HCD 3 MOD B EXAM Questions with Correct Solutions
Question:
1. Supplemental Oxygen
Answer:
- use: acute and chronic conditions that decrease O2 sat. prophylactically for pt under
anesthesia
- routes: N/C, simple face mask, NRB, Ventilator
- MOA: assists in normal cellular metabolism
- SE/AE: dry mucous membranes, oxygen toxicity, respiratory failure
- implications: education pt on physiologic effects (atelectasis, inflammation, CNS effects,
hypercapnia, reduced erythropoesis, pulmonary vasodilation and systemic vasoconstriction)
Question:
2. salbutamol (albuterol) & levalbuterol
Answer:
- class: Short-acting B2 adrenergic receptor agonists (SABA)
- use: rescue inhaler, bronchospasm, COPD, delay premature labor; elevated K levels (IV or
pill form)
- MOA: adenylyl cyclase -> converts ATP to CMP signaling cascade which lowers intracellular
concentration of calcium
- SE/AE: shakiness, headache, tachycardia, dizziness, anxiety; bronchospams,
arrythmias/palpitations, hypokalemia, insomnia, cramps, redness of skin (vasodilation)
- implications: educate pt on use and to report possible side effects
Question:
3. Salmeterol/fluticasone (adivair) & Budesonide/Formoterol (symbicort)
Answer:
- class: Long acting B2 adrernergic receptor agonist (LABA)
- use: asthma, COPD, SOB, bronchospasm, wheezing
- MOA: causes bronchodilation by increasing cAMP
- SE/AE: dizziness, headache, hypokalemia, tachycardia, hypertension, worsening breath
problems
- implications: given by dry-powder inhalation, could cause harm in pregnancy; report
tachycardia, HTN, worsening resp
Question:
4. Atrovent & Ipratropium Bromide
,Answer:
- class: Short acting Muscarinic Antagonist (anticholinergic)
- use: COPD, asthma
- MOA: relaxes smooth muscle by inhibiting calcium concentration
- SE/AE: urinary retention, allergic reaction, dry mouth, skin flushing, tachycardia, nausea,
headache
- implications: interacts w anticholinergics, TCAs, quinidine; teach pt to report symptoms
Question:
5. prednisone, hydrocortisone, dexamethasone, fludrocortisone
Answer:
- class: corticosteroids
- use: allergy, endocrinology, metabolism, reduce inflammation
- MOA: activate cortisol effect and promotes glucogenesis resulting in anti inflammatory and
immunosuppresion effects
- SE/AE: lipodystophy, hyperglycemia, insulin resistance, cushing syndrome, insomnia,
hypokalemia, hypernatremia, immunosupression, irreversible eye damage, fungal infection,
bone demineralization
- implications: usually given IV (systemic); warn of side effects
Question:
6. theophylline & caffeine
Answer:
- class: xanthines (adenosine receptor antagonists)
- use: asthma, respiratory distress syndrome
- MOA: reduces oxidative stress, returning steroid responsiveness to normal, reduces
inflammation & immunity
- SE/AE: tachycardia, increased contractility, nausea, diarrhea, arrythmia, irritability,
dizziness, possible seizures
- implications: monitor closely to avoid toxicity, antibiotics can increase chances of toxicity,
treat toxicity with beta blockers
Question:
7. Antibiotics, Antifungals, Antivirals
Answer:
- class: anti-infectives
- use: treat and prevent infections
- routes: PO, IV, Topical, eardops, eyedrops
- SE/AE: allergy, hypersensitivity, diarrhea, nausea, vaginal/GI flora, photosensitivity,
anaphylaxis
- implications: interacts with oral contraception, alcohol
, Question:
8. surfactant
Answer:
- class: exogenous surfactant
- use: premature infants
- MOA: type 2 pneumocyte cells, coats alveoli to reduce surface tension preventing collapse
which improves gas exchange
- SE/AE: no significant effects
- implications: administer endotracheally
Question:
9. vasopressin, epinephrine, norepinephrine, phenylephrine
Answer:
- class: vasopressors
- use: hypotension, shock, SVT, anaphylaxis
- MOA: vasoconstriction of arterioles increases blood pressure, decreases eye irritation and
nasal congestion
- SE/AE: dizziness, headahce, anxiety, tremors, insomnia, hypertension, tachycardia,
gangrene, dysrythmias, pallor
- implications: monitor VS, EKG, lung and heart sounds
Question:
10. propafol (diprivan), dexmedetomidine (precedex), midazolam (versed)
Answer:
- class: general anesthetic (sedatives)
- use: induction and maintenance of general anesthesia (unconsciousness)
- MOA: produces CNS inhibition
- SE/AE: hypotension, nausea, vomiting, bradycardia, toxicity, malignant hyperthermia
- implications: only IV; contraindicated in pregnancy, allergy, narrow angle glaucoma;
interacts with beta blockers and other sedatives
Question:
11. Total parenteral nutrition
Answer:
- administered to patients who cannot, or should not, get their nutrition through eating
(issues w obstruction, absoprtion, fistulas, etc)
- nutritional mix of glucose, salts, amino acids, lipids, vitamins, minerals
- administered through central line
- prevents malnutrition. usually begin use after 7 days of hospitalization
