Renal Drugs Review

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flashcards89204
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20149
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Renal Drugs Review
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2010-05-21 03:09:15
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Renal Drugs Review
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Term 2 Exam 3 Review
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  1. hydrochloridethiazide [Microzide, Oretic] is given to pt. w/ ESRD [final stage of kidney failure marked by complete/nearly complete irreversible loss of renal function] what assessments would you find that would indicate the need for the drug?
    • pt. has a urinary output of 90 mL over last 8 hrs [output should be at least 240 mL].
    • pt. has good skin turgor, mucous membranes pink & moist.
    • pt. has sacral & 2+ pitting edema.
    • pt's BP is 90/60.
    • pt's BP is 120/80.
  2. what are common side effects of furosemide [Lasix]?
    • electrolyte & hematologic imbalances.
    • anorexia.
    • nausea.
    • vomiting.
    • rash.
    • photosensitivity.
    • orthostatic hypotension.
    • glycosuria.
    • + ototoxicity.
    • hypokalemia.
  3. MD ordered 80 mEq of furosemide [Lasix] x2/day, pt's potassium level is 2.5 (low). what should you do?
    hold meds--don't give, notify MD.
  4. MD ordered 250 mg of acetazolamide [Diamox] Q6hrs, comes in 500 mg tablets. how many tablets should you give?
    250/500 = 0.5 x 4 (# of times drug will be given) = 2 tablets.
  5. which meds are ok to give & which ones are not?
    • pt. who has a BP of 168/84 & pitting edema, ok to give torsemide [Demadex].
    • pt. given bumetadine [Bumex] c/o headache, ok to give (normal side effect).
    • pt. taking furosemide [Lasix] now c/o leg cramps, hold meds & notify (pt. is losing too much potassium).
  6. pt. given furosemide [Lasix] b/c of edema, UAP reports that pt. lost 1 lb. should you be concerned?
    no, it's normal.
  7. pt. is c/o GI upset after taking meds, what advice should you give?
    take meds w/ milk, full glass of water, or w/ food.
  8. pt. is prescribed hydrochlorothiazide [Microzide, Oretic], what kind of juice should pt. drink when taking meds?
    cranberry juice.
  9. delegation question: what kind of tasks can you delegate to UAP [unlicensed assistant personnel]?
    • nothing that requires assessments (except for VS)/tx.
    • can measure I&O.
    • can help feed pt.
    • can helpt pt. ambulate.
    • can help bathe pt.
  10. MD orders: potassium 40 mEq PO daily. you have 10 mEq/5 mL, how many mL should you give?
    40/10 = 4 x 5 = 20 mL.
  11. what kind of drug is mannitol [Osmitrol]?
    • osmotic diuretic given for:
    • ARF [acute renal failure] to decrease IOP [intraocular pressure].
    • cerebral edema.
    • irrigation solution in prostate sx.
  12. how do you know if mannitol [Osmitrol] its effective?
    increase in hourly urine output.
  13. what are the side effects of spironolactone [Aldactone]?
    • headache.
    • diarrhea.
    • drowsiness.
    • lethargy.
    • hyperkalemia.
    • cramping.
    • gastritis.
    • erectile dysfunction.
    • gynecomastia.
  14. pt. is prescribed triamterene [Dyrenium], what kind of drug is it?
    what should you monitor pt. for?
    when should med be taken?
    • potassium sparing diuretic.
    • monitor for nausea, vomiting, hyperkalemia & photosensitivity.
    • med should be taken in the morning.
  15. pt. has been dx w/ glomerulonephritis [inflammation of the capillaries of the renal glomeruli] & is taking trimethoprim & sulfamethoxazole [Bactrim], what kind of drug is it?
    urinary anti-infective.
  16. how do you know if trimethoprim & sulfamethoxazole [Bactrim] is effective?
    CBC--leukocytes not present (in urine too).
  17. pt. is taking nitrofurantoin [Macrodantin] for UTI, she calls & says her urine is dark in color (coca-cola colored), what should you tell pt.?
    harmless side effect of med.
  18. what color does methenamine [Mandelamine] turn urine to?
    may cause urine to turn blue.
  19. color of urine for pt. on phenazopyridine hydrochloride [Pyridium] (urinary analgesic)?
    may discolor the urine reddish-orange & may stain contacts.
  20. -for pt. who has glaucoma [a disease of the eye marked by increased pressure w/in eyeball that can result in damage to optic disk & gradual loss of vision], is it ok to prescribe trimethoprim & sulfamethoxazole [Bactrim]?
    -is it ok for pt. to take methenamine [Mandelamine] (anti-infective) w/ has cirrhosis [widespread disruption of normal liver structure by fibrosis & formation of regenerative nodules caused by any of various chronic progressive conditions affecting liver]?
