NURSING 406 Test bank for Exam I patho:pharm Q & As BEST TESTBANK EXAM SOLUTION

routes of administration - ANS oral disintegration, suspension solutions, powders, capsules, tablets, coated tablets, enteric coated tablets pharmaceutics - ANS the science of preparing and dispensing drugs pharmacokinetics - ANS drug absorption, distribution, metabolism, and excretion (ADME); study of what happens to a drug from the time it is put in the body until the drug has left the body pharmacodynamics - ANS biochemical and physiological effect of drugs on the body enteral route - ANS oral, sublingual, buccal, and rectal parenteral route - ANS IV (fastest, IM, subq, intradermal, intraarterial, intrathecal, and intraarticular fluid and electrolytes percentages - ANS Water: 60% ICF fluid: 20% Interstitial fluid: 15% Intravascular fluid: 5% Renin Angiotensin-aldosterone system RAAS - ANS Renin converts angiotensinogen to angiotensin I in the liver ACE is made in the lung and turns angiotensin I to angiotensin II ACE inhibitors stop production of ACE to lower BP Vasoconstriction occurs and stimulates release of aldosterone to increase BP, increase fluid in blood vessels, a nd cause hypertension aldosterone function - ANS retains sodium and water ADH system function - ANS released when there is an increase in plasma osmolality or decrease in circulating blood volume hypotonic solution (hyponatremia) - ANS serum sodium level is less than 135 mEq/L which causes plasma hypo osmolality and cellular swelling Isotonic solution - ANS volume depletion (hypovolemia), volume excess (hypervolemia); the concentration stays the same, the difference is the amount of salt hypertonic solution - ANS serum sodium level is about 145 mEq/L related to sodium gain or weight loss hyponatremia - ANS less than 135 mEq/L; loss of sodium caused by diuretics, excessive perspiration symptoms of hyponatremia - ANS lethargy, stomach cramps, hypotension, vomiting, diarrhea, and seizures treatment of hyponatremia - ANS oral rehydration solutions (gatorade, pedialyte), salt tablets hypernatremia - ANS more than 145 mEq/L; high sodium levels caused by being thirsty, hot temperatures, kidney problems, and low water intake hypernatremia symptoms - ANS red, flushed skin, increased thirst, elevated temperature treatment of hypernatremia - ANS water , salt free drinks hypokalemia - ANS less than 3.5 mEq/L; loss of potassium from diarrhea hypokalemia manifestations - ANS T wave becomes shorter and flatter, skeletal muscle weakness, cardiac dysrhythmias treatment of hypokalemia - ANS replace potassium orally or IV hyperkalemia - ANS more than 5.5 mEq/L; increase of potassium caused by increased intake, hypoxia, acidosis, insulin deficiency, etc. hyperkalemia manifestations - ANS peaked T wave, tingling of lips and fingers, restlessness, intestinal cramping and diarrhea treatment of hyperkalemia - ANS insulin or glucose, give laxative to lower the K+ levels (kayexalate) Normal sodium levels - ANS 135-145 mEq/L Normal potassium levels - ANS 3.5-5.5 mEq/L Normal calcium levels - ANS 8.5-10.5 mg/dL Normal Phosphate (PO4) levels - ANS 2.5-5 mg/dL Normal magnesium levels - ANS 0.75-0.95 crystalloids function - ANS treat dehydration Normal saline solution - ANS 0.9% sodium chloride Half NS solution - ANS .45% sodium chloride Hypertonic saline solution - ANS 3% sodium chloride Dextrose 5% in water function - ANS maintains isotonic status; want the patient to have fluids not necessarily more water or sodium number one colloid - ANS blood innate immunity - ANS present at birth, gives initial response to invasion and injury (natural barriers, inflammation, rapid, involves phagocytes, no memory) adaptive immunity - ANS develops over the lifetime, provides long term protection (specific, involves memory cells, vaccines, previous diseases) Active immunity - ANS antibodies produced after natural exposure to antigen ex. immunizations, exposure (natural) passive immunity - ANS antibodies transferred from a donor to a recipient ex. mother to baby immune response - ANS antigens (foreign proteins), specific information is imprinted into a cellular ''memory bank'' of the immune system antibodies - ANS immunoglobulin molecules that are antigen-specific Human immunodeficiency virus (HIV) - ANS transmitted by body fluids (sexual contact, breast milk, blood-to-blood contact) complications/manifestations of HIV - ANS develop HIV specific antibodies, acquired immunodeficiency disease syndrome (AIDS), CD4 T cell count decreases symptoms of HIV - ANS fatigue, headache, lymphadenopathy, low grade fever treatment of HIV - ANS antiretroviral therapy (ART) HIV