CASE STUDY Flashcards
indications of morphine?
used for moderate-severe pain and should only be used in opioid tolerant patients
indications of atorvastatin?
Adjunctive management of primary hypercholesterolemia and mixed dyslipidemia. Primary prevention of coronary heart disease (myocardial infarction, stroke, angina,
and coronary revascularization)
indications of metoprolol?
for HTN, angina, prevention of MI
indications of Hydrochlorothiazide?
management of mild to moderate HTN, treatment of edema
indications of furosemide?
Edema due to heart failure, hepatic impairment or renal disease; HTN
is insulin lispro (humalog) rapid, short or long acting?
rapid acting (10-15 min onset)
is insulin glargine (lantus) rapid, short or long acting?
long acting (90 min onset)
whats the duration of humalog?
3-5 hours
what is the peak of humalog?
60-90 min
whats the duration of lantus?
24 hours
whats the peak of lantus?
there is no peak
indications of warfarin?
anticoagulant. treatment of venous thrombosis and pulmonary embolism
indications of ramipril?
used for HTN and reduction of risk of myocardial infarction, stroke, or death from cardiovascular causes
indications of digoxin?
antiarrhythmics. Heart failure. Atrial fibrillation and atrial flutter (slows ventricular rate). Paroxysmal atrial tachycardia
indications of Hydralazine?
moderate to severe HTN with a diuretic
what is troponin?
a cardiac marker. will be elevated if there’s cardiac damage
what is BNP and what does it stand for?
Brain natriuretic peptide (BNP) test is a blood test that is secreted by ventricles of heart in response to excessive stretching of cardiac muscle cells. DECREASES SYSTEMIC VASCULAR RESISTANCE AND CENTRAL VENOUS PRESSURE
what is a D-Dimer test?
blood test. body’s natural reaction to clot development is fibrinolysis. D-dimer is produced by the action of plasmin on the fibrin polymer clot. If a D-dimer comes back positive, there is a clot
what is hemglobin A1C?
A1C is a blood test that checks the amount of sugar (glucose) bound to hemoglobin. It shows an average BG control for the last 2-3 months
normal range for hemo. A1C? whats the percentage for people with diabetes?
less than 6.0%. 6.5% and higher for diabetes.
what is an ECG?
• Looks at electrical impulses in the heart
• They put 12 leads on you (different areas of your body and gives 12 different views of the heart and how the electrical impulses travel through the heart
• If a part of heart is not getting good blood supply, that electrical signal won’t work properly
-Can see where possible damage can be happening in the heart
what is an echo?
Uses sound waves to produce an imagine of the heart (US of Heart)
what is a chest xray?
xray of chest to detect possible infection in lungs, air collecting in space etc
what do you do if a patient has mild-moderate hypoglycemia? and what is the range that you must be in?
- 8-3.9mmol blood glucose range. You would give:
- 16g carbohydrate (4 tablets) 1 tube of glucose gel if can’t swallow
- repeat BG in 15 min
- repeat steps 1 &2 until BG is greater than 4.0mmol
- give meal or snack
- inform physician
- document hypoglycemia
what do you do if a patient has severe conscious hypoglycemia? what is the range
anything less than 2.8mmol. you would give:
- 20g carbohydrate (5 tablets) 1 tube of glucose gel if can’t swallow
- repeat BG in 15 min
- repeat steps 1 &2 until BG is greater than 4.0mmol
- give meal or snack
- inform physician VERBALLY*
- document hypoglycemia
what do you do if a patient has severe unconscious hypoglycemia? what is the range
less than 2.8mmol. you would give: 1. IV glucose, 25g OR 1mg glucagon s/c or IM OR call 911 if in community 2. wait 10 minutes and then retest. If lower than 4, you can re give 25g IV or 1mg glucagon 3. inform physician VERBALLY* 4. document hypoglycemia
what pre and post assessments would you want to do with ramipril?
BP pre and post and check potassium levels
pre and post assessments for morphine?
RR before and after**
pre and post assessments for atorvastatin?
evaluate serum cholesterol and triglyceride levels before and liver function and 3 months post admin
pre and post assessments for metoprolol?
Take apical pulse before administering and BP
pre and post assessments for hydrochlorothiazide?
monitor BP, intake and output, daily weight and assess feet, legs and sacral areas for edema
pre and post assessments for furosemide?
assess fluid status, monitor BP and pulse before and during administration.
pre and post assessments for insulin lispro (humalog)
Assess for symptoms of hypoglycemia (anxiety; restlessness; tingling in hands, feet, lips, or tongue; chills; cold sweats; confusion; cool, pale skin) etc
pre and post assessment for glargine (lantus)
Assess for symptoms of hypoglycemia (anxiety; restlessness; tingling in hands, feet, lips, or tongue; chills; cold sweats; confusion; cool, pale skin) etc.
pre and post for warfarin
Assess for signs of bleeding and hemorrhage, drop in hematocrit, BP, PT, INR,
pre and post for digoxin
monitor apical pulse for 1 min before, BP, ECG throughout treatment
pre and post for hydralazine
BP and pulse
