Nursing

Drug	Drug Class	Mechanism of Action	Adverse Effects	Nursing Implications
heparin	#1. ________	Inactivates clotting factors thrombin and factor Xa through the increased activity of antithrombin	Critical adverse effect: #2. __________________   **Critical Allergic reaction** #3. _____________	Monitor(labs): #4. ____________ Reversal/antidote:   #5. _____________ Administered Route: #6. (2 answers)_______________
Apixaban (Eliquis)	Anticoagulant	inhibits platelet aggregation (factor Xa) induced by thrombin.	Critical adverse effect: #7. ________________	1.       Increased risk of hemorrhage in pregnant patients 2.       Increased risk of bleeding in patients with renal impairment
Warfarin (Coumadin)	#8. ___________	Decreases the production of vitamin K-dependent clotting factors. (Vit K synthesis)	·         bruising ·         ____#9_______ (after long term use)	Monitor(labs): INR (2-3 is normal) Reversal/antidote: #10. ____________   Nursing Implications: Avoid in pregnancy or breast feeding Frequent monitoring of PT and INR
enoxaparin (Lovenox)	anticoagulant	#11. _____________	·         Critical adverse effect is hemorrhage ·         Critical allergic: ·          #12 ________ (induced by**hint)	Monitor(labs): #13 __________ Antidote: #14 _______________
fondaparinux	#15 ______________	#16 ______________	1. Can cause epidural bleeds.	Labs to monitor:  None   Nursing Implications: ·         Avoid giving in patients with decrease level of consciousness, complains of back pain or is paralyzed. ·         Do not administer to patients for at least 6 hours after #17_______or with a #18__________ epidural
Rivaroxaban (Xarelto) Apixiban (Eliquis) Edoxanban (Savaysa)	Anticoagulants	Inhibits factor Xa	Risk for neurological impairment	Lab monitoring: No routine clot studies   Nursing Implications: ·         Avoid over the counter medications (Vit E, ginkgo biloba, fish oils, garlic, NSAIDS)   ·         Teach patients to avoid bleeding by doing the following:                                  (3 examples)___#19______

 
 
 
 
 
 
 

Drug	Drug Class	Mechanism of Action	Adverse Effects	Nursing Implications
Aspirin (Acetylsalicylic Acid)     Indication: Reduce risk of CVA, TIA, prevent of MI   Treatment during episodes of unstable angina and MI   Prevention: occlusion of stents	#20. __________	Decrease platelet aggregation	Side effect: ·         #21_________(given in high doses) ·         Bruising ·         Gastric upset   Adverse reaction: ·         GI bleed ·         hemorrhagic stroke (uncontrolled HTN)	Monitor(labs):  platelets   Antidote for ASA toxicity:  #22 _______(There are 2 optional answers that will be accepted.    Monitor for signs of:  ***toxicity – tinnitus, hyperventilation,
Clopidogrel (Plavix)	Antiplatelet	#23 _________	Side effect: ·         diarrhea ·         gastric discomfort   Adverse Reaction: ·         bleeding ·         #24 ________	Monitor (labs): #25 __________ Administered: po
Abciximab   Indicated: after cardiac procedures	Antiplatelet (Glycoprotein (GP) receptor inhibitors)	Blocks GP IIB/IIIa receptors that stop platelet aggregation	Critical adverse reaction: ·         hemorrhage ·         Thrombocytopenia	Monitor: hgb & Platelets ***Assess for bleeding in 1.       #26 _____ 2.       #27_______ 3.       IV insertion sites Nursing Implications 4.       ECG changes 5.       No needle sticks or new IV injections

 

Drug	Drug Class		Mechanism of Action		Adverse Effects		Nursing Implications
tPA Alteplase Streptokinase	Thrombolytics		Break down, or lyse or existing clots		1.        Bleeding   Severe Effect: 1.       Severe bleeding		Administered:  #28 _(route)_ ONLY   Nursing Implications: 1.       Monitor for mental status changes 2.       No new IV, ABGS 3.       Never give through a (route) #29 _________. 4.       Do not give within 2 weeks of surgery 5.       Do not give to patients with active #30 _______ 6.       Can only be administered from #31______ hours from onset of symptoms 7.       Monitor for cardiac changes/dysrhythmias 8.       Uncontrolled hypertension or b/p (180/110)
Drug		Drug Class		Mechanism of Action		Adverse Effects		Nursing Implications
Erythropoietin Alfa		Hematopoietic Agents		#32_____________		·         #33 ________ ·         Cardiovascular events- MI, CVA, DVT		Monitor (labs): #34 _____ & _______ ***Iron levels- key ingredient with the production of RBCs Nurse Implications: 1.       Monitor:  #35 (hint: which main vital sign) during therapy 2.       Do not administer if hemoglobin 10-11
Filgrastim   Indicated for Neutropenia		Hematopoietic Agents		Increase production of neutrophils (in the bone marrow)		·         Enlarge spleen ·         __#36___ pain ·         Leukocytosis		Monitor baseline (labs): CBC and platelet counts Administered: IV & subQ
Oprelvekin		Hematopoietic Agents		Simulate platelet production		·         #37_______ (sign of fluid overload) ·         anemia ·         Cardiac dysrhythmias Severe Reaction: ·         Anaphylaxis		Administered: #38 _____ Monitor (labs): platelet counts, electrolyte status Nursing Implications: ·         Fluid retention: Teach patient to contact provider if symptoms worsen. ·         Use with caution in patients with cardiac history- a-fib, a-flutter

 
 

Iron Sulfate   Iron deficiency anemia, dietary supplement (prevention)	Hematinic Agents	Replacement of iron which is critical for hemoglobin function	Adverse Reaction ·         #39_______** ·         Nausea ·         Dark Tarry stools   Serious Side effect with IV route: #40_______	Patient Teaching 1.  Take with vitamin #41_______ source.   2. Infusion: Give a test dose when administering #42 (which route).  Keep epinephrine on h and for anaphylaxis. 3. Teach patient to increase fiber and drink plenty of fluids  to reduce constipation
Folic Acid   Indicated: Folic acid anemia, dietary supplement	Hematinic Agents	Replacement for folic acid	1.       Nausea 2.       Flatulence 3.       Rash	1. Teach patient dietary/lifestyle changes: – Increase consumption of foods high in #43_______ (e.g., green vegetables, liver). 2.  If alcoholism underlies dietary deficiency, offer counseling for alcoholism, as well as dietary advice. “
Vitamin B12	Hematinic Agents	Replacement Vitamin B12 anemia, Dietary supplement, absence of intrinsic factor	1.       Headache 2.       Nausea   Serious Adverse Reaction 1.       #44________** (low lab value) 2.       Pulmonary edema 3.       Anaphylaxis	1.       Labs to Monitor:  ***Serum ___#45___ Teach patient s/s of hypokalemia and instruct them to contact provider immediate. 2.       Treatment duration- is #46 (how long)

 
 
 
 
 
 
 
 
 
Answer Sheet
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• You must turn BOTH documents in to receive full credit. NO EXCEPTIONS.
• Provide your answers in the correct order. Make sure your numbers match what is given, or it will be marked incorrect.
• There is only one answer per blank. If the question indications there is more than one answer, then you must have all correct to receive credit.
• **You do not have to use this specific format. As long as you submit the answers in the correct order it will be accepted.  However, if you decide to use this format, make sure the answer matches and form it is NEAT.  Written answers will be accepted as long as they are in a pdf form so they can be read and graded.

 
 
 
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