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40 Cards in this Set

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What is Metamucil?!
Metamucil (psyllium)
Classifications: laxatives, bulk-forming agents

Indications:
• Management of simple or chronic constipation, particularly if associated with a low-fiber diet.
• Useful in situations in which straining should be avoided (after MI, rectal surgery, prolonged bed rest)
• Used in the management of chronic watery diarrhea.

Action: Combines with water in the intestinal contents to form an emollient gel or viscous solution that promotes peristalsis and reduces transit time. Therapeutic effects: Relief and prevention of constipation.
What are the contraindications and adverse reactions of Metamucil?
Contraindications:
• Hypersensitivity
• Abdominal pain, nausea or vomiting (esp. when associated with fever)
• Serious adhesions
• Dysphagia
Adverse reactions and side effects: Bronchospasm, cramps, intestinal or esophageal obstruction, nausea, vomiting.
Interactions: may decrease the absorption of warfarin, salicylates, or digoxins.
Metamucil Route and Dosage?
Route and dosage:
• PO(adults): 1-2 tsp/packet/wafer (3-6g psyllium) in or with a full glass of liquid 2-3 times daily. Up to 30g daily in divided doses.
• PO(children>6yr): 1 tsp/packet/wafer (1.5-3g psyllium) in or with 4-8 oz glass of liquid 2-3 times daily. Up to 15g daily in divided doses.
Metamucil Nursing implications?
Nursing Implications:
• Assess patient for abdominal distention, presence of bowel sounds, and usual pattern of bowel function.
• Assess color, consistency, and amount of stool produced.
• May cause elevated blood glucose levels with prolonged use of preparations containing sugar.
• For PO administration, give with full glass of water or juice, followed by additional glass of liquid. Solution should be taken immediately after mixing. Do not chew granules.
What is Lasix?
Lasix (furosemide)
Classifications: diuretics, loop diuretics
Indications:
Edema due to CHF, hepatic or renal disease, Hypertension, Hypercalcemia of malignancy
Actions:
• Inhibits the reabsorption of sodium and chloride from the loop of Henle and distal renal tubule.
• Increases renal excretion of water, sodium, chloride, magnesium, hydrogen and calcium.
• May have renal and peripheral vasodilatory effects.
• Diuresis and subsequent mobilization of excess fluid and decreased blood pressure.
What are the contra, indicatons and adverse reacions of Lasix?
Contraindications:
Hypersensitivity, electrolyte imbalance, severe liver disease. Use cautiously with geriatric patients (difficulty assessing hearing status; increased risk of hypotension)
Adverse reactions and side effects: dizziness, headache, dehydration, hypchloremia, hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic alkalosis.
Interactions:
• Increased risk of hypotension with antihypertensives, nitrates, or acute ingestion of alcohol.
• Increased risk of hypokalemia with other diuretics, piperacillin, amphotericin B, stimulant laxatives, and corticosteroids.
• May increase the effectiveness or warfarin, thrombolytic agents, or antocoagulants.
Route and Dosage for Lasix?
Route and dosage:
• PO(adults): Edema: 20-80mg/day as a single dose initially. Hypertension: 40mg twice daily initially (when added to regimen, decrease dose of other antihypertensives by 50%). Hypercalcemia: 120mg/day in 1-3 doses.
• IM, IV(adults): Edema: 20-40mg, may repeat in 2 hr and increase by 20mg every 2hr until response is obtained. Hypercalcemia: 80-100mg may repeat every 1-2hr.
Nursing implications for Lasix?
Nursing Implications: Assess fluid status. Monitor daily weight, intake and output ratios, lung sounds, blood pressure and pulse. Assess patient for tinnitus and hearing loss. Monitor electrolytes, renal and hepatic function, serum glucose, and uric acid levels.
What is vitamin b12
(cyanocobalamin, hydroxocobalamin)
Classifications: antianemics, vitamins, water soluble vitamins.

Indications: Vitamin B12 deficiency, pernicious anemia.

