NU 150 - TEST 2 QUESTIONS AND
ANSWERS
Lab evaluation for the effectiveness of statins & the difference between HDL & LDL -
Answer-Monitoring of the statin therapy by checking lipid panels at baseline; 6-8 weeks
after starting or adjusting medication dose; and then 4-6 months; check LFTs at
baseline approx. 12 weeks after starting therapy then annually or more if indicated
-LDL (BAD): transport cholesterol to the peripheral cells; excess penetrates the walls fo
the arteries, resulting in atherosclerotic plaque formation, increasing the risk for heart
disease.
-HDL (GOOD): take cholesterol from the peripheral cells and transport it to the liver,
where it is metabolized and excreted; the higher the HDL level the lower risk for
development of atherosclerosis
· importance of statin drugs in reducing risk of death - Answer-Statins - Actions:
-inhibit the manufacture of cholesterol
-promote breakdown of cholesterol
Uses:
-treatment of hyperlipidemia
-primary: prevention of coronary events (MI, TIA, STROKE)
-secondary: slow the progression of coronary atherosclerosis
ADRs:
-CNS: headache, dizziness, insomnia, memory and cognitive impairment
-GI: flatulence, abdominal pain and cramping, nausea, constipation, hyperglycemia in
non diabetic patients
-MS: muscle aches, pain or tenderness; muscle injury
Contraindications:
-hypersensitivity
-Serious liver disorders (hepatotoxicity)
Patient Education:
-Taken in the evening at meditate ^cholesterol synthesis at night
-Do not take with grapefruit juice to prevent an enzyme reaction
-Can cause photosensitivity
-Encourage exercises to help raise the HDSl
-Notify PHCP if muscle pain, tenderness or weakness occurs
· important instructions for patients taking beta blockers - Answer-Beta adrenergic
blocking drugs:
-block B-adrenergic receptors
-primarily receptors of heart
-Do not stop taking the drug abruptly
-Notify provider of ADRs
-Caution when driving. May cause dizzinesss, drowsiness
, -Report S/S of CHF: dyspnea, edema of extremities; weight gain
-Keep appointments
-Inform providers of meds being taken
· Alpha and Beta receptor sites of the adrenergic nervous system - Answer-A1:
peripheral vasoconstriction
B1: increase HR and force of contraction
B2: bronco dilation, vasodilation (coronary arteries), decrease motility of GIT.
B1: blockers affect heart
B2: blockers affect lungs
· Symptoms of Isoniazid toxicity and side effects of rifampin - Answer--Peripheral
neuropathy (numbness and tingling of the extremities) is the most common symptom of
toxicity.
-Severe hepatitis has been associated with isoniazid therapy and may appear after
many months of treatment and be fatal
· Nursing interventions for patients taking antihistamines - Answer-Implement fall
precautions for patients taking diphenhydramine (due to sedation)
Patient teaching regarding upper respiratory drug therapy - Answer-Inform, MD cough
persists for more than 10 days, do not exceed prescribed recommended dose
Push fluids = 1500-2000 mL/day, unless contraindicated, to help thin secretions and
raise from respiratory passages.
Patient teaching regarding lower respiratory drug therapy - Answer-Do not increase
dose of med unless instructed by primary provider
If GI upset, take med with food or milk
6-8 glasses of water (helps loosen secretions)
Instruct on med side effects
Avoid colas, coffee when on xanthines
Use of medication inhalers: open mouth, closed mouth, and spacers
Use of peak flow meter for monitoring
· Nursing interventions for patient taking expectorant - Answer--Assess allergy
symptoms (rhinitis, conjunctivitis, hives) before and periodically during therapy
-Assess lung sounds and character of bronchial secretions
-Maintain fluid intake of 1500-2000 mL/day to decrease viscosity of secretions
-Medication causes false-negative reactions on allergy skin test; discontinue 3 days
before testing
-Administer with food or milk to decrease GI irritation. Caps and tabs should be taken
with water or milk, not juice
-If drug is taken for sleep, assess quality of sleep and sleep patterns
S/S hypothyroidism - Answer-Decreased metabolism
ANSWERS
Lab evaluation for the effectiveness of statins & the difference between HDL & LDL -
Answer-Monitoring of the statin therapy by checking lipid panels at baseline; 6-8 weeks
after starting or adjusting medication dose; and then 4-6 months; check LFTs at
baseline approx. 12 weeks after starting therapy then annually or more if indicated
-LDL (BAD): transport cholesterol to the peripheral cells; excess penetrates the walls fo
the arteries, resulting in atherosclerotic plaque formation, increasing the risk for heart
disease.
