Download 00-1300 review - Glory Cubed Productions

Study Guide for 1300 Final
1.
How to prevent medication errors
a. Use the 5 rights.
i. Right patient
ii. Right medication
iii. Right dose
iv. Right route of administration
v. Right time of delivery
b. System check: Check label to med, Med to MAR, MAR to Pt. arm band
c. Labs
d. Medication orders must be written, if over the phone, ask them to write an order.
e. Make sure the order is legible.
f. Always determine pt. allergy to food, medication and other before dosing and document
2.
Nursing Process considerations when giving medication
a. Access for allergies
b. Access Pt. ability to swallow oral meds
c. Plan
d. See above for correct administration
e. Evaluate pt. understanding of medication and dosing method by client demonstration of actions
3.
What rights does a client have in refusing medications
a. Right of autonomy (right to refuse)
4.
What does a nurse do when they don’t understand the provider’s orders?
a. Double check with the provider
5.
How are drugs metabolized?
a. Chemically converting a drug to a form more easily removed from the body.
b. Drugs either enhance or block normal body funtions
c. The liver is the primary site – kidneys and cells of intestinal tracts also have high metabolic rates.
d. Hydrolysis, oxidation, reduction
e. PO drugs cross directly into the hepatic portal circulation, which carries blood to the liver b/f it is
distributed to other body tissues. As blood passes through the liver circulation, some drugs can be
completely metabolized to an inactive form b/f they ever reach the general circulations. These
drugs should be considered for SQ, rectal, or parenteral route.
f. Drugs are not filter out of body as efficiently by older people,
6.
Laxatives
a. Harsh laxatives = cathartics
b. Bulk forming laxative can be taken long term (metamusil)
c. Quickest acting laxative is Dulcolox
7.
Ace inhibitors, nursing action, teaching, classification and action of drug
a. End with “PRIL” (enalapril, captopril, benazepril)
b. Block the effects of angiotensin II thus lowering peripheral resistance and decreasing blood
volume.
c. Side effects: persistent cough (goes away when you stop med) & postural hypotension. If
hypotension occurs, put in supine position and get physician. Angioedema is life threatening –
swelling of skin, mucous membranes, and other organs.
d. Keep resuscitative equipment on hand during therapy, esp during IV therapy. Do not take with
heart failure that take potassium-sparing diuretics. Do not take with potassium foods. CBC b/f
therapy and every month for 3-6 months after.
e. Nursing DX: risk for injury R/T ortho hypotension
f. Stop diuretics 2-3 days before starting ACE inhibitors
g. First dose syndrome = severe hypotension upon first dose (have resesitative stuff available)
8.
Calcium channel blockers, nursing action, teaching, classification and action of drug
a. End with “PINE”, (nifedipine, amlodipine, felodipine, nicardipine)
b.
c.
d.
e.
f.
g.
h.
i.
Treat angina pectoris, dysrythmias, and HTN.
Decreases calcium in cardiac muscle = decreased muscular contractions.
EKG, HR, & BP during therapy
Vasodilators – may cause reflex tachycardia
AVOID GRAPEFRUIT JUICE! (could result in toxic OD) - drink plain water
Withhold if BP lower than 88/50, Causes constipation. Do not take with digoxin.
May cause syncope w/alcohol. HF, pulmonary edema
Monitor I&O because CCB’s may cause Edema
9.
Antihistamines, nursing action, teaching, action of drug
a. diphenhydramine (Benadryl), promethazine (Phenergan) / azelastine (Astlin) - nasal
b. Block the action of histamine at the H1 receptor
c. May cause sedation – avoid alcohol and other CNS depressants.
d. Treats chronic rhinitis
e. Most effective in preventing allergic symptoms, also used for motion sickness
f. Immediately report difficulty breathing (use epinephrine) EKG b/f therapy
g. May worsen thyroid function problems – hyperthyroidism S/S
h. Observe for renal toxicity (urine problems) / hypoglycemia
i. Avoid spices, alcohol, and nicotine. Take with food to avoid GI upset.
j. Increase fluid intake
k. Leads to urinary retention
l. Elderly s/s: hypotension, dizziness, sedation
m. Nursing DX. Risk for injury R/T sedation (first generation only, second generation does not
cause sedation)
n. Don’t take for 4 days prior to allergy test.
