Medication Notes for Nursing Students

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Questions and Answers

Glipizide primarily works by:

  • Inhibiting the breakdown of incretin hormones.
  • Increasing the sensitivity of peripheral tissues to insulin.
  • Directly stimulating the beta cells of the pancreas to secrete insulin. (correct)
  • Decreasing glucose absorption in the intestines.

NPH insulin typically reaches its peak effect within what timeframe after administration?

  • 2-4 hours
  • 12-16 hours
  • 1-3 hours
  • 4-12 hours (correct)

When mixing rapid-acting and intermediate-acting insulin, which sequence should the nurse follow?

  • It does not matter which order the insulins are withdrawn in, as long as the correct dose is administered.
  • Inject air into the rapid-acting insulin vial, then inject air into the intermediate-acting insulin vial, withdraw the intermediate-acting insulin, then withdraw the rapid-acting insulin.
  • Withdraw the intermediate-acting insulin first, then withdraw the rapid-acting insulin.
  • Inject air into the intermediate-acting insulin vial, then inject air into the rapid-acting vial, withdraw the rapid-acting insulin, then withdraw the intermediate-acting insulin. (correct)

A patient refuses to take their scheduled oral medication. What is the nurse's most appropriate initial action?

<p>Educate the patient about the importance of the medication and the potential consequences of refusal. (D)</p> Signup and view all the answers

Which medication is commonly prescribed to treat hypothyroidism?

<p>Levothyroxine (A)</p> Signup and view all the answers

Lisinopril is prescribed for a patient with hypertension. Which assessment finding would indicate that the medication is effective?

<p>Decreased blood pressure (A)</p> Signup and view all the answers

Which of the following is a manifestation of digoxin toxicity?

<p>Blurred vision and yellow halos around lights (B)</p> Signup and view all the answers

An adverse effect to monitor for in patients taking digoxin is:

<p>Hypokalemia (A)</p> Signup and view all the answers

Which electrolyte imbalance increases the risk of digoxin toxicity?

<p>Hypokalemia (B)</p> Signup and view all the answers

A patient taking nitroglycerin complains of a headache. What should the nurse do FIRST?

<p>Assess the patient's blood pressure. (D)</p> Signup and view all the answers

Before administering digoxin, what assessment is MOST important for the nurse to perform?

<p>Check apical pulse rate. (C)</p> Signup and view all the answers

What is the antidote for warfarin?

<p>Vitamin K (A)</p> Signup and view all the answers

Which medication is contraindicated for a patient taking warfarin due to an increased risk of bleeding?

<p>Aspirin (A)</p> Signup and view all the answers

Which adverse effect should the nurse monitor for in a patient taking beta-blockers?

<p>Bradycardia (B)</p> Signup and view all the answers

A patient has developed a 'tolerance' to a narcotic medication. What does this indicate?

<p>The patient requires a higher dose of the medication to achieve the same effect. (A)</p> Signup and view all the answers

Which of the following is a manifestation of lithium toxicity?

<p>Coarse tremors, confusion, and incoordination (D)</p> Signup and view all the answers

A patient is taking metronidazole. Which adverse effect should the nurse educate the patient about?

<p>Metallic taste in the mouth (B)</p> Signup and view all the answers

Which class of medications is MOST likely to increase a patient's risk of falls?

<p>Sedative-hypnotics (A)</p> Signup and view all the answers

A patient is prescribed disulfiram for alcohol use disorder. What should the patient be educated to avoid?

<p>Alcohol in any form (D)</p> Signup and view all the answers

A patient is taking alprazolam for anxiety. What activity should the patient AVOID while taking this medication?

<p>Operating heavy machinery (B)</p> Signup and view all the answers

A patient is prescribed diazepam. Which of the following is a potential adverse effect of this medication?

<p>Respiratory depression (A)</p> Signup and view all the answers

A patient is taking phenytoin. Which adverse effect requires immediate discontinuation of the medication?

<p>Severe skin rash or blistering (C)</p> Signup and view all the answers

A patient receiving IV morphine has developed respiratory depression. Which medication should the nurse prepare to administer?

<p>Naloxone (B)</p> Signup and view all the answers

A patient overdoses on an opioid analgesic. Which medication should be administered?

<p>Naloxone (B)</p> Signup and view all the answers

What is the antidote for benzodiazepines?

<p>Flumazenil (A)</p> Signup and view all the answers

A patient is taking omeprazole for peptic ulcer disease. What manifestation indicates that the medication is effective?

