NCLEX UNIT 5

What are systemic hemostatic agents used for?

Systemic hemostatic agents are used to prevent or treat excessive bleeding in hyperfibrinolytic states.

What is an advantage of low-molecular-weight heparins?

Low-molecular-weight heparins cause fewer systemic adverse effects because they do not greatly affect thrombin, clotting, or prothrombin times.

What is an appropriate nursing intervention for patients taking anticoagulants?

Establish safety precautions to reduce the risk of bleeding, such as using soft toothbrushes, electric razors, and avoiding injury.

Describe the process of blood coagulation and clotting.

Blood coagulation involves vasoconstriction, platelet aggregation, and activation of intrinsic and extrinsic clotting pathways. Prothrombin converts to thrombin, which converts fibrinogen into fibrin threads to form a clot.

How are blood clots dissolved naturally?

Plasminogen is converted into plasmin (fibrinolysin), which dissolves fibrin threads and breaks down blood clots.

How do antiplatelet drugs work?

Antiplatelet drugs decrease platelet aggregation and prevent platelets from sticking to vessel walls.

How do anticoagulants work?

Anticoagulants interfere with the clotting cascade and thrombin formation to prevent clot formation.

How do low-molecular-weight heparins work?

Low-molecular-weight heparins block clotting factors Xa and IIa.

How do thrombolytic agents work?

Thrombolytic agents activate the natural anticlotting system by converting plasminogen to plasmin, which breaks down fibrin.

What are antihemophilic agents?

Antihemophilic agents are replacement clotting factors used to replace missing clotting factors in patients with hemophilia.

How do hemostatic agents work?

Hemostatic agents stop bleeding by blocking plasminogen activation or directly inhibiting plasmin.

What are the five classifications of diuretics?

The five classes are thiazide and thiazide-like diuretics, loop diuretics, carbonic anhydrase inhibitors, potassium-sparing diuretics, and osmotic diuretics.

Why are diuretics given?

Diuretics increase sodium and water excretion to treat edema and lower blood pressure.

What conditions commonly require diuretics?

Conditions include congestive heart failure (CHF), liver disease, renal disease, pulmonary edema, and hypertension.

What is the action of thiazide diuretics?

Thiazide diuretics block the chloride pump in the ascending limb of the loop of Henle and distal tubule.

How do carbonic anhydrase inhibitors work?

Carbonic anhydrase inhibitors slow the movement of hydrogen ions, causing increased sodium and bicarbonate loss in urine.

Why should antitussive agents be used cautiously in patients with addiction histories?

Many antitussives contain narcotics such as codeine or hydrocodone, which may increase the risk of misuse or addiction.

How does guaifenesin work?

Guaifenesin is an expectorant that reduces mucus adhesiveness and surface tension, making mucus easier to expel.

What causes the common cold?

The common cold is caused by a virus that triggers inflammation in the upper respiratory tract.

What are common symptoms of the common cold?

Symptoms include sinus pain, nasal congestion, runny nose, sneezing, watery eyes, scratchy throat, and headache.

What causes seasonal rhinitis or hay fever?

Seasonal rhinitis is caused by allergic responses to allergens such as pollen or mold.

What are symptoms of seasonal rhinitis?

Symptoms include nasal congestion, sneezing, stuffiness, and watery eyes.

What is sinusitis?

Sinusitis is inflammation of the sinus cavities that often causes severe facial pain and pressure.

What are pharyngitis and laryngitis?

Pharyngitis is infection of the pharynx, while laryngitis is infection of the larynx.

What symptoms are associated with pharyngitis and laryngitis?

Symptoms include fever, pain, malaise, and muscle aches.

What are common anticholinergic effects of antihistamines?

Common effects include dry mouth, GI upset, dizziness, drowsiness, nausea, arrhythmias, dysuria, urinary hesitancy, and pruritus.

What are adverse effects of xanthines related to theophylline levels?

Adverse effects include GI upset, nausea, irritability, tachycardia, seizures, brain damage, and even death.

What are the contraindications for lung surfactants?

There are no contraindications because lung surfactants are emergency drugs used in newborns.

What nursing diagnosis is appropriate for a patient taking budesonide?

Risk for injury related to immunosuppression.

What is neonatal respiratory distress syndrome (RDS)?

Neonatal RDS occurs when premature infants lack surfactant, causing alveolar collapse and impaired gas exchange.

How is neonatal respiratory distress syndrome treated?

Treatment includes administration of surfactants to keep alveoli open and improve breathing.

What is adult respiratory distress syndrome (ARDS)?

ARDS is a severe loss of lung compliance and worsening hypoxia caused by major trauma, burns, or cardiovascular collapse.

How is ARDS treated?

Treatment focuses on correcting the underlying cause and providing ventilatory support.

What medications are used for acute asthma attacks?

Beta-agonists and inhaled steroids are commonly used during acute asthma attacks.

What medications are used for asthma prophylaxis?

Leukotriene receptor antagonists are commonly used to prevent asthma attacks.

Is there a drug interaction between antipeptides and penicillin?

False. Antipeptides interact with substances such as aluminum salts, phenytoin, fluoroquinolones, and penicillamine.

Which H2 antagonist is associated with antiandrogenic effects?

Cimetidine is associated with gynecomastia and galactorrhea due to antiandrogenic effects.

Why should laxatives only be used short term?

Long-term laxative use can lead to cathartic dependence.

Can Pepto-Bismol contribute to salicylate toxicity?

Yes. Pepto-Bismol contains bismuth subsalicylate, which can contribute to salicylate toxicity.

Which medication is a very popular OTC laxative?

Bisacodyl (Dulcolax) is a commonly used over-the-counter stimulant laxative.

What antiemetic is recommended for vestibular or inner ear problems?

Meclizine is an anticholinergic antihistamine used to treat nausea and vomiting caused by motion sickness and vestibular disorders.

How do antiemetics reduce vomiting?

Antiemetics reduce vomiting either by decreasing local stimuli sent to the medulla or by blocking the chemoreceptor trigger zone (CTZ) and vomiting center centrally.