- can cause
Question:
1. Supplemental Oxygen
Answer:
- use: acute and chronic conditions that decrease O2 sat. prophylactically for pt under
anesthesia
- routes: N/C, simple face mask, NRB, Ventilator
- MOA: assists in normal cellular metabolism
- SE/AE: dry mucous membranes, oxygen toxicity, respiratory failure
- implications: education pt on physiologic effects (atelectasis, inflammation, CNS effects,
hypercapnia, reduced erythropoesis, pulmonary vasodilation and systemic vasoconstriction)
Question:
2. salbutamol (albuterol) & levalbuterol
Answer:
- class: Short-acting B2 adrenergic receptor agonists (SABA)
- use: rescue inhaler, bronchospasm, COPD, delay premature labor; elevated K levels (IV or
pill form)
- MOA: adenylyl cyclase -> converts ATP to CMP signaling cascade which lowers intracellular
concentration of calcium
- SE/AE: shakiness, headache, tachycardia, dizziness, anxiety; bronchospams,
arrythmias/palpitations, hypokalemia, insomnia, cramps, redness of skin (vasodilation)
- implications: educate pt on use and to report possible side effects
Question:
3. Salmeterol/fluticasone (adivair) & Budesonide/Formoterol (symbicort)
Answer:
- class: Long acting B2 adrernergic receptor agonist (LABA)
- use: asthma, COPD, SOB, bronchospasm, wheezing
- MOA: causes bronchodilation by increasing cAMP
- SE/AE: dizziness, headache, hypokalemia, tachycardia, hypertension, worsening breath
problems
- implications: given by dry-powder inhalation, could cause harm in pregnancy; report
tachycardia, HTN, worsening resp
Question:
4. Atrovent & Ipratropium Bromide
,Answer:
- class: Short acting Muscarinic Antagonist (anticholinergic)
- use: COPD, asthma
- MOA: relaxes smooth muscle by inhibiting calcium concentration
- SE/AE: urinary retention, allergic reaction, dry mouth, skin flushing, tachycardia, nausea,
headache
- implications: interacts w anticholinergics, TCAs, quinidine; teach pt to report symptoms
Question:
5. prednisone, hydrocortisone, dexamethasone, fludrocortisone
Answer:
- class: corticosteroids
- use: allergy, endocrinology, metabolism, reduce inflammation
- MOA: activate cortisol effect and promotes glucogenesis resulting in anti inflammatory and
immunosuppresion effects
- SE/AE: lipodystophy, hyperglycemia, insulin resistance, cushing syndrome, insomnia,
hypokalemia, hypernatremia, immunosupression, irreversible eye damage, fungal infection,
bone demineralization
- implications: usually given IV (systemic); warn of side effects
Question:
6. theophylline & caffeine
Answer:
- class: xanthines (adenosine receptor antagonists)
- use: asthma, respiratory distress syndrome
- MOA: reduces oxidative stress, returning steroid responsiveness to normal, reduces
inflammation & immunity
- SE/AE: tachycardia, increased contractility, nausea, diarrhea, arrythmia, irritability,
dizziness, possible seizures
- implications: monitor closely to avoid toxicity, antibiotics can increase chances of toxicity,
treat toxicity with beta blockers
Question:
7. Antibiotics, Antifungals, Antivirals
Answer:
- class: anti-infectives
- use: treat and prevent infections
- routes: PO, IV, Topical, eardops, eyedrops
- SE/AE: allergy, hypersensitivity, diarrhea, nausea, vaginal/GI flora, photosensitivity,
anaphylaxis
- implications: interacts with oral contraception, alcohol
, Question:
8. surfactant
Answer:
- class: exogenous surfactant
- use: premature infants
- MOA: type 2 pneumocyte cells, coats alveoli to reduce surface tension preventing collapse
which improves gas exchange
- SE/AE: no significant effects
- implications: administer endotracheally
Question:
9. vasopressin, epinephrine, norepinephrine, phenylephrine
Answer:
- class: vasopressors
- use: hypotension, shock, SVT, anaphylaxis
- MOA: vasoconstriction of arterioles increases blood pressure, decreases eye irritation and
nasal congestion
- SE/AE: dizziness, headahce, anxiety, tremors, insomnia, hypertension, tachycardia,
gangrene, dysrythmias, pallor
- implications: monitor VS, EKG, lung and heart sounds
Question:
10. propafol (diprivan), dexmedetomidine (precedex), midazolam (versed)
Answer:
- class: general anesthetic (sedatives)
- use: induction and maintenance of general anesthesia (unconsciousness)
- MOA: produces CNS inhibition
- SE/AE: hypotension, nausea, vomiting, bradycardia, toxicity, malignant hyperthermia
- implications: only IV; contraindicated in pregnancy, allergy, narrow angle glaucoma;
interacts with beta blockers and other sedatives
Question:
11. Total parenteral nutrition
Answer:
- administered to patients who cannot, or should not, get their nutrition through eating
(issues w obstruction, absoprtion, fistulas, etc)
- nutritional mix of glucose, salts, amino acids, lipids, vitamins, minerals
- administered through central line
- prevents malnutrition. usually begin use after 7 days of hospitalization
- can cause
