sodium
135-145
Potassium
3.5-5.0
Calcium
9.0-10.5
PH
7.35-7.45
PACO2
35-45
HC03
21-28
PAO2
80-100
SAO2
95-100
Hemoglobin
14-18
Hematocrit
37%-52%
WBC
5000-10000
Cholesterol
Below 200 ideal
Platelets
150000-400000
APTT
3.5-4.0
Therapeutic is 1.5-2 times normal value
PT
11-12.5
Therapeutic is 1.5-2 times normal value
INR
0.7-1.8
therapeutic is 2-3
Fasting glucose
70-105
HbA1c
4-6%
Creatinine
0.5-1.2
Meds that prevent heart disease
Statins-atorvastatin
SE rhabdomyolysis, liver toxicity
Meds that prevent MI or stroke
Clopidogrel- antiplatelet drug
SE is bleeding, hemorrhage
Meds that slow progression of arthritis
Etanercept-cept
Meds that prevent urinary incontinence
oxybutynin aka ditropan. Antispasmodic prevents bladder contraction
meds that prevents rubella
MMR vaccine
Meds that lowers blood pressure
Valsartan-sartan
Meds that treat neuropathy
Pregabalin
Meds that treat GERD
Esomeprazole-PRAZOLE
Meds that treat bipolar disorder
Quetiapine-antiphyschotic
Meds that treat COPD
Tiotropium
Meds that treat depression
Duloxetine
Meds that decrease symptoms of herpes zoster
Valacyclovir-VIR
Meds that prevent bronchospasm
Montelukast
TPN is what type of solution?
Hypertonic
TPN can be given in what form?
PICC line and tunneled cath not NG
TPN is prepared how often
daily
Which lab value is checked every 4-6 hours for TPN
blood glucose
How often is a new TPN bag hung?
24 hours with a new filter each time
Minimal PPE requirement for contact
Gloves and gown
Minimal PPE requirement for droplet
think sneezing. Mask
Minimal PPE requirement for airborne
TB, SARS, varicella wear N95
Rebreather bags are used for what underlying cause
Respiratory acidosis. This hyperventilation, paper bag, panice attack
Diphenxylate/ atropine aka Lomotil is used for what underlying cause
Metabolic acidosis
Naloxone is used for what underlying cause
Respiratory acidosis
Ondansetron is used for what underlying cause
Metabolic alkalosis
Regular insulin is used for what underlying cause
Metabolic acidosis
Hydromorphone is used for what underlying cause
Respiratory acidosis and alkalosis
Pancreatitis diet
NPO, TPN
Diverticulosis diet
Clear liquids, high fiber
Cholecystitis diet
Low fat
Liver disease diet
Decrease protein
Celiac diet
avoid gluten
N/V diet
Clear liquids
Gout diet
avoid purines. Veggies has purines
Dumping syndrome diet
Small, frequent meals
Erikson stage 0-1
Trust vs mistrust health promote social and physical needs
Erikson stage 1-3
Autonomy vs shame health promote provide acceptable options
Erikson stage 3-6
Initiative vs guilt health promote age appropriate activities
Erikson stages 6-12
Industry vs inferiority health promote encourage child's participation in care
Erikson stages 12-20
Identity vs role confusion health promote same age support group
Erikson stages 20-35
Intimacy vs isolation health promote Private time w/ partner
Erikson stages 35-65
Generativity vs stagnation health promote assist client w/ illness and home/work demands
Erikson stages greater than age 65
Integrity vs despair health promote use personal items when not at home
Digoxin
Monitor potassium, apical pulse for 1 minute
Acetaminophen
Monitor temp
Glipizide
Monitor glucose
Morphine
Monitor respiratory rate
Prednisone
Monitor Delayed wound healing
Warfarin
Monitor INR
Zolpidem
Monitor sleep patterns
sleep walking can occur and changes in behavior
Olanzapine
Monitor Mood
Levofloxacin
monitor C & S
Antidote for Opioids
Naloxone
Antidote for warfarin
Vitamin K
Antidote for Heparin
Protamine sulfate
Antidote for acetaminophen
Acetylcysteine
Antidote for Benzos
Flumazenil
Antidote for Digitalis
Digoxin immune fab I call it digibind
Antidote for lead
succimer
