Archer NCLEX Pharm Questions & Answers Solved 100% Correct!!

Archer NCLEX Pharm Questions & Answers Solved 100% Correct!! what are the 2 types of anti-anxiety agents? What are their endings? and what anti-anxiety medication is mostly used on the NCLEX? short acting -MidazoLAM -DiazePAM intermediate-long acting -clonazePAM -alprazoLAM (Xanax) -lorazePAM (ativan) (anti-anxiety agents end in LAM or PAM, lorazepam [ativan] is the antianxiety agen that is mostly used within the NCLEX, the two types of anti-anxiety agents are short acting and intermedicate-long acting) Lorazapam (Ativan) therapeutic class, indication, action, and nursing considerations THERAPEUTIC CLASS: anti-anxiety agent INDICATION: anxiety, sedation, and seizures (lorazepam [ativan] is the first line of treatment for seizures lasting for than 5 minutes) ACTION: general CNS depression NURSING CONSIDERATIONS: avoid alcohol, monitor respiratory depression, antidote- flumazenil what is the first line of treatment for seizures lasting more than 5 minutes anti-anxiety agent lorazepam (Ativan) what is the antidote for lorazepam [ativan]? the antidoite for lorazepam (ativan) is flumazenil what are the top anti-arrhythmics listed in the NCLEX? ●Amiodarone ●ADENOSINE ●Procainamide what is adenosine's therapeutic class, indication, action, and nursing considerations? THERAPEUTIC CLASS: anti - arythmic INDICATION: SVT (super-ventricular tachycardia) ACTION: slows conduction though AV node, interrupts re-entry pathways though AV node, restoring normal sinus rhythm NURSING CONSIDERATIONS: there will be a period of asystole after administration, warn the patient - it iwll feel like someone kicked them in the chest (bc the heart is stopping), warn the family-they will flatline on the monitor, RAPID PUSH-OR IT WILL NOT WORK (need adenosine to be rapidly pushed into the heart within 2 second) if the patient has multiple IV lines, why would you use the IV line closest to the heart to administer adenosine? adenosine needs to be administered RAPID PUSH though an IV to reach the heart within 2 seconds. Choosing the IV line that is closest to the heart ensures a faster route. what must you warn the patient and the family before administering adenosine? Because adenosine is an anti - arrhythmic agent, the action of anti - arrhythmics are to slow conduction thought he AV node; interrupt reentry pathways though AV node; and restore normal sinus rhythm. Tell the patient that they will experience a great amount of pain because the heart is stopping and tell the family the monitor will show a flatline because there will be a period of asystole after administration what are popular anti - coagulants? Heparin warfarin enoxaparin (low-molecular weight heparin) clopidogrel (plavix) What is the classification of Heparin? Heparin is classified as an indirect thrombin inhibitor what is a an example of an indirect thrombin inhibitor? and how does it work? Heparin is an indirect thrombin inhibitor. Normally, thrombin catalyzes fibrinogen to fibrin, and firbrin froms clots. Antithrombin III inhibits thrombin. The indirect thrombin inhibitor, Heparin, ENHANCES antithrombin III = stops thrombin from being activated, which therefore prevents clots from forming = intrinsic coagulation pathway end result? SLOWS DOWN CLOTTING what are the uses of heparin? the uses of heparin are to prevent blood clots -strokes -post-operatively -chronic a-fib (we would want to use heparin with a pt with chronic a-fib bc the atria is quivering, resulting to blood pooling within the atria and clotting. This is dangerous bc the clot can breat loose and eject form the heart and go to the brain and cause a stroke, or go in the lungs and cause a pulmonary embolism how do you administer heparin? sub q or IV what is an important task to do when a patient is on a heparin drip? patient on a heparin drip have aPTT levels drawn q4-6 hours to titrate the drip aPTT = partial thromboplastin time -aPTT is drawn to have a heparin level (we want to to know if we are titrating heparin drip appropriately) and to know how quickly the patient's blood is clotting what are important nursing considerations when administering heparin? note that the biggest side effect to monitor for is BLEEDING -hematuria: pinktinged urine -hematemesis: bloody vomitus -bruising (ex. the patient bruises after taking pulse) -downtrending H&H (hemoglobin and hematocrit) what is the antidote for heparin? protamine sulfate what does HITT stand for? HITT: heparin induced thrombocytopenia and thrombosis What is Heparin induced thrombocytopenia and thrombosis (HITT)? what are some clinical manifestations, complications, and treatment of heparin induced thrombocytopenia and thrombosis (HITT)? -a LETHAL complication of heparin therapy -usually occurs 5-7 days after heparin exposure -suspect in any patient on heparin who has an unexplained platelet drop CLINICAL MANIFESTATION: -skin lesion at heparin injection sites (ex. blood ozing out form the IV inj site) -chills -fever -dyspnea -chest pain COMPLICATIONS - CLOTTING!: -DVT -PE -(complications explained: platelets are dropping, body is using platelets incorrectly and causing complications! body is unable to form clots in areas the body needs it to [ex. inj sites to where they are bleeding]) TREATMENT: -discontinue ALL heparin and start a different anticoagulant what is warfarin's therapeutic class, indication and action THERAPEUTIC CLASS: anticoagulant INDICATION: venous thrombosis, pulmonary embolism, A-fib ACTION: Distrupts liver synthesis of vitamin K dependent clotting factors (we need vitamin K for clotting) what are the nursing considerations for warfarin? -monitor for bleeding (bc warfin is a anticoagulant)