NSG 318 Exam 2 Questions with Answers 100% Correct
The RN administers sc epinephrine to a patient experiencing anaphylaxis. The RN should
monitor for which symptom? ✔✔ decreased urine output
A patient who has asthma is diagnosed with hypertension. Which drug will be safe to give this
patient? ✔✔ Selective Adrenergic Antagonist
*also called selective Beta blocker
Cholinergic system (Parasympathetic): Cholinergic nerves ✔✔ nerve cell has to contain all
enzymes and building blocks to produce or create acetylcholine
Cholinergic Nerve synapse ✔✔ stimulation of the receptor site, and then once that's occurred
the acetylcholine has to be destroyed, has to be broken down and gotten rid of, done by a
chemical called acetylcholine esterase.
acetylcholine esterase ✔✔ breaks down acetylcholine
happens in less than a thousandth of a sec.
its actually being broken down and taken away as a waste product.
*unlike norepinephrine where we have reuptake occurring where it reuptakes it back up and
stores it in vesicles so it can be used again.
Cholinergic Receptor are found in ✔✔ muscles and organs
2 types of cholinergic receptors ✔✔ nicotinic = skeletal muscle
muscarinic = stimulate smooth muscle & slow HR
,Cholinergic Agonists/Parasympathomimetics ✔✔ Drugs that stimulate the parasympathetic
nervous system
They mimic the parasympathetic neurotransmitter acetylcholine
Effects of Cholinergic Agonists ✔✔ -Cardiovascular: decrease HR and BP, vasodilation, slows
conduction of AV node
-GI: increase tone and motility, increase peristalsis, relax sphincter muscles
-GU: increase ureter tone, contract bladder and relax sphincter muscles, stimulate urination
-Eye: constrict pupils, increase accommodation
-Lungs: bronchial constriction, increase secretions
-Glands: increase salivation, perspiration, and tears
-Striated muscle: increase neuromuscular transmission, maintain muscle strength and tone
Direct acting cholinergic agonists ✔✔ bind with the receptor site to cause the stimulation of the
parasympathetic or cholinergic response
Bethanechol (Urecholine) ✔✔ cholinergic agnoist
used to increase urination
SE: blurred vision, hypotension, bradycardia, increased salivation or gastric acid, nausea,
vomiting, diarrhea, abdominal cramps, bronchoconstriction
Anticholinergics/Parasympatholytics ✔✔ action= inhibit action of AcH by occupying AcH
receptors
,antagonist for cholinergic or parasympathetic response
Anticholinergics effects ✔✔ -Heart: large doses increase HR, small doses decrease HR
-GI: relax smooth muscle tone, decrease motility, decrease peristalsis, decrease secretions
-GU: relax detrusor muscle, increase sphincter constriction
-Eye: dilate pupils, decrease accommodation
-Lungs: bronchodilator, decrease secretions
-Glands: decrease salivation, decrease perspiration
-CNS: decrease tremors, decrease rigidity (Parkinson's disease)
Atropine ✔✔ anticholinergic
used frequently during surgery
Action:
-increase pulse
-decrease motility
-decrease peristalsis
-decrease salivary secretions
used for less problems when being under anesthesia during surgery.
SE: may have some urinary retention, watch Is and Os.
Nursing Process: phenytoin ✔✔ · Assessment
o Obtain a current health history including drugs and herbs used.
o Determine renal and hepatic function lab values.
· Nursing dix
, o Injury, risk for
o Falls, risk for
· Planning
o Patient's seizure frequency will diminish.
o Client will adhere to anti-seizure drug therapy
o Clients side effects from phenytoin will be minimal.
· Nursing Interventions
o therapeutic range: 10-20 mcg/mL
o if below range=no therapeutic effect
o if above range= potential toxicity
o female taking this medication should use additional contraceptive method
o if in hospital seizure precautions: pad rails, non slip socks, suction available @ bedside
o Determine if client is receiving adequate nutrition
o advise pt's no to drive
o Omeprazole is a proton pump inhibitor= inhibits the hepatic enzymes involved in phenytoin
metabolism
Analgesics
Prevent peptic ulcer ✔✔ take w/ food or enteric coated pill
aspirin inhibits COX-1 & COX-2
Cox-1 protects stomach lining
Aspirin increases hand for development of peptic ulcers by inhibiting COX-1 enzyme.
