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45 Cards in this Set
- Front
- Back
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What is the correct procedure for using a MDI?
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-Deep breath in and out
-Activate -Breath in and hold -Breathe out through pursed lips -Space dosages 5 min apart |
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What are the advantages of a dry powder inhaler?
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-Less manual dexterity needed
-No spacer required *Exact count indicator |
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What is the advantage of using a nebulizer?
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Droplets are finer than those produced by inhaler -- more likely to reach periphery of lungs
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What are hypotonic saline nebulizers used for?
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Provide deeper penetration into distal airways and alveoli?
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What are hypertonic saline nebulizers used for?
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Stimulates a productive cough
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What are the side effects for albuterol (Proventil HFA, Ventolin HFA)?
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*Tachycardia
-Palpitations, angina -Anxiety, tremors -N/V, heartburn -Unusual taste *HA, insomnia, dizziness |
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What are the side effects for salmeterol (Serevent, Serevent Diskus)?
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*Tachycardia
-Palpitations, angina -Anxiety, tremors -N/V, heartburn -Unusual taste *HA, insomnia, dizziness |
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What are the side effects for terbutaline (Brethine)?
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*Tachycardia
-Palpitations, angina -Anxiety, tremors -N/V, heartburn -Unusual taste *HA, insomnia, dizziness |
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What are the nursing implications for albuterol (Proventil HFA, Ventolin HFA)?
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-Report chest pain or changes in HR/rhythm
-Determine Peak Expiratory Flow Rate -Identify triggers of attack -Teach pts how to use devices |
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What are the nursing implications for salmeterol (Serevent, Serevent Diskus)?
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-Report chest pain or changes in HR/rhythm
-Determine Peak Expiratory Flow Rate -Identify triggers of attack -Teach pts how to use devices |
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What are the nursing implications for terbutaline (Brethine)?
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-Report chest pain or changes in HR/rhythm
-Determine Peak Expiratory Flow Rate -Identify triggers of attack -Teach pts how to use devices |
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What is the indication for beclomethasone dipropionate (QVAR HFA)?
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*PREVENTATIVE*
-Prophylaxis of chronic asthma using a fixed schedule *Not used to abort ongoing attack |
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What is the indication for budesonide (Pulmicort Turbohaler)?
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*PREVENTATIVE*
-Prophylaxis of chronic asthma using a fixed schedule *Not used to abort ongoing attack |
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What is the indication for triamcinolone (Amzacort)?
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*PREVENTATIVE*
-Prophylaxis of chronic asthma using a fixed schedule *Not used to abort ongoing attack |
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What is the indication for fluticasone/salmetrerol (Advair Diskus)
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*PREVENTATIVE*
-Prophylaxis of chronic asthma using a fixed schedule *Not used to abort ongoing attack |
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What is the indication for methylprednisolone (Medrol)?
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*PREVENTATIVE*
-Prophylaxis of chronic asthma using a fixed schedule *Not used to abort ongoing attack |
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What is the indication for prednisolone?
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*PREVENTATIVE*
-Prophylaxis of chronic asthma using a fixed schedule *Not used to abort ongoing attack |
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What are the side effects for beclomethasone dipropionate (QVAR HFA)?
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*Oropharyngeal thrush
-Dysphonia *Osteoporosis -Retard growth in children *Cataracts, glaucoma |
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What are the side effects for budesonide (Pulmicort Turbohaler)?
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*Oropharyngeal thrush
-Dysphonia *Osteoporosis -Retard growth in children *Cataracts, glaucoma |
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What are the side effects for triamcinolone (Amzacort)?
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*Oropharyngeal thrush
-Dysphonia *Osteoporosis -Retard growth in children *Cataracts, glaucoma |
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What are the side effects for fluticasone/salmetrerol (Advair Diskus)?
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*Oropharyngeal thrush
-Dysphonia *Osteoporosis -Retard growth in children *Cataracts, glaucoma |
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What are the side effects for prednisolone?
