NR 293 Quiz 2 Questions and answers + rationales

What are some things an RN should instruct a patient on warfarin to remove from their diet?

- Green Leafy veggies

What items decrease the effect of Warfarin?

Vitamin K

What are some things an RN should educate a patient on Warfarin to utilize at home?

- Soft tooth brush

- Electric razor

- Medical ID bracelet

What are some adverse effects of Warfarin?

- Bleeding

- Skin necrosis

How many days can it take for Warfarin to become steady within the body?

- 5 days

What lab values a nurse monitor while a patient is on Warfarin?

- PT

- INR

- CBC levels

What drugs can be given with Warfarin?

- Heparin can be given

What is the Therapeutic effect of Warfarin?

- Prevention of thromboembolic events

- Acute cardiac disorders

- Prescribed prophylactic for coagulation disorders

What causes an Increase in bleeding related to patients taking Warfarin?

- Herbal products q

What does PT stand for?

- Prothrombin time

What does INR stand for?

- International normalized ratio

What is a normal INR without warfarin

- 1

What is a normal INR With Warfarin?

- 2.5 to 3.5 (if they have a mechanical Heart valve

What is the normal PT With Warfarin?

- 2-3

What is the Antidote for Warfarin?

- Vitamin K

What is the Antidote for Heparin?

- Protamine Sulfate

What is normal the first classification of drugs that are used to treat high Blood Pressure (BP)?

- Diuretics are normally the first drug of choice for treatment

What Drug Classifications is Warfarin?

- Anticoagulant

What should patients monitor for, Related to the integumentary system, with warfarin?

- Skin necrosis

What does PTT stand for?

partial thromboplastin time

What Drug classification is Heparin?

- Anticoagulant (Hep)

What route would an RN administer Heparin for Prophylaxis of DVTs?

SubQ (SQ)

What route would an RN administer Heparin for the Treatment of a Thombosis?

- IV drip

What are some adverse effects of anticoagulants like Heparin / Warfarin?

- Bleeding

What are some Adverse effects of Heparin?

- bleeding

- HIT

What does HIT stand for?

- Heparin induced thrombocytopenia

What is the therapeutic effect of Heparin?

- Prevention of Thrombus

- Prevention of extension of thrombi

AKA a prophylaxis for thrombus development

What lab values should an RN Monitor with a patient on Heparin?

- PTT

- CBC

What is a normal range for PTT in a patient on Heparin?

- 1.5 - 2 x baseline

- AKA 30-40 seconds

What is the Purpose of Anticoagulants?

- Prevention of Coagulation (AKA clotting)

What is the Purpose of Thrombolytic drugs?

- Break down or lysis of blood clots

What is the Purpose of Antifibrinolytic drugs?

- Prevents the lysis of fibrin

- Promotes clot formations

What does Antifibrinolytic drugs promote?

- Promotes clot formations

What is the Purpose of Antiplatelet drugs?

- Prevents platelet adhesion

- Prevents the start of clots

What drug classification is Clopidogrel considered?

- Antiplatelet drug

What anticoagulant drug can be given to pregnant or expecting mothers?

- Heparin (p)

What drugs can be considered Antiplatelet drugs?

- Aspirin

- Plavix

- Clopidogrel

What are some adverse reactions associated to Plavix?

- Flu-like symptoms

What are the therapeutic effects of Clopidogrel?

- Reduce risk of Myocardial infarctions

- Reduce risk of Strokes

Who should not use Clopidogrel?

- patients with genetic abnormalities

- Patients at risk for Cardiovascular events

What are some adverse reactions to Clopidogrel?

- Depression

- Fatigue

- Headache

- Neutropenia

- Bleeding

What are some lab values an RN should monitor for patients taking Clopidogrel?

- CBCs

- Bleeding time

- Prolonged bleeding time

What education can an RN provide for a patient taking Clopidogrel?

- Take as directed

- Do not double dose

- monitor for signs / symptoms of bleeding

- Notify HC provider before surgery

- Notify HC provider if pregnant or breastfeeding

What are some common adverse effects of Iron supplements?

- Nausea

- Vomiting

- Stomach cramps

- Dark / Tarry stools

- teeth staining

What impacts does iron supplements have on a patient's teeth?

- may cause teeth staining

What impacts does iron supplements cause on the stools?

- to become dark / tarry

What is the therapeutic effect of Iron supplements?

- Prevention / treatment of iron-deficiency anemia

What impacts does Ascorbic acid have on Iron supplements?

- Increases absorption of Iron

What impacts does Antacids / Calcium have on Iron supplements?

- Decreases absorption of Iron

What occurs to a patient who refuses to take iron supplements?

- Patient becomes anemic

What education can an RN give a patient taking Iron supplements?

- Wash mouth out after taking supplements

What are some instructions an RN can give with a patient on IV Dextran?

Contact provider if signs of the following:

- Chills

- Fever

- Malaise

- Nausea

- Vomiting

What are some adverse reactions a patient can have with IV dextran?

- High risk for Anaphylactic

- Orthostatic hypotension

What should an RN do when administering IV Dextran?

- Give a test dosage

- Wait an hour

- Then finish infusion if there are no signs of Anaphylactaxis

What is the Therapeutic effect of IV Dextran?