<p>Decreased abdominal pain and heartburn (D)</p> Signup and view all the answers

Which of the following is a modifiable risk factor for hypertension?

<p>Obesity (B)</p> Signup and view all the answers

What is the primary action of aspirin in a patient experiencing a myocardial infarction?

<p>Antiplatelet (A)</p> Signup and view all the answers

Which of the following is a non-modifiable risk factor for stroke?

<p>Age (D)</p> Signup and view all the answers

A nurse administers the wrong medication to a client. What is the priority nursing action?

<p>Notify the provider and assess the patient for adverse effects. (D)</p> Signup and view all the answers

Where should the nurse assess for the apical pulse?

<p>Left midclavicular line, 5th intercostal space (A)</p> Signup and view all the answers

Which of the following is a modifiable risk factor for heart disease?

<p>High LDL cholesterol (B)</p> Signup and view all the answers

The nurse receives a lab result indicating that a patient's INR is elevated. What action should the nurse take FIRST?

<p>Assess the patient for signs of bleeding. (D)</p> Signup and view all the answers

What is the action of glipizide on glucose control?

<p>It stimulates the pancreas to release more insulin. (D)</p> Signup and view all the answers

A patient on Lisinopril reports a persistent, dry cough. What is the most appropriate nursing intervention related to the medication?

<p>Notify the healthcare provider, as the cough may necessitate a change in medication. (A)</p> Signup and view all the answers

A patient is prescribed nitroglycerin for angina. What instruction should the nurse include in the patient's education regarding its use for acute chest pain?

<p>Place one tablet under the tongue and if pain persists after 5 minutes, call emergency services. (C)</p> Signup and view all the answers

A client on warfarin has an elevated INR. Which of the following nursing interventions is most appropriate based on this laboratory result?

<p>Assess the client for bleeding and prepare to administer vitamin K. (C)</p> Signup and view all the answers

What is the primary reason for assessing a patient's apical pulse before administering digoxin?

<p>To monitor for bradycardia or irregular heart rate. (B)</p> Signup and view all the answers

Which modifiable lifestyle factor is most important for a patient with hypertension to control their blood pressure?

<p>Regular physical activity. (B)</p> Signup and view all the answers

A patient who has been taking a narcotic pain medication for several months reports that it is no longer effectively controlling their pain. What does this most likely indicate?

<p>The patient has developed a tolerance to the medication. (A)</p> Signup and view all the answers

What is the primary goal of health promotion activities for a client with hypertension?

<p>To manage blood pressure and prevent complications. (D)</p> Signup and view all the answers

A patient taking metronidazole reports drinking a glass of wine with dinner. What potential adverse effect should the nurse monitor for?

<p>A disulfiram-like reaction. (C)</p> Signup and view all the answers

A patient is prescribed alprazolam for anxiety. What nursing education is important regarding the use of this medication?

<p>Avoid activities that require alertness, such as driving. (C)</p> Signup and view all the answers

When administering NPH insulin, what timeframe should the nurse inform the patient to be most vigilant for symptoms of hypoglycemia due to the medication's peak effect?

<p>4-12 hours after administration (C)</p> Signup and view all the answers

A patient is prescribed both rapid-acting and intermediate-acting insulin. What is the rationale for drawing up the rapid-acting insulin into the syringe first?

<p>To prevent contamination of the rapid-acting insulin vial with the intermediate-acting insulin. (C)</p> Signup and view all the answers

A patient taking digoxin is also prescribed a diuretic. The nurse knows to monitor one electrolyte level closely because alterations in this electrolyte can predispose the patient to digoxin toxicity. Which electrolyte is of MOST concern?

<p>Potassium (D)</p> Signup and view all the answers

A patient is prescribed disulfiram as part of an alcohol use disorder treatment program. Which of the following instructions is MOST important for the nurse to emphasize to the patient?

<p>Avoid all products containing alcohol, including cough syrup and mouthwash. (A)</p> Signup and view all the answers

A patient who has been taking phenytoin for seizure control is started on omeprazole for acid reflux. Recognizing the potential drug interaction, the nurse should closely monitor the patient for:

<p>Decreased seizure control due to increased phenytoin levels. (B)</p> Signup and view all the answers

Flashcards

Glipizide Action

Glipizide stimulates the release of insulin from the pancreatic beta cells, lowering blood glucose levels.

NPH Insulin Peak Time

NPH insulin typically peaks between 4 to 12 hours after administration.