Actions: necessary coenzyme for metabolic processes, including fat and carbohydrate metabolism and protein synthesis. Required for RBC formation. Corrects manifestations
what areteh contraindications and adverse reactions?
Contraindications: hypersensitivity, hereditary optic nerve atrophy. Use cautiously with cardiac disease, folic acid deficiency, concurrent infection, and iron deficiency.

Adverse reactions and side effects: peripheral vascular thrombosis, diarrhea, itching, swelling of the body, hypokalemia, pain at IM site, and hypersensitivity reactions including anaphylaxis.

Interactions: chloramphenicol and antineoplastics may decrease the hematologic response to vitamin B12. Aminoglycosides, extended-release potassium supplements, anticonvulsants, excess intake of alcohol and vitamin C can decrease oral absorption and effectiveness.
ROute and Dosage for Vitamin b12
Route and dosage: Cyanocobalamin:
PO (adults): Up to 1000mcg/day
IM, Subcut (adults): 30-100mcg/day for 6-7 days; then 100-200mcg/month.
Intranasal (adults): 500mcg (one spray in one nostril) once weekly.
Nursing implications for Vitamin B12
Nursing implications: Assess patient for signs of vitamin B12 deficiency (pallor, neuropathy, psychosis, red inflamed tongue) before and during therapy. Monitor plasma folic acid levels, reticulocyte count, and plasma vitamin B12 levels before and between day5-7 of therapy
What is Metropolol?
Metroprolol (Lopresor, Betaloc, Toprol XL)
Classifications: antianginals, antihypertensives, beta blockers.
Indications:
• Hypertension, angina pectoris, prevention of MI and decreased mortality in patients with recent MI, management of stable, symptomatic heart failure.
Actions: Blocks stimulation of beta-adrenergic receptors. Therapeutic effects: Decreased blood pressure and heart rate, decreased frequency of attacks of angina pectoris.
What are some contraindications and adverse reaciton of Metropolol?
Contraindications: Uncompensated CHF, pulmonary edema, cardiogenic shock, bradycardia or heart block.

Adverse reactions and side effects: Fatigue, weakness, anxiety, depression, impotence, bradycardia, CHF, pulmonary edema.

Interactions: General anesthesia, IV phenytoin and verapamil may cause increased myocardial depression. Increased rick for bradycardia may occur with digoxin. Increased risk for hypotension with use with other antihypertensives, acute ingestion of alcohol or nitrates. Concurrent use with amphetamines, cocaine, ephedrine, epinephrine, norepinephrine, phenylephrine, or pseudoephedrine may result in unopposed alpha-adrenergic stimulation.
Whatis the route and dosage of Metropolol?
Route and dosage:
• PO(adults): Antihypertensive/antianginal: 100mg/day as a single dose or 2 divided doses. May be increased q7days as needed up to 450mg/day. MI: 25-50mg q6hr for 48hr, then 100mg twice daily for a minimum of 3months. Heart failure: 12.5-25mg once daily; can be doubled every 2weeks up to 200mg/day.
• IV(adults): MI: 5mg q2min for 3 doses, followed by oral dosing.
What are nursing implications for Metropolol?
Nursing Implications: Monitor blood pressure, ECG, and pulse frequently. Monitor vital signs and ECG every 5-15 minutes during and for several hours after parenteral administration. If heart rate <40bpm administer atropine 0.25-0.5mg IV. Monitor intake and output ratios and daily weights. Assess routinely for signs and symptoms of CHF.
What is regular insulin?
Regular Insulin
Classifications: antidiabetics, hormones, pancreatics.

Indications: Treatment of insulin-dependent diabetes mellitus. Management of non-insulin-dependent diabetes mellitus unresponsive to treatment with diet or oral hypoglycemic agents.

