New Last Chapters

Front 1

Diaretics remove

Back 1

-remove sodium and water
-remove exracellular fluid (edema)

Front 2

Antihypertensives

Back 2

lower blood pressure

Front 3

Hypertension diagnosed at

Back 3

140/90 mmHg or higher

Front 4

Repeat measurement at least _ hrs apart before you give the diagnosis

Back 4

6

Front 5

Hypertension: what changes do u make first?

Back 5

lifestyle changes first when appropriate

Front 6

Removal of excess fluid results in: decreased

Back 6

-decreased preload
-decreased cardiac output
-decreased total peripheral resistance

Front 7

Loop Diaretics: Side Effects

Back 7

-Potassium depletion (Hypokalemia)
-Hearing loss (ototoxic)

Front 8

Osmotic Diuretics used to treat:

Back 8

intracranial pressure and renal failure
-Mannitol- antidiaretic

Front 9

Carbonic Anhydrase Inhibitors

Back 9

maintains alkalinity of the blood
-normal blood pH 7.35-7.45

Front 10

If you record _______ B/P, re-check it to rule out error or _____ _____ _____ stimulation.

Back 10

hypertensive, sympathetic nervous system

Front 11

Calcium Channel Blockers Action:

Back 11

reduce arterial blood pressure at rest and during exercise

Front 12

Beta-Adreneric Blocking Agents: Reduce: Adverse Effect:

Back 12

-heart rate
-force of contration

-Bronchoconstriction

Front 13

Instruct your clients

Back 13

-not to stop taking abruptly
-rebound hypertensive crisis
-Oral forms should be given with meals so the absorption is more gradual and effective
-IV usage should be a pump

Front 14

Use appropriate size _______ when taking B/P

Back 14

cuff

Front 15

if B/P is high ____ in ___ ___.

Back 15

retake, other arm

Front 16

Assess _____ needs.

Back 16

potassuim

Front 17

Salt substitutes may contain

Back 17

potassium

Front 18

Sinoatrical node normal:

Back 18

60-100 bpm; Primary pacemaker

Front 19

Digoxin end results:

Back 19

slows and strengthens contractions

Front 20

Take Apical pulse for _ min. Hold if HR is less than __ bpm.

Back 20

1, 60

Front 21

Antiarrhythmis and Antidysrhythmic Drugs work in 3 ways:

Back 21

-Decrease automaticity of cardiac tissues in the ectopic sites
-Alter rate of conduction
-Alter refractory period of cardiac muscle between consecutive contractions

Front 22

Antidysrhythmics: class

Back 22

-Quinidine gluconate- Class 1
-Lidocaine- Class 1B
-Dilantin- Class 1B
-Propranolol- Class 2
-Verapamil HCL- Class 4
-Digoxin- Class 4

Front 23

Adverse Affects

Back 23

-GI upset
-Hypotension
-Bradycardia

Front 24

Before each Antidysrhythmic med:

Back 24

take Pt apical pulse for one min before each administration

Front 25

Beta-Adrenergic Blocking Agents: Adverse Effects:

Back 25

-Cause bronchoconstriction
-Can cause heart failure
-Examples: Propranolol (Inderal)-Given for high B/P

Front 26

Patient taking Calcium Channel Antagonists, instruct the Pt to take their

Back 26

Pulse

Front 27

Hyperlipidemia

Back 27

too many fats floating in your blood

Front 28

Atherosclerosis

Back 28

accumulation of fatty substances on the inner wall of large and medium size arteries and capillaries also.

Front 29

atherosclerosis can lead to:

Back 29

CAD, Cerebral Vascular Disease, peripheral vascular disease or renal disease and failure

Front 30

Hyperlipidemia

Back 30

-Chylomicrons
-VLDL= very low-density lipoproteins (more fat)
-LDL= Low-density lipoproteins (less protein, more fat)
-HDL= high-density lipoprotiens (more proteins)
-> target >40mg/dL male/>50mg/dL women

Front 31

Lipoproteins: 1st line of defense is

Back 31

dietary managment

Front 32

the risk of coronary disease is __ times greater if the _______ level is at or above ____mg/dL compared to a person with a level of ___mg/dL or ______.

Back 32

three, cholesterol, 260, 200

Front 33

Classification of antihyperlipidemics

Back 33

-Niacin (nicotinic acid)
-Bile acid sequestrants: may bind other PO drugs; dont give within 1 hour after or 4 hours before other drugs

Front 34

Inhibit HMG-CoA reductase

Back 34

-Enzyme used by the liver to produce cholesterol
-Lowers the rate of cholesterol production

Front 35

Vitamin B3 Niacin

Back 35

-decreases triglycerides
-increases HDL
-effective and inexpensive

Front 36

Side Effect of Antihyperlipidemics

Back 36

prolonged prothrombin time

Front 37

Asses

Back 37

-dietary patterns, exercise level, height and weight, vital signs, and family history (genetics, and tobacco and alcohol use)

Front 38

teach PT that:

Back 38

dietary modifications are important when treating elevated serum lipids

Front 39

Tx for Iron Deficiency Anemia

Back 39

Ferrous sulfate more readily absorbed

Front 40

Iron should be taken:

Back 40

on an empty stomach

Front 41

food and antiacids can block:

Back 41

drug absorption by 50%

Front 42

Concurrent use of _____ _ can help _____ absorption: give with _____ ____.