Antidote for magnesium
calcium gluconate
Budesonide
It is used to prevent asthma attacks but is also a immunosuppresant
Gabapentin
The peak is 2-3 hrs used for epilepsy and neuralgia
Metformin
Oral diabetic drug. Can cause build up of lactic acid in body and monitor glucose
Insulin determir
peak is 6-8 hrs given IV don't give prior to food it replaces the missing pancreatic hormone
Levothyroxine
thyroid med and needs to be taken in the morning before eating breakfast
Methylergonovine
Used for retained placental fragments used for women who had twins too
Nitroglycerin
Have the patient lay down or sit before taking don't take it with tadalafil which is a male enhancement drug
Oxytocin
It is a uterine stimulant to stimulate labor
Antidote for oxytocin
tocolytic cancels contractions
PantopraZOLE
Used for GERD and changes the flora it is a proton pump inhibitor and can cause pnemonia
take 1 hours before meals
Risperidone
It effects cholesterol and causes hyperglycemia. It is used to decrease hallucinations and delusions watch for EPS and neutropenia
Vancomycin
Think of REDMAN Syndrome monitor BUN and creatinine. Treats C.DIFF intestional infection
Lithium
mood stabilizer Bipolar disorders
SE tremors, polyuria
Toxicity signs are GI upset, convulsion, coma, death, CNS changes
Therapeutic is 1, toxic at 2
Lithium range
0.5-1.4
Tylenol range
cannot exceed 4000 mg
Dilantin range
10-20 toxic is 30
Digoxin range
0.5-2 toxic is 2.5
Albumin
3.5-5.0
urine specific gravity
1.010-1.030
RBCs
3.2-5.2
Amiodarone
Antidysrthmic
treats v and a fib, tachycardia
SE lung damage, HF, liver and thyroid toxicity
DO NOT DRINK WITH GRAPEFRUIT JUICE
Aripiprazole
Atypical antipsychotic for schizos, BPD, major depression, autism
SE headache, agitation
Epoetin
colony stimulating factor
Chronic anemia from kidney disease
SE blood clots watch your H & H
Risedronate
Biphophonate
you lose phospherous
treats osteoporosis
Drink with full glass of water sit up in high fowlers and remain NPO 30-60 min after admin because you want to absorb it
SE pain in bones, muscles, and joints
Pregabalin (lyrica)
Anticonvulsant
for fibromyalgia, neuralgia, partial seizures
SE muscle twitching, confusion
Aspart
Rapid acting insulin peak is 40-50 min duration is 4-5 hrs
use before eating for both type 1 and 2
Diltiazem
Calcium channel blocker
for angina, htn, a fib, a flutter
SE HF, peripheral edema
Varenicycline
Smoking cessation
Take for 12 weeks
SE unusual dreams change in appetite
Furosemide
Loop diuretic
for renal and heart failure
not potassium sparing
SE hypokalemia, ototoxicity-give it slow
Loop diuretics
furosemide, bumetanide, torsemide non potassium sparing Think Lasix "L" for Loop= non potassium sparing
Potassium sparing diuretics
Amiloride, Spironolactone, Triamterene
Fluoroquinolone
Watch for tendon rupture
for penumonia, skin infection, sinusitis
SE photosensitivity and tendonitis
Sertraline
SSRI
Wait 14 days before switching meds
Watch for serotonin syndrome which is too much neuro activity
insomnia is SE
Serotonin syndrome
-fatal rxn
-hypertensive crisis
-hyperpyrexia
-delirium
-coma
-muscle rigidty
Fentanyl
change patch every 72 hours
narcotic analgesic
watch RR
Propranolol
Nonselective beta blocker
"olol" drugs you taper off
Used for htn, dyshthmias, migraine
Donepezil
is your alzheimer's/ dementia drug
SE decrease reaction time
Lisinopril
ACE inhibitor
Used for htn, MI
SE persistent cough, angioedema
"prils"
Use birth control
Rifampin
Antimyobacterial
This is your TB drug
SE liver toxicity
Body secretions turn orange
monitor liver function
Enoxaparin
DVT prevention
aka lovenox
antidote is Protamine sulfate
Macrocytic anemia
