What type of durg is Digoxin (Lanoxin)? What is its action, and what patients is it indicated for?
Cardiac Glycoside, increases force of contraction and decreases HR, used in CHF & atrial dysrhythmias
What are the side effects and adverse reactions of the cardiac glycoside Digoxin?
bradycardia, visual disturbances(green/ylw halos), fatigue, drowsiness, confusion, n/v(earliest sign of toxicity), headache, diplopia, anorexia, Hypokalemia (K+wasting)
What is the maintenance dose for the cardiac glycoside Digoxin?
0.125mg-0.5mg/day
What is the digitalizing(starter) dose that is given for the cardiac glycoside Digoxin?
0.5-1mg/day (given in two divided doses)
What are important nursing interventions to remember for patients who are taking digoxin?
take apical pulse rate for a full min. if <60 HOLD DOSE. Monitor serum levels & K+ level (watch for hypokalemia). report any significant changes in rate & rhythm.
What is the theraputic level for digoxin?
0.5-2mg/day
What is the antidote for digitalis toxicity?
immunefab/ digibind
What type of drug is furosemide? What is its action, and what is it indicated for?
loop (high ceiling) diuretic (K+ wasting), increases sodium and water excretion, indicated for pts with pulmonary edema, edema, and HTN.
What are some side effets and adverse reactions associated with furosemide, a high ceiling loop diuretic?
fluid & electrolyte imbalance, Hypokalemia, dehydration and, O-HoTN
What are the important nursing intervetions associated with taking furosemide?
monitor I&O, wt, serum levels/electrolyte, watch for signs of hypokalemia and encourage potassium intake, advise pt about O-HoTN when moving. (High risk of digoxin toxicity)
What are the osmotic diuretics used for?
to decrease ICP & IOP (not used in HF pts due to tachycardia)
Which type of patients are the carbonic anahydrase inhibitors (diuretic) used for?
Pts who have glaucoma (decrease IOP_
What are the potassium sparing diuretics used for?
to promote sodium and water excretion and can cause HYPERkalemia (especially when used with ace inhibitors)
A weight gain of >or = 2lbs indicates _____ of extra fluid.
1 liter
What electrolyte imbalances does the nurse need to watch for with a pt on thiazide and thiazide like diuretics (HCTZ)?
Three hypo's and cheesecake (Especially glucose levels)
Hypo- kalemia, magnesmia, chloremia
Hyper- glycemia, lipidemia, uricemia, calcemia
What type of dug is Gentamycin? What is its action and indication?
antibacterial-aminoglycoside, it inhibits bacterial synthesis and is used on gram negative bacteria.
What are the adverse reactions and side effects of Gentamycin (aminoglycoside)
Nephrotoxicity and Ototoxicity-tinnitus, vertigo, hearing loss
What are the important nursing interventions associated with patients who are taking gentamycin, an aminoglycoside?
Take baseline hearing test, wt, and renal function, monitor- I&O, BUN, creatinine, crCL, continue to monitor hearing during therapy. monitor peak and trough levels notify MD if there is ann occurance of rash, fever or perineal itching (s/sx of stevens-joh
What are the nursing interventions associated with patients who are taking the antibacterial penicililns?
Check C&S, monitor first 15mins after first dose for hypersensitivity (bronchospasm, cardiac arrest)- monitor for bleeding, superinfection, increase fluids, take one hour before or two hours after meals.
What are the nursing interventions associated with patients who are taking the antibacterial cephalosporins?
watch pts who are allergic to penicililns (similar molecular structure), watch for nephrotoxicity (monitor I&O, BUN, cr, & crCL), pseudomembranous colitis (antibiotic associated diarrhea), and seizures.
What are the nursing interventions associated with patients who are taking the antibacterial tetracyclines?
Check C&S, monitor ALT/AST, BUN/crCL, avoid milk, iron, and antacids pt to use sunscree , adv risk of tooth discoloration- DO NOT GIVE TO CHILDREN <8yo! & monitor for superinfection
What are the nursing interventions associated with patients who are taking the antibacterial macrolides?
Check C&S, monitor ALT/AST, monitor for Ototoxicity (tinnitus, vertigo, hearing loss), superinfection, & GI distress, take antacids 2h before or after meds.
What are the nursing interventions associated with patients who are taking the antibacterial floroquinolones?
increase fluid intake to 2000mL/day to avoid crystalluria, tell client to avoid caffiene, check for superinfection. (for IV infuse over 60-90m)
Which of the two antibacterial drugs are used mainly for URI and UTI?What are the nursing interventions associated with patients who are taking these drugs?
Increase fluid intake to 2000mL/day to avoid crystalluria, monitor for rash (stevens-johnson), superinfection, CBC, BUN, crCL, avoid antacids DO NOT TAKE during third trimester.
What is the antibacterial drug of choice for patients who are allergic to penicillin?
