Cholinesterase Inhibitors and Herbal Products Quiz
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Questions and Answers

What should the nurse assess for before administering cholinergic drugs to a patient?

  • Respiratory depression and hypertension
  • Allergies, GI or GU obstructions, asthma, and coronary artery disease (correct)
  • Neurological deficits and musculoskeletal pain
  • Dermatological conditions and endocrine disorders

    • How should the nurse advise a patient with myasthenia gravis to take cholinergic medications?

  • With meals to avoid gastrointestinal upset
  • As needed for symptomatic relief
  • 30 minutes before eating to improve chewing and swallowing (correct)
  • At bedtime to minimize daytime drowsiness

    • Why should patients taking cholinergic drugs avoid adjusting dosages unless directed by their health care provider?

  • To avoid gastrointestinal upset
  • To minimize the risk of developing resistance to the medication
  • To prevent life-threatening problems associated with overdosing (correct)
  • To prevent drug interactions

    • What are the common uses of herbal product Gingko?

    <p>Preventing memory loss and improving cognitive function</p> Signup and view all the answers

    What is the antidote for cholinergics in patients with myasthenia gravis?

    <p>Atropine</p> Signup and view all the answers

    What signs and symptoms should patients with myasthenia gravis notify their physicians about when taking cholinergic drugs?

    <p>Weakness, abdominal cramps, and diarrhea</p> Signup and view all the answers

    In postoperative patients with decreased GI peristalsis, what should nurses monitor for when patients are given cholinergic drugs?

    <p>Increased bowel sounds</p> Signup and view all the answers

    In patients with urinary retention or hypotonic bladder, how soon should urination occur after bethanechol administration?

    <p>60 minutes</p> Signup and view all the answers

    What is the mechanism of action of cholinergic-blocking drugs?

    <p>They compete with acetylcholine (ACh) for binding at muscarinic receptors in the parasympathetic nervous system (PNS)</p> Signup and view all the answers

    What effect do cholinergic-blocking drugs have on the cardiovascular system in large doses?

    <p>Increase heart rate</p> Signup and view all the answers

    How do cholinergic-blocking drugs affect the eye?

    <p>Cause mydriasis and cycloplegia</p> Signup and view all the answers

    What is the primary indication for using atropine, a cholinergic-blocking drug?

    <p>Sinus node dysfunction</p> Signup and view all the answers

    What should be included in patient education regarding the consistent intake of foods high in vitamin K?

    <p>Including tomatoes and dark leafy green vegetables in the diet</p> Signup and view all the answers

    Why is wearing a medical alert bracelet important for patients on anticoagulants?

    <p>To notify healthcare providers about their anticoagulant therapy during emergencies</p> Signup and view all the answers

    In patient education for anticoagulants, what is the significance of consulting a physician before taking other drugs or over-the-counter products, including herbals?

    <p>To avoid any potential drug interactions</p> Signup and view all the answers

    What should be emphasized in patient education regarding the measures to prevent bruising, bleeding, and tissue injury when on anticoagulants?

    <p>Using caution when handling sharp objects</p> Signup and view all the answers

    Why should patients taking antihypertensive drugs avoid abruptly stopping the medication?

    <p>To prevent rebound hypertensive crisis and potential stroke</p> Signup and view all the answers

    What should patients be instructed to do if they miss a dose of their antihypertensive medication?

    <p>Check with their physicians for instructions and never double up on doses</p> Signup and view all the answers

    Why should oral forms of antihypertensive medications be given with meals?

    <p>To ensure more gradual and effective absorption</p> Signup and view all the answers

    What is the importance of instructing patients to keep a journal of regular blood pressure checks?

    <p>To monitor the effectiveness of the antihypertensive therapy</p> Signup and view all the answers

    What is the recommended daily fluid intake for patients with chronic lung disease?

    <p>3000 mL/day</p> Signup and view all the answers

    How should the nurse educate patients regarding the use of inhalers in the context of chronic lung disease?

    <p>Educate on proper dosing and the use of metered-dose inhaler and spacer</p> Signup and view all the answers

    What should the nurse advise patients to avoid in order to prevent exacerbation of chronic lung disease?

    <p>Exposure to factors that exacerbate their condition</p> Signup and view all the answers

    What could be a consequence of overuse of nasal decongestants according to patient education implications?

    <p>Rebound nasal congestion or ulcerations</p> Signup and view all the answers

    What is the recommended dose of Argatroban for DVT prophylaxis?

    <p>Continuous IV infusion</p> Signup and view all the answers

    What are the adverse reactions associated with Argatroban?

    <p>Peripheral edema, dizziness, headache, bruising, diarrhea</p> Signup and view all the answers

    How does Argatroban compare to Heparin in terms of therapeutic administration?

    <p>Argatroban requires monitoring of aPTT every 6 hours until therapeutic effects are seen, while Heparin does not require monitoring</p> Signup and view all the answers

    What is the primary indication for using Argatroban?

    <p>Treatment of deep vein thrombosis and pulmonary embolism</p> Signup and view all the answers

    What is the specific indication for the use of Argatroban?

    <p>Active heparin-induced thrombocytopenia (HIT) and percutaneous coronary intervention (PCI)</p> Signup and view all the answers

    What is the route of administration for Argatroban?

    <p>Intravenous</p> Signup and view all the answers

    What distinguishes Argatroban from Dabigatran (Pradaxa) in terms of its mechanism of action?

