quiz3

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quiz3
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2011-08-14 21:59:43
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  1. Succinylcholine promotes the release of
    potassium from tissues.

    Significant hyperkalemia is most likely to develop in patients with major burns, multiple trauma, denervation of skeletal muscle, or upper neuron injury
  2. All NM blocking agents can cause
    cause respiratory arrest.

    They do not cause decreased urinary output, hyperglycemia, or hypoglycemia.
  3. Succinylcholine is an ultrashort-acting
    acting NM blocker used to facilitate mechanical ventilation in patients whose spontaneous respirations fight the rhythm of the respirator.

    It does not provide pain relief or loss of consciousness.

    It is not indicated for the treatment of status epilepticus.
  4. What is a rare and potentially fatal complication of succinylcholine and inhalation anesthesia
    Malignant Hyperthermia

    • Treatment includes discontinuation
    • of succinylcholine and anesthesia; cooling blankets and ice packs; and intravenous (IV) dantrolene, a muscle relaxant
  5. epinephrine will decrease
    local blood flow and delay systemic absorption of the anesthetic. This will prolong the effects of the anesthesia at the site of action and reduce the risk of systemic toxicity.

    epinephrine is a vasoconstrictor
  6. Procaine is an
    ester-type anesthetic
  7. Ester anesthetics pose a greater risk of
    allergic reactions than the amide-type anesthetics.
  8. Hypotension is the most common complication with
    epidural anesthesia. Monitoring blood pressure is an essential nursing intervention
  9. Local anesthetics can cause
    CNS excitation followed by depression when large enough amounts are absorbed in the system. This can lead to drowsiness, loss of consciousness, and death
  10. Halothane is an
    inhaled anesthetic.

    These drugs are taken in by the lungs, distributed to areas with high blood flow by the circulation, and eliminated by the lung
  11. Hypotension is a potential adverse effect of most
    inhaled anesthetics, including isoflurane. Hyperglycemia, kidney dysfunction, and tachypnea are not expected adverse effects with this drug
  12. At therapeutic doses nitrous oxide
    does not have serious adverse effects, such as longer central nervous system (CNS) depression or cardiac/respiratory depression.

    The major problem with this drug is postoperative nausea and vomiting.
  13. An opioid will enhance
    analgesia and reduce the required dosage of the general anesthetic.
  14. Opioids are not
    muscle relaxants.

    They can cause respiratory depression and do not necessarily decrease the adverse effects of surgery.
  15. Diprivan is an
    an intravenous (IV) sedative-hypnotic used for sedation during mechanical ventilation.

    It can cause profound respiratory depression and hypotension.

    It does not improve excursion or oxygenation nor decrease secretions.

    It does not have analgesic or muscle relaxant properties
  16. Naloxone is a
    narcotic antagonist that can reverse the effects, both adverse and therapeutic, of opioid narcotic analgesics
  17. Morphine can cause
    urinary hesitancy and urinary retention

    Liver toxicity is not a common adverse effect of morphine
  18. Codeine provides both
    analgesic and antitussive therapeutic effect
  19. Narcotic analgesics reduce
    • intestinal motility, leading to constipation. Increasing fluid and fiber in the diet can help manage this
    • adverse effect
  20. Full analgesic effects can take up to
    24 hours to develop with fentanyl patches.

    Most patches are changed every 72 hours.
  21. Fentanyl has the same adverse effects as
    other opioids, including respiratory depression.

    • Patients should avoid exposing the patch to external
    • heat sources since this may increase the risk of toxicity
  22. Pentazocine
    a partial agonist
  23. hydrocodone,
    a moderate to strong agonist, may cause respiratory depression but not as often and serious as morphine.
  24. (ACE) inhibitors, such as captopril, can cause
    lithium accumulation
  25. ACE inhibitors can cause
    hyperkalemia, renal insufficiency in some patients, and hypotension.
  26. First-dose hypotension is a serious potential adverse effect of
    (ACE) inhibitors, such as enalapril.