Patient's Right to Refuse Meds

Patients have the right to refuse medication. The nurse should assess the reason for refusal, educate about the medication, and document the refusal.

Hypothyroidism Medication

Levothyroxine is a synthetic thyroid hormone used to treat hypothyroidism by replacing or supplementing thyroid hormone.

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Lisinopril Mechanism & Efficacy

Lisinopril is an ACE inhibitor that blocks the conversion of angiotensin I to angiotensin II, leading to vasodilation and decreased blood pressure. Effectiveness is indicated by lowered blood pressure.

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Digoxin Toxicity Manifestations

Manifestations of digoxin toxicity include nausea, vomiting, visual disturbances (blurred or yellow vision), and cardiac arrhythmias.

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Adverse Effects of Digoxin

Adverse effects of digoxin include bradycardia, anorexia, nausea, vomiting, and visual disturbances.

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Electrolyte Monitoring with Digoxin

Monitor potassium levels. Hypokalemia can increase the risk of digoxin toxicity.

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Nitroglycerin Adverse Effects

Adverse effects of nitroglycerin include headache, hypotension, and dizziness. For a headache, the nurse should administer analgesic as prescribed and inform the client that headaches are common.

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Pre-Administration Assessment for Digoxin

Before administering digoxin, assess apical pulse for a full minute. Hold the dose if heart rate is less than 60 bpm and notify the provider.

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Warfarin Antidote

Vitamin K is the antidote for warfarin.

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Warfarin Contraindications

Medications contraindicated with warfarin include NSAIDs, aspirin, and other anticoagulants.

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Beta-Blocker Adverse Effect

An adverse effect to monitor for when taking beta-blockers is bradycardia (slow heart rate).

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Narcotic Tolerance

Tolerance means the patient requires more of the narcotic medication to achieve the same analgesic effect.

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Lithium Toxicity Manifestations

Manifestations of lithium toxicity include coarse tremors, confusion, ataxia, and seizures.

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Metronidazole Adverse Effects

Adverse effects of metronidazole include nausea, metallic taste, and dark urine.

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Fall Risk Medications

Sedative-hypnotics can increase a patient's risk of falls.

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Disulfiram Education

Patients on disulfiram should be educated not to consume alcohol in any form.

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Alprazolam Precautions

Patients taking alprazolam should avoid alcohol and activities requiring alertness, such as driving.

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Diazepam Side Effect

A side effect/adverse effect of diazepam is drowsiness and/or respiratory depression.

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Phenytoin Adverse Effect

Gingival hyperplasia (gum overgrowth) is a common adverse effect of phenytoin.

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Morphine Antidote

Naloxone is the antidote/antagonist for morphine.

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Opioid Overdose Med

Naloxone reverses overdose from opioids.

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Benzodiazepine Antagonist

Flumazenil is an antagonist for Benzodiazepines.

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Omeprazole Therapeutic Effects

Effectiveness of omeprazole is manifested by a decrease in heartburn and acid reflux symptoms.

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Hypertension Modifiable Risks

Modifiable risk factors for hypertension include diet, weight, exercise, and smoking.

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Aspirin Action in MI

Aspirin prevents platelet aggregation, reducing clot formation during a heart attack.

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Stroke Non-Modifiable Risks

Non-modifiable risk factors for stroke include age, race, and family history.

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Medication Error Priority

Priority nursing action: Assess the patient, report the error, and follow the facility's protocol.

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Apical Pulse Location

The apical pulse is assessed at the fifth intercostal space, midclavicular line.

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Heart Disease Modifiable Risks

Modifiable risk factors for heart disease include smoking, high cholesterol, high blood pressure, obesity, and physical inactivity.

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Elevated INR Action

If a patient has an elevated INR, the nurse should notify the provider, anticipate an order to hold or decrease the warfarin dose, and potentially administer vitamin K.

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Study Notes

  • These study notes cover various medications, their effects, contraindications, and related nursing interventions.

Glipizide

  • This medication works by stimulating the pancreas to release insulin.

NPH Insulin

  • NPH insulin peaks between 4-12 hours after administration.

Insulin Syringes

  • Insulin syringes can hold a maximum of 100 units.

Patient Rights and Medication Refusal

  • Patients have the right to refuse medication, respecting the 10 Rights of Medication Administration.
  • If a patient refuses, the nurse should:
    • Explore the reasons for refusal.
    • Educate the patient about the medication's importance.
    • Document the refusal and any education provided.
    • Notify the provider.

Hypothyroidism Treatment

  • Levothyroxine is used to treat hypothyroidism.

