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122 Cards in this Set
- Front
- Back
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What's the FDA recommendation about administering drugs during pregnancy?
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No drug administered unless benefit clearly outweighs risk of use.
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What is an autonomous decision made by a specific individual based on the nature of the condition, the treatment options, and the risks involved?
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informed consent
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What two jobs does the nurse do regarding informed consent?
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1. explains purpose of Rx
2. answers questions |
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What describes the role of the nurse in relation to medication administration?
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Nurse Practice Act
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What is one important feature of maintaining medication safety re: allergies?
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Recording any the client reports
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What must the nurse know about every drug given to a client? (2)
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Effects and potential effects
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Six rights
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right medication
right dose right client right route right time right documentation |
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What is an adverse drug reaction?
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undesired response to a drug
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What is the range of adverse drug reactions?
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mild to severe
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Children have ___________ body systems for handling drugs.
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immature
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Reduced liver and/or renal function may __________ medications effects; this is due to reduced ____________ and/or ___________ of a drug.
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prolong, metabolism, excretion
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What is the fastest acting route?
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IV
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What is the impact of food on drug absorption?
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may increase or decrease drug's absorption rate
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What is an example of food on drug toxicity?
What can happen? |
MAO inhibitors & tyramine (yeast, aged cheese.
Can raise blood pressure to a life-threatening level |
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Foods rich in Vit K can reduce the effect of what drug?
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warfarin (Coumadin)
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When are most herbs contraindicated?
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During pregnancy
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What are three conditions to use OPIOIDS cautiously?
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hepatic and renal disease, and pregnancy
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Do not use OPIOIDS with these conditions. (6)
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acute bronchial asthma or upper airway obstruction, increased intracranial pressure, convulsive disorders, pancreatitis, acute ulcerative colitis, severe liver or kidney insufficiency
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OPIOIDS: Significant Drug Interactions
These drugs can increase CNS depression (5) |
barbiturates, other narcotics, hypnotics, antipsychotics, or alcohol
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With OPIOIDS, what do the main drug interactions cause in the body?
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Increased CNS depression
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OPIOIDS: side effects (12)
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Nausea and vomiting, anorexia or loss of appetite, sedation, CONSTIPATION, GI cramps, urinary retention, oliguria, pruritis, light-headedness, dizziness
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OPIOIDS: adverse effects/toxicity (4)
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Respiratory depression, respiratory arrest, circulatory depression, increased intracranial pressure
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OPIOIDS
Assess what 5 things? |
pain, respiration, CNS changes, allergy, slower biotransformation in older adults
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OPIOIDS
Assess pain for ___, ___, and ___. When? With what? |
type, intensity, location.
Before administration. Pain scale |
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OPIOIDS
Assess respiration for ___, ___, and ___. When do you withhold? |
rate, depth, rhythm.
if less than 12 breaths per minute |
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OPIOIDS
CNS changes, assess for what? (x5) |
LOC, dizziness, drowsiness, hallucinations, and pupil size
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OPIOIDS: Pt education
Avoid what two substances? |
alcohol and other CNS depressants
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OPIOIDS: Pt education
Do not take ______ ______ without approval by prescriber. |
Over-the-counter medications
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OPIOIDS: Pt education
Avoid _____, _____, _____, or other activities without assistance until drug response is known |
ambulation, smoking, driving
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OPIOIDS: Pt education
Report any _____ changes, _____ reactions, _____ of _____ |
CNS changes, allergic reactions, shortness of breath
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OPIOIDS: Pt education
Long-term use can lead to what? |
withdrawal symptoms
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What are typical withdrawal symptoms with OPIOIDS? (6)
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nausea, vomiting, cramps, fever, faintness, anorexia
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OPIOIDS: Pt education
All 5 |
avoid alcohol and other CNS depressants; do not take OTC meds w/o approval; avoid ambulation, smoking, driving, other activities until drug response known; report CNS changes, allergy, SOB; can lead to withdrawal
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Name two
OPIOID ANTAGONISTS |
naloxone (Narcan)
naltrexone (ReVia) |
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OPIOID ANTAGONISTS
Used to reverse _______ _______ induced by _______ of ________, _______, _______ |
respiratory depression, overdose (of) opioids, pentazocine, propoxyphene
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OPIOID ANTAGONISTS
side effect |
reversal of analgesia
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OPIOID ANTAGONISTS
Nursing considerations evaluate what three things? |
evaluate therapeutic response, LOC, and need for reversal of respiratory depression
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OPIOID ANTAGONISTS
Nursing considerations assess what two things? |
assess respiratory function (rate, rhythm) and LOC
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Informed Consent:
_____ _____ made by a specific individual based on the _____ of the _____, the _____ options, and the _____ involved |
Autonomous, decision, nature (of the) condition, treatment, risks
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What is the generic name for Aspirin?