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-Adrenal suppression
-Osteoporosis -Hyperglycemia -PUD -Suppression of growth -Infections, poor healing |
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What are the nursing implications for the glucocorticoids (QVAR, Pulmicort Turbohalor, Azmacort, Advair Diskus, Medrol, prednisolone)?
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*Gargle after every use to minimize oral effects
-Use spacer (except QVAR) -Adequate daily intake of Vitamin D/Calcium, weight bearing exercise -Wait 5 min after taking beta agonists (albuterol) |
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How does cromolyn (Intal)work in the body??
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-Prophylaxis of asthma by suppressing inflammation, can prevent bronchospasm
-Inhibits release of inflammatory cells |
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What are the indications for cromolyn (Intal)?
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-Chronic asthma
-Exercise-induced bronchospasm -Allergic rhinitis |
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How does theophylline (Theo-24, Theo-Time) and aminophylline (Truphylline) work in the body?
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PO Drug
-CNS excitation -bronchodilation -Cardiac stimulation -Diuresis |
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What is the therapeutic range for theophylline?
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5-15 ug/ml
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What are the side effects of theophylline?
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-N,V,D
-Insomnia, restlessness -Dysrhythmias, tachycardia -Hyperglycemia -Convulsions |
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What are the drug interactions for theophylline?
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-caffeine, cimetidine, and fluoroquinolone antibiotics all increase levels
-Phenobarbital, phenytoin decrease levels |
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What are the nursing implications for thoephylline?
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-Monitor serum levels
-NO MEALS |
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What is the indication for montelukast (Singulair)?
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Prophylaxis and treatment of chronic asthma
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What is the indication for zafirlukast (Accolate)?
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Prophylaxis and treatment of chronic asthma
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What are the side effects of montelukast (Singulair)?
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-Liver toxicity
-Dyspepsia -HA, cough |
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What are the side effects of zafirlukast (Accolate)?
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-Liver Toxicity
-Dyspepsia -HA, cough |
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What are the nursing implications for montelukast (Singulair)?
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-Monitor LFTs
-Safe for childrens -Fewer interactions with other drugs |
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What is the route and what are the indications for acetylcysteine (Mucomyst)?
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Route: ultrasonic nebulizer
-Bronchopulmonary diseases -COPD -CF -Antidote for acetaminophen OD |
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What are the side effect for acetylcysteine (Mucomyst)?
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*unpleasant odor - N/V due to odor
-Throat or lung irritation -Rhinorrhea -Stomatitis *Bronchospasms |
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What is the mechanism of action for codeine and hydrocodone?
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Elevate the cough threshold in the CNS
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What are the side effects for codeine and hydrocodone?
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*Respiratory depression
-Potential for abuse |
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What are the nursing implications for codeine and hydrocodone?
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-Not indicated for children
-Caution for respiratory pts - may cause bronchoconstriction |
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What are the key points about dextromethorphan (Robitussin)?
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-Works well for mild-mod coughing
-Lacks abuse potential -No Respiratory depression |
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What are the indications for diphenhydramine (Benedryl)?
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*Mild/severe allergy
-Seasonal allergic rhinitis -Insomnia |
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What are the side effects for diphenhydramine (Benedryl)?
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*Sedation, dizziness, incoordination, confusion, fatigue
-N/V/D/Anorexia -Paradoxical reactions in elderly -Anticholinergic effects |
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What are the side effects for Claritin, Allegra, and Zyrtec?
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-N/V/D/Anorexia
-Paradoxical reactions in elderly -Anticholinergic effects |
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What are the nursing implications for diphenhydramine (Benedryl)?
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-Give at nighttime to decrease daytime sedation
-Avoid alcohol or CNS depressants -Give with food -Caution in pts with asthma, prostatic hypertrophy, narrow-angle glaucoma, and HTN |
