NUR521 Exam 2 Questions With Complete Solutions

NUR521 Exam 2 Questions With Complete Solutions •Acarbose (Precose) /ANSWER/•MOA: Act in the intestine to delay absorption of carbohydrates .A1C for patients who are meeting goals /ANSWER/A1C at least two times per year .A1C for patients who are not meeting goals or therapy has changed /ANSWER/A1C at least quarterly .Actos (pioglitazone) MOA /ANSWER/MOA: Decrease insulin resistance by activating insulin-responsive genes that regulate carbohydrate and lipid metabolism .Actos AE /ANSWER/Adverse Effects: Hypoglycemia but only in the presence of excessive insulin; Heart failure; Bladder cancer; Fractures (in women); Ovulation and thus possible unintended pregnancy .Actos BBW /ANSWER/BBW: Discontinue or use decreased dosage in patients with HF .Actos CI /ANSWER/Contraindications: Heart failure, bladder cancer, undiagnosed edema/SOB .Actos Use /ANSWER/Use: T2DM, mainly as add on to Metformin and/or sulfonylurea: .Aldosterone acts to /ANSWER/acts to promote sodium uptake in exchange for potassium secretion .Aldosterone antagonist /ANSWER/Added to standard HF therapy in patients with persistent symptoms despite treatment with ACE-I and B blockers .Aldosterone Antagonist acts to /ANSWER/retention of potassium and increased excretion of sodium .Aliskiren drug class /ANSWER/direct renin inhibitor .Aliskiren other name /ANSWER/tekturna .Aliskiren patient teaching /ANSWER/Educate about angioedema, hyperkalemia, high fat meals decrease absorption, do not take during pregnancy .Amiodarone AE /ANSWER/Adverse Effects: •Serious lung damage •Visual impairment •Thyroid toxicity •Optic neuropathy and optic neuritis •Photosensitivity •Bradycardia •hypotension .Amiodarone BBW /ANSWER/BBW: •Pulmonary toxicity •Liver Toxicity •Arrhythmia .Amiodarone Contraindications /ANSWER/Contraindications: • 2nd and 3rd degree heart block •Sick sinus syndrome .Amiodarone MOA /ANSWER/MOA •Delays repolarization, prolonging action potential .Antidote for digoxin /ANSWER/Digibind .ARB adverse effects /ANSWER/angioedema, renal failure, lower risk of cough and do not cause hyperkalemia .ARB BBW /ANSWER/BBW fetal harm, stop as soon as pregnancy is known .ARBs are approved to treat /ANSWER/Approved to treat hypertension, heart failure, diabetic nephropathy, and MI and for prevention of MI, stroke, and death in people at high risk for CV events. .Arteries /ANSWER/Do not stretch very easily, large increase in pressure causes small increase in diameter .Atorvastatin AE /ANSWER/Serious AE- hepatotoxicity, myopathy .Atorvastatin patient education /ANSWER/Patient Education: •Take without regard to food •Lifelong treatment is necessary •Risk of Rhabdo and s/s •US FDA Drug Safety .Canagliflozin (Invokana) AE /ANSWER/Adverse Effects: •Genital mycotic infections •Orthostasis •Dehydration •UTI •Increased urination .Canagliflozin (Invokana) MOA /ANSWER/MOA: Increase glucose excretion via the urine by inhibiting SGLT-2 in the kidney tubules, decreasing glucose levels and inducing weight loss by caloric loss through the urine .CCBs and B Blockers /ANSWER/Both reduce force of contraction, slow heart rate, and suppress conduction through the AV node .Chronic Kidney Disease BP meds /ANSWER/Ace inhibitor, ARB .Clopidogrel (Plavix): use /ANSWER/Use: •Prevent stenosis of coronary stents •Secondary prevention of MI, ischemic stroke, and other vascular events. .Cyanocobalamin /ANSWER/Vitamin B12 .Diabetes BP meds /ANSWER/Diuretic, B blcoker, ACE inhibitor, ARB, CCB, no aldosterone .Diabetes Criteria /ANSWER/FBG >126 GTT > 200 HgA1c >6.5 % .Digoxin /ANSWER/Lanoxin .Digoxin levels /ANSWER/•levels (0.5 to 0.8 ng/mL .Digoxin MOA /ANSWER/MOA: •Positive inotropic action •Increase myocardial contractile force à increase CO •Alter electrical activity of the heart (neurohormonal) •Reduces s/s of CHF, but does not prolong life (second line agent) .Digoxin most serious adverse effect /ANSWER/dysrhythmia, stop taking, may need antiarrhythmic or antidote