NUR 635 Final Exam Review Questions and Answers (GRADED A) Grand Canyon University

First line tmt for a previously healthy person who develops CAP? Azirthomycin If you see SSRI (selective serotonin reuptake inhibitor) and St. John's wort together? Serotonin syndrome Hype rsensitivity with Phenytoin? 3-8 weeks after treatment can occur (overly sensitive to this medication and have adverse reactions) This would look like a characteristic rash, fever, leukocytosis Carbamazepine can auto-metabolize? YES. This can auto-metabolize so you will end up with lower levels If a patient has been in range, and nothing has changed, it is due to this mediation auto-metabolizing so the levels are lower despite them taking medication with compliance INCREASE the dose Carbamazepine black box? Steven Johnsons Syndrome Carbamazepine monitoring Monitor a CBC, every 3-4 months to watch for agranulocytosis Gabapentin This affects GABA, and is used to treat neurontin pain When you drink alcohol there are more GABA production A patient is on gabapentin and having strange thoughts, what do you need to ask them? You need to ask about suicidal ideation Worried about a patient having a reaction to lamotrigine? This has a high risk for hypersensitivity How do Lamotrigine and oral contraceptives interact? Reduces the lamotrigine levels thus you end up increasing the lamotrigine dose TCA antidepressants, what comorbidities should you avoid when prescribing them? Cardiac disease How long are we going to tell patients that they are going to see a response with an SSRI? 2-6 weeks If you have a schizophrenic patient and you give them haldol what do you assess for? Extrapyramidal symptoms (EPS) Do not need peak and trough. Should have continuous EKG but EKG will not help monitor for EPS. Will the beta agonist overpower the digoxin? A beta agonist anything with dysrhythmia will speed up the HR Digoxin is dysrhythmic and slows down the HR. Do we give a beta 2 agonist (albuterol) with those with a pheochromocytoma (puts you at risk for HTN)? NO because it will cause a Hypertensive crisis on the adrenal glands You have moderate persistent asthma, which medication has a black box warning against using it as a singular agent to treat this? You do not treat asthma patients or should cautiously as there is an increased risk with asthma patients when using LABA (salmeterol and formoterol) Black box warning is that reports for severe asthma exacerbations occur thus causing death Spiriva inhales anticholinergics used for the tmt of COPD If you prescribe someone with beclomethasone how should they use it? Inhaled corticosteroid Rinse and spit after, spacers are good USE EVERYDAY, this is not a PRN inhaler Montelukast(singular) side effects? Aggression, anxiety, depression and suicidal ideation are mental health issues when taking this medication How are we going to get an elderly old man to not take benadryl? Causes urinary retention Why do we use the second generation antihistamines more often for seasonal allergies? They are more selective which makes them less sedative When you take calcium carbonate antacids chronically what do they put themselves at risk for? Kidney stones Patients on long term PPI (can create osteoporosis through calcium decrease absorption) can also have what else occurs? Iron deficiency Vitamin B12 deficiency anemia osteoporosis Methylnaltrexone is used to treat? Opioid induced constipation If you give an elderly patient lactulose every day what do you need to monitor? Electrolytes Inappropriate use of antimicrobials? Creates resistance to the medications What is an antibiogram? Every hospital has this, chart of the local resistance patterns that are being monitored Carbamazepine has a lot of warnings, black box warning for what allele? Asian ancestry has an increased risk for steven johnsons syndrome "Burning man rash" Chromyln eye drops can they wear their contacts? No they are not allowed to First line drug for a moderate GAD? Buspar Working someone up for depression, what lab do you get? Thyroid Good drug for treatment with depression and anxiety? Lexapro Go to taper an SSRI you do this how? You reduce the dose for 50% for 3-4 days then Then reduce by 50% after that If you prescribe someone fluoxetine (SSRI), why is it important they take it the same time every day and do not run out of their rx)? Short half life Rule with asthma, when do you do up or down? If they use their SAB more than 2x a week you adjust If your asthma patient is on an inhaled beta agonist and an inhaled steroid which one do you tell them to use first? The beta one is to be used first to bronchodilator them then use the steroid. When you get a tmt plan for asthma what do you need to know? Severity, and control How bad, how long do they last, how often TMT for mild intermittent asthma? SABA (short acting bronchodilator) then add on low dose corticosteroids What past medical hist