Macrolydes. (zithromax, zpak)
What are the types of antibacterials? What are the common nursing interventions associated with taking any kind of antibacterial drug?
Check C&S prior to administering first dose, Watch for superinfection, advise pt to take full regimen even when feeling better.
What is a urinary analgesic used for? What interventions are associated?
For UTI pain relief, do not take more than 3-5 days can cause hepatotoxicity. Urine will change to a reddish brown. still need to go to pcp for Rx to kill bacteria
What are unrinary antiseptics used for? what interventions are associated?
To help decrease the amount of bacteria to prevent full blown UTI in chronic UTI pts. Can stain-do not crush or chew.
What are the urinary stimulants used for?
They are Parasympathomimetic (stimulare muscarinic receptors) to prevent urinary stasis or in the event of a spinal cord injury.
What are the urinary antispasmodics used for? what are the interventions associated with them?
Parasympatholytic (anti-muscarinics) to block receptors and relax the bladder to prevent squirting or overactive bladder. Force fluids bc it is excreted through renal system
The extrapyramidal syndrome are symptoms that are related to what class of drugs?
Antipsychotics.
MAOI's and tricyclics are used to treat what? What are the main side effects associated with these drugs?
Treat depression. Side effects include sedation, drowsiness, dry mouth 7 urinary retention (cants), & eps
What are the nursing interventions when taking tricyclics for depression?
monitor for o-hotn and watch pts with heart disease carefully bc it can cause dysrhythmias
What are the nursing interventions when taking MAO inhibitors to treat depression?
Teach the pt to avoid any tyramine containing foods so as to avoid a HYPERtensive crisis. (cheeses, wine, yeast, bananas, yougurt, cream, coffee, chocolate)
What is the drug class for lithium and what is it indicated for? What are the main side effects associated with lithium?
mood stabilizer to treat bipolar disorder (manic episodes). tremors, n/v, lethargy, o-hotn, Hyponatremia & hypovolemic,
What are the important nursing interventions for pts on lithium?
monitor I&O and wt daily, assess for dehydration, watch serum levels due to narrow ther window
What are the ssri's indicated for? What are the common side effects and main nursing interventions?
depression, causes dry mouth, h/a, blurred vision, insomnia, nervousness and sexual dysfunction. teach the pt full effect comes at 6wks, advs pt of se
What are the two main types of anxiolytics and what are they used to treat? What are important nursing interventions for these drugs?
barbiturates and benzodiazapines. They can treat anxiety and insomnia. Benzo use for only 3-4wks, barbiturates >2wks, taper. no other CNS depressants, alcohol or drugs.
What is the antidote for benzo overdose?
Flumazenil (Romazicon)
What is the drug type for morphine sulfate? what is its indicated use? What are the main/major side effects associated?
narcotic analgesic for severe pain or cough supressant. side effects include resp. depression, n/v, constipation, pruritus, and urinary retention.
What are the nursing interventions for morphine sulfate, and what is the antidote for OD?
watch I&O, vitals and assess for resp depression (>10 r/min) & pinpont pupils (early indication of OD), Antidote is Narcan.
Which hormones are secreted by the anterior pituitary gland (Adenohypophysis)
TSH, ACTH, FSH, LH, & PL
Which hormones are secreted by the posterior pituitary gland (neurohypophysis)
ADH & oxytocin
Which hormones are secreted by the thyroid gland? What do they affect?
T4(thyroxine) and T3 (triiodthyronine). controls metabolic rate and activity which affects nearly every organ and tissue in the body, namely the heartE
Explain the cascade that affects the growth hormones.
Hypothalamus secretes GH-RH (releasing factor) which stimulates the anterior pituitary which then secretes GH so a child will grow.
Hypothalamus secretes GH-IH (inhibiting factor) which stimulates the anterior pituitary which then creases GH prodection ce
Explain the cascade that will affect the thyroid function.
Hypothalamus secretes TRH (thy. releasing horm.) which will stimulate the anterior pituitary to secrete TSH which stimulates the thyroid to secrete T3 and T4.
Explain the cascade that affects the glucocorticoids and mineralcorticoids.
Hypothalamus secretes CRF (corticotropin releasing factor) which stimulates the AP to secrete ACTH (adrenocorticotropic hormone) which stimulates the adrenal cortex to secrete glucocorticoids and mineralicorticoids.
What is secreted from the adrenal cortex?
mineralicorticoids and glucocorticoids.
GH insufficiency is called what? how can GH be given and when and for what purpose? What can occur with long term use?
Dwarfism. GH is given SQ and IM on newly forming bone to normalize growth. long term use can impair insulin secretion and cause type 4 DM (medication induced)
GH hypersecretion is called what? What is hypersecretion generally caused by and how is it treated?
Gigantism (child) Acromegaly (adult). caused by tumor on the pituitary gland, radiation therapy, surgery, or IM/SQ injections are used to treat.