Nursing Medications Quiz

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Questions and Answers

What is a common adverse effect associated with barbiturates?

Increased appetite

Nausea

Hypertensive crisis

CNS depression (correct)

Which nursing consideration is essential for clients taking tricyclic antidepressants?

Instruct to rise slowly to avoid orthostatic hypotension (correct)

Discontinue medication if insomnia occurs

Consume alcohol to enhance medication effectiveness

Encourage high-fiber foods to prevent diarrhea

What should clients taking MAO inhibitors avoid consuming?

Lean proteins

Tyramine-rich foods (correct)

Fresh vegetables

Whole grains

Which of the following drug classes includes fluoxetine?

Second-generation antidepressants Signup and view all the answers

What is the mechanism of action for antipsychotic drugs?

Block dopamine receptors Signup and view all the answers

Which nursing consideration should be taken into account for clients waking up from benzodiazepine treatment?

Monitor for a common period of confusion and excitement Signup and view all the answers

Which schedule of medication requires avoiding abrupt discontinuation without medical consultation?

Benzodiazepines Signup and view all the answers

What is NOT a common adverse effect of tricyclic antidepressants?

Respiratory depression Signup and view all the answers

What is a key nursing consideration for administering ACE inhibitors?

They may cause rebound hypertension if stopped abruptly. Signup and view all the answers

Which of the following is NOT a potential adverse effect of beta blockers?

Chronic dry cough Signup and view all the answers

What is the proper application technique for a transdermal patch?

Use a new patch on a different hairless site each day. Signup and view all the answers

What should be done if a sublingual medication does not relieve pain after three doses?

Seek medical help. Signup and view all the answers

What indicates that a sublingual tablet is fresh when administered?

Stinging or burning sensation. Signup and view all the answers

Which medication type should be swallowed and not crushed?

Sustained-release medications. Signup and view all the answers

Which patient condition is a beta blocker indicated for?

Raynaud's disease. Signup and view all the answers

Why should a patient not swallow a sublingual medication?

Absorption may be inhibited by digestive enzymes. Signup and view all the answers

What are some symptoms of extra pyramidal syndrome (EPS)?

Lip smacking and fine wormlike tongue movements Signup and view all the answers

What nursing consideration is vital for clients taking narcotic analgesics?

Monitor for potential respiratory depression Signup and view all the answers

Which of the following conditions should be reported immediately to a physician when recognized in a patient on antipsychotic medication?

Signs of neuroleptic malignant syndrome (NMS) Signup and view all the answers

What is a common side effect of non-narcotic analgesics like aspirin?

Bleeding complications Signup and view all the answers

What should be monitored in clients taking aspirin to avoid complications?

Signs of hearing loss Signup and view all the answers

Which of the following statements is true regarding the management of narcotic overdose?

Naloxone is the antidote for narcotic overdose Signup and view all the answers

Which nursing action is necessary to prevent complications for patients taking phenothiazine?

Assure oral doses are swallowed and not hoarded Signup and view all the answers

What is the mechanism of action for non-narcotic analgesics?

They relieve pain by inhibiting the prostaglandin pathway Signup and view all the answers

What is the primary adverse effect associated with cholinergic blocking agents?

Dry mouth Signup and view all the answers

Which of the following indicates the appropriate use of atropine?

To treat bradycardia Signup and view all the answers

What nursing consideration is important for a client using adrenergic agents?

Watch for signs of heatstroke and dehydration Signup and view all the answers

What is the main mechanism of action of adrenergic agents?

Stimulate alpha and beta adrenergic receptors Signup and view all the answers

Which of the following adverse effects is associated with the use of epinephrine?

Palpitations Signup and view all the answers

What precaution should be taken for clients with a history of hyperthyroidism when administering adrenergic agents?

Avoid these agents completely Signup and view all the answers

Which of the following nursing interventions is appropriate for managing dry mouth caused by cholinergic blocking agents?

Encourage the use of sugarless gum or candy Signup and view all the answers

What is the primary mechanism of action for histamine-2 blockers?

Block H2 receptors in the stomach Signup and view all the answers

What is the purpose of collecting a specimen for C & S before starting antibiotics?

To identify the specific pathogen Signup and view all the answers

Which nursing consideration is essential when administering cimetidine?

Avoid giving it with other drugs Signup and view all the answers

What side effect is specifically associated with chronic use of cimetidine?

Gynecomastia Signup and view all the answers

What is the recommended timing for administering proton pump inhibitors?

Before meals, preferably in the morning Signup and view all the answers

What is a key nursing consideration when administering misoprostol?

Contraindicated for pregnant patients Signup and view all the answers

How do anti-diarrheal agents primarily function?

Decrease stomach motility Signup and view all the answers

What should be monitored when administering diphenoxylate due to its potential side effect?

Atropine toxicity Signup and view all the answers

Which laxative type retains fluid to distend the intestine?

Osmotic laxatives Signup and view all the answers

Study Notes

Barbiturates

Prototype: Phenobarbital
Adverse effects include hangover effect, dizziness, central nervous system depression, respiratory depression, and drug dependence.
Nursing considerations:
- Warn clients about the risk of injuries and falls.
- Benzodiazepines may cause brief confusion and excitement upon awakening.
- Advise against abrupt discontinuation of medications without physician consultation.
- Avoid alcohol while on these medications.
- Rotate ampoules and avoid mixing with other drugs.
- Warn female clients about the association between diazepam and cleft lip.

