Nursing Pharmacology Quiz

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Questions and Answers

What occurs during infiltration of an IV catheter?

  • The IV solution causes vein inflammation.
  • The IV site becomes infected.
  • The IV catheter becomes dislodged or a vein ruptures. (correct)
  • The IV fluid enters the bloodstream directly.

Which of the following is a sign of phlebitis?

  • Tenderness along the course of a vein. (correct)
  • Paleness of the surrounding tissue.
  • Swelling of the entire limb.
  • Coolness at the IV site.

What should be assessed immediately when infiltration occurs?

  • The duration of the IV therapy.
  • The patient's history of IV use.
  • The patient's level of hydration.
  • The type of additives in the infiltrated fluid. (correct)

Which factor might increase the risk of developing phlebitis?

<p>Using acidic or hypertonic IV solutions. (C)</p> Signup and view all the answers

In case of extravasation, which treatment might differ according to the type of solution involved?

<p>Application of vasoconstrictors or other specific treatments. (D)</p> Signup and view all the answers

What is the most common type of transfusion reaction?

<p>Febrile nonhemolytic reaction (D)</p> Signup and view all the answers

Which medication is commonly used to manage fever in transfusion reactions?

<p>Acetaminophen (B), Antipyretics (D)</p> Signup and view all the answers

What is the primary treatment approach for a febrile nonhemolytic transfusion reaction?

<p>Stop the transfusion and provide supportive care (C)</p> Signup and view all the answers

What is considered the adult dose of elemental iron when treating iron deficiency anemia?

<p>50 to 100 mg two to three times daily (C)</p> Signup and view all the answers

Why should aspirin be avoided in thrombocytopenic patients?

<p>It can lead to increased bleeding risk (B)</p> Signup and view all the answers

What is the mechanism of action of iron in the body?

<p>It carries oxygen in hemoglobin and myoglobin (A)</p> Signup and view all the answers

What should be monitored during a transfusion to identify potential reactions?

<p>Vital signs and clinical symptoms (D)</p> Signup and view all the answers

Which form of iron is most frequently used for oral supplementation?

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

What is the importance of taking ferrous sulfate with 4 to 6 oz of water?

<p>It increases absorption and reduces gastrointestinal irritation. (C)</p> Signup and view all the answers

Which dietary sources are good for obtaining folate?

<p>Dried beans, peas, and leafy green vegetables. (B)</p> Signup and view all the answers

Why should a patient wait 2 hours before or after taking antacids when taking ferrous sulfate?

<p>Antacids can reduce the absorption of ferrous sulfate. (D)</p> Signup and view all the answers

What is the best time to take ferrous sulfate for optimal absorption?

<p>On an empty stomach if tolerated. (C)</p> Signup and view all the answers

What is megaloblastic anemia primarily caused by?

<p>Vitamin B12 deficiency. (B)</p> Signup and view all the answers

Which of the following is a symptom of anemia?

<p>Fatigue and weakness. (D)</p> Signup and view all the answers

Which food group is considered beneficial for increasing iron intake?

<p>Dark leafy greens and fortified cereals. (D)</p> Signup and view all the answers

In men, what hemoglobin level indicates anemia?

<p>Less than 14 g/dL. (A)</p> Signup and view all the answers

What condition commonly results from atrial fibrillation?

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

Which symptom is indicative of venous thrombosis?

<p>Localized redness (C)</p> Signup and view all the answers

Which of the following is a common cause of excessive production of red blood cells?

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

What complication can arise from a mesenteric artery thrombosis?

<p>Small bowel ileus (C)</p> Signup and view all the answers

Which of the following is a recommended activity for patients at risk of increased clotting?

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

Which type of bleeding may occur as a result of impaired clotting ability?

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

Which sign indicates the presence of purpuric lesions?

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

What should patients with decreased clotting ability do in case of unusual bleeding?

<p>Immediately notify their healthcare provider (A)</p> Signup and view all the answers

What indicates a phlebitis grade of 2 on the Phlebitis Scale?

<p>Pain at access site with erythema and/or edema (C)</p> Signup and view all the answers

What is a dangerous consequence of phlebitis?

<p>Formation of associated blood clots (B)</p> Signup and view all the answers

Which observation would indicate a phlebitis grade of 4?

<p>Pain, erythema, streak formation, and purulent drainage (B)</p> Signup and view all the answers

What complication is associated with bleeding at the venipuncture site?

<p>Increased risk for patients on anticoagulants (C)</p> Signup and view all the answers

What is identified as a common cause of local infection during IV catheter insertion?

