NUR-641 Exam 3 (MIDTERM) QUESTION
AND VERIFIED CORRECT ANSWERS
GRADED A+ [LATEST UPDATE] 100%
GUARANTEED PASS
What is the purpose, risk, and adverse effects of thrombolytic (lysing clots) therapy - CORRECT
ANSWER-Purpose to break down already existing clots
Adverse/risk: BLEEDING
They're not fibrin specific
Can induce a systemic thrombolytic state instead of focusing on the specific clots
Internal, intracranial, or superficial bleeding
Anemia
Nausea
Vomiting
hypotension
cardiac dysrhythmias
Protamine Sulfate (page 1044 in drug guide) - CORRECT ANSWER-Antidote for Heparin toxicity
Typically 1 mg good to reverse up to 100 units unfractionated Heparin
1 mg needed per 1mg of enoxaparin, dose directly proportional.
What are Protamine sulfate adverse effects? - CORRECT ANSWER-Bleeding
,Anaphylaxis
angioedema
pulmonary edema
bradycardia
dyspnea
pulmonary HTN
HTN or hypotension
Emesis
flushing
Important teaching for Protamine sulfate? - CORRECT ANSWER-Access pt for fish allergies,
infertile men, hypersensitivity
Vitamin K (phytonadione) [on page 1003 in drug guide] - CORRECT ANSWER-Preg category C
Used as antidote for Warfarin/Coumadin toxicity or overdose. Dose/route given will determine
turn around timeframe
High doses (10mg) given IV will reverse in 6 hours.
Providers prefer to give oral form
Vitamin K adverse effects - CORRECT ANSWER-Suggest to use lowest dose possible then titrate
up, if given too much it'll take up to a week for warfarin resistance to wear off.
Important teaching for Vit. K - CORRECT ANSWER-Avoid drastically changing diet in which vit K
intake changes frequently. Keep consistent diet.
How can you take aspirin to decrease GI upset? - CORRECT ANSWER-With food
, What are cautions of Pradaxa? - CORRECT ANSWER-most serious side effect is bleeding and
renal disease
Statins - CORRECT ANSWER-Use is contraindicated with pregnancy/lactation (Category X)
1st line therapy for hypercholesterolemia
contraindicated with liver dysfcn and elevated serum transaminase levels.
Decreases bad cholesterol 30-40%
Increases good cholesterol 2-15%
What is the mechanism of action of statins? - CORRECT ANSWER-lower blood cholesterol level
by decreasing the rate of cholesterol production
Statin adverse effects - CORRECT ANSWER-Mild, transient GI upset
Rash
headache
increased blood sugars
MYOPATHY (muscle pain) can lead to rhabdomyolysis - break down of muscle releasing proteins
which is damaging for kidneys, can lead to kidney failure or death
Increased liver enzymes / liver disease
HMG-CoA interactions (Statins) - CORRECT ANSWER-Oral anticoagulants
Drugs metabolized by CYP3A4 : erythromycin, Azole antifungals, verapamil, diltiazem, HIV
protease inhibitors, amiodarone, Grapefruit Juice - can cause drug toxicity :-(
Simvastatin specific warnings - CORRECT ANSWER-Can cause memory loss, confusion, increased
blood glucose levels and glycosylated hemoglobin (HbA1-c) as well as regular statin adverse
effects
AND VERIFIED CORRECT ANSWERS
GRADED A+ [LATEST UPDATE] 100%
GUARANTEED PASS
What is the purpose, risk, and adverse effects of thrombolytic (lysing clots) therapy - CORRECT
ANSWER-Purpose to break down already existing clots
Adverse/risk: BLEEDING
They're not fibrin specific
Can induce a systemic thrombolytic state instead of focusing on the specific clots
Internal, intracranial, or superficial bleeding
Anemia
Nausea
Vomiting
hypotension
cardiac dysrhythmias
Protamine Sulfate (page 1044 in drug guide) - CORRECT ANSWER-Antidote for Heparin toxicity
Typically 1 mg good to reverse up to 100 units unfractionated Heparin
1 mg needed per 1mg of enoxaparin, dose directly proportional.
What are Protamine sulfate adverse effects? - CORRECT ANSWER-Bleeding
,Anaphylaxis
angioedema
pulmonary edema
bradycardia
dyspnea
pulmonary HTN
HTN or hypotension
Emesis
flushing
Important teaching for Protamine sulfate? - CORRECT ANSWER-Access pt for fish allergies,
infertile men, hypersensitivity
Vitamin K (phytonadione) [on page 1003 in drug guide] - CORRECT ANSWER-Preg category C
Used as antidote for Warfarin/Coumadin toxicity or overdose. Dose/route given will determine
turn around timeframe
High doses (10mg) given IV will reverse in 6 hours.
Providers prefer to give oral form
Vitamin K adverse effects - CORRECT ANSWER-Suggest to use lowest dose possible then titrate
up, if given too much it'll take up to a week for warfarin resistance to wear off.
Important teaching for Vit. K - CORRECT ANSWER-Avoid drastically changing diet in which vit K
intake changes frequently. Keep consistent diet.
How can you take aspirin to decrease GI upset? - CORRECT ANSWER-With food
, What are cautions of Pradaxa? - CORRECT ANSWER-most serious side effect is bleeding and
renal disease
Statins - CORRECT ANSWER-Use is contraindicated with pregnancy/lactation (Category X)
1st line therapy for hypercholesterolemia
contraindicated with liver dysfcn and elevated serum transaminase levels.
Decreases bad cholesterol 30-40%
Increases good cholesterol 2-15%
What is the mechanism of action of statins? - CORRECT ANSWER-lower blood cholesterol level
by decreasing the rate of cholesterol production
Statin adverse effects - CORRECT ANSWER-Mild, transient GI upset
Rash
headache
increased blood sugars
MYOPATHY (muscle pain) can lead to rhabdomyolysis - break down of muscle releasing proteins
which is damaging for kidneys, can lead to kidney failure or death
Increased liver enzymes / liver disease
HMG-CoA interactions (Statins) - CORRECT ANSWER-Oral anticoagulants
Drugs metabolized by CYP3A4 : erythromycin, Azole antifungals, verapamil, diltiazem, HIV
protease inhibitors, amiodarone, Grapefruit Juice - can cause drug toxicity :-(
Simvastatin specific warnings - CORRECT ANSWER-Can cause memory loss, confusion, increased
blood glucose levels and glycosylated hemoglobin (HbA1-c) as well as regular statin adverse
effects