primary infection phase - ANS signs of systemic infection and immune system response and antibodies against HIV appear (1-6 months) HIV latency phase - ANS virus is replication (TH cell count gradually falls) Overt AIDS phase - ANS TH cell count less than 200 cells/mL AIDS medication - ANS HAART reverse transcriptase inhibitors lupus - ANS chronic multisystem inflammatory disease with antibodies against nucleic acids, erythrocytes, coagulation proteins, phospholipids, etc. lupus is more common in - ANS females manifestations of lupus - ANS arthritis, vasculitis and rash, renal disease, hematologic changes (anemia), and cardiovascular disease diagnosis and treatment of lupus - ANS 4/1 findings indicates lupus; NO CURE but treated with NSAIDs symptoms of lupus - ANS facial rash, photosensitivity, oral or nasopharyngeal ulcers, renal disorders, etc. keloid - ANS elevated, rounded, and firm clawlike margins that extend beyond the original site of injury due to excessive collagen formation dermatitis - ANS caused by hypersensitivity reaction; allergen comes in contact with the skin stasis dermatitis - ANS occurs in the legs as a result of venous stasis, edema, and vascular trauma seborrheic dermatitis - ANS inflammation of the skin involving the scalp, eyebrows, eyelids, nasolabial folds, and ear canals (scaly, white, or yellowish plaques) AKA ''cradle cap'' in babies discoid lupus erythematosus (DLE) - ANS autoimmune disease where the immune system attacks itself causing the injury; butterfly pattern over the nose and cheeks tinea capitis - ANS most common fungal infection of childhood (caused by cats, dogs, and rodents) tinea corporis - ANS ringworm (kitten, and puppies are common source) scleroderma - ANS sclerosis of the skin that can progress to the internal organs scabies - ANS contagious disease caused by itch mite and transmitted by personal contact, infected clothing, and bedding lyme disease - ANS multisystem inflammatory disease melanoma cancer - ANS tumor arising from melanocytes basal cell cancer - ANS tumor arising from cutaneous basal cells acne vulgaris - ANS most common skin disease managed with topicals acne conglobata - ANS highly inflammatory form of severe acne formed by cysts and abscesses beneath the skin managed with topicals diaper dermatitis - ANS group of inflammatory disorders affecting the lower abdomen, genitalia, buttocks, and upper thigh; inflammation caused by prolonged exposure to urine and feces, wet diapers, etc. rubella - ANS RNA virus mild in most children manifestations of rubella - ANS enlarged cervical lymph nodes, low-grade fever, headache, sore throat, runny nose, cough rubeola - ANS RNA paramyxovirus symptoms of rubeola - ANS high fever, malaise, enlarged lymph nodes, runny nose, conjunctivitis, barking cough roseola - ANS fever and an erythematous macular rash that lasts about 24 hrs. treatment of MRSA - ANS mupirocin (antimicrobial) silver sulfadiazine use - ANS burns, topical antiinfective (treat infection at site of second and third degree burns) adverse effects of silver sulfadiazine - ANS pain, burning, itching benzoyl peroxide use - ANS used to treat acne benzoyl peroxide adverse effect - ANS peeling skin, redness, sensation of warmth isotretinoin use - ANS treats severe cystic acne AKA ''accutane'' isotretinoin nursing implications - ANS patient is required to use a form of contraception and cannot become pregnant while on the drug; monitor for signs of depression and suicidal thoughts tretinoin use - ANS used to treat acne and reduce dermatologic changes associated with sun damage antifungal drugs - ANS -zole ex. clotrimazole- vaginal suppository or cream for yeast infections or athletes foot miconazole- topical cream for vagina antiviral drugs - ANS -vir ex. acyclovir- used to treat herpes simplex 1 & 2, human papillomavirus anesthetic drug - ANS lidocaine anti-inflammatory drug - ANS diphenhydramine benadryl - ANS antihistamine used to relieve symptoms of allergy, hay fever, and the common cold (symptoms of rash, itching, watery eyes, itchy nose/eyes/throat, cough, runny nose, and sneezing) corticosteroids - ANS lower inflammation in the body and reduce immune system activity; eases swelling, itching, redness, and allergic reactions (can be used to treat asthma) pregnancy category X drug - ANS finasteride eye drugs - ANS mydriatics and miotics mydriatics function - ANS dilate the pupil (apraclonidine) miotics function - ANS constrict the pupil (acetylcholine and pilocarpine) cycloplegic mydriatics - ANS used for eye exams and glaucoma - ANS inhibition of the normal flow and drainage of aqueous humor resulting in increase IOP