    -pt. who has hyperlipidemia [presence of excess fat/lipids in blood], is it ok to give cipro [Ciprofloxacin]?
    -pt. who has a hx of gastritis [inflammation of mucous membrane of stomach], is it ok to take nitrofurantoin [Macrodantine] (anti-infective)?
    • yes, med doesn't affect glaucoma.
    • no, med can be toxic to pt. due to cirrhosis.
    • yes.
    • yes.
  21. if pt. has UTI [urinary tract infection], in addition to anti-infectives, what else should you encourage what?
    lots of fluid (particularly cranberry juice to acidify urine b/c bacteria doesn't grow in acidic environment)
  22. nitrofurantoin [Macrobid] (anti-infective) can cause which pulmonary side effects?
    • dsypnea.
    • chest pain.
    • chills.
    • fever.
    • cough.
    • alveolar infiltrates.
    • pulmonary fibrosis (Macrodantin lung).
  23. nalidixic acid [NegGram] is contraindicated w/ pts who have what disorders?
    contraindicated in pts w/ hx of seizures.
  24. what is aluminum carbonate gel [Basaljel] given for?
    • used to bind intestinal phospate eliminated in feces.
    • used in pts w/ ESRD to reduce serum phosporus levels (hyperphophatemia > 4.5 mg/dL).
    • also used as an antacid.
  25. if sevelamer hydrochloride [Renagel] is given to balance elexctrolytes & fluids for pts on dialysis, how do you if its effective?
    pt. has normal levels of fluid & electrolytes.
  26. sodium polystyrene sulfonate [Kayexelate], how do you know if its effective?
    potassium level is WNR.
  27. pt. has potassium of 5.9, MD ordered sodium polystyrene sulfonate [Kayexelate] enema, nursing actions after enema?
    • retain for 30-60 min.
    • irrigate colon w. non-sodium containing fluid after Kayexelate is expelled.
  28. what is the best way to give oral potassium supplements?
    should be given w. at least 4 oz. of liquid [orange juice].
  29. expected side effects of magnesium supplements?
    • hypersomnolence (sleepy).
    • hot flashes.
    • lethargy.
  30. what kind of drug is tacrolimus [Prograf] & what is it used for?
    • immunosuppressant.
    • used for tx of autoimmune disorders, prevent organ rejection--life long therapy,
  31. pt. taking tacrolimus [Prograf] is c/o sore throat, what should you do?
    notify MD b/c drug increases risk of infection such as fever &/sore throat.
  32. what side effects does azathioprine [Imuran] (immunosuppressant) have?
    • bone marrow suppression.
    • *monitor for neutropenia, thrombocytopenia, & take precautionary measures.
  33. immunosuppressants are usually taken & how often are labs done?
    • for life.
    • every 3 mo.
  34. why would immunosuppressants drugs & prednisone (glucocorticoid) given together?
    to prevent organ rejection.
  35. what are the diff. types of immunosuppresant drugs?
    • calcineurin inhibitors: cyclosporine [Sandimmune, Genegraf, Neoral]
    • glucocorticoid: [Prednisone]
    • cytotoxics: azathioprine [Imuran]
    • other: tacrolimus [Prograf], methotrexate [Rheumatrex, Trexall]
  36. pt. w/ neurogenic bladder [nerve damage--spasm, flaccidity] given bethanechol chloride [Urecholine)], what precautions are done?
    advise pt. to rise slowly b/c drug causes hypotension.
  37. 3 yr. old weighs 33 lbs is given 25 mg/kg of medication divided in 3 doses, you have 150 mg/mL. how many mL do you give in each dose?
    • 1 kg = 2.2 lbs.
    • 33/2.2 = 15 x 25 = 375/3 = 125/150 = 0.8 mL.
  38. tolterodine [Detrol] is given for what?
    • overactive bladder.
    • *may cause dry mouth, constipation, headache, dizziness.
  39. darvocet (non-opioid analgesic--synthetic drug) is given for what?
    urinary spasms.
  40. flavoxate [Urispas] is given for?
    • used to relieve symptoms/dysuria.
    • urinary urgency.
    • nocturia.
    • suprapubic pain & frequency (spasms).
    • urge incontinence.
  41. adverse reactions of urinary anti-spasmodics?
    • dry mouth.
    • drowsiness.
    • constipation/diarrhea.
    • decreased tears & sweating.
    • GI disturbances.
    • blurry vision.
    • urinary hesitancy.
  42. what does bethanechol chloride [Uricholine] do?
    • used to increase bladder tone & function.
    • used to tx urinary retention & speed up peristalsis for urogernic bladder.
  43. MD ordered potassium chloride 30 mL daily, how many teaspoons is given?
    • 5 mL = 1 teaspoon
    • 30/5 = 6 teaspoons.
    • *1 Tablespoon = 3 teaspoons.

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