A form of anemia characterized by large, immature red blood cells
Pneumothorax
air in the pleural cavity caused by a puncture of the lung or chest wall
HHNS
hyperglycemic hyperosmolar nonketotic syndrome caused by dehydration
CML
a cancer which comes from a translocation in chromosome 9 and chromosome 22
chronic myelogenous leukemia
Thyrotoxic crisis
life threatening complication of hyperthyroidism
high fever, tachycardia, Mi, HF
Air embolism
TACHYCARDIA
DYSPNEA
HYPOTENSION
CYANOSIS
DECREASED LEVEL OF CONSCIOUSNESS
signs and symptoms of Hyperglycemia
The 3 P's
-polydipsia
-polyphagia
-polyuria
-blurred vision
signs and symptoms of Hypoglycemia
Confusion, irritability, diaphoresis, tremors, hunger, weakness, visual disturbances
Glomerulonephritis
acute inflammation of the kidney, typically caused by an immune response
Left sided congestive heart failure
Think Left "L" Lungs
DOE
Dry cough, crackles, wheezing
Paroxysmal nocturnal dyspnea-sob when lying down
Cheyne-Stokes respirations
Tachypnea and cardia
Right sided congestive heart failure
JVD
Dependent peripheral edema
Weight gain
ascites
Tachycardia
fatigue, weakness
hypothyroidism signs and symptoms
-Bradycardia
-Weight gain
-Low BP
-Cold skin
-Constipation
-Sluggish
hyperthyroidism signs and symptoms
restless, tachycardia, weight loss, high blood pressure, exophthalmos-bulging eyes, heat intolerance
Diabetes insipidus
insufficient antidiuretic hormone resulting in excessive thirst and urination
ALS
amyotrophic lateral sclerosis aka lou gehrigs disease
Oral glucose tolerance test
greater than 200 is diabetes mellitus
Addison's disease
too low cortisol, weight loss, hypotension and hypoglycemia, bronzing of skin
Chvostek's sign
facial twitching crooked smile
deficiency in calcium
Trousseau's sign
BP cuff on and hand retracts and twitches deficiency in calcium
Pancreas
Contains beta cells,
Regulates the level of sugar in the blood
G
number of pregnancies
P
births whether alive or stillborn
Nagele's rule
determine first day of LNMP, subtact three months and add 7 days to calculate EDD
Kernig's sign
positive when flexes leg at hip and knee and complains of pain= meningeal irritation
three point gait
Both crutches move, then uninvolved leg
NWB
plant and swing
Two point gait
One crutch and opposite extremity move together followed by opposite crutch and extremity
Four point gait
used when both legs can bear some weight; right foot, left crutch, left crutch, right foot
Rheumatoid arthritis
A disease characterized by the debilitating destruction of the joints due to inflammation
Stiffness after resting
activity helps
autoimmune disease
morning stiffness
cholinergic crisis
SLUDGE-Salivation, Lacrimination, Urination, Diarrhea, GI. liquid pouring out of every oriface.
Myasthenia Gravis
Grave muscle weakness. test is to test for ptosis which goes away after rest. Tensilon test-injection causes muscles to improve
Guillain Barre syndrome
disorder in which the body makes anti-bodies against myelin, disrupting nerve conduction. Can be caused by flu vaccine
Multiple sclerosis
muscle weakness, tingling, numbness. Affects myelin sheath. Plasmapheresis removes antibodies attacking myelin sheath.
Rhomberg test
assessing the vestibular equilibrium of the patient; balance for 20 seconds eyes closed
Weber test
Assesses bone conduction w/ vibrating tuning fork in middle of forehead
Rinne test
Done by placing the base of a vibrating tuning fork on the patient's mastoid bone (behind each ear)
Presbyopia
Vision decreases starting at age 40
Myopia
nearsightedness
Hyperopia
farsightedness
Sanguineous
bright red which indicates active bleeding
Serosanguineous
?uid drainage com-posed of serum and blood.