- Prevents Iron deficiency

- Treatment for Iron Deficiency

What does supplementation of Folic acid in pregnant individuals prevent?

- Neural tube defects

What therapeutic effect does Folic acid have?

- Treatment of Folic acid deficiency

- Treatment of Vitamin B deficiency

- Prevents neural tube defects

- Essential for Erythropoiesis

What vitamin is associated with Folic Acid?

- Vitamin B

What does erythropoiesis mean?

production of red blood cells

What commonly causes folic acid deficiency?

- Malabsorption syndromes

What are the adverse effects of Folic acid supplements?

- Urine turns a yellow/ lime green coloration

What are some nursing considerations associated with Folic Acid supplementation?

- Ensure the actual cause of Anemia is determined

What does Cyanocobalamin treat?

- Pernicious Anemia

What vitamin is associated with Cyanocobalamin?

- Vitamin B-12

What therapeutics effects does Cyanocobalamin have?

- Pernicious anemia treatment

- Vitamin B-12 deficiency treatment

- Anticonvulsant

- Aminoglycoside antibiotic

- Long-acting Potassium preparation

What therapeutics effects does Cyanocobalamin have regarding Potassium?

- Is a long-acting Potassium preparation

What type of antibiotic can Cyanocobalamin be classified as?

- Aminoglycoside antibiotic

What supplement is considered an Anticonvulsant?

- Cyanocobalamin

What classification is Ketorolac considered?

- Nonsteroidal anti-inflammatory agent

- Nonopioid analgesics

What Therapeutic effects does Ketorolac have?

- Short term management of pain

How long can a patient stay on Ketorolac?

- maximum of 5 days total

What adverse effects does Ketorolac have?

- Drowsiness

- Altered LOC

- Myocardial Infarction

- Stroke

- Bleeding

What should a nurse assess for in patients about to take Ketorolac?

- Rhinitis

- Asthma

- Urticaria

What Vital signs should an RN monitor for with a patient taking Ketorolac?

- BP

- Pain

-

How does Ketorolac impact bleed times?

- May causes prolonged bleed times

What lab values should a nurse monitor while on Ketorolac?

- Liver functions

- BUN

- Creatinine

- Potassium concentration

How does Ketorolac impact BUN, Creatinine, and Potassium concentration values?

- causes an increase in lab values

What liver Function values should a nurse pay specific attention to with a patient on Ketorolac?

- AST

- ALT

What is some nursing education an RN can give a patient taking Ketorolac?

- May cause Drowsiness

- May cause Dizziness

- Do not consume ETOH

What is some nursing education an RN can give a patient taking NSAIDs?

- Follow instructions carefully

- Increase fluid intake

- Increase fiber intake

- change positions slowly due to Orthostatic hypotension

What therapeutic effects does Hydrocodone have on the body?

- Decrease in severity of Moderate Pain

- Suppression of the Cough Reflex

What vital signs should a nurse monitor while on Hydrocodone?

- BP

- Pulse

- Respiratory Rate

- Pain

What Lab values should a nurse monitor while a patient is on Hydrocodone

- Plasma Amylase

- Lipase concentration

What Nursing education can an RN give a patient on Hydrocodone

- Educate about addictive/ potential drug abuse

- Rotate positions slowly

- Avoid ETOH

- Avoid CNS depressants

- educate on sedative

What should a patient on Hydrocodone avoid?

- ETOH

- CNS depressants

What are the therapeutic effects of gabapentin?

- Decreases incidences of seizures

- Decreases Postherpetic pain

- Decreases Restless leg syndrome

What is the antidote for Opioids?

- Naloxone (Narcan)

What are the adverse effects of Gabapentin?

- Suicidal thoughts

- Confusion

- Depression

- Drowsiness

- hypertension

What is some education an RN can provide a patient on Gabapentin?

- Discontinuation should be gradually done over 1 week

What is general anesthesia?

administration of drugs by inhalation or intravenous route that makes the patient lose consciousness

What is local anesthesia?

- Loss of sensation without loss of consciousness

What are some nursing implications for a patient on gabapentin?

- Monitor for changes in behavior

- May cause Leukopenia

What are the therapeutic effects of Lidocaine?

- Control of ventricular arrhythmias

- Local Anesthesia

What are the adverse effects of Lidocaine?

- Seizures

- Cardiac Arrest

- Arrhythmias

- Bradycardia

- Hypotension

What is some education an RN can provide a patient on Lidocaine?

- Monitor ECG

- Monitor BP

- Monitor Respiratory Rate

What should an RN monitor for with a patient on Lidocaine?

- Explain purpose of lidocaine

- Ask for help ambulating / transferring

- Use caution when having a mammogram

What are the therapeutic effects of Propofol?

- Induction / Maintenance of Anesthesia

What are the adverse effects of Propofol?

- Apnea

- Numbness / Cold @ IV site

- Discoloration of urine (green)

What should an RN monitor for with a patient on Propofol?

- Assess RR

- Assess Pulse

- Assess BP

- Assess level of sedation / LOC

- Monitor for propofol infusion snydrome

What is some education an RN can provide a patient on Propofol?

- Mental recall will be altered

- May cause Drowsiness / Dizziness

- Avoid ATOH / CNS depressants