    Monitoring blood pressure will be a priority nursing intervention.
  27. Calcium channels are coupled to
    beta1-adrenergic receptors in the heart.

    For that reason, calcium channel blockers have effects on the heart that are similar to beta blockers
  28. Nifedipine
    a calcium channel blocker from the dihydropyridine family.

    As such, it blocks calcium channels in the blood vessels but less in the heart.

    It is used to treat angina and hypertension but not cardiac dysrhythmias
  29. Nifedipine, amlodipine, and isradipine are
    dihydropyridine calcium channel blockers and cause less risk of constipation than diltiazem and verapamil
  30. Diltiazem and verapamil have a risk for
    constipation
  31. Verapamil causes peripheral and cardiac
    vasodilation, which leads to decreased blood pressure and improved coronary perfusion.
  32. Vasodilators may cause
    postural hypotension and reflex tachycardia.
  33. Patients should be taught to move slowly when changing positions to avoid dizziness
  34. Hydralazine is a
    vasodilator causing arteriolar dilation, decreased resistance, and decreased blood pressure.

    Monitoring blood pressure and heart rate would receive the highest priority for assessment
  35. Hydralazine is a vasodilator that lowers blood pressure but can trigger
    reflex tachycardia.

    Beta blockers, such as propranolol, are added to the regimen to normalize the heart rate.
  36. minoxidil is reserved for patients who have
    failed to respond to safer drugs.

    • The only cardiovascular indication for minoxidil is
    • severe hypertension
  37. Furosemide,
    a diuretic, is often combined with nitroprusside to decrease the risk of edema and fluid retention.

    Furosemide does not decrease reflex tachycardia
  38. Vasodilators can cause serious
    orthostatic hypotension
  39. Many antihypertensive medications can produce
    adverse sexual effects, including impotence.
  40. Hypertension is the most common complication of pregnancy, occurring in about 10% of pregnant women. When drug therapy is initiated during pregnancy
    methyldopa is the traditional agent of choice because of its limited effects on the fetus.

    • Women with pre-existing hypertension can typically continue taking antihypertensives they were
    • previously prescribed except for

    angiotensin-converting enzyme (ACE) inhibitors, such as captopril; angiotensin II receptor blockers (ARBs), such as valsartan; and direct renin inhibitors, such as aliskiren
  41. Preferred antihypertensives for patients with diabetes include
    • (ACE) inhibitors (enalapril),
    • (ARBs),
    • and calcium channel blockers

    ACE inhibitors are particularly useful since they slow progression of diabetic nephropathy in addition to lowering blood pressure.

    Thiazide diuretics promote hyperglycemia and are used with caution.
  42. Medication therapy is not indicated until blood pressure (BP) is greater than
    140 systolic or 90 diastolic.
  43. Thiazide diuretics lower BP by
    reducing blood volume and arterial resistance. They are considered initial first-line therapy for most patients.
  44. Which of these medications should a nurse administer first to a patient who is exhibiting hypotension, laryngeal edema, and bronchospasm after eating peanuts?
    Epinephrine (Adrenalin)
  45. Tiotropium is an anticholinergic medication used to relieve bronchospasm associated with COPD. The most common adverse effect is
    dry mouth, and patients can suck on sugarless hard candy for symptomatic relief
  46. use a daily stool softener, or wear protective clothing when taking
    tiotropium.
  47. Rebound congestion develops in topical
    sympathomimetic agents.
  48. Anticholinergic effects (dry mouth, constipation) are uncommon with
    second-generation antihistamines.
  49. Antihistamines are the most effective when taken
    prophylactically
  50. Expectorant drugs are used to reduce the
    viscosity of secretions, allowing them to be more easily expectorated
  51. Oxymetazoline (Afrin) is an effective nasal decongestant, but overuse results in worsening, or
    rebound, congestion. It should not be used more often than every 4 hours for several days
  52. Intranasal glucocorticoids are the most effective when taken for the
    prevention and treatment of allergic rhinitis.
  53. Cromolyn is best suited for prophylaxis and should be given
    before symptoms start since responses may take a week or two to develop
  54. Pseudoephedrine (Sudafed) is a sympathomimetic that activates
    alpha1 receptors and causes vasoconstriction
  55. A nurse instructs a patient that which of these nonprescription medications will require patient identification and a signature for purchase?
    Ephedrine (Pretz-D)

