66 Questions
What should the nurse assess for before administering cholinergic drugs to a patient?
Allergies, GI or GU obstructions, asthma, and coronary artery disease
How should the nurse advise a patient with myasthenia gravis to take cholinergic medications?
30 minutes before eating to improve chewing and swallowing
Why should patients taking cholinergic drugs avoid adjusting dosages unless directed by their health care provider?
To prevent life-threatening problems associated with overdosing
What are the common uses of herbal product Gingko?
Preventing memory loss and improving cognitive function
What is the antidote for cholinergics in patients with myasthenia gravis?
Atropine
What signs and symptoms should patients with myasthenia gravis notify their physicians about when taking cholinergic drugs?
Weakness, abdominal cramps, and diarrhea
In postoperative patients with decreased GI peristalsis, what should nurses monitor for when patients are given cholinergic drugs?
Increased bowel sounds
In patients with urinary retention or hypotonic bladder, how soon should urination occur after bethanechol administration?
60 minutes
What is the mechanism of action of cholinergic-blocking drugs?
They compete with acetylcholine (ACh) for binding at muscarinic receptors in the parasympathetic nervous system (PNS)
What effect do cholinergic-blocking drugs have on the cardiovascular system in large doses?
Increase heart rate
How do cholinergic-blocking drugs affect the eye?
Cause mydriasis and cycloplegia
What is the primary indication for using atropine, a cholinergic-blocking drug?
Sinus node dysfunction
What should be included in patient education regarding the consistent intake of foods high in vitamin K?
Including tomatoes and dark leafy green vegetables in the diet
Why is wearing a medical alert bracelet important for patients on anticoagulants?
To notify healthcare providers about their anticoagulant therapy during emergencies
In patient education for anticoagulants, what is the significance of consulting a physician before taking other drugs or over-the-counter products, including herbals?
To avoid any potential drug interactions
What should be emphasized in patient education regarding the measures to prevent bruising, bleeding, and tissue injury when on anticoagulants?
Using caution when handling sharp objects
Why should patients taking antihypertensive drugs avoid abruptly stopping the medication?
To prevent rebound hypertensive crisis and potential stroke
What should patients be instructed to do if they miss a dose of their antihypertensive medication?
Check with their physicians for instructions and never double up on doses
Why should oral forms of antihypertensive medications be given with meals?
To ensure more gradual and effective absorption
What is the importance of instructing patients to keep a journal of regular blood pressure checks?
To monitor the effectiveness of the antihypertensive therapy
What is the recommended daily fluid intake for patients with chronic lung disease?
3000 mL/day
How should the nurse educate patients regarding the use of inhalers in the context of chronic lung disease?
Educate on proper dosing and the use of metered-dose inhaler and spacer
What should the nurse advise patients to avoid in order to prevent exacerbation of chronic lung disease?
Exposure to factors that exacerbate their condition
What could be a consequence of overuse of nasal decongestants according to patient education implications?
Rebound nasal congestion or ulcerations
What is the recommended dose of Argatroban for DVT prophylaxis?
Continuous IV infusion
What are the adverse reactions associated with Argatroban?
Peripheral edema, dizziness, headache, bruising, diarrhea
How does Argatroban compare to Heparin in terms of therapeutic administration?
Argatroban requires monitoring of aPTT every 6 hours until therapeutic effects are seen, while Heparin does not require monitoring
What is the primary indication for using Argatroban?
Treatment of deep vein thrombosis and pulmonary embolism
What is the specific indication for the use of Argatroban?
Active heparin-induced thrombocytopenia (HIT) and percutaneous coronary intervention (PCI)
What is the route of administration for Argatroban?
Intravenous
What distinguishes Argatroban from Dabigatran (Pradaxa) in terms of its mechanism of action?
Reversibly binds to both free and clotbound thrombin
What is the most common adverse effect of Argatroban?
Bleeding
What is the specific antidote for dabigatran?
Idarucizumab
What is the black box warning associated with Andexxa?
Thromboembolic events
What is the risk associated with IV vitamin K administration?
