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NR 566 Final Exam / NR566 Final Exam(New, 2023/2024)(V1): : Chamberlain College of Nursing, Exams of Nursing

A review for the NR 566 Final Exam, which covers topics related to advanced pharmacology for care of the family. information on various medications, their side effects, patient teaching, and appropriate usage. It also covers topics related to migraine therapy, panic disorder, performance anxiety, and generalized anxiety disorder. a comprehensive overview of the subject matter and is a useful study tool for students preparing for the final exam.

Typology: Exams

2022/2023

Available from 07/06/2023

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NR 566 Final Exam / NR566 Final Exam Review :
Advanced Pharmacology for Care of the Family
Doxazosin side effects (due to alpha 1 receptor being blocked) -
dizziness/syncope, headache, first-dose orthostatic hypotension,
drowsiness, nasal congestion
Dutasteride (finasteride) patient teaching - benefits take months to develop,
must continue taking med even if improvement not rapidly seen
may lower ejaculatory volume & libido
How to know Terazosin is working? - improved symptoms of dysuria,
urgency, urinary tract infections, hesitancy etc.
When is it safe and not safe to prescribe Progesterone (Progestin)? - if
woman has had a hysterectomy/pregnant
side effects of progestin-only oral contraceptives? - more likely to cause
irregular/inconsistent bleeding, must be taken at same time every day to be
effective
Benefits of prescribing medroxyprogesterone acetate - doesn't cause
thromboembolic disorders, headaches, nausea, or most of the other adverse
effects associated with combo OCs.
does not decrease milk supply during lactation
Testosterone replacement therapy routes: - treatment that involves
administering testosterone supplements through pills, injections, or skin
patches
testosterone patch patient teaching: - ○ good hand washing is required after
application
○cover application site with clothing after medication has dried
○wash the application site before skin-to-skin contact with another person
females and children may experience negative effects from exposure to
testosterone
if cross contamination occurs, wash the affected area with soap and
water to prevent absorption
When is androgen therapy appropriate vs. not needed related to puberty? -
Short term: The psychological pressures of delayed sexual maturation are
causing a boy significant distress.
Long term: if delayed puberty related to true hypogonadism
testosterone replacement therapy side effects? - Hot flashes, bone fractures,
decreased libido, insulin resistance, erectile dysfunction, gynecomastia,
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NR 566 Final Exam / NR566 Final Exam Review :

Advanced Pharmacology for Care of the Family

Doxazosin side effects (due to alpha 1 receptor being blocked) - dizziness/syncope, headache, first-dose orthostatic hypotension, drowsiness, nasal congestion Dutasteride (finasteride) patient teaching - benefits take months to develop, must continue taking med even if improvement not rapidly seen may lower ejaculatory volume & libido How to know Terazosin is working? - improved symptoms of dysuria, urgency, urinary tract infections, hesitancy etc. When is it safe and not safe to prescribe Progesterone (Progestin)? - if woman has had a hysterectomy/pregnant side effects of progestin-only oral contraceptives? - more likely to cause irregular/inconsistent bleeding, must be taken at same time every day to be effective Benefits of prescribing medroxyprogesterone acetate - doesn't cause thromboembolic disorders, headaches, nausea, or most of the other adverse effects associated with combo OCs. does not decrease milk supply during lactation Testosterone replacement therapy routes: - treatment that involves administering testosterone supplements through pills, injections, or skin patches testosterone patch patient teaching: - ○ good hand washing is required after application ○cover application site with clothing after medication has dried ○wash the application site before skin-to-skin contact with another person ■ females and children may experience negative effects from exposure to testosterone ■ if cross contamination occurs, wash the affected area with soap and water to prevent absorption When is androgen therapy appropriate vs. not needed related to puberty? - Short term: The psychological pressures of delayed sexual maturation are causing a boy significant distress. Long term: if delayed puberty related to true hypogonadism testosterone replacement therapy side effects? - Hot flashes, bone fractures, decreased libido, insulin resistance, erectile dysfunction, gynecomastia,

acne, HTN, sterility, hepatotoxicity, mood swings/ aggression.

Adverse effects associated with Pramipexole - nausea, dizziness, daytime somnolence, insomnia, constipation, weakness, and hallucinations. Impulse control disorder can occur (excessive gambling, spending etc.) Sleep attacks (overwhelming and irresistible sleepiness that comes on without warning) When is Pramipexole best used in treating Parkinson's? - early stages of Parkinsons when are COMT inhibitors indicated? (I.e. Entacapone) - If patient experiences "off" phases with their medication therapy (return of symptoms for random periods of time) extends the half-life of Levadopa What are sleep attacks associated with Parkinsons treatment? - overwhelming/irresistible sleepiness that comes on without warning How to manage side effects of Bromocriptine (dopamine agonist): - Take with food to decrease GI upset start with lowest effective dose and gradually increase screen for hx of compulsion/sleep disturbance what seizure meds reduce OC efficacy? - carbamazepine, eslicarbazepine, lamotrigine, oxcarbazepine, phenytoin, phenobarbital, rufinamide, topiramate Phenytoin side effects - drowsiness, ataxia nystagmus blurred vision lethargy GI upset suicidal behavior/cognitive decline patient teaching with Phenytoin - strict adherence to medication is important due to its narrow therapeutic range patient teaching regarding anti-seizure meds and OC/pregnancy: - effectiveness of OC may be decreased by many anti-seizure meds, if pregnancy is unwanted the pt should consider adding or increasing contraception. lowest dose/lowest number of meds used during pregnancy tends to be most safe. Risk vs benefit!

Folic acid is essential

Paroxetine (Paxil) and Fluoxetine (Prozac)

SNRIs- Buspirone (Buspar) Approach when first anti-depression drug doesn't seem to be working? - wait at least 4 weeks minimum before increasing/changing dose. 1st increase dose, then change drug within same class, then switch to new class, then start second med How long should it take antidepressants to work? - 4-8 weeks Suicide risk associated with antidepressants: - increased risk of suicide in those taking antidepressants, especially in children and young adults never to be stopped abruptly (increases risk) First-line treatment options for sleep disturbance? - Benzodiazepines: Triazolam Benzodiazepine-Like Drugs: Zolpidem (Ambien), Zaleplon (sonata), eszopiclone (Lunesta) Melatonin Receptor Agonist: Melatonin, Ramelteon (Rozerem) Orexin Receptor Agonist: Suvorexant (Belsomra) Therapeutic drug level of lithium: - 0.6-0.8 mEq/L Lithium drug-drug interactions - •Thiazides-Diuretics- lithium toxicity •NSAIDS- higher plasma lithium levels •Haloperidol-encephalopathic syndrome (weakness, tremors, confusion, lethargy) -Carbamazepine •anti-acids-decreases effectiveness of lithium *** Common adverse reactions of 1st generation antipsychotics - extrapyramidal symptoms: Parkinsonism, akathisia, dystonia (all manageable w/ anticholinergics), Tardive Dyskinesia (no treatment) dry mouth, constipation (anticholinergic effects) pt teaching regarding first gen. antipsychotics: - inform provider immediately about any signs/symptoms of tardive dyskinesia/adverse effects sunscreen use s/s of toxicity