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69 Cards in this Set
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- Back
- 3rd side (hint)
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heparin antidote
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protamine sulfate
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sounds like protein
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coumadin antidote
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phytonadione (vitamin k)
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phy
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therapeutic INR is
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2.0 - 3.0
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not 1
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coumadin pt
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prothrombin time
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heparin ptt
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partial thrombin plastin time
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hold coumadin if INR
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over 3.0
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ace inhibitors
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A pril
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hold betablockers (end in(olol)
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if SBP <90 or Apical pulse <60 (check for 1 full minute)
Sudden discontinuing of beta Blockers can cause: angina, HTN, & acute MI |
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calcium channel blockers
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some slow hr which decreases o2 demand
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hold calcium channel blockers
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if SBP <90 or pulse <60. prior to giving obtain baseline BP, Apical pulse, rate and rhythm
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Diuretic side effects
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dehydration, hypokalemia (low k+, low bp etc.
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potassium normal levels
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3.5 -5.0
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low k+ (hypokalemia)
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increases risk of digoxin toxicity. so does st. johns wort
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digoxin action
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increases myocardial output and slows hr
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lasix/furosemide action
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diureses fluid to remove edema. Sodium chloride and water reabsorption inhibited in the Loop of Henle
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nystatin action
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an antifungal that binds to fungal cell membrane releasing cellular contents
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potassium action
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replaces electrolytes
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coumadin/warfarin action
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anticoagulant that inhibits the clotting factors of vitamin k
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nitropatch action
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an antianginal vasodilator that increases coronary bloodflow by dialating corinary arteries. Reduces myocardial o2 consumption
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lasix hold
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if pt. dehydrated or k+ level <3.5, SBP <90
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digoxin hold
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Apical pulse <60 or > 100, if digoxin level > 2, k+ < 3.5
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nystatin hold
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mucousal irritation
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potassium hold
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if k+ > 5 ( 3.5-5 normal)
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coumadin/warfarin hold
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s/sx of bleeding, platelets < 150,000, INR > 3
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nitropatch hold
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SBP <90
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6 rights of medication administration
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PMTRDD. Patient ,Medication, Time, Route, Dose, Documentation
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3 checks performef
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1) at source check with MAR 2) when preparing 3) at pt. bedside
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SQ angle and gage
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45/90 angle. 3/8-5/8 inch
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calcium channel blockers
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Verapamil
Nifedapine Diltiazem (action: blocks calcium access to cells》decreasing contractility and conductivity of the heart, lowers o2 demand) Side effects: decreased BP bradycardia headache may precipitate AV block peripheral edema abdominal discomfort (constipation, nausea) |
Very Nice Drugs
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Blood clot formation
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a complex cascading system with the end result being a large concentration of fibrin.
Action- blood vessels constrict & become aggrigate (sticky) in order to clot, then platelets breakdown & release chemicals to assist clotting *creating a mesh network formation* then large amount of fibrin collects |
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Blood clot formation
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a complex cascading system with the end result being a large concentration of fibrin.
Action- blood vessels constrict & become aggrigate (sticky) in order to clot, then platelets breakdown & release chemicals to assist clotting *creating a mesh network formation* then large amount of fibrin collects |
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Thrombus
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blood clot
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Embolus
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traveling blood clot
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Anticoagulants
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prevent new blood clots from forming and can't breakdown existing clots but can prevent existing clots from getting bigger.
Action- decreases blood coagulability to prevent thrombus |
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DVT
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Deep vein thrombosis is a blood clot in the leg.
