Hesi Milestone exam 1 WITH SOLUTIONS 2024
Histamine1 blockers action(mine, zine, dine) - Answer -bind selectively to H1-histaminic receptors, blocking the actions of histamine at these sites H1 antagonists are useful in treating - Answer --mild allergies(seasonal rhinitis) -severe allergies(anaphylaxis) -motion sickness -insomnia -common cold Histamine (H2)-Receptor Antagonists action(tidine) - Answer -block the H2 receptors responsible for stimulating the secretion of gastric acid Exenatide (Byetta) hypoglycemia - Answer --can occur right after meals -for severe hypoglycemia give IV dextrose Exenatide (Byetta) hypoglycemia teaching - Answer --teach about s/s of hypoglycemia(cold and clammy give them candy) -have glucagon emergency kit available -regular monitoring of A1c levels are required Exenatide (Byetta) hypoglycemia causes - Answer --insulin overdose -reduced food intake -vomiting and diarrhea -excessive alcohol intake -unaccustomed exercise -termination of pregnancy signs and symptoms of hypoglycemia - Answer --tachycardia -palpitations -sweating -nervousness 1 / 3
-headache -confusion -drowsiness -fatigue antitussives therapeutic action is to - Answer -Act on the cough control center in the medulla to suppress the cough reflex; used for a cough that is nonproductive and irritating Anaphylaxis‐PCN - Answer --laryngeal edema, bronchoconstriction, severe hypotension= immediate hypersensitivity reaction Anaphylaxis treatment - Answer -epinephrine (subQ, IM, or IV) plus respiratory support What drugs are effective and safe alternatives for patients with penicillin allergies? - Answer - vancomycin, erythromycin, and clindamycin To ensure prompt treatment if anaphylaxis should develop patients should be? - Answer -observed for at least 30 minutes after drug injection (i.e., until the risk of an anaphylactic reaction has passed).To minimize the chances of an anaphylactic reaction, penicillin should be administered - Answer -an initial small dose is followed at 60-minute intervals by progressively larger doses until the full therapeutic dose has been achieved Morphine overdose treatment - Answer --Naloxone (narcan) -Intravenous, IM, and subQ. For initial treatment, administer IV CT‐diarrhea‐action - Answer --decrease intestinal motility and thereby slow intestinal transit, which allows more time for absorption of fluid and electrolytes -activation of opioid receptors decreases secretion of fluid into the small intestine and increases absorption of fluid and salt.ACE inhibitor‐hyperkalemia - Answer --Inhibition of aldosterone release (secondary to inhibition of angiotensin II production) can cause potassium retention by the kidney.-significant potassium accumulation is limited to patients taking potassium supplements, salt substitutes (which contain potassium), or a potassium-sparing diuretic.Leukotrienes‐teaching - Answer -1. To take medication 1 hour before or 2 hours after meals
- To increase fluid intake 2 / 3
- Not to discontinue the medication and to take it as
- / 3
prescribed, even during symptom-free period Methadone therapeutic use - Answer -Relief or prevention of moderate to severe pain while causing minimal respiratory depression, constipation, urinary retention, and other adverse effects.methadone pain assessment - Answer --Assess pain before administration and 1 hour later -Determine the location, time of onset, and quality of pain (e.g., sharp, stabbing, dull) -assess for psychologic factors that can lower pain threshold (anxiety, depression, fear, anger) methadone is given - Answer -Oral, IM, IV, subQ, rectal, epidural, intrathecal, transdermal (fentanyl), and transmucosal (fentanyl) Methadone assess for - Answer --QT prolongation(dyshythmias) -overdose -respiratory depression -substance abuse -withdrawal symptoms Methadone is used as - Answer -a replacement medication for opiate dependence and to facilitate withdrawal When starting a patient on ACE inhibitors monitor what? - Answer -blood pressure closely for 2 hours after the first dose and periodically thereafter.a major side effect of alpha blocker(osin) is what? - Answer -orthostatic hypotension diclofenac does what to the liver? - Answer -cause severe injury while taking diclofenac patients should? - Answer --have periodic liver functions tests -monitor and report for signs of liver damage(jaundice, fatigue, nausea) calcium channel blockers toxicity signs - Answer --severe hypotension -cardiac-toxicity(bradycardia and av block) -ventricular tachydhythmias Managing Acute Toxicity in calcium channel blockers - Answer --gastric lavage followed by activated charcoal