-HDL (GOOD): take cholesterol from the peripheral cells and transport it to the liver,
where it is metabolized and excreted; the higher the HDL level the lower risk for
development of atherosclerosis
· importance of statin drugs in reducing risk of death - Answer-Statins - Actions:
-inhibit the manufacture of cholesterol
-promote breakdown of cholesterol
Uses:
-treatment of hyperlipidemia
-primary: prevention of coronary events (MI, TIA, STROKE)
-secondary: slow the progression of coronary atherosclerosis
ADRs:
-CNS: headache, dizziness, insomnia, memory and cognitive impairment
-GI: flatulence, abdominal pain and cramping, nausea, constipation, hyperglycemia in
non diabetic patients
-MS: muscle aches, pain or tenderness; muscle injury
Contraindications:
-hypersensitivity
-Serious liver disorders (hepatotoxicity)
Patient Education:
-Taken in the evening at meditate ^cholesterol synthesis at night
-Do not take with grapefruit juice to prevent an enzyme reaction
-Can cause photosensitivity
-Encourage exercises to help raise the HDSl
-Notify PHCP if muscle pain, tenderness or weakness occurs
· important instructions for patients taking beta blockers - Answer-Beta adrenergic
blocking drugs:
-block B-adrenergic receptors
-primarily receptors of heart
-Do not stop taking the drug abruptly
-Notify provider of ADRs
-Caution when driving. May cause dizzinesss, drowsiness
, -Report S/S of CHF: dyspnea, edema of extremities; weight gain
-Keep appointments
-Inform providers of meds being taken
· Alpha and Beta receptor sites of the adrenergic nervous system - Answer-A1:
peripheral vasoconstriction
B1: increase HR and force of contraction
B2: bronco dilation, vasodilation (coronary arteries), decrease motility of GIT.
B1: blockers affect heart
B2: blockers affect lungs
· Symptoms of Isoniazid toxicity and side effects of rifampin - Answer--Peripheral
neuropathy (numbness and tingling of the extremities) is the most common symptom of
toxicity.
-Severe hepatitis has been associated with isoniazid therapy and may appear after
many months of treatment and be fatal
· Nursing interventions for patients taking antihistamines - Answer-Implement fall
precautions for patients taking diphenhydramine (due to sedation)
Patient teaching regarding upper respiratory drug therapy - Answer-Inform, MD cough
persists for more than 10 days, do not exceed prescribed recommended dose
Push fluids = 1500-2000 mL/day, unless contraindicated, to help thin secretions and
raise from respiratory passages.
Patient teaching regarding lower respiratory drug therapy - Answer-Do not increase
dose of med unless instructed by primary provider
If GI upset, take med with food or milk
6-8 glasses of water (helps loosen secretions)
Instruct on med side effects
Avoid colas, coffee when on xanthines
Use of medication inhalers: open mouth, closed mouth, and spacers
Use of peak flow meter for monitoring
· Nursing interventions for patient taking expectorant - Answer--Assess allergy
symptoms (rhinitis, conjunctivitis, hives) before and periodically during therapy
-Assess lung sounds and character of bronchial secretions
-Maintain fluid intake of 1500-2000 mL/day to decrease viscosity of secretions
-Medication causes false-negative reactions on allergy skin test; discontinue 3 days
before testing
-Administer with food or milk to decrease GI irritation. Caps and tabs should be taken
with water or milk, not juice
-If drug is taken for sleep, assess quality of sleep and sleep patterns
S/S hypothyroidism - Answer-Decreased metabolism