Nystatin
used for candida
Rule of nines
9 = head, 18 = arms, 36 = torso, 36 =legs, and 1= perineum = 100%
kids is head 18%, torso is 36, arms are 18, legs are 27, perineum is 1
Paget's disease
Increased bone breakdown and formation
Osteoarthritis
Pain increases with activity
A disease of the joints in which cartilage breaks down chronic unliateral pain
Maslow's hierachy of needs
Physiological
Safety
Love and belonging
Self esteem
Self actualization
Self Transcendence
What is an extreme AE of a bronchodilator
Increases myocardial o2 use cause episode of angina and increase HR
PAD
Peripheral Arterial Disease Think A legs need to go down legs are shiny, cool to touch, hair loss on legs, cyanotic extremities
PVD
peripheral vascular disease V legs need to go up painless ulcers lower leg edema hyperpigmentation
Strategy for order of care
least restrictive/invasive
survival odds
Acute over chronic
stable vs unstable client
Early signs versus late signs of hemorrhage
Early sign is increase HR late sign is thready pulse, cold, clammy skin
Metformin is contraindicated with what dye?
Iodine causes renal impairment
If the chest drainage system becomes disconnected what can you do for a temporary fix?
Bottle of sterile water to create seal again without water seal the lung can collapse
what is the measurement below the axillary for crutches to be set at?
6-10 inches
Tetrology of the load
Pulmonic
Aortic
Ventric
Right Ventricular hypertrophy
key sign is when the child is in tripod position and squats
Neglience
Key is there has to be actual injury or harm
Ebola
A virus that causes severe bleeding, organ failure, and can lead to death.
There is no vaccine.
Takes 3 weeks for symptoms to show
Action of digoxin
Medication increases heart contraction which then increases cardiac output you use this med for cardiac dysrhythmias and heart failure
If a patient is taking nitro after which dose do they call 911?
After the 1st dose
Patient reports difficulty breathing during transfusion what do you do?
The NCLEX answer is different from ATI they want you to notify the RN you would not stop the transfusion :(
What is the first sign of a reaction to a blood transfusion
HR
Iron preparation meds
Do take with tannin which is in teas and coffee it decreases absorption
Vitamin C increases absorption
Use straw try not to get on teeth
Heparin labs
PTT + aPTT think H has two T's
Warfarin labs
INR, PT think of coumadin=COINR also
Metronidazole
Contraindicated avoid alcohol interferes w/ liver function test antabuse effect antiinfective
Nephrotoxic meds
Gentamycin and vancomycin
do whisper test
effects the acoustic cranial nerve 8
Restraints rules
within 1 hr you need physician
every 15 min you check on pt
release restraints every 2 hours
What is the name of the suction device for seizure protocol to have at bedside?
yaunker
Using crutches while ambulating stairs
Up with the good foot, down the stairs down with the bad foot
Walkers
Pick walker up and step into it 12 inches forward
Varicella precautions
Provider wears N95 and the patient wears surgical mask
BMI
if it is 25% or greater it indicates obesity
PAP test
Starting at age 21 you need one done once every 3 years
Mammogram
Starting at age 40
1 kg equals how many liters
1 liter
Formula for urine output of adult
0.5 ml/kg/hr adult
Formula for urine output of infant
1 ml/ kg/ hr
Hypotonic solution
Solute concentration is less than that inside the cell; cell gains water. 1/2 NS
Hypertonic solution
Solute concentration is greater than that inside the cell; cell loses water
Isotonic solution
a solution whose solute concentration is equal to the solute concentration inside a cell. NS, LR, D5W
Diarrhea causes what to the PH?
acidosis because the stomach is acid and it gets rid of base if it occurs above the waist then it is alkalosis
How often should you suction care on a patient?
every 8 hrs
COPD expected findings
barrel chest
musculoskeletal wasting because they have a hard time eating
clubbed toes and fingers
The amount of residual that you should withdraw feeding?