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Acetylsalicylic acid
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ASPIRIN
dosage varies depending on what? (2) |
age of client and condition being treated
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ASPIRIN
When is the best time to administer? |
30 minutes prior or 2 hours after a meal
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ASPIRIN: Contraindications
History of hypersensitivity to _____, or other _____, ___ _____, _____ _____. |
salicylates, NSAIDs, GI bleeding, bleeding disorders
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ASPIRIN: Contraindications
Who shouldn't take it? (4) |
children younger than 12 y/o, children or teens w/ chicken pox or flu-like symptoms, during 3rd trimester, lactating
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ASPIRIN: Contraindications
Don't take with these medical conditions: 4 |
vitamin K deficiency, peptic ulcer disease, anemia, renal or hepatic dysfunction
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ASPIRIN: Significant drug interactions
Increased bleeding with ______ and _______ |
anticoagulants, alcohol
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ASPIRIN: Significant drug interactions
Increased GI bleeding when taken concurrently with _______ |
corticosteroids
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ASPIRIN: Side effects
What increases? (3) |
prothrombin time (PT), activated partial thromboplastin time (APTT), bleeding time
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Tinnitus is a potential side effect for what analgesic med?
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Aspirin
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How is Reye's syndrome characterized?
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encephalopthy and fatty liver degeneration
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ASPIRIN
Assess for ... (x2) |
allergy to salicylates and hepatotoxicity
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What are symptoms of hepatotoxicity? (x6)
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dark urine, clay-colored stools, yellowing of skin & scelra, itching, fever, diarrhea
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Acetaminophen
usual dose? max dose? |
325-600 mg q4-6h PO or PR
4 grams |
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Acetaminophen
GI adverse effect |
hepatotoxicity
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Acetaminophen
Toxicity (x11) |
cyanosis, anemia, neutropenia, jaundice, pancytopenia, CNS stimulation, delirium followed by vascular collapse, convulsions, coma, and death
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Acetaminophen
Assess for ... (x3) |
liver function tests, chronic poisoning, hepatotoxicity
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Antidote for acetaminophen
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acetylcysteine (Mucomyst)
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NSAIDs
Assess what (x2) |
Ear and eye problems
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NSAIDs Client education
Report problems with eyes and ears (x3) |
blurred vision, ringing, roaring in ears (may indicate toxicity)
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NSAIDs Client education
Report changes in . . . (x6) |
urine pattern, increased weight, edema, increased pain in joints, fever, blood in urine (indicating nephrotoxicity)
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Black cohosh
Active ingredients (x3) |
triperpenoid glycosides, isoflavonones, aglycones
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Black cohosh
What does it act like? |
estrogen
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Black cohosh
Primary uses (x2) |
treatment of PMS and post-menopausal symptoms
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Black cohosh
other uses (x2) |
promotes labor of pregnancy and decreases blood pressure
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Black cohosh
dosage |
safe dosage not yet determined
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Black cohosh
Drug contraindications (x2) |
antihypertensives or hormone replacement
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Black cohosh
Caution, may cause . . . (x3) |
bradychardia, hypotension, joint pain
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Black cohosh
contraindicated when? |
lactation
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Black cohosh
When to use in pregnancy? |
only when birth is imminent to promote labor
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Echinacea: Action on blood cells
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activates T lymphocytes and intensifies phagocytosis of macrophages
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Echinacea
Stimulates what? |
nonspecific stimulation of immune system
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Echinacea
Stabilizes _____ _____ (a component of connective tissue) to protect cells and connective tissue from _____ _____ and attack from _____ _____. |
hyaluronic acid, microorganism invasion, free radicals
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Echinacea
Inhibits lipoxygenase to _____ _____ |
reduce inflammation
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Echinacea
Most common use |
prevention or reduction of symptoms of cold/flu
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Echinacea
Secondary use (x2) |
boost immune system and increase body's resistance to infection
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Echinacea
Increases body's resistance to infection, particularly _____ _____ and _____ infection |
upper respiratory, urinary
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Echinacea
Best timing for dose regimen Why? |
8 weeks on and 1 week off,
to reduce decreased effects with continued use |
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Echinacea
Do not use in presence of ... (x3) |
autoimmune disease, severe, illness, allergy to sunflower or daisy family
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examples of autoimmune diseases (x4)
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HIV/AIDS, collagen disease, multiple sclerosis, tuberculosis
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Echinacea
not to be used with what type of drugs (two examples) |
immunosuppressants
(e.g. corticosteroids or cyclosporine) |
