NURS 615 EXAM 3 – MARYVILLE WITH
CORRECT ANSWERS AND QUESTIONS
RATED A+ (2024-2025)
corticosteroid drugs - ANS-prednisone, methylprednisolone, dexamethasone, topical such as
hydrocortisone, and then joint injections for pain
MOA of corticosteroids drugs - ANS-drugs that suppress inflammation by mimicking glucocorticoid
hormones
Patient teaching in CCB - ANS-Teach patients to change positions slowly, avoid exercise in hot weather,
and stay hydrated; teach patients to check pulse and report if <50bpm or irregular; teach patients to
report s/sx of hf:dyspnea, dizziness, nausea, swelling, decreased UO;
amlodipine has long half-life-skip missed dose
do not stop suddenly as fatal arrhythmia s may happen
* do not drink with grapefruit juice as it will increase the levels in your system
Thizaides MOA - ANS-•Act on distal tubule to inhibit sodium reabsorption
,•Deplete sodium and fluid through urination
causes vasodilaiton
Inhibit interleikin one, tumor necrosis factor and other cytokines, impairs phagocytosis, impairs
lymphocytes, and inhibits tissue repair
indications for cortocosteriod use - ANS-Allergy or hypersensitivity, respiratory, shock, rheumatology,
neurology, hepatic, neoplastic... basicly every organ is covered if there is an issue.
withdrawal from corticorsteriod symptoms - ANS-malaise, myalgia, headache, nausea, fevers,
hypotension and relapse of symptoms (pain, inflammation, ashtma)
what must you do with corticosteriods to prevent withdrawal - ANS-Must taper them down, you can
have possible adrenal crisis if you do not.
corticosteriod considerations - ANS-suppression patients response to infections- no live viral vaccines,
and have increased susceptibility to disease.
If used over 6 months: Increase blood glucose, impair immune function (get vaccines) , impair wound
healing, GI complaints (report black tarry stools) , osteoporosis (decreases calcium), anxiety/insomnia,
sodium & fluid retention 9monitor weight and fluid retention)
If on 1gram or more also prescribe PPI (omeprazole) to prevent PUD
contraindicated with active infection and hypersensitivity
What are the adverse effects of corticosteroids if administered for six months or more? - ANS-The main
thing you want to worry about is osteoporosis
It can also worsen diabetic control
Patients should report any tarry black stools or abdominal pain.
,NSAIDS - ANS-nonsteroidal anti-inflammatory drugs
Ibprofen, aspirin, torsdol, naproxin, Mobic
Arachidonic Acid Cascade - ANS-Cell membrane ► Arachinidonic acid ► Cycloxygenerase (COX)►
prostaglandin's
Or
Cell membrane ► Arachinidonic acid ► Lipoxygenase► Leukotrines
NSAID mechanism of action - ANS-• NSAIDs inhibit the enzymes COX I and II
• Results in reduction in formation of prostaglandin precursors and thromboxanes from arachidonic acid
COX1- ibuprofen, naproxen, aspirin, when this is inhibited you are also inhibiting the prostaglandins that
protect the stomach
COX2 - celebrex more stomach proctective
Drug interactions with NSAIDS - ANS-Pretty much anything that is highly protien bound. Do not give
together with
ACE inhibitors - counteracts antihypertensive effect
BetaBlockers - counteracts antihypertensive effect
lithium - increases lithium levels
Anticoagulants - increases bleeding
, Antidiabetics- increases hypoglycemic effect
Black box warning for NSAIDS - ANS-May cause an increased risk of serious cardiovascular thrombotic
events:
•Patients with cardiovascular disease or with risk factors for cardiovascular disease may be a greater
risk. **
•Myocardial-infarction
•Stroke which can be fatal.**
•This risk may increase with duration of use.
NSAIDs can also cause an increased risk of serious gastrointestinal adverse effects including
•Bleeding**
•Ulceration
•Perforation the stomach or intestines which can be fatal.
•These events can occur at any time during use and without warning symptoms.
•Elderly patients are at greater risk for serious GI events.
Tylenol - ANS-non opioid, non NSAID analgesic
treatment for mild pain and fever, has no anti- inflammatory properties
The main mechanism is performed a proposed is the inhibition of cox.
And recent findings suggest that it's highly selective cox-2.
Because of its selectivity for cox-2 it does not significantly inhibit the production of pro clotting
thromboxanes.
Tylenol warnings - ANS-Acute overdoses of acetaminophen can cause potentially fatal liver damage.