<p>Poor aseptic technique during the procedure (D)</p> Signup and view all the answers

Infiltration occurs when IV fluid enters which area?

<p>Subcutaneous tissue around the venipuncture site (C)</p> Signup and view all the answers

Which phlebitis grade indicates the absence of any symptoms?

<p>Grade 0 (C)</p> Signup and view all the answers

What is the primary reason to recognize and treat local infections early?

<p>To prevent bacteria from entering the bloodstream (B)</p> Signup and view all the answers

Which of the following is NOT a sympathetic nervous system sign associated with acute pain?

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

What is the primary difference between nociceptive pain and neuropathic pain?

<p>Nociceptive pain results from skin or organ damage, while neuropathic pain relates to nervous system mechanisms. (C)</p> Signup and view all the answers

Which of the following is a common side effect of opioid administration?

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

What kind of risks are associated with opioid use during pregnancy?

<p>Fetal risks including withdrawal symptoms (D)</p> Signup and view all the answers

What condition may arise from the rapid cessation of opioid medication?

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

Which side effect is specifically related to long-term opioid use?

<p>Impaired immune function (D)</p> Signup and view all the answers

What is a key factor in providing effective pain control for postoperative patients?

<p>Using basal continuous doses in patient-controlled analgesia (B)</p> Signup and view all the answers

Which symptom is commonly linked to opioid side effects affecting the central nervous system?

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

Flashcards

Infiltration

IV fluid leaking into surrounding tissue, often due to a dislodged or ruptured vein.

Extravasation

Infiltration with damaging additives causing tissue damage.

Infiltration Signs

Coolness, paleness, and swelling at the IV site.

Phlebitis

Inflammation of a vein, often due to IV fluids or medications.

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Phlebitis Risk Factors

Acidic/hypertonic solutions, rapid IV rate, certain IV drugs, poor catheter placement, or poor hygiene.

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Phlebitis Symptoms (light skin)

Heat, redness, tenderness along the vein.

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Phlebitis Symptoms (dark skin)

Careful assessment for subtle color changes at the IV site, as redness may not be visible.

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Phlebitis Grade 0

No symptoms of phlebitis at the IV site.

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Phlebitis Grade 1

Erythema (redness) at the IV site, possibly with mild pain.

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Phlebitis Grade 2

Pain at the IV site, along with redness and swelling (edema).

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Phlebitis Grade 3

Pain along the IV track, induration (hardening), and redness.

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Phlebitis Grade 4

Advanced phlebitis, with significant pain, redness, hardness, a cord-like vein, and possibly pus.

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Phlebitis

Inflammation of a vein.

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Thrombophlebitis

Phlebitis with blood clots.

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Air embolism

Air entering a patient's vein.

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Infiltration

IV fluid leaking into surrounding tissue.

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Extravasation

Leakage of IV medication into the surrounding tissues.

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Febrile Nonhemolytic Transfusion Reaction

A common blood transfusion reaction caused by a reaction between white blood cell antigens and antibodies, triggering an inflammatory response.

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Symptoms of Febrile Nonhemolytic Reaction

Symptoms can include fever, chills, nausea, headache, and anxiety, often appearing acutely and immediately.

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Transfusion Reaction Interventions

Stop the transfusion, change the administration set, maintain IV access, initiate a transfusion reaction protocol, and administer antipyretics as needed.

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Prevention of Febrile Nonhemolytic Reaction

Premedicate with antipyretics if there's a prior history of reactions, and utilize leukocyte-reduced blood products.

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Iron Deficiency Anemia Treatment

Ferrous sulfate, a ferrous iron salt, is the most common treatment used for iron deficiency anemia.

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Ferrous Sulfate Dosage (Adult)

Typically 300 mg, two to three times daily, though common commercial products are 324 mg, and interchangeable. Dosage will vary on elemental iron content.

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Elemental Iron Dosage

The recommended adult dose of elemental iron is 50 to 100 mg, two to three times daily.

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Iron Function in the Body

Iron carries oxygen in hemoglobin and myoglobin, and is necessary for energy transfer.

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Dietary Iron Sources

Meats, dark leafy greens, and fortified grains are good sources of dietary iron.

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Iron Supplement Timing

Take ferrous sulfate with plenty of water (4-6 oz) on an empty stomach, if possible; wait 2 hours before or after taking antacids.

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Folate Sources

Leafy greens, citrus fruits, beans, nuts, seeds, whole grains, and organ meats are good sources of folate.

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Folate's Importance

Crucial for preventing neural tube defects in pregnancy.