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Echinacea
Adverse effects (x2) |
allergic reaction and anaphylaxis
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Echinacea
Contraindicated with what kind of people? (x4) |
alcoholism, children, pregnancy and lactation
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Feverfew: Suppresses secretion of _____ in _____ and _____ to inhibit _____ _____
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granules (in) platelets, neutrophils, platelet aggregation
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Feverfew
Inhibits release of _____ |
serotonin
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Feverfew
Principle use (x2) |
prevention of recurrent migraine headaches, treatment of arthritis
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Feverfew
other use |
relief of menstrual pain
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Feverfew
Dosage and when? |
50-125 mg of dried herb, w/ or after meals to reduce GI colic
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Feverfew
Adverse effects (x6) |
allergic reaction, lip and tongue swelling, mouth ulcers, abdominal colic, palpitations, increased menstrual flow
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Feverfew
May interfere with _____ _____ _____; not to be used with _____, _____, _____, _____. |
blood clotting mechanism, bilberry, garlic, ginger, gingko
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Garlic
Inhibits _____ _____ |
platelet aggregation
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Garlic
Effect on cholesterol (x2) |
inhibits metabolism of cholesterol, leading to reduction
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Garlic
Primary uses (x2) |
reduce cholesterol and treatment of mild hypertension
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Garlic
Avoid large amounts of garlic with other herbs affecting _____ (+4 ex) |
coagulation (bilberry, feverfew, ginger, ginkgo)
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Garlic may potentiate _____ drugs
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antidiabetic
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Garlic
Contraindicated with what medical conditions (x4) |
pregnancy, peptic ulcer, GERD, bleeding disorders
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Ginger
Principle uses (x4) |
antiemetic, improve appetite, treatment of motion sickness, vertigo
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Ginger
Adverse effects (x7) |
headache, anxiety, insomnia, elevated blood pressure, tachycardia, asthma attack, postmenopausal bleeding
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Ginger
Not to be used comcomitantly with _____, _____, _____, or _____ (increased risk of _____) |
bilberry, feverfew, garlic, ginkgo (bleeding)
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Ginkgo
Uses (x3) |
short-term memory loss, cerebral vascular insufficiency, peripheral vascular disease
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Ginkgo
Not to be used comcomitantly with _____, _____, _____, or _____; or other anticoagulants such as _____ and _____. |
bilberry, feverfew, garlic, ginger; ASA (and) warfarin
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Herbals
Avoid whose unprocessed leaves? |
Ginkgo
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Korean Ginseng
Improves _____ ____ and _____ levels |
serum cholesterol, triglyceride
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Korean GinsengMost common use
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counteract effects of physical and mental fatigue
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Korean Ginseng
improves body's ability to ____ ____ and _____; increase _____ |
resist stress (and) disease; vitality
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Korean Ginseng
Adverse effects (x3) |
insomnia, palpitations, pruritus
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Siberian Ginseng
What's it do? (x2) |
elevates T lymphocytes, boosts immune system
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Siberian GinsengDosing period?
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2-3 weeks off every 4-8 weeks
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Siberian Ginseng
Contraindications (x6) |
pregnancy, lactation, premenopausal women, hypertension, CNS stimulants, or antipsychotics
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HawthorneActs as _____ that decreases damage by _____ _____ to CV sys by increasing levels of _____ _ intracellularly
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antioxidant, free radicals, Vitamin C
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Hawthorne
Decreases _____ _____ _____ to decrease _____ _____ |
peripheral vascular resistance, blood pressure
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Hawthorne
Uses |
mild hypertension, athero-/arteriosclerosis, chronic angina, early CHF
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Saw palmettoSimilar in effect to .... with ...
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finasteride (Proscar) with fewer side effects
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Saw palmetto
No effect on _____-_____ _____ |
prostatic-specific antigen
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Saw palmetto
Helps initiate |
urine stream
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Saw palmetto
Uses: decreases (x3) |
urinary frequency, residual volumes, nocturia, dysuria
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Saw palmetto
Caution, may interfere with _____ _____ |
iron absorption
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Saw palmetto
Caution, supervision by PCP for diagnosed ___ |
BPH
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Valerian
Action similar to _____, but . . . (x3) |
benzodiazepines, nonaddicting, nondependence, no morning hangover
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Valerian
Uses x2 |
sedative, insomnia
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Valerian
Not to be used with ... (x3) |
other sedatives/hypnotics, anxiolytics, or antidepressants
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Valerian
Caution, may cause |
hepatotoxicity
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Herbals are not intended for (x2)
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acute illness or long-term therapy
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