10.
Actions of inhalers for asthma clients, patient teaching, classification and action
a. When inhaling, the patient should inhale and hold breath for 10 seconds and wait 2 full minutes
before the next inhalation.
b. Corticosteroids inhibits inflammatory response used in daily dosing plans
c. Patients teaching should include:
i. Limiting caffeine
ii. Immediately report difficult breathing, heart palpitations, tremor, vomiting, nervousness, or
vision changes
iii. Call Dr. Immediately if medication is not effective
11.
Beconase (beclomethasone) classification, patient teaching and action of drug
a. Intranasal glucocorticoid – one spray BID-QID
b. Check nose b/f administering – blood, infection – do not swallow
c. May take 2-4 weeks to be effective
d. If taking a nasal decongestant, do it first, then the glucocorticoid spray
12.
Contraindications, adverse actions of NSAIDS
a. Contraindicated with hypersensitivity to ASA or NSAIDs, bleeding disorders (hemophilia, von
Willebrand’s disease, telangiectasia), favism
b. GI bleeding, hepatic toxicity, renal dysfunction
c. Report sight or hearing changes; urination changes & pitting edema
d. Take with food – side effects: dizziness, nausea, ABD pain, anorexia, & drowsiness, headache.
13.
Digitalis toxicity
a. Always take apical pulse before dosing (pulse >60)
b. Hypokalemia and antacids increases risk of Digitalis toxicity
c. DIGIBIND counteracts digitalis
d. First signs of toxicity usually GI symptoms: Anorexia, nausea, vomiting, also visual disturbances,
fatigue, dysrhythmias.
14.
Why is aspirin contraindicated for children
a. ASA can cause Reye’s syndrome with flulike illnesses esp if dehydrated
b. Do not take if younger than 19 yrs
15.
Ambien (zolpidem), patient teaching, classification and action of drug
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a.
b.
c.
d.
Schedule IV – short-term treatment of insomnia to preserve deep sleep - 7-10 days
Take 7-27 minutes b/f bedtime – not with food – CNS depressant
Metabolized in liver and excreted in kidneys - Avoid alcohol
Preserves stages III & IV sleep – does not effect REM sleep
16.
When are oral contraceptives contraindicated?
a. Increased risk in 35 years old & smokers
b. Contradicted in personal with risk of clotting, familial history of breast cancer, liver tumors,
hemorrhagic disorders.
c. Use in caution with HTN, cardiac or renal disease, liven dysfunction, diabetes, gallbladder disease
& history of depression.
17.
Proscar (finasteride), classification, patient teaching and action of drug
a. Used for BPH – antiandrogen – inhibits metabolism of testosterone
b. Shrinks prostate – also promotes hair growth but prescribes 5x higher dose
c. Causes sexual dysfunction – impotence, diminished libido, & ejaculatory dysfunction
d. Digital rectal exam & PSA periodically
e. Avoid evening fluids esp caffeine & alcohol
f. Women should not handle this medication or the semen of the man taking it!
g. May take 6-12 months – may have to take for life
18.
Cimetidine (Tagament), classification, patient teaching and action of drug
a. H2-Receptor Antagonist – decreases acid secretion in the stomach
b. Numemrous drug-drug interactions – taken up to 4x/day
c. GI bleeding – avoid alcohol – 1 hr /bf antacids – no smoking – avoid spices
19.
How do you give insulin (When mixing)
a. Mix clear (regular) before cloudy
b. Do not mix lantus with anything
c. Novalog can only be mixed with NPH
d. Only Regular insulin can be given IV
20.
Hypoglycemic reaction, peak of insulins, regular, intermediate, long acting
a. Humalog – fast acting within 15-30 minutes – peak ½ - 1 ½ hours
b. Novolog – intermediate acting within 10-20 minutes – peak ½ - ¾ hour
c. Novolin – acts within 1-1 ½ hours – peak 2-3 hours – can mix with Novolog
d. Lantus – long acting – lasts 24 hours – DO NOT MIX
21.