greater than 100 ml
GERD treatment
Prokinetic
PPI
Histamine blockers
Peptic ulcer treatment
Antbiotics
PPI
histamine blockers
antiacids
IBS treatment
antidiarrheals
bulk agents
probiotics
Diverticulosis
Pouches grow on colon seeds get stuck puss forms into the pouches treatment is antibiotics and bulk agents
What is a risk in bariatric surgery
dizziness, sweating, tachycardia
Dumping syndrome-avoid sugar
small frequent meals
protein to make it last longer
consume liquids after eating
have them lay down
How often do you change a colostomy bag?
when it is 1/3 full
Osteoarthritis
...
med for Osteoarthritis
glucosamine
Med for rheumatoid arthritis
DMARD, methotrexate, reduces inflammation
Med for gout
colchicine
What type of dressing is used for amputees?
Figure 8 to get them fitted for their prostesis
In what order is NPH drawn?
Drawn up last remember cloudy clear, clear, cloudy
Gold standard test for MI
troponin
C reactive marker
Inflammatory marker
BNP
Hear failure lab
Myocardial infarction
inverted PQRST
V fib
squiggly with no R wave
P wave
atrial depolar aka Pre
QRS
ventricular depolar
T wave
Ventricular repolar aka rest period
Cardiac cath patients with what allergies should not have this done
iodine or shellfish and cannot take metformin because of the dye
What type of dressing is needed after cardiac cath
pressure dressing and keep leg straight
When does Nitro expire
6 months
Signs of MI
elephant on chest
N/V
Crushing quality radiates to jawline
Tachy
hypo
dyspnea
dysrhythmias
Too much fluid in heart protocol
pump it-digoxin
park it-nitrate
pee it-lasix
enoxaparin
low molecular heparin
start 2-3 days before heparin
Early vs late signs of shock
Early-pallor, tachypnea, confusion
late-cold moist skin, weak thready pulses, anuria, hypotension, metabolic acidosis
Nephrosis
Severe protein in uria
cystitis
inflammation of the urinary bladder, dysuria urgency
CVA assessment
one thing at a time-FAST
Face. droop. can you smile?
Arms.equal.Drifting?
Speech.quality changed?
Time.immediate care
Erythematosus lupus
Butterflu rash
fibrous tissue
clubbing
use NSAIDS, sunscreen, small, frequent meals
What type of dressing is used for burn patients?
silvadene
Cirrhosis
pitting edema, blood cannot get through, no foods high in sodium
Braxton hicks
Painless, irregular contractions that are usually relieved with walking
Chadwick's sign
estrogen causes bluish color of cervix during pregnancy
wernicke korsakoff
paralysis of eye muscles, impaired muscle coordination; thiamin deficiency
stages of delivery
1st stage latent phase 30-70 seconds contractions fhr, teaching, comfort
active phase stronger contractions
dilated 8-10 cm baby is at zero station ischial spines engaged and ready
2nd stage fhr q 15 min delivery of baby
3rd stage placental delivery
newbo
clostridium
first discharge breast milk
Vitamin K in an infant is given in which site
vastus lateralis and immediately after birth
phenochromolytoma
rare tumor of adrenal glands
2 months
lift head up
4 months
chest up
6-7 months
Bear all weight
8 months
sit unsupported
9 months
take steps
Toddler 1-3 yo food choices
bananas, yogurt, sliced turkey
3 year olds
can ride tricycles
4 year olds
can throw balls
5 year olds
can jumprope
ortolani
click in hip, hip dysplasia
wilms tumor
DO NOT PALPATE
Therapeutic drug level for Aminophylline
10-20mcg/mL. Above 20 = toxic
Therapeutic drug level for Digoxin
0.8-2.0 ng/mL. Above 2.4 = toxic
Therapeutic drug level for Lithium