Actions: Lower blood glucose by increasing transport into cells and promoting the conversion of glucose to glycogen. Promote the conversion of amino acids to proteins. Inhibit the release of free fatty acids. Control of blood glucose in diabetic patients.
What are the adverse reactions and contraindications of regular indications?
Contraindications: Allergy or hypersensitivity to a particular type of insulin, preservatives, or other additives.

Adverse reactions and side effects: Hypoglycemia, lipodystrophy, anaphylaxis, itching, redness, swelling, blurred vision, dry mouth, rash.

Interactions: Beta blockers may block some of the signs and symptoms of hypoglycemia and delay recovery from hypoglycemia. Thiazide diuretics, corticosteroids, diltiazem, dobutamine, thyroid preparations, estrogens, nicotine may increase insulin requirements. Glucosamine may worsen blood glucose control. Fenugreek, chromium, and coenzyme Q-10 may produce additive hypoglycemic effects.
What is the route and dosage of regular insulin?
Route and dosage: Dose depends on blood glucose, response, and many other factors.
• IV(adults): 0.1 unit/kg/hr as a continuous infusion.
• IV(children): individualized on the basis of a patient’s weight.
• Subcut (adults and children maintenance therapy): 0.5-1 unit/kg/day.
Nursing implcations for regular insulin?
Nursing Implications: Assess patient for signs and symptoms of hypoglycemia and hyperglycemia. Monitor body weight periodically. Changes in weight may necessitate changes in insulin dose. Monitor urine ketones during illness. Monitor blood glucose q2hr pc.
What is heparin?
Heparin
(Hep-Lock, Hep- Lock U/P)
Classifications: anticoagulants, antithrombotics

Indications: Prophylaxis and treatment of various thromboembolic disorders including venous thromboembolism, pulmonary emboli, arterial fibrillation with embolization. Used in very low doses to maintain patency of IV catheters (heparin flush).

Actions: Potentiates the inhibitory effect of antithrombin on factor Xa and thrombin. In low doses, prevents the conversion of prothrombin to thrombin by its effects on factor Xa. Prevents thrombus formation and prevents extension of existing thrombi.
what are contraindicaitons and adverse reactions for heparin?
Contraindications: Hypersensitivity, uncontrolled bleeding, open wounds.

Adverse reactions and side effects: Drug-induced hepatitis, alopecia, rashes, bleeding, anemia, thrombocytopenia, pain at injection site.

Interactions: Risk of bleeding may be increased by concurrent use of drugs that affect platelet function, including aspirin, NSAIDs, clopidogrel, dipyridamole, some penicillins, ticlopidine, and dextran. Increased risk of bleeding with concurrent use of drugs that cause hypoprothrombinemia, and thrombolytic agents. Heparins affect the prothrombin time used in assessing the response to warfarin. Digoxin, tetracyclines, nicotine, and antihistamines may decrease the anticoagulant effect of heparin. Increased risk of bleeding with natural products such as anise, chamomile, clove, garlic, ginger, and Panax ginseng.
Route and Dosage for Heparin?
Route and dosage:
IV (adults): Intermittent bolus: 10,000 units, followed by 5000-10,000 units q4-6hr. Continuous infusion: 5000 units (35-70 units/kg) followed by 20,000-40,000 units infused over 24hr (approx, 1000 units/hr.)
Subcut (adults): 5000 units IV, followed by initial subcut dose of 10,000-20,000 units; then 8000-10,000 units q8hr or 15,000-20,000 units q12hr.
Nursing implications for Heparin?
Nursing Implications: Assess patient for signs of bleeding and hemorrhage (bleeding gums, nosebleed, unusual bruising, black tarry stools, fall in hematocrit or blood pressure). Assess patient for evidence of additional or increased thrombosis. Monitor patient for hypersensitivity reactions. Observe injection sites for hematomas, ecchymosis, or inflammation.
What is lovenox?
Lovenox
(enoxaparin) Low molecular weight heparin.
Classifications: anticoagulants, antothrombotics

Indications: Prevention of thromboembolic phenomena including deep vein thrombosis and pulmonary emboli after abdominal surgery. Prevention of ischemic complications. Treatment and prevention of DVT in patients at risk for thromboembolic complications due to severely restricted mobility during acute illness.
Actions: Potentiate the inhibitory effect of antithrombin on factor Xa and thrombin. Prevention of thrombus formation.
What are contraindications and adverse reactions of lovenox?
Contraindications: Hypersensitivity to specific agents or pork products; uncontrolled bleeding; active major bleeding; thrombocytopenia associated with the presence of antiplatelet antibodies associated with low-molecular weight heparins; body weight <50kg.