pilocarpine function - ANS used as a miotic in the treatment of glaucoma beta-blockers function and ending - ANS -lol; BP med that decreases HR/contractility side effects of beta blockers - ANS bradycardia, lethargy, GI disturbance, congestive HF, hypotension, depression beta blocker contraindications - ANS HF, brady-dysrhythmia, masking of hypoglycemia included tachycardia, bronchoconstriction, vascular disease beta blocker nursing implications - ANS monitor pulse rates and report bradycardia Carbonic anhydrase inhibitors - ANS inhibit the enzyme carbonic anhydrase to reduce aqueous humor formation in the eye carbonic anhydrase mechanism of action - ANS results in decrease IOP to treat glaucoma adverse effects of carbonic anhydrase inhibitors - ANS drowsiness, confusion, myopia, tinnitus, anorexia, vomiting, diarrhea; patients with sulfa allergies may develop cross-sensitivities prostaglandin antagonists mechanism of action - ANS reduce IOP by increasing the outflow of aqueous fluid to treat glaucoma prostaglandin ending - ANS -prost adverse effect of prostaglandin - ANS in patients with hazel, green, or blue eyes, eye color will change permanently to brown antimicrobial drugs - ANS -mycin, -cin ear wax removers (debrox) - ANS put in the ear to soften the earwax ear infection treatment - ANS treated with PO meds instead of otic antibiotics; can put eyes drops in ear but not vice versa earwax emulsifiers - ANS loosen and help remove cerumen pneumothorax - ANS occurs when there is a large open wound in the chest wall pneumothorax causes - ANS trauma (stab wounds), lung biopsy, tube thoracostomy S/S of pneumothorax - ANS sudden chest pain, shortness of breath, rapid and shallow breathing, fast HR, and hypoxia tension pneumothorax - ANS air enters the pleural cavity and air cannot leave due to the tension and the fact that there is no route of exit causes of tension pneumothorax - ANS traumatic chest injury, mechanical ventilation symptoms of tension pneumothorax - ANS shortness of breath, acute chest pain, decreased BP, decreased blood O2, increased HR atelectasis - ANS when a section of the alveoli in the lung collapses; common complication after surgery causes of atelectasis - ANS foreign body, mucous plug, tumor, scar tissues COPD - ANS characterized by bronchospasm and dyspnea where tissue is NOT reversible and increases in severity and eventually leads to respiratory failure symptoms of atelectasis - ANS shortness of breath, cough, chest pain, fast shallow breathing, fast HR bronchiectasis - ANS enlargement and thickening of the airway walls bronchiectasis causes - ANS infection that lead to lung tissue damage, aspirating, autoimmune disease, obstructed airways symptoms of bronchiectasis - ANS chest pain and tightness, coughing with mucus, coughing up bloody mucus, difficulty with deep breathing, wheezing, joint pain, clubbing empyema - ANS collection of pus in the cavity between the lung and the pleural space causes of empyema - ANS infected chest wound, ruptured lung abscess, tuberculosis chest wall disorders - ANS flail chest, scoliosis flail chest - ANS instability of a portion of the chest wall due to a portion of the rib cage being fractured flail chest effect on breathing - ANS the area of the lung under the unstable chest wall will flatten on inspiration; on expiration the unstable area inflates pneumonia symptoms - ANS cough, fever, chills, tachycardia, tachypnea, dyspnea, pleural pain, malaise, decreased breath sounds bacterial pneumonia - ANS most common: streptococci and staphylococci viral pneumonia - ANS most common viral pneumonia in young children is respiratory syncytial virus (RSV) atypical mycoplasma pneumonia - ANS most common cause of community acquired pneumonia for school age and young adults pulmonary hypertension - ANS when the pulmonary artery pressure is 5-10 mmHg above normal causes of pulmonary hypertension - ANS high BP, coronary heart disease, liver disease, blood clots to the lungs signs and symptoms of pulmonary hypertension - ANS dizziness, irregular heartbeat, nausea, vomiting, fainting, low BP lung non small cell cancer types - ANS squamous cell carcinoma, adenocarcinoma, and large cell carcinoma lung small cell cancer types - ANS neuroendocrine tissue risk factors of lung cancer - ANS smoking, environmental factors, and occupation symptoms of lung cancer - ANS coughing, chest pain, shortness of breath, and wheezing causes of sleep apnea - ANS obesity, excessive weight, adenotonsilar hypertropy in kids croup - ANS causes inflammation of the larynx, trachea, bronchi, bronchioles and lung parenchyma causes of croup - ANS