    <p>Reversibly binds to both free and clotbound thrombin</p> Signup and view all the answers

    What is the most common adverse effect of Argatroban?

    <p>Bleeding</p> Signup and view all the answers

    What is the specific antidote for dabigatran?

    <p>Idarucizumab</p> Signup and view all the answers

    What is the black box warning associated with Andexxa?

    <p>Thromboembolic events</p> Signup and view all the answers

    What is the risk associated with IV vitamin K administration?

    <p>Warfarin resistance for up to 7 days</p> Signup and view all the answers

    In the context of anticoagulants, what action should always be taken if two anticoagulants are ordered?

    <p>Confirm the order with the physician</p> Signup and view all the answers

    Which drug can reverse the anticoagulation effects of warfarin within 6 hours when given intravenously at high doses?

    <p>Vitamin K1</p> Signup and view all the answers

    What should be used for severe bleeding caused by warfarin?

    <p>Clotting factor concentrates</p> Signup and view all the answers

    What is the role of fibrin in the coagulation system?

    <p>It is a clot-forming substance</p> Signup and view all the answers

    What is the primary function of plasmin in the fibrinolytic system?

    <p>To break down the fibrin thrombus into fibrin degradation products</p> Signup and view all the answers

    What distinguishes hemophilia from other coagulation disorders?

    <p>Limited or absent natural coagulation and hemostasis factors</p> Signup and view all the answers

    What is the significance of the term 'thrombus' in the context of hemostasis?

    <p>It is a technical term for a blood clot</p> Signup and view all the answers

    What is the primary indication for using Fondaparinux (Arixtra)?

    <p>Prophylaxis or treatment of DVT or PE</p> Signup and view all the answers

    What distinguishes Dabigatran (Pradaxa) from other anticoagulants in terms of monitoring?

    <p>It does not require any coagulation monitoring</p> Signup and view all the answers

    Which drug is the prototypical LMWH with greater affinity for factor Xa than for factor Iia?

    <p>Enoxaparin (Lovenox)</p> Signup and view all the answers

    What is the specific indication for the use of Argatroban?

    <p>Active HIT and percutaneous coronary intervention procedures in patients at risk for HIT</p> Signup and view all the answers

    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)?

    <p>Hypertension</p> Signup and view all the answers

    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?

    <p>SBP &gt; 140 mm Hg and DBP &gt; 90 mm Hg</p> Signup and view all the answers

    How can hypertension be classified based on its cause?

    <p>Primary vs secondary hypertension</p> Signup and view all the answers

    What is the equation used to calculate blood pressure (BP) according to the provided text?

    <p>$BP = CO × SVR$</p> Signup and view all the answers

    What should patients be instructed to do regarding weight gain when taking beta-blocking drugs?

    <p>Report weight gain of more than 2 lb in 1 day or 5 lb in 1 week</p> Signup and view all the answers

    What potential adverse effect should patients taking cholinergic drugs be advised to report to their physicians?

    <p>Excessive fatigue or weakness</p> Signup and view all the answers

    What is the nursing implication related to rebound hypertension or chest pain with the discontinuation of beta-blocking drugs?

    <p>It may occur if the medication is discontinued abruptly</p> Signup and view all the answers

    What should patients be advised to notify their physicians about when taking beta-blocking drugs?

    <p>Shortness of breath</p> Signup and view all the answers

    What is the primary use of esmolol (Brevibloc)?

    <p>Rapid temporary control of ventricular rate in patients with supraventricular tachydysrhythmias</p> Signup and view all the answers

    What distinguishes carvedilol (Coreg) from other beta blockers?

    <p>It is a nonselective beta blocker and an alpha1-blocker</p> Signup and view all the answers

    What is the most common oral form of metoprolol (Lopressor)?

    <p>Metoprolol tartrate</p> Signup and view all the answers

    Which beta blocker is indicated for the management of difficult-to-treat dysrhythmias?

    <p>Sotalol (Betapace)</p> Signup and view all the answers

    In which condition is atenolol (Tenormin) commonly used to prevent future heart attacks?

    <p>Angina</p> Signup and view all the answers

    What is the primary use of propranolol (Inderal)?

    <p>Treatment of tachydysrhythmias</p> Signup and view all the answers

    What is the primary role of cardioselective beta blockers in the treatment of dysrhythmias?

    <p>Reducing myocardial contractility to decrease myocardial oxygen demand</p> Signup and view all the answers

    How do nonselective beta blockers contribute to dysrhythmias?

    <p>Constricting bronchioles and causing vasoconstriction of blood vessels</p> Signup and view all the answers

    Why are nonselective beta blockers potentially detrimental in the treatment of dysrhythmias?

    <p>They constrict bronchioles, narrowing airways</p> Signup and view all the answers

    What is the main concern when considering the use of nonselective beta blockers in patients with dysrhythmias?

    <p>Constricting bronchioles and narrowing airways</p> Signup and view all the answers

    How do cardioselective beta blockers affect the heart, and why is this beneficial in the context of dysrhythmias?

    <p>Decrease myocardial contractility to reduce myocardial oxygen demand</p> Signup and view all the answers

    Why are nonselective beta blockers problematic for patients with dysrhythmias?

    <p>They constrict bronchioles, resulting in narrowing of airways and shortness of breath</p> Signup and view all the answers

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