Adverse reactions and side effects: Dizziness, headache, constipation, nausea, vomiting, ecchymoses, bleeding, anemia, thrombocytopenia, erythema at injection site, irritation, pain.

Interactions: Risk of bleeding may be increased by concurrent use of warfarin or drugs that affect platelet function, including aspirin, NSAIDs, dipridamole, some penicillins, clopidogrel, ticlopidine, thrombolytics, and dextran. Increased risk of bleeding with natural products such as anise, chamomile, clove, garlic, ginger, ginkgo, and Panax ginseng.
What is the route and dosage of lovenox?
Route and dose:
Subcut (adults): DVT prophylaxis before knee/hip surgery: 30mg twice daily, starting with 24hr postop and continued for 7-10 days or until ambulatory. DVT prophylaxis before abdominal surgery: 40mg once daily starting with 24hr postop and continured for 7-10 days or until ambulatory. Treatment of DVT/PE: 1mg/kg q12hr or 1.5mg/kg q24hr. Angina/non-Q wave MI: 1mg/kg q12hr (with aspirin 100-325mg/day) for 2-8 days.
what are nursing implications for lovenox?
Nursing implications: Assess for signs of bleeding and hemorrhage (bleeding gums, nosebleed, unusual bruising, black tarry stools, fall in hematocrit or blood pressure). Assess for additional or increased thrombosis. Monitor for hypersensitivity reactions. Monitor patients with epidural catheters for signs and symptoms of neurological impairment. Observe injection sites for hematomas, ecchymosis, or inflammation.
What is docusate sodium?
Docusate Sodium (colace)
Classifications: laxatives, stool softeners

Indications: PO: prevention of constipation (in patients who should avoid straining, such as after MI or rectal surgery). Rect: Used as enema to soften fecal impaction.

Actions: Promotes incorporation of water into stool, resulting in softer fecal mass. May promote electrolyte and water secretion into colon. Softening and passage of stool.
what are contraindications and adverse reactions?
Contraindications: hypersensitivity, abdominal pain, nausea, or vomiting, especially when associated with fever or other signs of an acute abdomen.

Adverse Reactions: throat irritation, mild cramps, rashes.

Interactions: None significant
What is the route and dosage of docusate sodium?
Route and Dosage:
PO (adults and children >12yr) 50-500mg once daily
PO (children 6-12) 40-120mg once daily
PO (children 3-6) 20-60mg once daily
PO (children<3yr) 10-40mg once daily
Rect (adults) 50-100mg or 1 unit containing 283mg docusate sodium, soft soap and glycerin.
What are some nursing implications fo docusate sodium?
Interventions:
• Assess patient for abdominal distention, presence of bowel sounds and usual pattern of bowel function. Assess color, consistency and amount of stool.
• Medication does not stimulate intestinal peristalsis.
• Administer PO with full glass of water or juice. May be administered on empty stomach for more rapid results.
• Oral solution may be diluted in milk or fruit juice to decrease bitter taste.
• Do NOT administer within 2 hours of other laxatives, especially mineral oil. May cause increased absorption.
What is ferrous sulfate?
Ferrous Sulfate
(APO-ferrous sulfate, ED-IN-SOL, Feosol, Fer-in-sol, Fer-iron)
Classifications: antianemics, iron supplements.

Indications: Prevention and treatment of iron deficiency anemias. Dietary supplement for iron. Supplemental use during epoetin therapy to ensure proper hematological response.