    Ephedrine is a sympathomimetic agent associated with abuse since it can be converted to methamphetamine
  56. Cold remedies should not be used for children under the age of
    2 years because of the risk of harm with little evidence of efficacy
  57. Mu Receptors
    analgesia, respiratory depression, euphoria, sedation

    with constipation blood goes into the intradominal area, then with relaxation massive blood return involves a stroke and respiratory depression
  58. morphine
    Pure Opioid agonist
  59. Meperidine (Demerol)
    Pure opiod agonists
  60. Methadone (Dolphine)
    pure opioid agonist

    blocks euphoria from heroin and morphine
  61. What should you caution with a head injury
    opioids
  62. what is used for an MI
    morphine
  63. what is used for post operative pain
    opioids
  64. Pentazocine (Talwin)
    Agonist-Antagonist Opioid
  65. Benadryl is what generation
    1st generation
  66. Benedryl (Diphenhydramine) relieves symptoms of
    Allergic rhinitis

    Blocks release of histamine
  67. Why don't you want to give benedryl to an older adult who is confuesed
    problem is older adults have a lack of acetylcholine and benedryl is an anticholinergic which blocks even more acetylcholine
  68. What is the only antihistamine that is a nasal spray
    Azelastine

    2nd generation
  69. 2nd generation antihistamine is used to
    • relieve symptoms associated with seasonal and perennial
    • allergic rhinitis, conjunctivitis
    • uncomplicated urticaria
    • angioedema
  70. 2nd generation antihistamines physiologic action
    selective, blocks the effects of histamine at the H1-receptor sitesf

    has some anticholinergic and antipruritic effect
  71. Intranasal glucocorticoids most effective drugs for the
    Prevention and treatment of seasonal and perennial rhinitis
  72. Decongestant drugs activate
    alpha 1 adrenergic receptors on nasal blood vessels
  73. Sudafed relives the
    pressure of otitis media by promoting drainage
  74. Because Sudafed activates alpha 1 what does that mean for the pt
    raises BS and HR

    not for the anxious pt

    caution diabetes, glaucome (IOP), BPH (death grip of urethra)
  75. Main side effect for decongestent Afrin nasal spray
    Rebound congestion

    discontinue drug use in one nostril at a time to decrease the rebound congestion
  76. Antitussive drugs are
    cough suppressents
  77. Dextromethorphan is a
    antitussive drug and nonopioid

    Do not treat pts cough resulting from emphysema and asthma

    can act as a halucigenic
  78. Tessalon Perles (Bensonatate); what kind of pts should you watch out for
    Kids and elderly risk for choking

    works by numbing the stretch receptors in the lungs that during breathing elicit a cough
  79. Codeine is an
    Opioid antitussive
  80. Hydrocodone is more
    sedating than codeine
  81. Codeine can make people
    sick and a lot of people dont prefer it
  82. Codeine should have a catious use for
    head injuries because...

    narcotics suppress the respriatory drive so you dont blow off co2 a retaining it will increase pressure

    change position slowly
  83. Guaifenesin gets rid of the
    Gunk
  84. Mucomyst (Acetylcysteine) is used for
    acetaminophin OD (Tylenol overdose)
  85. Sympathomimetic (albuterol ventolin proventil) are
    beta 2 adrenergic agonists

    fight or flight drug and palpitations
  86. Ipratropium Bromide (spiriva, atroven, combivent, duineb) will not
    abort an asthma attack in progress
  87. Glucocorticoid Sterioids
    Anti-inflammatory

    the most effective anti-inflammatory drugs available for the management for respiratory disorders

