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23 Cards in this Set

  • Front
  • Back
List nursing responisbilities when administering an antiemetic
a. Assess/identify underlying cause of nausea
b. Administer prior to incidences known to cause N/V
c. Monitor fluid and electrolyte status
What is an indisyncratic reaction?
Genetic Polymoprhism - any abnormal or peculiar response to a drug
Overresponse- require less drug
Underresponse- Require more drug
A different response
List common aminoglycosides, adverse reactions of these drugs, and nursing interventions when administering
Gentamicin (Garamycin), tobramycin (Tobrex)
Oxotoxcitiy, Nephrotoxicity
Assess hearing and renal functioning; assess peak and trough levels
List the general nursing interventions when administering an antibiotic
List nursing interventions when administering phenytoin (Dilantin)
Monitor neurological status and seizure activity; create a safe environment
Monitor blood studies; platelet count
Inform client of possible color change in urine
Implement/teach good oral hygiene
Monitor dilantin level (10-20
Mix parenteral phenytoin in Normal Saline Only
What are the benefits of using combination therapy to treat neoplastic disorders? What is nadir? What is the lab value to monitor for nadir?
Increases the disease-free intervals and survival rates
Prevents or delays failure owing to resistance
Provides maximum cell kill without producing excessive toxicity
Prevents or slows the emeergence of new resistant cell lines.
Nadir - Lowest point of counts, between day 10 and 14 (WBC, RBC, platelet) ****
What drugs are given to patients who have undergone an organ transplant? What is their purpose and major side effect?
Immunosuppressants - cyclosporine (Sandimmune), azathrioprine (Imuran)
Selectively inhibits lymphocyte proliferation and activity that normally would have been associated with cell mediated immune response. Prevent of rejection of tissue in transplant of organs
What are the common causes of hypoglycemia in the diabetic patient? What are the different types of insulin? Which routes can you administer them by? What are importnat nursing responsibilities when administering insulin? What is the protocol for rotating administration sites? Rationale?
Type - Onset/peak/duration
Rapid (Lispro) - 10 -15 minutes / 30-60 minutes/ less than 5 hours
Short acting (Regular) - 30 -60 minutes/2-4 hours/6-8 hours
Intermediate Acting (Lente, NPH) - 1-4 hours/ 8-12 hours/ 18-24 hours
Long Acting (Ultralente)- 4-8 hours/14-24 hours/ 36 hours
Combination (70/30)
Lantus - No defined peak effect/constant long duration
All can be given Sub Q, Regular can be given IV
Monitor serum blook suger (ac and hs)
Client Education
Injection technique
Types of insulin: onset, peak, duration
Signs/symptoms of hypoglycemia
Causes of hypoglycemia
Treatment of hypoglycemia
Rotate Sub Q sites of administration to avoid lipodystrophies (*)
What group of antidepressant drugs are considered to be the initial drugs of choice? Why are the other two groups of antidepressants drugs not first line agents?
Selective Serotonin Reuptake inhibitors (SSRI): fluoxetine (Prozac), sertraline (Zoloft), paroxatine (Paxil)
These cause more side effects, suchs as Tricyclin - orthostatic hypertension, anticholinergic effect, sedation, - Monoamine Oxidase (MAO) inhibitors -hypertensive crisis with food containing tyramine.
What is morphine sulfate? What type of pain is it used for? What is important to assess when administering this drug? List common side effects.
Side effects: constipation, respiratory depression, hypotension, itching, tolerance/dependancy
Implementations: Asses/evaluate effectiveness of pain relief using scale, monitor bowel pattern, increases fluids and roughage, monitor respiratory rate prior to administration of drug, monitor blood pressure, observe/assess the client for tolerance/physical dependance, opiod antagonist: naloxene hydrochloride (Narcann) -antidote, record use of the drug on the controlled substance form.
What is the actions of the bronchodilating agents? What are the important nursing interventions when administering these drugs?
Relax bronchial smooth muscles
Instruct client on use of the inhaler
Hold breath for 10 seconds after inhaling medication and water 2 minutes before second inhalation; administer 15 minutes prior ot a steroid to open airways
Instruct client to limit use of products that contain caffiene
Report difficulty breathing, heart palpitation, tremors, vomiting, nervousness.
Assess/respiratory staus/auscultating lung sounds
take heart rate
Monitor vital signs; assess respiratory rate/breath sounds
Administer with food or milk
Monitor theophylline levels (10-20 mcg/dll)
How does Metamucil work? How should it be administered? What are the advantages of this drug?
Absorbs water increasing volume, bulk, moisture of nonabsorbable intertinal content psyllium hyrophilic mucillod
What is the action og the loop diuretic Lasix? Most common side effects? How do you monitor for side effects? List assessment data that would indicate a positive response to diuretic therapy. What would be some safety precautions for elderly clients who you are administering a diuretic?
List the many uses of atropine, side effects, and nursing implementations when giving this drug.
Mydriasis or cycloplegia during eye surgery
Decrease secretion of the gastric adic; slow intestinal mobtitly @ high doses
Acceleration of the heart rate
Preanesthesia: Decrease respiratory secretions
Antidote for cholinergic toxicity from excessive cholinesterase inhibitors
What is the cardioglycoside Digoxin used for? What is its action? What are the early and late signs of toxicity? What are the two most important things to monitor when giving this drug?
Heart failure
Increases the force of myocardial contraction (positive inotropic)
Slows the heart rate (negative chronotropic)
GI: Anorexia, nausea, vomiting
CV: Bradycardia
CNS: Visual disturbances (halo vision)
Heart rate, withold if heart rate is less that 60 bpm.
Assess cardiac output
Monitor the K level as a low level with digoxin administration will potentitae the effect of digoxin
Monitor serum Dig level (therapeutic level 0.8-1.8 ng/ml)
Which anticoagulant is given orally? What is the action of this drug? What is important to teach the client taking this drug? What lab value is important to monitor?
Warfarin Sodium (Coumadin)
Inhibits the hepatic synthesis of several coagulation factors, inhibits synthesis of vit. k dependant clotting factors.
Avoid sudden dietary increase in dark green leafy vegetables.
PT: (Normal 12-15 seconds) Therapeutic: 1.5- 2 times the clients baseline of the INR value( 2-3.5 are considered therapeutic)
Go in daily until therapeutic dose is achieved then monthly
What type of pain is acetaminophen with codeine used for? What are the potential side effects nad information that should be included in your teaching plan at discharge?
Gastric Irritation, hepatic toxicity
Stay upright, take with food, administer no more than 4000 mg in 24 hours.
Describe the action of antacids. What are the consequences of this action for some patients?
Neutralize gastric acids
Diarrhea or constipation
What are the common antidiarrheals? How do they work?
Local Acting
Adsorbents: Coar abdominal wall of GI tract absorbing bacterial/toxins - Pepto bismol
Intestinal Flora Modifiers: Supress the growth of diarrhea producing pathogens and reestablish normal intestinal flora (Lactinex)
Probiotic: Acidophilus
Systemic Acting - Decrease GI motility
Opiate : Paregoric
Synthetic opiates: lomotil, imodium
What are ACE inhibitors used for? What are the nursing interventions when administering these agents?
Monitor for the first dose phenomenon of profound hypotension
Instruct client to change position slowly
Monitor for cough
Educate client to take the medication as prescribed: monitor blood pressure at home.
What is the difference between Sched I, Sched II, and Sched III-14 drugs? What are the nurses legal obligations when handling controlled substances
List nursing responsibilities associated with drug administration, for each phase of the nursing process.
What is guafensin (Robitussin) Why is it used? What nursing interventions should be implemented with this drug?