NR 293 Final Exam Questions With Answers 2023/2024 | Graded A+

adverse reactions of metronidazole - answeranorexia nausea diarrhea headache dry mouth metallic taste bone marrow suppression contraindications of metronidazole - answeroral anticoagulants hypoprothombinemia alcohol (deathly sick if they drink) lithium (increases levels) how to administer metronidazole - answertopical: treats rosacea combination: treat h pylori infection vancomycin MOA - answerbacteriocicdal inhibits cell wall synthesis uses of vancomycin - answergram positive bacteria bone infection skin infection lower respiratory infection MRSA (Most effective drug for MRSA) adverse effects of vancomycin - answerflushing hypotension ototoxicity nephrotoxicity Steven Johnsons syndrome red man syndrome (occurs, when rapid IV admin, large amounts of histamine are released and dace, neck, trunk of body turn red) blood dycrasias pseudomembranous colitis nursing interventions for vancomycin - answerpeak and trough levels are drawn after 3 doses Labs (BUN, Cr) monitor hearing administer over 1-2 hours nursing role for antibiotics - answercultures prior to antibiotic therapy monitor 1/2nd dose for allergy monitor labs (kidney, liver, peak and trough) increase fluids check for superinfection (fever, perineal itching, cough, lethargy, unusual discharge) educate patient to finish prescription even if they feel better amphotericin B MOA - answerbroad spectrum anti fungal medication binds to ergosterol in fungal cell membranes uses of amphotericin B - answersevere systemic infections adverse effects of amphotericin B - answerfever rash chills hypotension tachycardia malaise muscle and joint pain anorexia nausea and vomit headache hypokalemia hypomagesemia nephortoxicity liver failure anaphylaxis MI thombocytopenia leukopenia agranulocytosis anemia administration of amphotericin B - answerpremedicate: 1st dose: 1 mg over 20-30 min administer slowly via IV, can cause cardiovascular collapse withhold if BUN is over 40mg withhold if serum creatinine rises about 3mg nursing interventions for amphotericin B - answermonitor labs Cr, BUN, ALK AST and ALT may increase K, Ca, Mg may decrease premeditate with antipyretics, antihistamines, antiemetics and corticosteroids monitor vital signs promote hydration liquid form of drug causes fewer side effects but is more expensive antiviral acyclovir (Zovirax) MOA - answerprevents viral DNA synthesis acyclovir uses - answerherpes virus decreases duration and episodes contraindications of acyclovir - answerrenal impairment adverse effects of acyclovir - answerPO: nausea/ vomit anorexia headache elevated hepatic enzymes IV: nephrotoxicity neurotoxicity patient education of acyclovir - answerstart as soon as signs and symptoms begin virus may be activated by stress, trauma, fever, sunlight, sex menstruation, immunosuppressive drugs refrain from sex when you have visible lesion drowsiness in older adults may increase fall risk CNS depressants dose dependents - answerlow: calms without inducing sleep high: calms with sleep main groups of CNS depressants: benzodiazepines MOA - answerdepress CNS activity affects hypothalamic, thalamic, and limbic systems of the brain: calming effect controls agitation and anxiety (panic attack) reduce sensory stimuli. inducing sleep induce skeletal and muscle relaxation does not suppress REM sleep as much as baribiturates does not increase metabolism of other drugs what receptor is used for benzodiazepines? - answerGABA: gamma aminobutyric acid uses or benzodiazepines - answersedation sleep induction skeletal muscle relaxation anxiety relief/ depression acute seizure disorders alcohol withdrawl agitation relief balanced anesthesia (before they give you actual anesthesia they will give this to you to calm you down) side effects of benzodiazepines - answerheadache, drowsiness, dizzy cognitive impairement vertigo lethargy fall hazard for older adults hangover effect toxicity and OD for benzodiazepines - answersomnolence confusion coma diminished reflexes contraindication of benzodiazepines - answerother CNS depressants (alcohol, opioids): hypotension and respiratory depression azalea antifungals verapamil diltiazem protease inhibitors macrolide antobiotics grapefruit juice olanzapine rifampin overdose treatment of benzodiazepines - answerFlumazenil (romazicon) administered IV drugs for benzodiazepines long acting - answerclonazepam (klonopin) diazepam (valium) first benzo drug, varied uses including anxiety drugs for benzodiazepines intermediate acting - answeralprazolam (xanax) lorazepam (Ativan) temeazepam (restoril): used for sleep induces sleep within 20-40 min take 1 hour before bed drugs for benzodiazepines short acting - answereszophiclone (lunesta) zolpidem (ambien) nonbenzodiazepine zolpidem (ambien) - answershort acting