0.4-1.4 mEq/L. Above 2.0 = toxic
Therapeutic drug level for Phenobarbital
10-40 mcg/mL. Above 40 = toxic
Therapeutic drug level for Phenytoin
10-20 mcg/mL
Appropriate lab levels for Sodium (Na)
136-145 mEq/L
Appropriate lab levels for Potassium (K)
3.5-5 mEq/L
Appropriate lab levels for Calcium (Ca)
9.0-10.5 mg/dL
Appropriate lab levels for Magnesium (Mg)
1.3-2.1 mEq/L
Appropriate lab levels for Phosphorus (PO4)
3.0-4.5 mg/dL
Appropriate lab levels for Chloride (Cl)
98-106 mEq/dL
Appropriate lab levels for pH
7.35-7.45
Appropriate lab levels for PaCO
35-45 mm Hg
Appropriate lab levels for PaO2
80-100 mm Hg
Appropriate lab levels for HCO3
21-28 mEq/L
Appropriate lab levels for RBCs
Male: 4.7-6.1 million/uL
Female: 4.2-5.4 million/uL
Appropriate lab levels for Hgb
Male: 14-18 g/dL
Female: 12-16 g/dL
Appropriate lab levels for Hct
Male: 42%-52%
Female: 37%-47%
Appropriate lab levels for WBC
5,000-10,000 mm3
Appropriate lab levels for Erythrocyte sedimentation rate
Less than 20 mm/hr
Appropriate lab levels for total serum cholesterol
<200 mg/dL (150 mg/dL is target range)
Appropriate lab levels for LDL
<130 mg/dL
Appropriate lab levels for HDL
Males: >45mg/dL
Females: >5mg/dL
Appropriate lab levels for Triglycerides
Males: 40-160 mg/dL
Females: 35-135 mg/dL
Therapeutic INR
2.0-3.0
Appropriate PT time
11-12.5 seconds
Appropriate aPTT (partial thromboplastin time)
30-40 seconds
Normal INR
0.8-1.1
Appropriate lab levels for platelets
150,000-400,000/mm3
Appropriate lab levels for Albumin
3.5-5 g/dL
Appropriate lab levels for Ammonia
15-45 mcg/dL
Appropriate lab levels for total bilirubin
0.1-1.0 mg/dL
Appropriate lab levels for total protein
6- g/dL
Appropriate lab levels for urine specific gravity
1.005-1.030
Appropriate lab levels for urine protein
0-8 mg/dL
Appropriate lab levels for urine glucose
<0.5 g/day
Appropriate lab levels for urine ketones
None
Appropriate lab levels for urine pH
4.6-8
Appropriate lab levels for urine WBCs
Male: 0-3
Female: 5
Appropriate lab levels for serum creatinine
Male: 0.6-1.2 mg/dL
Female: 0.5-1.1 mg/dL
Appropriate lab levels for BUN
10-20 mg/dL
Appropriate lab levels for blood glucose
70-105
Appropriate lab levels for HbA1c
4%-6% (>than 7% indicated diabetes)
Late signs of fluid volume deficit
Oliguria
Decreased central venous pressure
Flattened neck veins
Isotonic IV fluids
Treats vascular system fluid deficit
Concentration equal to plasma
0.9% NS
LR
D5W
Hypotonic IV fluids
Treats intracellular dehydration
Lower osmolarity than ECF
0.45% NS
D2.545%NS
Hypertonic IV fluids
Used only when serum osmolarity is critically low
Osmolarity higher than ECF
D50W
D10W
D5NS
D5W in 0.45% NaCl
d5LR
Signs of fluid volume excess
Cough, dyspnea, crackles
Increased BP
Tachypnea & tachycardia
Bounding pulse
Weight gain
Jugular vein distention
Increased central venous pressure
Pitting edema
Intracellular electrolytes
Potassium
Phosphorus
Magnesium
Extracellular electrolytes
Sodium
Calcium
Chloride
Bicarbonate
ACE inhibitors (ril)
*Catopril
*Enalapril
*Enalaprilat
*Fosinolpril
**Lisinopril
What do ACE inhibitors do?
What are they used for?
What levels should you watch?
What are the S/AEs?
Block conversion of angiotensin I to angiotensin II
Used for: *Hypertension
*Heart failure
*MI
Watch potassium levels
S/AE: Persistent, non-productive cough, ANGIOEDEMA, hypotension
Calcium Channel Blockers
Nifedipine
Verapamil
Diltiazem
Amlodipine
What are Calcium Channel Blockers used for?
What are some contraindications?