Warfarin resistance for up to 7 days
In the context of anticoagulants, what action should always be taken if two anticoagulants are ordered?
Confirm the order with the physician
Which drug can reverse the anticoagulation effects of warfarin within 6 hours when given intravenously at high doses?
Vitamin K1
What should be used for severe bleeding caused by warfarin?
Clotting factor concentrates
What is the role of fibrin in the coagulation system?
It is a clot-forming substance
What is the primary function of plasmin in the fibrinolytic system?
To break down the fibrin thrombus into fibrin degradation products
What distinguishes hemophilia from other coagulation disorders?
Limited or absent natural coagulation and hemostasis factors
What is the significance of the term 'thrombus' in the context of hemostasis?
It is a technical term for a blood clot
What is the primary indication for using Fondaparinux (Arixtra)?
Prophylaxis or treatment of DVT or PE
What distinguishes Dabigatran (Pradaxa) from other anticoagulants in terms of monitoring?
It does not require any coagulation monitoring
Which drug is the prototypical LMWH with greater affinity for factor Xa than for factor Iia?
Enoxaparin (Lovenox)
What is the specific indication for the use of Argatroban?
Active HIT and percutaneous coronary intervention procedures in patients at risk for HIT
What is the primary risk factor for coronary artery disease (CAD) and cardiovascular disease (CVD) according to the Joint National Committee on Prevention, Detection, Evaluation, and Treatment of High Blood Pressure (JNC-8)?
Hypertension
According to the JNC-8, at what blood pressure (BP) levels should therapy be initiated for patients younger than 60 and those with chronic kidney disease or diabetes?
SBP > 140 mm Hg and DBP > 90 mm Hg
How can hypertension be classified based on its cause?
Primary vs secondary hypertension
What is the equation used to calculate blood pressure (BP) according to the provided text?
$BP = CO × SVR$
What should patients be instructed to do regarding weight gain when taking beta-blocking drugs?
Report weight gain of more than 2 lb in 1 day or 5 lb in 1 week
What potential adverse effect should patients taking cholinergic drugs be advised to report to their physicians?
Excessive fatigue or weakness
What is the nursing implication related to rebound hypertension or chest pain with the discontinuation of beta-blocking drugs?
It may occur if the medication is discontinued abruptly
What should patients be advised to notify their physicians about when taking beta-blocking drugs?
Shortness of breath
What is the primary use of esmolol (Brevibloc)?
Rapid temporary control of ventricular rate in patients with supraventricular tachydysrhythmias
What distinguishes carvedilol (Coreg) from other beta blockers?
It is a nonselective beta blocker and an alpha1-blocker
What is the most common oral form of metoprolol (Lopressor)?
Metoprolol tartrate
Which beta blocker is indicated for the management of difficult-to-treat dysrhythmias?
Sotalol (Betapace)
In which condition is atenolol (Tenormin) commonly used to prevent future heart attacks?
Angina
What is the primary use of propranolol (Inderal)?
Treatment of tachydysrhythmias
What is the primary role of cardioselective beta blockers in the treatment of dysrhythmias?
Reducing myocardial contractility to decrease myocardial oxygen demand
How do nonselective beta blockers contribute to dysrhythmias?
Constricting bronchioles and causing vasoconstriction of blood vessels
Why are nonselective beta blockers potentially detrimental in the treatment of dysrhythmias?
They constrict bronchioles, narrowing airways
What is the main concern when considering the use of nonselective beta blockers in patients with dysrhythmias?
Constricting bronchioles and narrowing airways
How do cardioselective beta blockers affect the heart, and why is this beneficial in the context of dysrhythmias?
Decrease myocardial contractility to reduce myocardial oxygen demand
Why are nonselective beta blockers problematic for patients with dysrhythmias?
They constrict bronchioles, resulting in narrowing of airways and shortness of breath
Test your knowledge on cholinesterase inhibitors such as Neostigmine, Pyridostigmine, and Physostigmine, along with herbal products like Gingko. Explore their uses, potential interactions, and side effects in this quiz.
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