Actions: An essential mineral found in hemoglobin, myoglobin, and many enzymes. Elevates serum iron concentration and is then converted to hemoglobin or trapped in reticuloendothelial cells for storage and conversion to a usable form of iron
what are contraindications and adverse reactions for ferrous sulfate?
Contraindications: Primary hemochromatosis, hemolytic anemias and other anemias not due to iron deficiency.

Adverse reactions and side effects: hypotension, nausea, GI upset, constipation, dark stools, diarrhea, epigastric pain, skin staining and pain at the IM site.
Interactions: tetracycline and antacids increase oral absorption of iron by forming insoluble compounds. Decrease absorption of and may decrease effects of levodopa and methyldopa. Chloramphenicol and vitamin E may cause hematologic response to iron therapy.
What is the route and dosage of ferrous sulfate?
Route and dosage:
PO (adults): Prophylactic: 325mg/day. Therapeutic: 300mg 2-4 times daily. Timed-release tablets may be given twice daily.
PO (children): Prophylactic: 5mg/kg/day. Therapeutic: 10mg/kg tid.
Nursing implications for ferrous sulfate?
Nursing Implications:
• Assess nutritional status and dietary history to determine possible cause of anemia and need for patient teaching.
• Assess bowel function for constipation or diarrhea.
• Assess patient for signs and symptoms of anaphylaxis.
• Administer liquid preps in water or juice to mask taste and prevent staining of teeth. Have pt. drink solution with straw.
• Warn patient that stool may be dark or green.
• Monitor hemoglobin and hematocrit levels.
• Give drug on empty stomach with water.
What is NPH insulin?
NPH Insulin (isophane insulin suspension)
Classifications: antidiabetics, pancreatics, hormones
Indications: Treatment of insulin-dependent diabetes mellitus. Management of non-insulin dependent diabetes mellitus unresponsive to treatment with diet.

Actions: Lower blood glucose by increasing transport into cells and promoting the conversion of glucose to glycogen. Inhibits the release of free fatty acids. Controls blood glucose in diabetic patients.
what are contraindications and adverse reactions from NPH insulin?
Contraindications: Allergy of hypersensitivity to a particular type of insulin, preservatives, and other additives. Use cautiously in stress, pregnancy, and infection.
Adverse reactions and side effects: hypoglycemia, lipodystrophy, itching, lipohypertrophy, redness, swelling, allergic reactions including anaphylaxis.

Interactions: Beta blockers may block some of the signs and symptoms of hypoglycemia and delay recovery from hypoglycemia. Thiazide diuretics, corticosteroids, diltiazem, dobutamine, thyroid preparations, estrogens, nicotine may increase insulin requirements. Glucosamine may worsen blood glucose control. Fenugreek, chromium, and coenzyme Q-10 may produce additive hypoglycemic effects.
Route and Dosage of NPH insulin?
Route and dosage: dose depends on blood glucose, response, and many other factors.
Subcut (Adults and Children): 0.5–1 unit total insulin/kg/day. Adolescents during rapid growth—0.8–1.2 units total insulin/kg/day.
Nursing implications for NPH insulin?
Nursing Implications:
• Assess patient periodically for symptoms of hypoglycemia (anxiety; restlessness; mood changes; tingling in hands, feet, lips, or tongue; chills; cold sweats; confusion; cool, pale skin; difficulty in concentration; drowsiness; excessive hunger; headache; irritability; nausea; nervousness; rapid pulse; shakiness; unusual tiredness or weakness)and hyperglycemia (confusion, drowsiness; flushed, dry skin; fruit-like breath odor; rapid, deep breathing, frequent urination; loss of appetite; tiredness; unusual thirst) during therapy.
• Monitor body weight periodically. Changes in weight may necessitate changes in insulin dose.
• Monitor blood glucose and ketones q6hr during therapy, more frequently in ketoacidosis and times of stress. Glycosylated hemoglobin may also be monitored to determine effectiveness.