What are the S/AEs?
Angina
Hypertension
A-fib & A flutter (Verapamil & Diltiazem)
Clients who have heart failure, heart block, or bradycardia should NOT take these medications
DO NOT CONSUME GRAPE-FRUIT JUICE
Reflex tachycardia
Peripheral edema
Toxicity
Constipation
Alpha Adrenergic Blockers
Prazosin
Doxazosin mesylate
Where do Alpha Adrenergic Blockers work in the body?
What are the Alpha Adrenergic Blockers used for?
What are the S/AEs?
Work in the brain
Used for **hypertension, benign prostatic hypertrophy
Dizziness & fainting
Beta Adrenergic Blockers (lol)
Metoprolol
Atenolol
Metoprolol Succinate
Propranolol
Nadolol
Labetolol
What are Beta Adrenergic blockers used for?
What are the precautions for Beta Adrenergic Blockers?
What are the S/AEs?
Used for: hypertension, angina, tachydysrhythmias, heart failure, & MI
Do NOT administer nonselective beta blockers (Propranolol, Atenolol, & Metoprolol Succinate) to clients who have asthma, bronchospasm, or heart failure
Bradycardia, nasal stuffiness, A
Vasodilators
Nitroglycerin
Enalaprilat
Nitroprusside
Hydralazine
What do vasodilators do?
What are they used for?
What are the S/AEs?
Decrease BP rapidly
Used for hypertensive emergencies
Dizziness, headache, profound hypotension, cyanide toxicity, thiocyanate poisoning
Albuterol:
route
onset
use
Inhaled (short acting)
5-15 minutes
Acute bronchospasm
Formoterol & Salmeterol:
route
onset
use
Inhaled (long lasting)
Formoterol- onset 1-3 minutes ; duration 10 hours
Salmeterol- onset 10-20 minutes ; duration 12 hours
Long-term control of asthma
Terbutaline:
route
onset
use
Oral (long-acting)
Long-term control of asthma
What do Glucocorticoids do?
What can abrupt d/c of Glucocorticoids cause?
Prevent inflammatory response by suppression of airway mucus production
Can cause Addisonian Crisis
Oral Glucocorticoids (one)
Prednisone
Prednisolone
Betemethasone
Inhaled Glucocorticoids
Beclomethasone diproprionate
Budesonide
Fluticasone proprionate
Triamcinolone acetonide
Intravenous Glucocorticoids
Hydrocortisone Sodium succinate
Methylprednisolone Sodium succinate
Betamethasone sodium phosphate
What are Alpha-glucosidase inhibitors?
What do they do?
What are the precautions?
Acarbose & miglitol
Slows carbohydrate absorption & digestion
Contraindicated in clients who have intestinal disease due to increased gas formation
What are Biguanides?
What do they do?
What are the precautions?
Metformin
Reduces gluconeogenesis & makes muscle tissue more sensitive to insulin
Withhold 48 hours prior to & following a test with contrast media
Contraindicated in clients who have severe infection, shock, or hypoxic conditions
What are Gliptins?
What do they do?
What are the precautions?
Sitagliptin
Promotes the release of insulin, lowers glucagon secretion, & slows gastric emptying
Caution with reduced renal function; dose will be reduced
What are meglitinides?
What do they do?
What are the precautions?
Repaglinide & nateglinide
Stimulate beta cells to release insulin
They are short acting, administer before each meal, & there is a risk of hypoglycemia
What are Sulfonylureas?
What do they do?
What are the precautions?
Promote the release of insulin from the pancreas
**Extreme high risk of hypoglycemia in clients who have renal, hepatic, or adrenal disorders & can cause disulfiram-like reaction with alcohol ingestion
What are Thiazolidinediones?
What do they do?
What are the precautions?