Crystalloids as volume expanders, nursing consideration and actions
a. Contains electrolytes resembling plasma (NS, LR, D5W)
b. Readily leave the blood and enter cells
c. Replace fluids that have been lost – frequent blood drawn
22.
Colloids
a. Don’t cross plasma membrane – restore plasma volume, increases volume in blood vessesls,
pulls fluid from tissues
b. Often proteins (Dextran, Hetastarch, 5% albumien)
c. Draw fluid from tissue into plasma
d. Monitor BP, HR, Lung sounds, pulse oximetry – BP is primary indication of successful
treatment of hypovolemic shock.
e. Major side effect = fluid overload.
f. Hetastarch – occasional allergy if urticaria (rash) – stop infusion immediately
23.
Packed red blood cells
a. Mix only with NS
b. Monitor Vitals Q15 for first hour (increased temp and BP during transfusion – slow infusion)
c. Rash = allergic reaction STOP INFUSION NOW, recognize reaction and notify Dr.
24.
Adverse reaction to aspirin, patient teaching (Reduce GI upset?)
a. GI bleeding, heartburn – high doses: (salicylism) tinnitus, dizziness, headache, & sweating.
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b. If GI upset, take enteric-coated and buffered preparations or take with food - do not take with
antacids
c. Reye’s syndrome: starts with flu like symptoms leads to fatty deposits and damage to liver and
brain. (don’t give aspirin to young children)
25.
What is the action of cardiac antiarrythmia drugs?
a. Alter electrophysiologic properties of the heart by blocking flow through ion channels or altering
autonomic activity.
b. Sodium channel blockers (class I) – blocks opening of sodium ion channels – slows ectopic
pacemaker activity
c. Beta-adrenergic blockers (class II) – slow heart rate & conduction velocity
d. Potassium channel blockers (class III) – block potassium ion channels – lengthen the refractory
period. Need eye exams
e. Calcium channel blockers (class IV) – slow conduction velocity
26.
digoxin (Lanoxin), toxicity level, nursing considerations, patient teaching, classification and action of
drug.
a. Cardiac glycoside – heart beats more forcefully and slowly to improved output with decreased
O2 requirements.
b. Side effects – fatigue, drowsiness, dizziness, visual disturbances, anorexia, N&V.
c. Eat potassium rich foods – may lead to hypokalemia
d. Antacids or antidiarrheals 2 hours after – do not give with cholesterol-lowering agents
e. Hold if apical pulse is less than 60 – if digoxin level is more than 1.8 hold!
27.
What is digibind? (prototype box)
a. Bind and subsequently removes digoxin from the body and prevents toxic effects of OD.
28.
Benadryl (diphenhydramine) adverse reactions, patient teaching classification of drug
a. Antihistamine - Drowsiness, sedation, dry mouth, N&V. Photosensitivity – use sunblock
b. Also relieves motion sickness.
c. Avoid alcohol & CNS other depressants
d. Commonly causes constipation in the elderly
29.
What are expectorants, what is it’s primary effect?
a. Increase bronchial secretions to reduce the thickness/viscosity, this increasing mucus flow
that can be removed easily by coughing. guaifenesin (Resyl)
30.
Opioids aka narcotics
a. May lead to respiratory depression
b. Most effective cough suppressant
c. Prevent pain by modify pt. pain perception.
d. USE NARCAN to counteract
31.
Glucocorticoids, classification, patient teaching and action of drug
a. End with “ONE” - Prednisone
b. Suppress severe inflammation – monitor for edema (weigh daily)
c. Serious side effects – mask S/S of infection! (don’t give if systemic infection is present) –
hyperglycemia – GI bleeding
d. Give with food or antacids
e. May cause Cushing’s syndrome (moon face, Buffalo hump, big ABD, and bone fractures)
f. Do not abruptly discontinue.
g. Immediately rinse mouth after administration of drug to prevent dental issues
32.
Thrombolytics, classification, patient teaching and action of drug
a. End with “ASE” - streptokinase (Kabikinase), alteplase (Activase)
b. Promote clot destruction by converting plasminogen to plasmin. (DVT)
c. Need to be given within 1-3 hours of stroke or MI.
d. May cause epixatis, report immediately
33.