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PE
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Pulmonary embolus is a lung clot that has traveled
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Heparin
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poorly absorbed in the GI tract
DO NOT GIVE IM (causes pain and muscle damage) Action- turns off the coagulation pathway and prevents clot formation. Is measures in units. Has shorter 1/2 life. |
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Heparin contraindications
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Allergy, Acute bleeding process
Side effects: bleeding, bruising, Thrombocytopenia (HIT) is a HIGH ALERT medication!!!!!! |
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Thrombocytopenia
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low platelet count
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Lovenox
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a more stable version of heparin (LMWH) low molecular weight heparin with a more predictable anticoagulant response
*be sure to inject air bubble to help with absorption* |
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Coumadin/warfarin
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major oral anticoagulant in the US
antagonizes vitamin k dependent clotting factors including prothrombin *may take several days to reach its desired effects* Used for: PE DVT prosthetic heart valves diseased mitral valve chronic atrial fibrillation |
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Therapuetic INR
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2-3
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INR > 3
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HOLD Coumadin/warfarin
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INR > 3
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HOLD Coumadin/warfarin
The higher the number, the higher the risk for bleeding. Always check for signs of bleeding before administration of med. Check in urine, stool,emesis (vomit) |
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Melena
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Bloody stool
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Bleeding precautions
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Razor-electric
Aspirin-NO!!!!(no NSAIDS (ibuprofen/aleve) Needles-small gage Decrease- needles (limit needle sticks) Injury-protect from |
RANDI
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Anti-hypertensives types are:
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Ace Inhibitors
Beta Blockers Calcium Channel Blockers |
ABC
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Ace inhibitors action
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inhibit angiotensin converting enzyme *ACE* by preventing the conversion of angiotensin I to angiotensin II.
As angiotensin II is reduced, arterioles dialate & peripheral vascular resistance is reduced. |
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If conversion to angiotensin II happens
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aldosterone is released from adrenal cortex and results in the body holding H2O, Na (sodium) and kicks out K+
*ace inhibitors stop this from happening and will cause secretion of H2O, Na and increase K+* |
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A ok to give ace inhibitors with
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low pulse However, do not give with a low SBP under 90 (it can indicate dehydration)
Watch for Hyperkalemia, elevated BUN and Creatinine and monitor I&O |
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ACE Inhibitors action
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Decreases peripheral vascular resistance without increasing:
cardiac output cardiac rate cardiac contractility Side effects: dizziness orthostatic hypotension GI distress Cough Headache |
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ACE Inhibitors action
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Decreases peripheral vascular resistance without increasing:
cardiac output cardiac rate cardiac contractility Side effects: dizziness orthostatic hypotension GI distress Cough Headache |
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Diuretics
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decrease preload (return of blood to heart)
results in a decreased heart size |
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causes of Hyperkalemia
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ACE Inhibitors
Renal failure K+ supplements K+ sparing diuretics trauma/burns metabolic acidosis |
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causes of Hypokalemia
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vomiting (losing electrolytes)
diarrhea (laxative od) diuretics malabsorption corticosteroids |
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Insulin antagonists
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corticosteroids
epinephrine thyroid hormones lasix |
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Hypoglycemia
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Tachycardia
Irritability Restless Excessive hunger Diaphoresis/Depression certain drugs increase Hypoglycemia: alcohol maoi's salicylates |
TIRED
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Bactericidal antibiotics action
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kills bacteria by inhibiting cell wall synthesis
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Bacteriostatic antibiotic action
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inhibit growth of susceptible bacteria and leads to bacterial death.
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Empiric therapy
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treatment of an infection prior to establishing results of a culture or before culture is ordered.
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Prophylactic therapy
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Treament with antibiotics to prevent a potential infection.
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Therapeutic response
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decreases s/s of infection
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Subtherapeutic response
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s/s don't improve
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Superinfection
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antibiotics reduce or eliminate normal flora or patient develops a 2nd infection
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superinfection s/s
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fever
perineal itching cough lethargy vaginal discharge oral lesions |
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Vancomycin
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used to kill gram + bacteria such as MRSA and Enterococcus
*Watch for red mans syndrome if given too quickly* is a histamine reaction |
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Fluoroquinolones used for
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UTI's
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Metronidazole (flagyl)
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treats protozoal infections & is only effective on anaerobic bacteria (in vaginal and colorectal areas) such as C-diff
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before beginning antibiotic therapy
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assess drug allergies
check renal, liver and cardiac function obtain thorough health history and immune status assess for potential drug interactions |
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