Rosiglitazone & Pioglitazone
Decreases cellular insulin resistance
Exacerbation of heart failure
Rapid-acting insulin;
type
onset
peak
duration
Lispro
15-30 minutes
0.5-2 hours
3-6 hours
Short acting insulin;
type
onset
peak
duration
Regular
0.5-1 hour
1-5 hours
6-10 hours
Intermediate insulin;
type
onset
peak
duration
NPH
1-2 hours
6-14 hours
16-24 hours
Long-acting insulin;
type
onset
peak
duration
Insulin Glargine
70 minutes
none
24 hours
Thyroid hormone antagonist;
medication
uses
precautions
Methimazole
Hyperthyroidism, thyroid crisis, thyroid storm
NO BREASTFEEDING
Thyroid hormone;
medication
uses
S/AEs
Levothyroxine
hypothyroidism
tachycardia, restlessness, diarrhea, weight loss, decreased bone density, heat intolerance, insomnia
What things increased iron preparation when taken together?
vitamin c
What things decreased iron preparation when taken together?
coffee, tea, cola
What are the thrombolytic medications?
What do they do?
What are they used for?
What are the precautions?
Alteplase, tenecteplase. & reteplase
Dissolve clots that have already formed by converting plasminogen to plasmin (destroys fibrinogen & other clotting factors)
Acute MI, DVT, PE, & ischemic stroke
Contraindicated for intracranial hemorrhage, active inter
S/AEs of Aluminum hydroxide
Constipation & hypophosphatemia
S/AEs of Magesium hydroxide (milk of magnesia)
Diarrhea, renal impairment, & hypermagnesemia
S/AEs of Sodium bicarbinate
Constipation
PPIs
Omeprazole
Lansoprazole
Raberprazole sodium
Esomeprazole
H2 blockers
Ranitidine hydrochloride
Cimetidine
Nizatidine
Famotidine
What are PPIs and H2 blockers used for?
What are the precautions?
What are the S/AEs?
Gastric & duodenal ulcers
GERD
Zollinger-Ellison syndrome
Contraindicated during lactation & use with caution if client has COPD
Can increase risk for osteoporosis, decreased libido, lethargy, depression & confusion
What is promethazine?
What are the S/AEs?
What are the precautions?
Antiemetic med
Drowsiness, anticholinergic effects, severe respiratory depression in patients <2, EPS, potentiates effects when given with narcotics
Cardiac & hepatic disease
What is metoclopramide?
What are the S/AEs?
What are the precautions?
Antiemetic med
Drowsiness, anticholinergic effects, restlessness, EPS, tardive dyskinesia
**What is ondansetron?
What are the S/AEs?
What are the precautions?
Antiemetic med
Headache, EPS
Administer tablets 30 minutes before chemo & 1-2 hours before radiation
What is scopolamine?
What are the S/AEs?
What are the precautions?
Antiemetic med
Blurred vision, sedation, anticholinergic effects
Increased mydriatic effect causes increased ocular pressure, Use with caution in patients who have glaucome
Antidiarrheals
Diphenoxylate plus atropine
Loperamide
Paregoric
What are the S/AEs for antidiarrheals?
Increased risk for megacolon for clients who have IBS & is contraindicated in clients who have COPD
Psyllium
Bulk forming. Decreases diarrhea
Docusate sodium
Surfactant. Relieve constipation
Bisacodyl
Stimulant. Preproduce colon evacuation
Magnesium hydroxide
Prevent painful elimination (low-dose osmotic)
Promote rapid evacuation (high-dose osmotic)
SSRIs
Citalopram
Fluoxetine
Paroxetine
Sertraline
SNRIs
Duloxatine
Venlafaxine
What are SSRIs & SNRIs?
What are the S/AEs?
What are the precautions?
Antidepressant
Weight gain, sexual dysfunction, fatigue & drowsiness
Avoid alcohol, do not d/c abruptly, monitor for serotonin syndrome
Tricyclic medications
Amitriptyline
Imipramine
What are tricyclic medications?
What are the S/AEs?
What are the precautions?
Antidepressants
Anticholinergic effects, orthostatic hypotension, cardiac dysrhythmias, decreased seizure threshold
Do not administer with MAOIs or St. John's wort, MUST avoid alcohol, contraindicated in patient's who have seizure disorders
MAOIs
Isocarboxazid
Tranylcypromine
Phenelzine
What are MAOIs?
What are the S/AEs?
What are the precautions?
Antidepressants