Radioactive iodine (Iodine-131), what is it’s action on the patient’s condition
a. It destroys overactive thyroid glands by emiting ionizing radiation.
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b. May take several months for full benefit. Usually a single dose. Given for thyroid storm.
c. Works because thyroid will absorb any type of iodine, the radioactive particle in the iodine destroy
the thyroid.
34.
Prior to administration of narcotics what is important to know? What should a nurse chart concerning
the patient’s pain?
a. Complete HH including recreational drugs. LOC & allergies
b. Pain level of 0-10
c. RESPIRATION rate
35.
Allergies, why is it important to chart and document?
a. Safety of patient.
b. Allergies go on armband on pt.
36.
When discharging patients, why is it important and what is important when teaching the patient
concerning medications?
a. Teach side effects, how to take the drug, when to stop, and when to notify physician of serious side
effects.
b. Evaluate effectiveness of teaching
37.
Pepcid (famotidine) classification, action of drug, patient teaching
a. H2-Receptor antagonist to treat PUD & GERD by decreasing acid secretion in the stomach.
b. If dysrythmias or hypotension with cimetidine IV – use famotidine IV instead
c. Avoid alcohol – stop smoking – avoid spices
d. 1 hour b/f antacids – may cause GI bleeding
38.
What are control substances, categories, and action of drugs (Schedule II, etc)
a. Schedule 1 highest abuse and dependence
b. no refills on Schedule II or phone orders due to risk for physical dependancy
c. Schedule V lowest abuse and dependence (OTC)
39.
How do you teach patients about insulin administration
a. Rotate sites to prevent lipodystrophy, don’t use sight for 6 months if you get lipodystrophy.
b. Rotate insulin pump sites every 2-3 days
c. Best absorbption in stomach, then arm, then leg
d. Refrigerate insulin, warm before injection – wear a medic alert bracelet.
e. Monitor glucose b/f meals and administration.
f. Use only an insulin syringe calibrated the same as the strength of insulin.
g. Wash injection sight with soap and water at home, and alcohol in the hospital
40.
Lorazepam (Ativan) same as above for other drugs
a. Benzodiazepine
b. Half-life of 10-20 hours
c. Anxiety, insomnia, and status epilepticus. Avoid alcohol!
d. Respiratory assessment – do not use with narrow-angle glaucoma!
e. If OD – use flumasenil (Romasicon)
41.
Antiepileptic drugs, patient teaching, what is the action of the drug such as Dilantin (phenytoin)
a. Treats all types of epilepsy except absence seizures by preventing the spread of disruptive
electrical charges in the brain that produce seizures.
b. Has a narrow range r/t therapeutic and toxic range.
c. Monitor serum blood levels.
d. May cause hypotension and hyperglycemia. Severe skin reactions - give in vein (not in
hand).
e. Take missed dose ASAP but do not double dose. Take with food. Avoid constipation.
42.
Methylphenidate hydrochloride (Ritalin) same as above for other drugs.
a. Used for ADHD – CNS stimulant. Schedule II drug
b. Monitor BP and pulse.
c. Take with meals to reduce GI upset and counteract anorexia (eat frequently).
d. Need drug holidays. May have reduction in growth rate. Take no later than 4 pm.
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43.
.Sumatriptan (Imitrex) patient teaching, nursing actions, classification and action drug
a. Antimigraine – need baseline info on migraines, apical pulse, respirations, and BP.
b. Quiet, calm environment – use cold packs – use caution when pregnant, is excrete in breast milk.
c. Causes vasoconstriction – contraindicated in HTN, MI, CAD, history of MI, dysrythmia or HF,
& diabetes.
d. Side effects: nausea, vomiting, weakness in legs, myalgia, numbness and tingling fingers & toes,
angina-like pain, & tachycardia. Dizziniess, drowsiness, or warming is normal – cont drug.
e. Kidney & liver damage. Physical dependence. Need initial dose in health care setting.
f. Avoid tyramines (pickled foods, beer, wine, chocolate, organ meats, and aged chesses)
44.