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Anemia Definition

A reduction in red blood cells, hemoglobin, or hematocrit.

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Anemia Causes

Dietary problems, genetic disorders, bone marrow disease, or excessive bleeding can cause anemia.

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Anemia Hemoglobin Levels (Men)

Lower than 14 g/dL (8.7 mmol/L) indicates anemia.

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Anemia Hemoglobin Levels (Women)

Lower than 12 g/dL (7.4 mmol/L) indicates anemia.

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Sympathetic Nervous System Signs in Acute Pain

Physical responses to acute pain, including nausea/vomiting, sweating (diaphoresis), increased blood pressure, respiratory rate, pulse, and pupil dilation.

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Nociceptive Pain

Pain resulting from damage or inflammation to skin or organs.

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Neuropathic Pain

Pain caused by nervous system issues, potentially without tissue damage.

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Opioid Side Effects

Unwanted effects of opioid medications, including constipation, nausea, sedation, respiratory depression, and potential for abuse/addiction, memory & thought changes.

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Opioid Abuse/Addiction Concern

Risk of dependency and misuse associated with opioid use, especially for chronic pain.

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Postoperative Pain Control

Managing pain after surgery, often through patient-controlled analgesia (PCA) and preemptive measures.

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Patient-Controlled Analgesia (PCA)

Pain management technique where patients self-administer medication through a machine.

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Tolerance (Opioids)

The body's increased need for higher doses of opioids to achieve the same pain relief effect.

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Withdrawal Syndrome (Opioids)

Set of symptoms (e.g., rhinitis, chills, diarrhea,) experienced when opioid use is stopped or drastically reduced.

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Pain/Emotional Stress (Post-Op)

Primary sources of discomfort in post-operative patients requiring preemptive/prevention strategies.

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Venous Thrombosis

Formation of a clot in a vein, often in the leg.

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Arterial Clot

Blood clot formation in an artery.

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Embolus

Dislodged clot that travels through the bloodstream.

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Stroke (Embolic)

Embolus travels to the brain, causing a stroke

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Pulmonary Embolus

Occurrence when an embolus reaches the lungs.

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Hemorrhagic Stroke

Internal bleeding in the brain causes this type of stroke.

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GI Bleeding (Internal)

Bleeding occurring inside the gastrointestinal tract.

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Renal Artery Thrombosis

Clot in the renal artery, causing kidney damage.

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Mesenteric Artery Thrombosis

Clot in mesenteric artery, leading to bowel issues.

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Polycythemia

Excess red blood cell production, increasing clot risk.

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Atrial Fibrillation

Irregular heartbeat, leading to blood pooling and potential clots.

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Dehydration

Insufficient fluid intake, increasing risk for clots.

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Prolonged Sitting

Extended periods of sitting, increasing clot risk.

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Study Notes

Metabolic Acidosis

  • Occurs from an increase of metabolic acid or decrease of base (bicarbonate).
  • Kidneys unable to excrete enough metabolic acids, which accumulate in blood or bicarbonate is removed from body.
  • Blood HCO3− decreases, and pH falls.
  • Conditions that cause removal of HCO3− also lead to decrease in blood HCO3−.
  • Characterized by pH level less than 7.35 and bicarbonate (HCO3−) level less than 22 mEq/L.
  • Lung compensation involves increasing rate/depth of ventilation (Kussmaul respiration) to remove excess carbon dioxide.

Underlying Causes of Metabolic Acidosis

  • Starvation ketoacidosis (inadequate caloric intake, prolonged fasting)

    • What happens: absence of glucose, body uses fat stores for energy, keto-acids accumulate in blood
  • Diabetic ketoacidosis (Type I diabetes mellitus)

    • What happens: glucose not transported into cells due to lack of insulin, body uses fat for energy, keto-acids accumulate in blood
  • Lactic acidosis (sepsis, cardiac arrest, trauma, seizures)

    • What happens: lack of oxygen in cells, leads to anaerobic metabolism and lactic acid accumulation
  • Renal tubular acidosis (renal failure)

    • What happens: kidneys unable to remove acids via urine acidification
  • Hyperchloremic acidosis (diarrhea, laxative abuse)

    • What happens: gastrointestinal loss of bicarbonate (HCO3−)

Signs and Symptoms of Metabolic Acidosis

  • Decreases level of consciousness (lethargy, confusion, coma)
  • Increased respiratory rate and depth (compensatory hyperventilation)
  • Abdominal pain
  • Dysrhythmias (irregular heartbeats)

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