NURS 6015 LATEST QUESTIONS AND ANSWERS.
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What are the important safety measures to take for a patient receiving a heparin
infusion (including reversal agent)?
determine correct dosing, continuous monitoring, have reversal agent protamine sulfate
readily available,
What are the nursing interventions to take for a patient receiving a heparin
infusion?
avoid giving IM injections, hold the heparin dose if aPTT >3.5x higher than normal
What are the clinical signs of being too anticoagulated from heparin?
tachycardia
What priority nursing actions should you take if your patient is too anticoagulated
from heparin?
stop heparin administration, administer reversal agent protamine sulfate
What approach should you take to transition your patient from IV heparin to PO
warfarin?
expect average of 5-6 days to achieve effect, not uncommon to start both at same time
What are the dietary considerations for warfarin?
avoid NSAIDs, keep vitamin K intake consistent (not too much, not too little)
What are the adverse effects for warfarin?
bleeding!!!, toxicity, tachycardia, hypotension
What are the clinical signs of being too anticoagulated from warfarin?
unexplained bruising, vomiting coffee grounds, red/pink/brown urine, black tarry stool
What drugs does warfarin interact with?
NSAIDs (increased potential for bleeding)
Which lab values should you monitor for your patient on warfarin (and what's the
normal range)?
INR (normal = 2-3)
What is the reversal agent for warfarin?
vitamin K
What are the steps for proper drug administration of enoxaparin?
- choose fatty area on lower abdomen 2 inches from belly
- do not jet air bubble
- do not rub injection site as it can cause bruising
What is the duration of action for clopidogrel?
typically 5-7 days
What are the administration instructions for clopidogrel?
take with food, avoid alcohol and other drugs that can cause GI distress, maintain
hydration
What are the surgical considerations for clopidogrel?
must stop 1-2 weeks prior to surgery
How do you assess therapeutic efficacy with ferrous sulfate?
, monitor CBC (Hgb and Hct)
What are the adverse effects of ferrous sulfate?
dark stools, constipation
What dietary considerations need to be taken with ferrous sulfate?
- take on an empty stomach
- take with vitamin C or orange juice (to enhance absorption)
What labs need to be monitored with epoietin alfa?
Hgb in CBC and RBC
What vital signs need to be monitored with epoietin alfa?
BP (risk for HTN)
How to assess therapeutic efficacy of filgrastim?
monitor CBC (WBC), neutrophil production should be increased, and ability to fight off
infection
What are the adverse effects of filgrastim?
bone pain, fever, rash, splenic enlargement
What are the indications for use of vitamin B12?
megaloblastic/pernicious anemia, vitamin B12 deficiency
What is the mechanism of action for ondansetron?
blocks serotonin receptors in the chemoreceptor trigger zone (CTZ) - serotonin receptor
antagonist
What are the adverse effects of ondansetron?
serotonin syndrome, stevens johnson syndrome, prolonged QT interval, disorientation,
headache, diarrhea
What are the adverse effects of prochlorperazine?
sedation (monitor RR), twitching, blurred vision, constipation, headache,
unconsciousness, dizziness, nasal congestion, chest pain
What is the mechanism of action for metochlopramide?
blocks dopamine receptors and increases threshold of CTZ - increases tone of lower
esophageal sphincter, increases peristalsis in both stomach & intestines
What are the indications for use of metochlopramide?
diabetic gastroparesis, N/V, GERD
What are the drugs that reduce stomach acid (GERD)?
famotidine, omeprazole, aluminum hydroxide, metoclopramide
What are the administration instructions for omeprazole?
- take 30-60 min before eating
- increase fluid intake
- take low dose for shortest duration possible
- educate potential for rebound acid
- don't chew/break/crush delayed-release capsules
What is the mechanism of action for famotidine?
blocks histamine receptors responsible for stomach acid secretion
How do you assess therapeutic efficacy of treatment regimen for H. Pylori peptic
ulcers?
urea breath test, serum test, gastric biopsy
what treats h. pylori peptic ulcers
antibiotic regimen (2-3 meds)
Buy Quality Materials!