Haldol (haloperidol), patient teaching, nursing actions, classification and action of drug.
a. Nonphenothiazine – management of acute and chronic psychotic disorders.
b. May cause confusion, depression, and hallucinations in elderly.
c. Less sedation & hypotension but more EPS than phenothiazines. Anticholingeric effect.
d. Avoid caffeine, alcohol, smoking and illegal drug use.
e. Beneficial if can’t take PO. IM or SC last up to 3 weeks. May take several months to work.
f. May cause brownish discoloration of object or photophobia.
45.
Monoxamine oxidase inhibitor (MAOI), patient teaching, nursing actions, classification and action of
drug.
a. For patient’s that haven’t responded to SSRIs or TCAs. (phenelzine, Nardil)
b. Side effects: ortostatic hypotension, headache, insomnia, & diarrhea.
c. Large drug-drug and food-drug interactions. Do not use with SSRI = serotonin syndrome.
d. Avoid tyramines – cardio assessment – avoid with seizures – avoid caffeine.
e. Takes 4-8 weeks for therapeutic effects.
46.
Benzotropine (Cogentin), patient teaching, nursing actions, classification and action of drug
a. Treats Parkinsonism symptoms and EPS.
b. Suppresses tremors but doesn’t affect tardive dyskinesia.
c. Anticholingeric side effects: sedation, dry mouth, constipation, & tachycardia.
47.
Treating patients with antiparkisonian medications, nursing consideration, actions of drug
a. levodopa (L-Dopa, Larodopa) can cross the blood-brain barrier (Dopamine can’t)
b. Report: hypotension, dizziniess, lightheadedness, racing or skipping heart, or dypsnea.
c. Watch for newly formed tremors
d. Take on empty stomach (food in 15 minutes if GI upset)
e. Avoid B6 (bananas, wheat germ, green veggies, liver, & legumes)
f. Urine & sweat may darken. (normal)
g. Monitor Parkinson’s pt.’s for ability to swallow
48.
Anticholinergic drugs, actions, nursing considerations.
a. Compete with acetylcholine – atropine, benztropine (Cogentin), Atrovent
b. Parasympathetic reaction – dilate pupils, increase HR, dry secretions, relax bronchi
c. Used for GI disorders, Ophthalmic procedures, cardiac rhythm abnormalities, preanesthesia, &
asthma.
d. High incidence of side effects: urinary retention, tachycardia, CNS stimulation,
e. Decreasing sweat = hyperthermia, photophobia.
f. Do not stop abruptly
49.
Adrenergic drugs, actions, classification, nursing considerations.
a. Beta dilates
b. Alpha constricts
c. Withhold medication if BP less than 88/50
d. Side effects: slow pulse, difficulty breathing, dizziness, confusion, fatigue, weakness, and
impotence. Monitor fluid I&O (daily weights) – drink plain water.
e. Non-selective B adrenergic blockers cause bronchospasm (caution in asthma and COPD)
f. A adrenergic Blockers – don’t take hot bath when taking these drugs
g. Oral adrenergic agents are contraindicated in tachycardic pt.
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50.
What is a “rebound effect” when a medication is discontinued abruptly?
a. What the drug was controlling comes back worse when it is discontinued abruptly.
51.
Salmetrol (Serevent), classification, nursing considerations, action of drug
a. Causes bronchodilation – taken 30-60 b/f exercise to prevent bronchospasm.
b. Takes 15-25 minutes to act – NOT FOR ACUTE BRONCHOSPASM
c. No serious side effects – tachycardia should be monitored in HF
52.
Beta blocker (atenolol), nursing consideration , action of drug
a. Slow heart rate & reduce contractility to reduce O2 demand– decrease frequency & severity
of anginal attacks caused by exertion. Treatment of HTN and prevention of MI.
b. May cause nausea, and light headedness, orthostatic hypotension
c. 7-9 hr half-life (usually taken once/day)
d. Starts with low doses and gradually increased.
e. Avoid nicotine and caffeine
f. Don’t give to pt. with bronchitis.
g. Pt. angina or vaso-oclusive issues monitor pulse and respirations.
53.
Donepezil, classification, action of drug (What is this drug used to treat)
a. Ace Inhibitor that improves memory in Alzheimer’s dementia. 6 months for max effects.
b. Only taken once a day.
c. Side effects: vomiting, diarrhea, darkened urine, insomnia, syncope, depression, headache,
irritability, muscle cramps, arthritis, bone fractures, fatigue, chest pain, increased libido, hot flashes,
urinary incontinence, dehydration, and blurred vision.
d. Does NOT cause heptotoxicity
54.
