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68 Cards in this Set

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Why do neonates require higher mg/kg dosing of water-soluble drugs?
Babies have a higher percentage of water in their body weight.
What is active immunization?
Active immunization occurs when the person comes in contact with a relatively harmless form of the antigen and develops immunity to the disease. This is generally a long-lasting and sometimes lifetime immunity.
Give an example of passive immunization
passed from mother to infant via the placenta or mother's milk, snake antivenom, immuno globins
Explain why immunosuppressed individuals do not benefit from active immunization
people who are immunodeficient and cannot develop immunity in response to a toxoid or vaccination because their immune system is too depressed
How many kg is 45lb?
20.45
Child with congestive heart failure ordered digoxin 40mcg, IV, bid
Child’s weight and age 6lb, 1 month
What are the 4 major
considerations a nurse must take into account when administering medications to a pediatric patient?
WEIGHT, HEIGHT, AGE AND ORGAN MATURITY
What is the most acceptable site for an IM injection in a 2 month old?
vastus lateralis
What is the most acceptable site for an IM injection In an 8 year old?
Injection sites include the vastus lateralis, ventrogluteal, deltoid, and as a last resort the dorsogluteal site.
True or false: an LPN can hang Ancef 1gm IVPB?
false, ancef is an antibiotic.
m. What are signs and symptoms of an infiltrated IV?
Infiltration is characterized by coolness of the skin around the site, taut skin, edema, absence of blood backflow into the catheter or a pinkish blood return, and the slowing or stopping of the infusion.
Explain why antacids should not be taken with certain medications.
antacids change the ph of the body system. Drugs that require an acidic environment for absorption will be impacted, as will drugs more readily absorbed in a less acidic environment.
b. Give an example of a Proton Pump inhibitor
lansoprazole (Prevacid), omeprazole (Prilosec), rabeprazole (Aciphex), and pantoprazole (Protonix).
Why is Docusate sodium safe to give after an MI?
Colace decreases straining with defecation and is frequently used post myocardial infarction or surgery
What is the mechanism of action of Reglan?
prokinetic agent used post operative to initiate the emptying of the GI tract that is sluggish to get moving after prolonged anesthesia or bedrest
Why do patients who are hospitalized benefit from H2 blockers?
these medications prevent stress ulcers and reduce the recurrence of all ulcers. stressors in the environment, or situations where an individual may experience an increased stress response, can increase the need for acid controller type drugs.
Give two examples of why post surgical patients may need laxatives
immobility (recovery in bed) and anesthesia cause constipation,
What is the recommended treatment for overdose in a child?
Administering activated charcoal
What type of diuretic is Lasix?
loop
What electrolyte abnormality may present cardiac complications due to lasix administration & is typically the most common imbalance noted with this drug?
low potassium. also hyponatremia, hypocalcaemia, hypomagnesemia
What class of anit-hypertensives does Capoten fall into?
ACE inhibitors. ACE inhibitors work by blocking the formation of angiotensin II which in turn stops the actions of vasoconstriction, thirst and fluid ret
What is the therapeutic dose for Digoxin?
0.5 to 2 ng/mL. levels above 2 ng/mL are toxic
Why are most beta-blockers avoided in patients with COPD?
Beta-blockers can block the beta-2 receptors in the lungs, leading to constriction of the bronchioles.
Explain how to educate a patient taking sublingual nitro (indications & dosage)
Tell patient to take S.L. tablet at first sign of attack. Patient should wet the tablet with saliva and place under the tongue until absorbed; he should sit down and rest. Dose may be repeated every 5 minutes for a maximum of three doses. If drug doesn't provide relief, he should obtain medical help promptly.
What tests are necessary to check on a patient taking Amiodarone?
get baseline pulmonary, liver, and thyroid function test results and baseline chest x-ray. alkaline phosphate, ALT, AST, GGT, T4, T3, PT, INR
What does it mean to have a “proarrythmic effect”?
they can cause worse dysrhythmias than the ones they were prescribed to treat
What test is used to monitor possible liver damage due to statin therapy?
Alanine aminotransferase (ALT)
Aspartate aminotransferase (AST)
Bilirubin Albumin Total Protein
What types of food are patients encouraged to limit when taking Coumadin & why?
vitamin K may impair anticoagulation.
Explain the mechanism of action of nitrates in treating angina
nitrates produce vasodilation and decrease preload and after load and reduce myocardial oxygen consumption.
Do patients taking aldactone have to take potassium supplements and why?
no. aldactone is a potassium-sparing diuretic.
Explain relationship between inotropic and chronotropic effect with Digoxin
positive isotropic action increases the force of myocardial contrations. negative chronographic action depresses the SA node, reduces conduction of the impulse of the AV node and slows the heart rate.