Back 42

Vitamin C, increase, orange juice

Front 43

iron should be given in:

Back 43

devided doses

Front 44

Therapeutic Agents: Iron Salts: side effects

Back 44

-GI upset
-Constipation and dark stools

Front 45

Low dose may be:

Back 45

lethal for children

Front 46

Educate Pt to store iron:

Back 46

out of children's reach

Front 47

Remind Pt that iron may cause

Back 47

black stools

Front 48

Need to educate Pt on the necessity of taking iron on a:

Back 48

long-term basis

Front 49

Remind to take with:

Back 49

Vitamin C source

Front 50

Iron: Usual adult dose

Back 50

300 mg 2-4 times daily

Front 51

Vitamin B12 deficiency can be caused by

Back 51

pernicious anemia

Front 52

Folic Acid deficiencies are:

Back 52

related to neural tube defects in the developing fetus >spina bifida

Front 53

Encourage pregnant women or those planning to become pregnant to take:

Back 53

folic acid supplements

Front 54

Active Immunity

Back 54

-administration of antigen, a weakened or killed vaccine
-stimulates your immune system to form antibodies against the disease
-lasts for many years

Front 55

Passive Immunity

Back 55

-think (breast feeding, placenta)
-provides instant protection
-short duration

Front 56

IM injection sites

Back 56

deltoid muscle or vastus lateralis

Front 57

Ibuprofen or Tylenol for:

Back 57

premedication

Front 58

observe the Pt after the vaccine administration for any:

Back 58

distres

Front 59

keep accurate

Back 59

records
-document lot number, location

Front 60

Interferons and Interleukins

Back 60

assist with communication between the cells of the immune (and other) system(s)
-axtent and duration of the immune response

Front 61

Immunodepressant Agents

Back 61

-must be taken every day- no missed doses
-compliance necessary

Front 62

Immunodepressant Agents: teach

Back 62

clients to avoid infections
-instruct to wear a mask if going out
-immunosuppressant agents are expensive ($50,000/year or more)

Front 63

Mitotic

Back 63

-Percentage of cell undergoing mitosis
-Antineoplstics most effective when the growth fraction and mitotic index are high

Front 64

Antineoplastic Agents: Dose limiting Effects

Back 64

-hair falls out
-cells in the GI gtract die
-Nausea and vomiting occur; emetic potential
-Myelosuppression
->nadir: lowest point for the bone marrow cells, WBC's, platelets

Front 65

Adjuvant Agents: Antiemetics

Back 65

Ondansetron HCI (Zofran)

Front 66

Adjuvant Agents: Appetite Stimulants

Back 66

-Megace ES (megestrol acetate)
-Marinol (THC)

Front 67

Adjuvant Agents: Blood cell forming agents

Back 67

-Epoetin alfa (Procrit)
-Neulasta

Front 68

Provide significant hydration to prevent

Back 68

nephrotoxicity

Front 69

Always check

Back 69

red blood cells

Front 70

Adverse Effects: Chemotherapy

Back 70

-risk for infection
-nausea and vomiting
-risk for vesicant extravasation

Front 71

If you are pregnant as a nurse, avoid handling:

Back 71

cytotoxic drugs

Front 72

Education regarding:

Back 72

signs and symptoms to report to provider

Front 73

Acute Attacks: Gout

Back 73

-Nonsteroidal anti-inflammatory drugs (NSAIDs)
-Corticosteroids

Front 74

Gout: Increase

Back 74

fluid intake

Front 75

Analeptics

Back 75

common central nervous system stimulant

Front 76

Anorexiants

Back 76

-drugs that reduce appetite
-use is controversial

Front 77

Attention-Deficit Hyperactivity Disorder

Back 77

Has a paradoxical effect
-calming effect
-improves attention span
-allows focusing of thoughts

Front 78

Treatment for Alzheimer's Disease

Back 78

-Alzheimer's disease seriously affects memory (Acetylcholine: neurotransmitter is notably absent)
-Ex of drug agents: Stop the action of cholinesterase inhibitor
-Donepezil HCI (Aricept)
-Rivastigmine tartrate (Exelon)

Front 79

Treatment for Alzheimer's Disease

Back 79

-improves the availability of acetylcholine
-improves memory

Front 80

Adverse Side Effects

Back 80

-Mild GI symptoms
-nausea, vomiting, and diarrhea
-Agitation during initial few weeks

Front 81

Neuromuscular Blocking Agents: Action

Back 81

-block the action of acetylcholine
-mimic acetylcholine action and prevent cholinesterase from working; the muscle becomes overtired and the client is unable to use the muscle

Front 82

Neuromuscular Blocking Agents

Back 82

-paralyze skeletal muscle groups
-does not affect cardiac muscle
-to assist intubation and mechanical ventilation
-usually administered IV
-close monitoring required (could stop respiration)
-antidotes should be readily available

Front 83

Centrally-acting musculoskeletal agents

Back 83

-Diazepam (Valium)- PO, IM, IV
-may cause dependence
-cannot be mixed in syringe with other drugs
-Discontinue gradually to avoid withdraw reactions

Front 84

Centrally-acting skeletal muscle agents

Back 84

patients should be cautious when performing activities dues to sedation

Front 85

Direct-Acting Skeletal Muscle Relaxants: Adverse Effects

Back 85

-Hepatoxicity
-Hepatitis

Front 86

Skeletal- Muscle Stimulants: Side Effects/Adverse Effects

Back 86

-Caused by unusual cholinergic activity
-increased salivation
-diarrhea
-intestinal cramping
-bradycardia
-miosis