Quinidine sulfate (Quinidex), classification, action, adverse and side effects( prototype box)
a. Antidysrythmic drug – block sodium ion channels in myocardial cells.
b. Diarrhea is the most common side effect. It doubles digoxin levels; need to adjust dose.
c. Maintain diet low in sodium and fat.
d. Avoid caffeine and tabacco.
55.
Nitroglycerin, ointment, topical, nitrates, nursing consideration, classification and action of drug
a. Treat angina by relaxing both arterial and venous smooth muscle = vasodilating
b. Nitroglycerin – short acting
i. Make sure patient is sitting or in supine position and monitor BP after each dose
ii. If hypotension occurs, hold nitrate and remove topical forms until normal.
iii. Dissolve under the tongue – If not relieved after 3 doses – call EMS!
c. Isosorbide dinitrate (Isordil) – long acting – oral or transdermal patch to  episodes & HF
i. Tolerance is a common problem with long acting
ii. Should withhold patch for 6-12 hours each day or hold nighttime oral dose
iii. Rotate transdermal locations and wash with soap & water
d. BP IS THE MOST IMPORTANT VITAL B/F & DURING THERAPY!
e. Avoid alcohol – will cause sever hypotension and cardiovascular collapse.
f. S/S of OD – blurred vision, dry mouth, or severe headache – call physician!
g. Replace Rx every 6 months
56.
sildenafil (Viagra) contraindications, actions, nursing consideration, classification (prototype box)
a. Relaxes smooth muscle and increases blood flow to the penis in about 70% of men
b. Take 1 hour to work and lasts 2-4 hours.
c. DO NOT TAKE WITH MEALS – ESP HIGH FAT MEALS
d. AVOID GRAPEFRUIT JUICE
e. Side effects: hypotension if taking nitrates – common side effects: headache, dizziness,
flushing, rash, nasal congestion, diarrhea, hyspepsia, UTI, chest pain, or indigestion.
f. Report priaprism (longer than 6 hours) – emergency!
57.
Hypokalemia and potassium deficiency, manifestations, nursing considerations
a. Potassium level below 3.5 mEq/L
b. Will have strenuous muscular activity and severe diarrhea & vomiting when significant
c. Muscle weakness, lethargy, anorexia, dysrythmias, and cardiac arrest are possible
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d.
e.
f.
g.
Mild hypokalemia = increase dietary intake
Severe deficiencies = higher doses of oral or parenteral potassium supplements.
Do not give with renal impairment or dehydration!
Take oral form with meals. Check labs b/f parenteral therapy. Monitor EKG changes!
58.
Thyroid replacement therapy, adverse effects, side effects, nursing considerations
a. levothyroxine (Synthroid) – synthetic form of thyroxine (T4)
b. May take 3 or more weeks for T4 levels to stabilize.
c. Doses may require periodic adjustments for several months.
d. Adverse effects are those of hyperthyroidism.
e. May cause menstrual irregularities & osteoporosis in women.
f. Therapeutic & toxic level is narrow – use caution!
g. DO NOT GIVE WITH ADRENAL INSUFFICIENCY!
h. Do Cardiovascular assessment!
i. Take on empty stomach.
59.
Morphine sulfate (Duramorph), actions, nursing considerations
a. Opiod analgesic with high efficacy
b. Relieves pain, shortness of breath with HF & pulmonary edema, & acute chest pain MI.
c. May cause restlessness, depression, anxiety, hallucinations, nausea, constipation, dizziness, and
itching.
d. OD = severe respiratory distress or cardiac arrest
e. Physical & mental dependence with long term use of high doses.
f. Need CBC, allergy history, and character, duration, and location of pain b/f therapy.
g. AVOID ALCOHOL AND OTHER CNS DEPRESSANTS!
h. May cause respiratory depression. Check respirations b/f therapy! Do not give if  12.
i. Narcan can reverse morphine if respirations fall below 10. (May cause increased ICP)
j. If N&V give antiemetic.
60.