Would it be safe to give an IM injection to someone receiving Heparin?
to prevent hematomas, avoid IM injections.
What is a potential life threatening side effect of opioid therapy?
CNS depression that can lead to respiratory depression.
What side effects are most common in medications such as atropine and what drug class does it fall into?
over-suppression of the parasympathetic nervous system. These include worsening of some types of glaucoma, tachycardia, restlessness, delirium and urinary retention. ant cholinergic drugs block the action of acetylcholine, primarily in smooth muscle, the heart, and certain exocrine glands. By decreasing parasympathetic tone, they allow the sympathetic nervous system to exert a greater influence.
What side effects are most common in medications such as epinephrine and what drug class does it fall into?
mixed adrenergic agonist, which includes both alpha and beta receptors. nervousness, tremor, headache, drowsiness, cerebral hemorrhage, stroke, palpitations, vfib, shock, nausea, vomiting
What class of medication is used to treat Parkinson’s disease?
increase dopamine. Levodopa/Carbidopa
What is a benzodiazepine used for?
CNS depressant. sedative-hypnotic, control of convulsions, reduction of intracranial pressure, treatment of alcohol withdrawal, and as a component of anesthesia. Diazepam (Valium), lorazepam (Ativan), and midazolam (Versed) are examples of benzodiazepines
What is appropriate scheduling for dosing Ritalin?
This drug should be administered in the morning to avoid problems with insomnia. For example, a twice-daily dose is taken at breakfast and lunch.
What is a common side effect of anticholinergics that individuals with BPH should be warned about?
decrease bladder tone which can lead to urinary retention
What is a common side effect of anticholinergic drugs that you should warn patients about?
dry mouth and throat, headache, and GI distress.
What common over-the-counter medication is contraindicated with hypertension?
Decongestants, Adrenergics
What inhaler is most effective in an acute asthmatic attack?
Beta-agonists are commonly used to treat the acute phase of an asthma attack because they quickly reduce airway constriction and restore airflow. Proventil, Ventolin, Albuterol
Why are “spacers” beneficial with inhaler usage?
Releasing the medication into the chamber actually provides the patient with more time to inhale the medication and increases the amount of drug that reaches the lungs.
Should cromolyn inhalers be used to treat acute asthmatic episodes?
no. prophylactically as adjuncts to the overall management of patients with COPD
What medication is most effective with a non-productive cough?
antitussives, expectorants
What medication is most effective with a productive cough?
antitussives if the cough needs to be supressed
What is the duration of action for Regular Insulin?
duration 5-7 hours, onset ½-1 hour
How do you prepare a dose of both NPH and Regular Insulin?
draw up regular insulin first. administer within 5-15 minutes. 45-90 degree angle.
Give symptoms of hypoglycemia
mild: hunger, nervousness, palpitations, sweating, tachycardia, tremor. moderate: confusion, double vision, drowsiness, emotional change, headache, light-headed, slurred speech, numbness of lips. severe: difficulty arousing from sleep, disoriented, loss of consiousness, seizures
What is the mechanism of action for sulfonylureas? Can they be given to Type I diabetics?
stimulate the pancreas beta cells to produce more insulin. used with type 2.
What is a common side effect of corticosteroid administration on diabetic patients?
hyperglycemia
What is vasopressin most commonly used to treat and why?
ant diuretic hormone used in diabetes insipidus.
What is the normal fasting blood glucose level?
70-110
What is the safest way to discontinue prednisone therapy?
gradually reduce dosage.
Explain acute angle glaucoma and what is most commonly used to treat it and why?
obstruction to outflow to aqueous humor. rapid onset of IOP greater than 50-70 mmHg. miotics
What medication is contraindicated in patients with glaucoma and why?
avoid mydriatics(atropine), cyclopedias, these increase IOP.
Where do you administer ophthalmic agents?
conjunctival sac
How does a wax emulsifier work?
Ear wax emulsifiers work to loosen and remove cerumen.
Is it safe to abruptly stop dilantin therapy & why?
stress importance of good oral hygeine. stopping drug suddenly may worsen seizures.
What medication requires good oral care after administering?
dilantin
Antihistamines
Fexofenadine (Allegra)
Diphenhydramine (Benedryl)
Decongestants
Pseudoephedrine
Antitussives
Dextromethorphan
Expectorants
Guaifenesin
Bronchodilators
Beta2-adrenergic - Albuterol (Proventil)
Xanthines - Theophylline (Bronkodyl, Theo-Dur)
Anticholinergic - Ipratropium bromide (Atrovent)
anti-inflammatory
Corticosteroids - Beclomethasone (Vanceril)
Mast Cell Stabilizers - Cromolyn (Intal)
Leukotriene receptor antagonist - Montelukast (Singulair)
Mucolytics
Acetylocysteine
Herbs/Supplements
Comfrey
Lobelia