parainfluenza, influenza A, RSV symptoms of croup - ANS runny nose, seal like bark sounding cough, laryngitis, fever epiglottitis - ANS inflammation of structures above the glottis causes of epiglottitis - ANS haemophilus influenzae type B symptoms of epiglottitis - ANS sore throat, difficulty and pain while wallowing, fever, drooling, hoarse voice bronchiolitis - ANS infection of the small airways in the lungs; inflammatory obstruction of the small airways cause of bronchiolitis - ANS RSV symptoms of bronchiolitis - ANS congestion, runny nose, sore throat, mild fever, wheezing respiratory distress syndrome - ANS when there is poor lung structure and lack of adequate surfactant cause of respiratory distress syndrome (RDS) - ANS widespread atelectasis, respiratory distress, pulmonary hypertension asthma symptoms - ANS shortness of breath, tight chest, wheezing, trouble sleeping due to SOB risk factors of asthma - ANS parent w/asthma, severe respiratory infection, allergic condition sudden infant death syndrome risk factors - ANS low birth weight, respiratory infection, premature babies, sleeping in bed with parents, males, age of 1-4 months, nonwhite cystic fibrosis - ANS autosomal recessive multisystem disease where exocrine or mucus-producing glands secrete abnormally thick mucus because of defective ion transport symptoms of cystic fibrosis - ANS persistent cough that produces thick mucus, wheezing, exercise intolerance, repeated lung infections, inflamed nasal passage or stuffy nose treatment of cystic fibrosis - ANS medication (bronchodilators), pulmonary therapy, nutritional therapy adrenergic agonists mechanism of action - ANS stimulate the SNS by mimicking epinephrine, norepinephrine, or dopamine B-2 agonists - ANS respiratory drugs (you have 2 lungs) Bs-1 agonists - ANS cardiac drugs (you only have one heart) beta-adrenergic agonists - ANS relief of bronchospasm related to asthma, bronchitis and other pulmonary diseases; used to treat and prevent acute attacks contraindications of beta-adrenergic agonists - ANS known drug allergy, uncontrolled hypertension, cardiac dysrhythmias, high risk of stroke adverse effects of beta-adrenergic agonists - ANS hypotension, symptoms of chronic HF, bradycardia, drowsiness short acting beta agonists - ANS -erol ex. albuterol; rapid onset of 5-15 min used for rapid relief for asthmatic attacks long acting beta agonist inhalers - ANS -terol ex. salmeterol epinephrine and asthma - ANS works by relaxing the muscles around the airways so that they can open up so patient can breath easier; used in emergency situations terbutaline - ANS used to prevent and treat wheezing, shortness of breath and chest tightness caused by asthma alpha agonists - ANS nasal and eye congestion, glaucoma phenylephrine - ANS topical nasal decongestant used to treat stuffy nose and sinus congestion caused by the cold (only for temporary relief not for long term use) antihistamines - ANS H1 blockers -ine oral decongestant - ANS pseudoephedrine Psuedophedrine - ANS decongestant that shrinks blood vessels in the nasal passage and dilated BV can cause a stuffy nose topical adrenergic medications - ANS -ine ex. ephedrine, oxymetazoline,phenylephrine, tertrahydrozoline topical steroid medications - ANS budesonide, flunisolide, fluticasone antitussives - ANS drugs used to reduce or stop coughing; used only for nonproductive cough dextromethorphan - ANS cough suppressant (does not treat the cause of cough) opiates (codeine) - ANS suppresses the cough reflex by direct action on the cough center in the medulla benzonatate - ANS suppresses the cough reflex by numbing the stretch receptors in the respiratory tract and prevent reflex stimulation of the medullary cough center expectorant - ANS drugs that aid in the removal of mucus guaifenesin - ANS used to relieve chest compression and clear mucus when you have congestion from the cold or flu bronchodilators - ANS relax bronchial smooth muscles with cause dilation of the bronchi and bronchioles that are narrowed as a result of disease process; opens the airway up anticholinergics - ANS -tropium; antagonize the effects of acetylcholine on nicotinic receptors; bronchodilation occurs without cardiac effects ipratropium - ANS work by relaxing and opening the air passages to the lungs to make breathing easier xanthine derivatives - ANS caffeine, theobromine, theophylline caffeine function with respiratory system - ANS promotes alertness, cardiac stimulant in infants with bradycardia, enhancement of respiratory drive in infants theophylline - ANS xanthine derivative that is used as a bronchodilator, most commonly used, stimulates the