ATI Module 2 Study Flashcards
Order Insulin Fast to Slow
Lispro (humalog), Regular (humulin R), NPH, Glargine (lantus)
Onset and peak times for all 4 insulins
Lispro
ONSET: Less than 15 minutes.
PEAK: 30 minutes to 1 hour
Regular
ONSET: 30 minutes to 1 hour.
PEAK: 2 to 3 hours.
NPH
ONSET: 1 to 2 hours.
PEAK: 4 to 12 hours.
Lantus
ONSET: 1 hour
PEAK: None
What is ginkgo biloba used for
Promotes vasodilation, improve recall and metal process
Alzheimer and dementia
ED
interact with meds that lower seizure threshold, like antihistamines, antidepressants, and antipsychotics
What is Valerian used for
Increase GABA to prevent insomnia
promotes sleep
avoid using with pregnancy
HEPAIN ACRONYM
H eparin sodium prevents thrombin from converting fibrinogen to fibrin. It is administered IV or SQ.
E noxaparin (Lovenox) is a low-molecular weight heparin. It has the same action as heparin, but has a longer half-life. It is administered via subcutaneous injection.
P rotamine sulfate is the antidote for heparin.
A dminister heparin when there is the likelihood of clot formation, such as with myocardial infarction or deep-vein thrombosis.
R isk for bleeding is the major side effect that clients should be educated about. Clients should be educated to monitor for bleeding, including bleeding gums, bruises, hematuria, and petechiae.
I nstruct clients to avoid corticosteroid use, salicylates, NSAIDs, green leafy vegetables, and foods high in Vitamin K.
N ormal activated partial thromboplastin time (aPTT) is 20 to 36 seconds, but to maintain a therapeutic level of anticoagulation while on heparin, the aPTT should be 1.5 to 2 times the normal value (60 to 80 seconds).
COUMADIN
C oumadin (generic name Warfarin sodium) interferes with coagulation factors by antagonizing vitamin K.
O ral administration is typically used. Clients may need continued heparin infusion via IV until therapeutic effect of Coumadin is experienced (may take 3-5 days).
U se is contraindicated in clients with low platelet counts or uncontrolled bleeding.
M ephyton (trade name vitamin K) is the antidote for Coumadin.
A dvise clients to avoid foods that are high in vitamin K, and avoid the use of acetaminophen, glucocorticoids, and aspirin. Clients should wear a medical alert bracelet indicating warfarin use.
D oses are typically taken once daily.
I NR and PT are monitored for clients who are taking Coumadin. Depending on intent of therapy, PT should be 1.5 to 2 times control and INR should be 2-3. Target INR is 3 to 4.5 for clients with a mechanical heart valve.
N o Coumadin for pregnant women! Oral anticoagulants fall into Pregnancy Risk Category X. Heparin may be safely used in pregnancy.
Symptoms of hemolytic reaction
RBC’s have lysed, or ruptured
- hypotension’
-LOW BACK PAIN
-tachycardia
chill, fever, light headedness, dizziness, flank pain
Steps if a hemolytic reaction occurs during a blood transfusion
STOP the blood. Give IV .9% NaCL fluids through new tubing, report to HCP immediately, asses BP, HR, and RR,
take urine specimen- checks for hemolyzed RBC’s
treat and prevent kidney failure and shock
4 types of blood transfusion reactions
Febrile
anaphylactic
circulatory overload
hemolytic
What are s/sx of a febrile transfusion reaction and treatment
Mild reaction, flushing, itchy- give tylenol and Benadryl
What are s/sx of a anaphylactic transfusion reaction and treatment
wheezing, hives, and hypotension
more severe than febrile
What are s/sx of a circulatory overload transfusion reaction and treatment
Lung crackles
restlessness
dark urine
SOB and dyspnea
JVD
Big risk of HF (HF for heart failure and Heavy Fluid)
Action
-slow infusion (4 hrs max)
- wait at least 2 hrs between infustions
-give HOPE
H- HOB elevated (at least 45 degrees)
O- Oxeygen
P- Push diuretics ending in ide
E- end all IV fluids
Notify the HCP