What are the important safety measures to take for a patient receiving a heparin
infusion (including reversal agent)?
determine correct dosing, continuous monitoring, have reversal agent protamine sulfate
readily available,
What are the nursing interventions to take for a patient receiving a heparin
infusion?
avoid giving IM injections, hold the heparin dose if aPTT >3.5x higher than normal
What are the clinical signs of being too anticoagulated from heparin?
tachycardia
What priority nursing actions should you take if your patient is too anticoagulated
from heparin?
stop heparin administration, administer reversal agent protamine sulfate
What approach should you take to transition your patient from IV heparin to PO
warfarin?
expect average of 5-6 days to achieve effect, not uncommon to start both at same time
What are the dietary considerations for warfarin?
avoid NSAIDs, keep vitamin K intake consistent (not too much, not too little)
What are the adverse effects for warfarin?
bleeding!!!, toxicity, tachycardia, hypotension
What are the clinical signs of being too anticoagulated from warfarin?
unexplained bruising, vomiting coffee grounds, red/pink/brown urine, black tarry stool
What drugs does warfarin interact with?
NSAIDs (increased potential for bleeding)
Which lab values should you monitor for your patient on warfarin (and what's the
normal range)?
INR (normal = 2-3)
What is the reversal agent for warfarin?
vitamin K
What are the steps for proper drug administration of enoxaparin?
- choose fatty area on lower abdomen 2 inches from belly
- do not jet air bubble
- do not rub injection site as it can cause bruising
What is the duration of action for clopidogrel?
typically 5-7 days
What are the administration instructions for clopidogrel?
take with food, avoid alcohol and other drugs that can cause GI distress, maintain
hydration
What are the surgical considerations for clopidogrel?
must stop 1-2 weeks prior to surgery
How do you assess therapeutic efficacy with ferrous sulfate?
, monitor CBC (Hgb and Hct)
What are the adverse effects of ferrous sulfate?
dark stools, constipation
What dietary considerations need to be taken with ferrous sulfate?
- take on an empty stomach
- take with vitamin C or orange juice (to enhance absorption)
What labs need to be monitored with epoietin alfa?
Hgb in CBC and RBC
What vital signs need to be monitored with epoietin alfa?
BP (risk for HTN)
How to assess therapeutic efficacy of filgrastim?
monitor CBC (WBC), neutrophil production should be increased, and ability to fight off
infection
What are the adverse effects of filgrastim?
bone pain, fever, rash, splenic enlargement
What are the indications for use of vitamin B12?
megaloblastic/pernicious anemia, vitamin B12 deficiency
What is the mechanism of action for ondansetron?
blocks serotonin receptors in the chemoreceptor trigger zone (CTZ) - serotonin receptor
antagonist
What are the adverse effects of ondansetron?
serotonin syndrome, stevens johnson syndrome, prolonged QT interval, disorientation,
headache, diarrhea
What are the adverse effects of prochlorperazine?
sedation (monitor RR), twitching, blurred vision, constipation, headache,
unconsciousness, dizziness, nasal congestion, chest pain
What is the mechanism of action for metochlopramide?
blocks dopamine receptors and increases threshold of CTZ - increases tone of lower
esophageal sphincter, increases peristalsis in both stomach & intestines
What are the indications for use of metochlopramide?
diabetic gastroparesis, N/V, GERD
What are the drugs that reduce stomach acid (GERD)?
famotidine, omeprazole, aluminum hydroxide, metoclopramide
What are the administration instructions for omeprazole?
- take 30-60 min before eating
- increase fluid intake
- take low dose for shortest duration possible
- educate potential for rebound acid
- don't chew/break/crush delayed-release capsules
What is the mechanism of action for famotidine?
blocks histamine receptors responsible for stomach acid secretion
How do you assess therapeutic efficacy of treatment regimen for H. Pylori peptic
ulcers?
urea breath test, serum test, gastric biopsy
what treats h. pylori peptic ulcers
antibiotic regimen (2-3 meds)