CORRECT ANSWERS AND QUESTIONS
RATED A+ (2024-2025)
corticosteroid drugs - ANS-prednisone, methylprednisolone, dexamethasone, topical such as
hydrocortisone, and then joint injections for pain
MOA of corticosteroids drugs - ANS-drugs that suppress inflammation by mimicking glucocorticoid
hormones
Patient teaching in CCB - ANS-Teach patients to change positions slowly, avoid exercise in hot weather,
and stay hydrated; teach patients to check pulse and report if <50bpm or irregular; teach patients to
report s/sx of hf:dyspnea, dizziness, nausea, swelling, decreased UO;
amlodipine has long half-life-skip missed dose
do not stop suddenly as fatal arrhythmia s may happen
* do not drink with grapefruit juice as it will increase the levels in your system
Thizaides MOA - ANS-•Act on distal tubule to inhibit sodium reabsorption
,•Deplete sodium and fluid through urination
causes vasodilaiton
Inhibit interleikin one, tumor necrosis factor and other cytokines, impairs phagocytosis, impairs
lymphocytes, and inhibits tissue repair
indications for cortocosteriod use - ANS-Allergy or hypersensitivity, respiratory, shock, rheumatology,
neurology, hepatic, neoplastic... basicly every organ is covered if there is an issue.
withdrawal from corticorsteriod symptoms - ANS-malaise, myalgia, headache, nausea, fevers,
hypotension and relapse of symptoms (pain, inflammation, ashtma)
what must you do with corticosteriods to prevent withdrawal - ANS-Must taper them down, you can
have possible adrenal crisis if you do not.
corticosteriod considerations - ANS-suppression patients response to infections- no live viral vaccines,
and have increased susceptibility to disease.
If used over 6 months: Increase blood glucose, impair immune function (get vaccines) , impair wound
healing, GI complaints (report black tarry stools) , osteoporosis (decreases calcium), anxiety/insomnia,
sodium & fluid retention 9monitor weight and fluid retention)
If on 1gram or more also prescribe PPI (omeprazole) to prevent PUD
contraindicated with active infection and hypersensitivity
What are the adverse effects of corticosteroids if administered for six months or more? - ANS-The main
thing you want to worry about is osteoporosis
It can also worsen diabetic control
Patients should report any tarry black stools or abdominal pain.
,NSAIDS - ANS-nonsteroidal anti-inflammatory drugs
Ibprofen, aspirin, torsdol, naproxin, Mobic
Arachidonic Acid Cascade - ANS-Cell membrane ► Arachinidonic acid ► Cycloxygenerase (COX)►
prostaglandin's
Or
Cell membrane ► Arachinidonic acid ► Lipoxygenase► Leukotrines
NSAID mechanism of action - ANS-• NSAIDs inhibit the enzymes COX I and II
• Results in reduction in formation of prostaglandin precursors and thromboxanes from arachidonic acid
COX1- ibuprofen, naproxen, aspirin, when this is inhibited you are also inhibiting the prostaglandins that
protect the stomach
COX2 - celebrex more stomach proctective
Drug interactions with NSAIDS - ANS-Pretty much anything that is highly protien bound. Do not give
together with
ACE inhibitors - counteracts antihypertensive effect
BetaBlockers - counteracts antihypertensive effect
lithium - increases lithium levels
Anticoagulants - increases bleeding
, Antidiabetics- increases hypoglycemic effect
Black box warning for NSAIDS - ANS-May cause an increased risk of serious cardiovascular thrombotic
events:
•Patients with cardiovascular disease or with risk factors for cardiovascular disease may be a greater
risk. **
•Myocardial-infarction
•Stroke which can be fatal.**
•This risk may increase with duration of use.
NSAIDs can also cause an increased risk of serious gastrointestinal adverse effects including
•Bleeding**
•Ulceration
•Perforation the stomach or intestines which can be fatal.
•These events can occur at any time during use and without warning symptoms.
•Elderly patients are at greater risk for serious GI events.
Tylenol - ANS-non opioid, non NSAID analgesic
treatment for mild pain and fever, has no anti- inflammatory properties
The main mechanism is performed a proposed is the inhibition of cox.
And recent findings suggest that it's highly selective cox-2.
Because of its selectivity for cox-2 it does not significantly inhibit the production of pro clotting
thromboxanes.
Tylenol warnings - ANS-Acute overdoses of acetaminophen can cause potentially fatal liver damage.