Use different pain med to prevent this
Selective COX-2 inhibitor
Analgesics ✔✔ salicylates, propionic acid agents, COX-2 inhibitors = anti-inflammatory effect
The RN administers sc epinephrine to a patient experiencing anaphylaxis. The RN should
monitor for which symptom? ✔✔ decreased urine output
A patient who has asthma is diagnosed with hypertension. Which drug will be safe to give this
patient? ✔✔ Selective Adrenergic Antagonist
*also called selective Beta blocker
Cholinergic system (Parasympathetic): Cholinergic nerves ✔✔ nerve cell has to contain all
enzymes and building blocks to produce or create acetylcholine
Cholinergic Nerve synapse ✔✔ stimulation of the receptor site, and then once that's occurred
the acetylcholine has to be destroyed, has to be broken down and gotten rid of, done by a
chemical called acetylcholine esterase.
acetylcholine esterase ✔✔ breaks down acetylcholine
happens in less than a thousandth of a sec.
its actually being broken down and taken away as a waste product.
*unlike norepinephrine where we have reuptake occurring where it reuptakes it back up and
stores it in vesicles so it can be used again.
Cholinergic Receptor are found in ✔✔ muscles and organs
2 types of cholinergic receptors ✔✔ nicotinic = skeletal muscle
muscarinic = stimulate smooth muscle & slow HR
,Cholinergic Agonists/Parasympathomimetics ✔✔ Drugs that stimulate the parasympathetic
nervous system
They mimic the parasympathetic neurotransmitter acetylcholine
Effects of Cholinergic Agonists ✔✔ -Cardiovascular: decrease HR and BP, vasodilation, slows
conduction of AV node
-GI: increase tone and motility, increase peristalsis, relax sphincter muscles
-GU: increase ureter tone, contract bladder and relax sphincter muscles, stimulate urination
-Eye: constrict pupils, increase accommodation
-Lungs: bronchial constriction, increase secretions
-Glands: increase salivation, perspiration, and tears
-Striated muscle: increase neuromuscular transmission, maintain muscle strength and tone
Direct acting cholinergic agonists ✔✔ bind with the receptor site to cause the stimulation of the
parasympathetic or cholinergic response
Bethanechol (Urecholine) ✔✔ cholinergic agnoist
used to increase urination
SE: blurred vision, hypotension, bradycardia, increased salivation or gastric acid, nausea,
vomiting, diarrhea, abdominal cramps, bronchoconstriction
Anticholinergics/Parasympatholytics ✔✔ action= inhibit action of AcH by occupying AcH
receptors
,antagonist for cholinergic or parasympathetic response
Anticholinergics effects ✔✔ -Heart: large doses increase HR, small doses decrease HR
-GI: relax smooth muscle tone, decrease motility, decrease peristalsis, decrease secretions
-GU: relax detrusor muscle, increase sphincter constriction
-Eye: dilate pupils, decrease accommodation
-Lungs: bronchodilator, decrease secretions
-Glands: decrease salivation, decrease perspiration
-CNS: decrease tremors, decrease rigidity (Parkinson's disease)
Atropine ✔✔ anticholinergic
used frequently during surgery
Action:
-increase pulse
-decrease motility
-decrease peristalsis
-decrease salivary secretions
used for less problems when being under anesthesia during surgery.
SE: may have some urinary retention, watch Is and Os.
Nursing Process: phenytoin ✔✔ · Assessment
o Obtain a current health history including drugs and herbs used.
o Determine renal and hepatic function lab values.
· Nursing dix
, o Injury, risk for
o Falls, risk for
· Planning
o Patient's seizure frequency will diminish.
o Client will adhere to anti-seizure drug therapy
o Clients side effects from phenytoin will be minimal.
· Nursing Interventions
o therapeutic range: 10-20 mcg/mL
o if below range=no therapeutic effect
o if above range= potential toxicity
o female taking this medication should use additional contraceptive method
o if in hospital seizure precautions: pad rails, non slip socks, suction available @ bedside
o Determine if client is receiving adequate nutrition
o advise pt's no to drive
o Omeprazole is a proton pump inhibitor= inhibits the hepatic enzymes involved in phenytoin
metabolism
Analgesics
Prevent peptic ulcer ✔✔ take w/ food or enteric coated pill
aspirin inhibits COX-1 & COX-2
Cox-1 protects stomach lining
Aspirin increases hand for development of peptic ulcers by inhibiting COX-1 enzyme.
Use different pain med to prevent this
Selective COX-2 inhibitor
Analgesics ✔✔ salicylates, propionic acid agents, COX-2 inhibitors = anti-inflammatory effect