sympathetic NS. therapeutic level: 10-20 theorbromine - ANS helps to open airways leukotriene receptor antagonists - ANS -lukast ex. motelukast, zariflukast, and zileuton; nonbronchodilation, blocks leukotrienes which causes inflammation, bronchoconstriction and mucus side effects of leukotriene receptor antagonists - ANS headache and GI upset corticosteroids (glucocorticoids) - ANS -one and -ide; has anti-inflammatory properties and used for chronic asthma corticosteroid mechanism of action - ANS stabilize membranes of leukocytes and increase responsiveness of bronchial smooth muscles to beta-adrenergic stimulation inhaled corticosteroids - ANS -sone or -ide, inhaled long term treatment of asthma and COPD and used with SABAs and LABAs corticosteroid contraindications - ANS drug allergy, not a sole therapy for acute asthma attacks corticosteroid adverse effects - ANS oral fungal infections (need to wash mouth after use of inhaler) deep vein thrombosis (DVT) - ANS clot develops in the large deep vein of the limbs; can lead to pulmonary embolism causes of DVT - ANS hypercoagulability, blood stasis, vessel injury symptoms of DVT - ANS throbbing/cramping, redness and swelling (edema), hard, sore veins factors of DVT - ANS virchow's triad, cancer, orthopedic surgery, trauma, HF, immobility virchow's triad - ANS venous stasis, venous endothelial damage, hypercoagulable states pulmonary embolism - ANS blood clot that develops in a blood vessel in the body that then travels to a lung artery where it suddenly blocks blood flow risk factors of pulmonary embolism - ANS smoking, DVT, inactivity, obesity symptoms of pulmonary embolism - ANS pain in calf or thigh, wheezing, loss of consciousness, dull chest pain, sudden shortness of breath chronic venous insufficiency - ANS inadequate venous return over a long period due to varicose veins or valvular incompetence or reflux (backward flow) causes of chronic venous insufficiency - ANS high BP, lack of exercise, blood clot in a deep vein symptoms of chronic venous insufficiency - ANS varicose vein, pain and heaviness in lower leg, swelling (edema), leg cramps and spasms, restless leg syndrome, itchy skin risk factors of chronic venous insufficiency - ANS females, family history, history of DVT, obesity, pregnancy, overly tall siting or standing for too long varicose veins - ANS vein in which blood has pooled; distended, tortuous, and palpable veins risk factors of varicose veins - ANS age, female gender, family hx, obesity, pregnancy, DVT, prior leg injury aneurysms - ANS local dilation or outpouching of a vessel wall or cardiac chamber true aneurysms - ANS fusiform aneurysms, circumferential aneurysms false aneurysms - ANS saccular aneurysms Buerger's disease - ANS inflammatory disease of peripheral arteries resulting in lesions symptoms of buergers disease - ANS pain, tenderness, hair loss raynaud disease - ANS episodic vasospasm in arteries and arterioles of the fingers, less commonly the toes causes of raynaud's disease - ANS collagen vascular disease, smoking, pulmonary hypertension, myxedema, cold environment symptoms of raynauds disease - ANS pallor, cyanosis, pain primary hypertension - ANS genetic and environmental factors risk factors of primary hypertension - ANS family hx, advancing age, cigarette smoking, obesity, heavy alcohol consumption, black race, high sodium intake secondary hypertension - ANS caused by a systemic disease process that raises peripheral vascular resistance or CO causes of secondary hypertension - ANS renal artery stenosis, renal parenchymal disease, pheochromocytosis, drugs malignant hypertension - ANS rapidly progressive hypertension; diastolic pressure is greater than 140 mmHg and causes life threatening organ damage stable angina - ANS someone who puts a lot o stress on the heart (obese person running a marathon) unstable angina - ANS sitting on the couch and having chest pain; unexpected prinzmetal angina - ANS caused by vasospasm; no plaque build up myocardial infarction - ANS sudden and extended obstruction of myocardial blood supply myocardial infarction symptoms - ANS chest pain, nausea/vomiting, diaphoresis (sweating), and dyspnea treatment of myocardial infarction - ANS MONA Morphine Oxygen therapy- improves ischemia Nitroglycerin- dilates arteries Aspirin- decreases platelet aggregation heart failure causes - ANS myocardial infarction, coronary artery disease, cardiomyopathy, valvular insufficiency, infection, ischemia, pulmonary and systemic hypertension left sided HF - ANS systolic heart failure; inability of the heart to generate adequate cardiac output to perfuse tissues; ventricular remodeling