Lisinopril

  • Lisinopril is an ACE inhibitor that works by blocking the conversion of angiotensin I to angiotensin II, resulting in vasodilation.
  • Effective outcomes of lisinopril include:
    • Lowered blood pressure.
    • Reduced heart failure symptoms.

Digoxin Toxicity Manifestations

  • Manifestations of digoxin toxicity include:
    • Nausea, vomiting, and anorexia.
    • Visual disturbances (blurred vision, yellow or green halos around lights).
    • Bradycardia and dysrhythmias.

Digoxin Adverse Effects

  • Adverse effects of digoxin include:
    • Bradycardia.
    • Dysrhythmias.
    • Visual disturbances.
    • GI upset.

Digoxin and Electrolytes

  • Monitor potassium levels in patients taking digoxin.
  • Hypokalemia can increase the risk of digoxin toxicity.

Nitroglycerin

  • Adverse effects of nitroglycerin include:
    • Headache.
    • Hypotension.
    • Dizziness.
  • For a headache:
    • It is an expected side effect, administer acetaminophen if prescribed.
    • Monitor blood pressure.
  • Expected adverse effects include headache, flushing, and dizziness.

Digoxin Administration

  • Before administering digoxin, the nurse should:
    • Assess apical pulse for one full minute.
    • Check digoxin and potassium levels.
  • Documentation is required for:
    • Irregular heart rate.
    • Heart rate below 60 bpm.
    • Signs of digoxin toxicity.

Warfarin Antidote

  • Vitamin K is the antidote for warfarin.

Warfarin Contraindications

  • Medications contraindicated with warfarin include:
    • Aspirin and NSAIDs.
    • Other anticoagulants.
    • Certain antibiotics.

Beta-Blocker Adverse Effects

  • Monitor for bradycardia as an adverse effect of beta-blockers.

Narcotic Tolerance

  • Tolerance to a narcotic medication means the patient requires more of the medication to achieve the same effect.

Lithium Toxicity

  • Manifestations of lithium toxicity include:
    • Tremors.
    • Confusion.
    • Nausea and vomiting.
    • Muscle weakness.
    • Seizures.

Metronidazole Adverse Effects

  • Adverse effects of metronidazole include:
    • Nausea and vomiting.
    • Metallic taste.
    • Dark urine.
    • Peripheral neuropathy.

Sedative-Hypnotics and Falls

  • Sedative-hypnotics can increase a patient's risk of falls.

Disulfiram Education

  • Patients on disulfiram should be educated not to consume alcohol.

Alprazolam Education

  • Avoid alcohol and activities requiring alertness when taking alprazolam.

Diazepam

  • A side effect/adverse effect of diazepam is respiratory depression.

Phenytoin Adverse Effects

  • The most common adverse effect of phenytoin that requires immediate discontinuation is skin rash, indicating Stevens-Johnson Syndrome.

Morphine Antidote

  • Naloxone is the antidote/antagonist for morphine.

Opioid Overdose

  • Naloxone is administered for opioid analgesic overdose.

Benzodiazepine Antagonist

  • Flumazenil is an antagonist for benzodiazepines.

Omeprazole Therapeutic Effects

  • Effective outcomes of omeprazole include a decrease in heartburn and acid reflux symptoms.

Hypertension Health Promotion

  • Modifiable risk factors for hypertension include:
    • Obesity.
    • High sodium intake.
    • Physical inactivity.
    • Excessive alcohol consumption.
  • Interventions:
    • Diet changes (low sodium, DASH diet).
    • Regular exercise.
    • Weight loss.
    • Limit alcohol intake.

Aspirin for Heart Attack

  • Aspirin's action in a heart attack is to prevent further clot formation by inhibiting platelet aggregation.

Stroke Risk Factors

  • Non-modifiable risk factors for stroke include:
    • Age.
    • Race.
    • Family history.

Medication Error

  • The priority nursing action for a medication error is to assess the patient and ensure their safety.

Apical Pulse Assessment

  • Assess the apical pulse at the fifth intercostal space, midclavicular line.

Heart Disease Risk Factors

  • Modifiable risk factors for heart disease include:
    • Smoking.
    • High cholesterol.
    • High blood pressure.
    • Physical inactivity.
    • Obesity.
    • Diabetes.

Elevated INR

  • If a patient has an elevated INR, the nurse should:
    • Hold the next dose of warfarin and notify the provider.
    • Administer Vitamin K if prescribed.
    • Monitor for signs of bleeding.

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