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Questions and Answers
What are patient variables that should be considered when administering medications?
What are patient variables that should be considered when administering medications?
What is the antidote for opioid overdose?
What is the antidote for opioid overdose?
Naloxone
Chlorpromazine is a conventional or first-generation antipsychotic.
Chlorpromazine is a conventional or first-generation antipsychotic.
True
What is the therapeutic range for lithium?
What is the therapeutic range for lithium?
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Flumazenil is the antidote for benzodiazepine overdose.
Flumazenil is the antidote for benzodiazepine overdose.
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Gentamicin has a narrow therapeutic window.
Gentamicin has a narrow therapeutic window.
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Aminoglycosides are generally considered potent antibiotics.
Aminoglycosides are generally considered potent antibiotics.
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Aspirin is a medication that can cause Reye’s syndrome in children.
Aspirin is a medication that can cause Reye’s syndrome in children.
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What is the antidote for insulin overdose?
What is the antidote for insulin overdose?
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Peptic ulcers are a contraindication for anticoagulation therapy.
Peptic ulcers are a contraindication for anticoagulation therapy.
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What is the primary mechanism of action for acetazolamide?
What is the primary mechanism of action for acetazolamide?
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Acetazolamide can cause metabolic acidosis.
Acetazolamide can cause metabolic acidosis.
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Ondansetron (Zofran) is an antiemetic medication used to treat nausea and vomiting.
Ondansetron (Zofran) is an antiemetic medication used to treat nausea and vomiting.
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Proton pump inhibitors are medications used to reduce gastric acid production.
Proton pump inhibitors are medications used to reduce gastric acid production.
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Digoxin is a medication that can cause increased heart rate.
Digoxin is a medication that can cause increased heart rate.
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Baroreceptors are pressure sensors located in blood vessels that help regulate blood pressure.
Baroreceptors are pressure sensors located in blood vessels that help regulate blood pressure.
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The renin-angiotensin-aldosterone system (RAAS) is activated when blood pressure is high.
The renin-angiotensin-aldosterone system (RAAS) is activated when blood pressure is high.
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Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia.
Spironolactone is a potassium-sparing diuretic that can cause hyperkalemia.
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Misoprostol is a medication used to treat intracranial pressure.
Misoprostol is a medication used to treat intracranial pressure.
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Acetazolamide is a diuretic that can cause hypokalemia.
Acetazolamide is a diuretic that can cause hypokalemia.
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Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia.
Hydrochlorothiazide is a thiazide diuretic that can cause hypokalemia.
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Study Notes
Nursing Pharmacology Final Exam Blueprint
- The exam will contain 60 questions.
- Each question will have 1.5 minutes to answer.
- The exam blueprint covers core drug knowledge, core patient variables, and patient teaching.
Opioids
- Side effects: Respiratory depression, central nervous system depression, headache, constipation, increased fluid intake, bradycardia, drowsiness.
- Antidote: Narcan (naloxone)
- Patient Variables: Age, weight, race, medical history, genetics, diet.
- Teaching: Increase fiber intake, avoid alcohol, assess respiratory/cardiac before administering medication.
Levodopa-Carbidopa
- Mechanism of action: Increase dopamine production in the brain by preventing levodopa from breaking down.
- Use: Parkinson's disease (improves daily living activities).
- Adverse effects: Tremor, dizziness, numbness, weakness, agitation, anxiety, anorexia, nausea, vomiting, dry mouth, dysphagia, urinary retention, flushing, cardiac irregularities, psychosis.
- Contraindications: Angle-closure glaucoma, history of melanoma, psychosis, peptic ulcer disease, depression, bipolar disorder.
Cystic Fibrosis
- The disease involves the epithelial lining of the respiratory, gastrointestinal, and reproductive tracts.
- There is a defective gene on chromosome 7.
- Results in thick secretions in the lungs, requiring low calorie/high protein diet and chest physical therapy.
Parkinson's Disease
- A progressive neurodegenerative disorder affecting movement control.
- It occurs due to dopamine-producing neuron loss in the brain.
- Chlorpromazine (Antipsychotic) side effects include dry mouth, constipation, blurred vision, tachycardia, and photosensitivity.
Lithium
- Therapeutic level: 0.6-1.2 mEq/L
- Increased level (1.2-1.5mEq/L): Lethargy, CNS, muscle weakness, fine tremors, polyuria (renal toxicity), ECG changes, bradycardia.
- Severe levels (2.0-2.5 mEq/L): CNS ataxia, clonic movements, cardiovascular changes in ECG.
- Further increased levels (2.5+): Multi-system organ failure – keep patient hydrated.
Antipsychotic Care
- Goal: Prioritize patient safety and encourage the patient to stay on their medication regimen.
