A nurse treating a patient taking Terbutaline should understand/do which of the following?

Correct Answer: A

Rationale: Terbutaline, a beta-2 adrenergic agonist, stimulates the sympathetic nervous system, potentially causing tachycardia and angina as side effects. Monitoring the pulse for significant increases (20-30 beats/min) is critical to assess for these cardiovascular effects. The other options list incorrect side effects or monitoring requirements.

Correct Answer: B

Rationale: The correct answer is B) vasoconstrictive effects. In the context of patients with conditions like hypertension, cerebrovascular disease, dysrhythmias, and coronary artery disease, it is crucial to avoid decongestants like Phenylephrine due to their vasoconstrictive effects. Vasoconstriction can lead to an increase in blood pressure, which can worsen hypertension and exacerbate conditions like cerebrovascular disease and dysrhythmias. Option A) vasodilatory effects is incorrect as decongestants like Phenylephrine actually have vasoconstrictive effects, leading to narrowing of blood vessels. Option C) sedative effects and Option D) mucolytic effects are unrelated to decongestants like Phenylephrine and are not the reason why it should be avoided in patients with the mentioned conditions. In an educational context, it is important for nurses to understand the pharmacological effects of medications like decongestants and how they can impact patients with specific health conditions. By educating patients about the potential risks of using decongestants like Phenylephrine in these scenarios, nurses can help prevent adverse effects and promote patient safety and well-being.

Correct Answer: A

Rationale: In the context of advanced pharmacology across the lifespan, understanding drug interactions and factors that can influence drug effectiveness is crucial. In this scenario, the correct answer is A) CoQ-10. CoQ-10 is a biochemical cofactor that can decrease the effectiveness of warfarin due to its structure. CoQ-10 is structurally similar to vitamin K, which is essential for blood clotting. Warfarin works by inhibiting the action of vitamin K-dependent clotting factors, thereby preventing blood clot formation. When CoQ-10 is present in the body, it can compete with vitamin K, potentially reducing the effectiveness of warfarin and increasing the risk of blood clotting. Now, let's analyze why the other options are incorrect: - B) Resveratrol: Resveratrol is a compound found in red wine and has antioxidant properties. While it may have health benefits, there is no evidence to suggest that it interferes with the effectiveness of warfarin. - C) Glucosamine: Glucosamine is often used as a supplement for joint health. While it can interact with certain medications, there is no significant evidence to suggest it interferes with warfarin. - D) Coumarine: This option is a misspelling of "coumarin," which is a compound found in some plants but is not directly relevant to the interaction with warfarin. Educationally, this question highlights the importance of understanding how biochemical cofactors can influence drug effectiveness. It emphasizes the need for healthcare providers to be aware of potential interactions between medications and supplements, especially in the case of critical drugs like warfarin that require careful monitoring and management to ensure patient safety.

Correct Answer: A

Rationale: The correct answer is A) LMW heparins and factor Xa inhibitors only inactivate factor Xa. Low molecular weight (LMW) heparins, such as Enoxaparin, have a unique mechanism of action compared to unfractionated heparin. LMW heparins primarily work by inactivating factor Xa, which is a crucial component in the coagulation cascade. By inhibiting factor Xa, LMW heparins prevent the conversion of prothrombin to thrombin, thereby reducing the formation of blood clots. Option B) stating that LMW heparins activate factor X is incorrect. LMW heparins do not activate factor X; instead, they inhibit factor Xa to prevent clot formation. Option C) mentioning inactivation of factor XIa is also incorrect. LMW heparins primarily target factor Xa, not factor XIa. Educationally, understanding the mechanism of action of LMW heparins is essential for healthcare professionals, especially in the context of managing thrombotic disorders. Knowing that LMW heparins specifically target factor Xa helps in making informed decisions regarding anticoagulant therapy and ensuring optimal patient care.

Correct Answer: C

Rationale: The correct answer is C) the patient's warfarin dose is at therapeutic levels. Warfarin is an oral anticoagulant commonly used in patients with mechanical heart valves, and the therapeutic range for INR in these patients is typically between 2.5 to 3.5. An INR level of 3 indicates that the patient's blood is clotting within the desired range, which means that the warfarin dose is effectively preventing clot formation without causing excessive bleeding. Option A is incorrect because an elevated INR would not be related to intravenous heparin, which works differently from warfarin. Option B is incorrect as a low INR would suggest inadequate warfarin dosing. Option D is incorrect as it mentions intravenous heparin, which is not the medication being monitored in this case. Understanding the appropriate anticoagulant therapy and monitoring parameters is crucial for nurses caring for patients on these medications, especially those with mechanical heart valves who are at high risk for thromboembolic events. Monitoring INR levels helps ensure that the patient is receiving the correct dose of warfarin to prevent complications.