Antidepressants and Mood Disorders

Prototypes include:
- Tricyclic antidepressants (amitriptyline, imipramine, desipramine)
- MAOIs (phenelzine, tranylcypromine)
- Second-generation antidepressants (fluoxetine)
Common adverse effects: dry mouth, blurred vision, urinary retention, constipation (anticholinergic effects), orthostatic hypotension, insomnia, hypertensive crisis (MAOIs).
Nursing considerations:
- Instruct clients to rise slowly to mitigate orthostatic hypotension.
- Take with food to enhance absorption.
- Full therapeutic response may take several weeks.
- Monitor for constipation with tricyclic use.
- Clients on MAOIs should avoid tyramine-rich foods (e.g., aged cheese, wine, chocolate) to prevent hypertensive crisis.
- Inform physician if rashes develop with fluoxetine.

Antipsychotic Drugs (Neuroleptics)

Prototypes: Phenothiazines (chlorpromazine, thioridazine) and other agents (olanzapine, haloperidol).
Mechanism: Block dopamine receptors in the brain.
Adverse effects: Extrapyramidal symptoms (EPS - dystonia, pseudoparkinsonism, tardive dyskinesia), neuroleptic malignant syndrome (NMS), orthostatic hypotension.
Nursing considerations:
- Educate family on signs of EPS and NMS for immediate reporting.
- Note normalization of symptoms may take several weeks.
- Monitor for orthostatic hypotension and photosensitivity.
- Ensure oral doses are swallowed and not hoarded.

Drugs Used in Pain Management

Analgesics

Prototypes: Narcotic analgesics (codeine, meperidine, morphine) and non-narcotic analgesics (NSAIDs - aspirin, ibuprofen, acetaminophen).
Mechanism of narcotics: Alter pain perception by binding to opioid receptors.
Mechanism of non-narcotics: Relieve pain by inhibiting the prostaglandin pathway.
Nursing considerations:
- Monitor for respiratory depression and hypotension in narcotic users.
- Advise precautions against injury while using narcotics.
- Warn about dependency risk; do not discontinue abruptly.
- Naloxone is the antidote for narcotic overdose.
- Take NSAIDs with food to prevent bleeding complications.
- Aspirin is contraindicated for children under 18 with flu-like symptoms.

Cardiovascular System Drugs

Anticoagulants

Prototypes: Heparin (SQ and IV), Warfarin (orally).

Antihypertensives

ACE Inhibitors: End in “-pril” (e.g., captopril, enalapril).
Mechanism: Prevent vasoconstriction, lowering resistance.
Adverse effects: Hyperkalemia, chronic dry cough.
Nursing considerations: Do not discontinue abruptly to avoid rebound hypertension; avoid potassium-sparing diuretics.

Adrenergic Blocking Agents

Prototypes: Beta blockers (end in “-olol,” e.g., atenolol, metoprolol).
Mechanism: Compete with epinephrine in target receptors.
Adverse effects: Orthostatic hypotension, bradycardia, CHF, depression, insomnia, bronchospasm.
Nursing considerations: Administer before meals, monitor for bowel pattern changes.

Histamine-2 Blockers

Prototypes: Cimetidine, ranitidine, famotidine.
Mechanism: Block H2 receptors in the stomach, reducing acid secretion.
Nursing considerations: Administer before meals, avoid other drugs with cimetidine, gynecomastia risk with chronic use.

Proton Pump Inhibitors (PPIs)

Prototypes: Omeprazole, lansoprazole, pantoprazole.
Mechanism: Inhibit proton exchange to reduce hydrochloric acid.
Nursing considerations: Administer before meals, preferably in the morning.

Mucosal Barriers

Prototypes: Sucralfate, misoprostol.
Mechanism: Coat mucosa to prevent ulceration.
Nursing considerations: Administer before meals; misoprostol is contraindicated in pregnancy; sucralfate may cause constipation.

Antiemetics

Examples: Dimenhydrinate (motion sickness), Diphenhydramine (antihistamine), Metoclopramide (dopamine antagonist).

Antidiarrheal Agents

Prototypes: Diphenoxylate, loperamide, kaolin/pectin.
Mechanism: Decrease stomach motility and peristalsis.
Nursing considerations: Monitor for rebound constipation; caution with infectious diarrhea.

Laxatives

Types include osmotic agents (lactulose, magnesium salts) that retain fluid in the intestine.

Drugs with Multiple Uses

Cholinergic Blocking Agents

Prototype: Atropine.
Mechanism: Block acetylcholine binding in parasympathetic receptors.
Indications: Preoperative drying of secretions, treatment of bradycardia, asthma, and organophosphate poisoning.
Adverse effects: Dry mouth, tachycardia, urinary retention.
Nursing considerations: Keep clients cool, encourage fluid intake.

Adrenergic Agents

Prototypes: Epinephrine, phenylephrine.
Mechanism: Stimulate adrenergic receptors causing sympathetic effects.
Indications: Cardiopulmonary arrest, COPD, nasal congestion.
Adverse effects: Restlessness, insomnia, tachycardia.
Nursing considerations: Contraindicated in patients with hyperthyroidism and certain cardiovascular conditions.

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Description

Test your knowledge on common adverse effects and nursing considerations for various medication classes including barbiturates, tricyclic antidepressants, and MAO inhibitors. This quiz will assess your understanding of drug mechanisms and essential nursing practices related to psychotropic medications.