    Peak effect in 1-2 weeks of regular use
  88. ________use first to open up airway then ____ to really get in lungs then _____
    • Beta agonist
    • Steroidal
    • Rinse mouth
  89. Cromolyn Sodium teach pts to use
    15-20 minutes prior to engaging in precipitant to bronchospasm
  90. Xolair
    Omalixumab

    high cost
  91. captopril (Capoten
    ACE Inhibitors:

    Decreases peripheral vascular resistance and lowers blood pressure; vasodilatation

    Cardiac output is increased but there is no increase in the heart rate
  92. losartan (Cozaar)
    Angiotensin II Receptor Antagonists (ARBs):

    • Blocks action angiotensin II which results in
    • vasodilatation, excretion of Na+ and water, retention K+
  93. aliskiren (Tekturna):
    Direct Renin Inhibitor

    • Binds tightly with renin inhibiting conversion of
    • angiotensinogen into angiotensin I
  94. Dihydropyridines
    nifedipine (Procardia, Adalat)

    drops bp not used to stop arrythmias, peripheral edema

    Act on arterioles

    Calcium channel blocker
  95. Phenylakylamines:
    verapamil (Calan):

    affect heart, constipation, pheripheral edema

    Act on arterioles and heart

    Calcium channel blocker
  96. Benzothiazepine:
    dilitiazem (Cardiazem):

    affect heart cause constipation and peripheral edema

    Act on arterioles and heart

    Calcium channel blocker
  97. Side effect of Verapamil and Diltiazem:
    Orthostatic hypotension, peripheral edema, constipation, bradycardia, heart failure, dysrhythmias, acute toxicity
  98. hydralaxine (Apresoline)
    Vasodilator

    Other drugs in the class: Minoxidel (Loniten), Diazoxide (Hyperstat)
  99. Big therapeutic use for Hydralaxin and Minoxidel
    Hypertensive crises
  100. Hydralaxin and Minoxidel Physiologic Symptoms
    • Produces direct smooth muscle relaxation of the
    • arterioles, which results in decreased BP and decreased Peripheral vascular resistance (arterial heart trying to pump blood out)

    • Little to no effect on the veins
    • frequently coadministered with a diuretic
  101. Hydralaxin side effects
    • reflex tachycardia, fluid retention (aldosterone), systemic lupus erythematosus (SLE)mimics lupus
    • sometimes can cause joint and muscle pain butterfly rash
  102. Minidoxel Side effects
    • serious fluid retention, pericardial effusion, cardiac tamponade (fluid pressing on heart
    • medical emergency), can worsen angina pectoris

    Hypertrichosis (increased hair) (Rogaine)
  103. Hypertensive Crisis
    sodium Nitroprusside (Nipride)

    Directly relaxes vascular smooth muscle, allowing dilation of peripheral arteries and veins
  104. Big side effect with Sodium Nitroprusside
    cyanide poisoning if it is infusing rapidly (pts with liver disease and low store of thyosulfate),
  105. Selective Peripherally Acting Alpha-1 Blockers
    prazosin (Minipress)

    Therapeutic use is for BPH
  106. prazosin (Minipress) Side effect
    Significant first-dose effect of hypotension, especially orthostatic hypotension (really educate pt)

    Take first dose at bedtime (because they are having hypotensive at least they are laying down)
  107. Beta Adrenergic Blockers:
    Propanolol (Inderal) (used to try to protect heart
  108. Big side effect with propanolol
    Blockade of Beta 2 (be careful in pts with asthma):

    • hypoglycemia you don’t get fight or flight like sweating so you have no idea be very careful
    • with pts in diabetes and asthmatics. You cannot get your hr up if you are an athlete, complaints with sexual functions
  109. Peripherally Acting Antiadrenergics:
    Reserpine: depression, sedation suicide is big with this drug watch out
  110. Centrally Acting Alpha-2 Agonists:
    clonidine (Catapress)

    Used in step 3 or step 4 antihypertensive therapy

    Can be administered orally or transdermally problem with patch is they come off

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