitamin K
Test your knowledge of the respiratory indications for adrenergic drugs such as albuterol and epinephrine. Explore the effects of sympathomimetic drugs on the sympathetic nervous system and their impact on heart rate, blood pressure, and oxygen demand.
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