- Adverse Effects (Chlorpromazine): Anticholinergic effects (dry mouth, constipation, urinary retention, blurred vision, tachycardia), suppressed sexual drive, erectile dysfunction, severe dysrhythmias, dermatitis, photosensitivity. Neuroleptic malignant syndrome (NMS) is a serious condition of high fever, rigidity, VS instability, and loss of consciousness, and is more common with high potency medications than chlorpromazine.
MAOIs and Food/Drug Interactions
- Avoid certain foods and drugs with Monoamine oxidase inhibitors (MAOIs) to prevent hypertensive crisis.
Benzodiazepine
- Antidote: Flumazenil
- Signs and symptoms of overdose: Respiratory depression
Antifungal Medication Management
- Safe medication regimen for patient taking Antifungal (e.g., Amphotericin B).
- Patient education on harmful side effects like orange colored urine, tears, and sweat.
Rifampin
- Use: Treats TB and other bacterial infections.
- Side effect: Urine, tears and sweat may change color to orange.
Gentamicin
- Usage precautions: Type 2 diabetic patients, chronic renal failure, nephrotoxicity, ototoxicity.
- Monitoring: Peak (30-90 min) and trough serum levels.
- Do not accumulate the drug to toxic levels.
Aminoglycoside
- Strong antibiotic and broad spectrum: Narrow therapeutic window.
- Monitor urine output to avoid toxicity.
- Labs: checking for normal range to prevent toxicity.
Tylenol (Acetaminophen)
- Antidote: Acetylcysteine
- Toxicity: Monitor levels for liver toxicity.
Ibuprofen
- Monitoring/Assessment: Monitor BUN and creatinine (kidney function).
- Reye's syndrome: linked in pediatric populations, should not give aspirin.
Acetylsalicylic Acid (Aspirin)
- Low dose used as anti-platelet/anticoagulant.
Antibiotics
- Patient teaching: Full course of antibiotics, take at the same time each day with food and full glass of water, some medications should not be taken with food.
- Drug-to-drug interaction monitoring (Warfarin): Avoid foods high in vitamin K, avoid NSAIDS and fish oil.
Warfarin
- Antidote: Vitamin K
- Monitoring: INR (goal range usually 2-3), APTT or WBCT
- Precautions: Recognize bleeding signs, avoid activities with high risk of injury, avoid alcohol, avoid IM injections unless necessary, do not rub injection site.
Diabetic Type I
- Insulin replaces Beta cells. Rotate injection sites to prevent fatty lumps.
Levothyroxine
- Lab Monitoring: TSH, T3, T4
- Therapeutic Levels: Adjust initial dosage based on patient response.
Hyperthyroid
- Goal: Lower thyroid hormone levels to manage hyperactivity.
Anticoagulation
- Purpose: Prevent clots or manage conditions like deep vein thrombosis or atrial fibrillation.
- Administration: Specific instruction for oral vs. injectable anticoagulants, like heparin.
- Monitoring: Regular blood tests to monitor clotting times.
- Precautions: Teach patients to recognize signs of bleeding and avoid risky activities.
Hypertensive Crisis
- Medication administration (e.g., Nitroprusside) may be used.
Loop Diuretics
- Used to treat fluid imbalances.
Asthma Management
- Inhaler administration instruction.
- Take with food if needed.
Neurological Deficient Patient Care
- Bowel management: Laxatives, stool softeners, digital evacuation.
Misoprostol
- Indications: Glaucoma, edema, and acute mountain sickness. It helps lower intraocular pressure.
Acetazolamide
- Indications: Glaucoma, edema, and acute mountain sickness. It helps lower intraocular pressure.
- Mechanism: Inhibits carbonic anhydrase for aqueous humor formation and promotes urine production.
- Precautions: Allergy to acetazolamide or sulfonamides. Chronic noncongestive angle-closure glaucoma, pregnancy. Avoiding use in fluid/electrolyte imbalances, renal or hepatic disease, respiratory acidosis, COPD.
Hydrochlorothiazide
- Uses: Management of hypertension, edema.
- Monitor for adverse effects.
Cimetidine
- Adverse effects: Gynecomastia (men), confusion, joint and muscle pain, elevated liver enzymes.
Clopidogrel
- Contraindications: Patient history with certain diseases. Stop administering it 5 days before a procedure.
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Description
Prepare for your Nursing Pharmacology final exam with this comprehensive blueprint covering essential drug knowledge, core patient variables, and patient education. This quiz emphasizes key concepts related to opioids and Levodopa-Carbidopa, including their mechanisms, side effects, and safety measures. Test your understanding effectively and get ready for success.