Tolerance, addiction, toxicity, therapeutic range in administration of drugs
a. Tolerance – adapting to a drug and requiring higher doses.
b. Addiction – continued use of a substance despite health and social consequences.
c. Toxicity – level of a drug that will result in serious adverse effects.
d. Therapeutic range – dosage range achieves the desired drug effect.
61.
Guaifenesin (Robitussin) (What is the action of this drug?)
a. Expectorant – increase bronchial secretions to easily cough out.
b. Few adverse effects.
62.
Vancomycin (red man syndrome)
a. Antibiotic reserved for serious infection usually resistant to other antibiotics.
b. Ototoxicity – do hearing evaluation throughout therapy. Nephrotoxicity.
c. Given PO or IV – NOT IM!
d. Red man syndrome – hypotension with flushing and red rash on face and upper body.
e. Antihistamine may be ordered to treat red man syndrome
63.
Colchicine (used for gouty arthritis)
a. Uric Acid-Inhibiting drug for gout that inhibits inflammation and reduces pain.
b. Take on empty stomach when symptoms first appear.
c. May interfere with absorption of Vitamin B12.
d. Increase fluids to 3-4L/day – report decreased UOP.
e. Avoid alcohol – limit alkaline foods:
i. Milk, fruits, carbonated drinks, veggies, molasses, baking soda.
f. GI complaints – ABD cramping, N&V, and/or diarrhea.
g. Avoid ASA and Vitamin C
64.
IVP intravenous pyelogram (What do you assess patient for)
a. Assess for allergy to shellfish.
65.
Stress incontinence (Patient teaching)
a. Do Kegel exercises (also stop urinating mid-stream to identify pelvic floor muscles)
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b. Tighten pelvic muscles when need to void is perceived and relax the ABD while walking to Bath.
c. Limit alcohol, citrus juice, and artificial sweeteners.
d. Limit fluid no less than 1.5 to 2.0 L/day – limit evening fluids
66.
Cystectomy (Patient teaching post -op)
a. Expect pink or bright red urine fading to clear by 3rd day.
b. Expect stoma to be bright red / slightly edematous initially. Bleeding during cleansing is normal.
c. Increase fluid intake – catheterization techniques for continent reservoirs.
67.
Urinary calculi (subjective findings)
a. Kidney stones: dull, aching flank pain – microscopic hematuria – S/S of UTI
b. Ureteral stones: renal colic – acute, severe flank pain on affected side – N&V, pallor, cool clammy
skin.
c. Bladder stones: dull suprapubic pain – gross or microscopic hematuria – S/S UTI
68.
Diuretics
a. Monitor for hypovolemia, hypcalemia
b. Monitor BP and Daily weights
c. Spiralactone is potassium sparing (avoid salt substatutes)
d. Hydrochlorathyazide report leg cramps and muscle weakness to DR.
69.
Anemia
a. Decreased RBCs – nutritional, blood loss, hemolytic
70.
Anti-coagulant
a. Priority is to prevent bleeding injury
b. Reduces clotting in blood
c. Contraindicated in people with bleeding disorders
d. Watch for easy bruising, unstoppable bleeding, persistant bleeding
71.
HIV (How does the virus invade the body)
a. Blood bourn retrovirous – invades, alters DNA, then destroys CD4+ helper T Cells
72.
Hemolytic anemia (signs and symptoms)
a. Premature destruction of RBCs
b. Jaundice, bone deformities & fractures, splenomegaly
73.
Sickle cell crisis (priority nursing intervention)
a. Give oxygen
b. Increase fluids
c. Decrease pain
74.
Polycythemia vera
a. Overproduction of RBCs b/c of absence of erythropoietin.
b. HTN is common – plethora – ruddy, red color of face, hands, feet, and mucous membranes.
c. Severe, painful itching of fingers and toes. Weight loss / night sweats
d. Affects Eurpoean and Jewish mean 40-70
e. Vision & hearing alterations
f. Stop smoking
g. Adequate hydration
Please know what the diagnostic test or condition is and be able to apply it to a situation. Know the drugs,
classification, action, side effects, contraindications and nursing considerations when administering drugs. Know
what to teach your patient on discharge teaching. And remember the nursing process! Good luck
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