2019 NCLEX for LPN

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