NUR2474 Pharmacology for Professional Nursing – Examination Blue Print – Exam 2

NUR2474 Pharmacology for Professional Nursing – Examination Blue Print – Exam 2*Focus on medication side effects and how the nurse evaluates for these in the client as well as client teaching for related medications* Respiratory Medication  Metered Dose Inhaler (MDI) o Client teaching  Chronic Obstructive Pulmonary Disease (COPD) o Treatment regimens-Examples: inhaled glucocorticoids, beta-2 adrenergic agonists, tiotropium etc o Know the goals of different medication therapy and client teaching  Asthma o Treatment regimens-Examples: inhaled glucocorticoids, short acting beta 2 adrenergic agonists, maintenance inhalers, rescue inhalers, etc o Know the purpose/goal for combinations used in asthma treatment o Know the adverse effects and nursing intervention/client teaching  Common Cold o Review drugs for cough, runny nose congestion, and fever Gastrointestinal Medication  Peptic Ulcer Prevention o Proton Pump Inhibitors-most effective drug for suppressing gastric acid secretion. Used for ulcers and GERD Omeprazole is PPI- single dose reduces acid production 97% within 2 hours. Effects last a few weeks even when drug has left body. TX should be limited to 4-8 weeks  Sucralfate and ciprofloxacin teaching Sucralfate- antiulcer med with minimal side effects and no significant drug interactions. Promotes ulcer healing by creating a protective barrier from acid. Does NOT decrease acid secretion. Ciprofloxacin- Sucralfate can impede the absorption of this drug, take 2 hours apart.  Cimetidine- Histamine 2 Receptor Antagonist, treats ulcers by suppressing gastric acid secretion. Try to take on empty stomach for faster absorption. CNS effects can occur. Take 4-6 weeks to heal duodenal ulcers and 8-12 weeks to heal gastric ulcers. Helps to relieve symptoms of GERD S/E: Decreased sex drive, CNS effects (confusion, hallucinations, CNS depression & excitation), pneumonia Take antacids one hour apart from Cimetidine  Antacids- neutralize stomach acid by raising gastric pH, can influence absorption of drugs like cimetidine, take one hour apart. Also can interfere with sucralfate  HMG-COA reductase inhibitor- Statins, most effective drugs to lower LDL and total cholesterol. Great for patients with atherosclerosis  Colesevelam and insulin considerations- approved for adjunctive therapy of hyperglycemia in clients with type 2 diabetes. This study source was downloaded by from CourseH on :49:31 GMT -06:00 This study resource was shared via CourseH A+  Cholesterol lowering agents  Gastroesophogeal Reflux Disease (GERD) o What kind of medication? Why? Client teaching Reflux esophagitis is an inflammatory condition caused by reflux of gastric contents back into the esophagus. Cimetidine is a drug of choice for relieving symptoms. However, cimetidine does little to hasten healing. For drug therapy, the principal options are proton pump inhibitors (PPIs) and histamine2 receptor antagonists (H2RAs). However, since PPIs are much better than H2RAs at healing esophagitis and maintaining remission, PPIs are considered the clear drugs of choice. Unfortunately, when PPIs are discontinued, the relapse rate is high, occurring in 80% to 90% of patients within 6 to 12 months. Accordingly, for patients with severe GERD, long-term maintenance therapy is recommended.  Constipation: Constipation is defined in terms of symptoms, which include hard stools, infrequent stools, excessive straining, prolonged effort, a sense of incomplete evacuation, and unsuccessful defecation. o Assessment: Laxatives are contraindicated for individuals with abdominal pain, nausea, cramps, and other symptoms of appendicitis, regional enteritis, diverticulitis, and ulcerative colitis. Laxatives are also contraindicated for patients with acute surgical abdomen, fecal impaction, and obstruction of the bowel. o Bulk-forming laxatives: Bulk-forming agents have the same impact on bowel function as dietary fiber. Following ingestion, these agents, which are nondigestible and nonabsorbable, swell in water to form a viscous solution or gel, thereby softening the fecal mass and increasing its bulk. o Opioids and constipation/treatment Renal Medications  Indications (assessment) for diuretics- Loop diuretics are indicated for patients with (1) pulmonary edema associated with congestive heart failure; (2) edema of hepatic, cardiac, or renal origin that has been unresponsive to less effective diuretics; (3) hypertension that cannot be controlled with thiazide and potassium-sparing diuretics; and (4) all patients who need diuretic therapy but have low renal blood flow.  Gentamicin and furosemide considerations- Taking together raises risk of ototoxicity. Cardiovascular and Hematologic Medications  ACE inhibitors o Know characteristics of the class  Beta Blockers o Know characteristics of the class  Nifedipine and metoprolol considerations  Hemophilia A o Treatment  Deep Vein Thrombosis o Treatment  Assessing for bleeding o Client teaching? Signs of bleeding?  Hypertension This study source was downloaded by from CourseH on