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A. NCLEX > CAT 3 Remediation > Flashcards

CAT 3 Remediation Flashcards

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1
Q

Biguanides: Metformin Adverse effects

A

Dizziness
Nausea
Vomitting
Diarrhea
Abdominal discomfort
Lactic acidosis

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2
Q

Biguanides: Metformin Nursing care

A
  • Do not give with kidney or liver impairment
  • Monitor glucose, ketones
  • Take with food
  • Swallow extended release tablet whole
  • Avoid alcohol
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3
Q

Sulfonylureas (1st gen) are…

A

rarely used for diabetes

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4
Q

Sulfonylureas (1st gen): Chlorpropamide adverse (DM II)

A
  • Increased risk of cardiac death
  • Epigastric distress
  • Aplastic anemia
  • prolonged hypoglycemia
  • Dilutional hyponatremia
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5
Q

Sulfonylureas (2nd gen): Glimepiride (Adverse) (DMII)

A
  • Dizziness
  • Leukopenia
  • Agranulocytosis
  • thrombocytopenia
  • aplastic anemia
  • Hypoglycemia
  • Dil. Hyponatremia
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6
Q

Sulfonylureas (2nd gen): Glimepiride Nursing care

A
  • May be used with insulin
  • Monitor for hypoglycemia
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7
Q

Sulfonylureas (2nd gen): Glimepiride Client EDU

A
  • Take with first meal of day
  • Medical identification
  • Signs of hypoglycemia
  • Discuss OTC meds with HCP
  • Avoid alcohol
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8
Q

Glipizide: Action

A
  • Stimulates release of insulin from pancreas
  • increases insulin sensitivity at receptor sites
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9
Q

Glipizide: Adverse

A
  • Photosensitivity
  • Rashes
  • Hypoglycemia
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10
Q

Glipizide: Nursing care

A
  • Assess for allergy to sulfonamides
  • Use caution with:
  • Diuretics
  • Steroids
  • Oral contraceptives
  • Thyroid preparation
  • Isoniazid
  • Combined use may decrease glipizide action
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11
Q

Glipizide: PT EDU

A
  • Signs of hypoglyc
  • take 30 min before meals
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12
Q

Glyburide: Action

A
  • Stimulates pancreas to secrete insulin
  • Increases insulin sensitivity at receptor sites
  • Decreases blood and hepatic glucose production
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13
Q

Glyburide: Adverse

A

Hypoglycemia
Aplastic anemia
Constipation
Diarrhea
Dizziness
HA
Hypo Na
Pancytopenia
Weakness
Drowsiness
Cramps
Hepatitis
Photosensitivity
Rash
Hemolytic anemia
Agranulocytosis
Nausea
Vomiting
Increased appetite

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14
Q

Glyburide: Nursing care

A

Beta blockers may cause hypoglycemia

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15
Q

Glyburide: PT EDU

A
  • Symptoms of and treatment for hypoglycemia or hyper
  • Medical identification
  • Avoid stress, alc
  • Take with breakfast
  • Avoid activities requiring mental alertness
  • Discuss all meds with HCP
  • Discuss pregnancy with HCP
  • Do not use oral contraceptives
  • Sun protection
  • Carry 15 gram carb to treat hypoglyc.
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16
Q

Thiazolidinediones: Rosiglitazone and Pioglitazone –> Action of these two meds

A
  • Augments cell insulin sensitivity at receptor sites
  • Improves glucose utilization
17
Q

Thiazolidinediones: Rosiglitazone and Pioglitazone –> Adverse

A

Liver failure
Heart failure
Elevated liver enzymes
Fractures
Bladder cancer
Anemia
Macular edema
Rhabdomyolysis
Edema

18
Q

Thiazolidinediones: Rosiglitazone and Pioglitazone –> PT EDU

A

Self blood glucose monitoring
Discuss al meds and preg. with HCP

19
Q

Alpha-Glucasidase inhibitors: EX: Acarbose, Voglibose, Miglitol –> Action

A
  • Inhibit the absorption of carbohydrates from the small intestine
  • Competitively inhibit enzymes that convert complex non-absorbable carbs into simple absorbable carbs
20
Q

Alpha-Glucasidase inhibitors: EX: Acarbose, Voglibose, Miglitol –> Adverse

A

Abdominal pain
Diarrhea
Flatulence
Hypocalcemia

21
Q

Alpha-Glucasidase inhibitors: EX: Acarbose, Voglibose, Miglitol –> Nursing care

A

Monitor levels of: Calcium, HGB, HCT
Observe for hypoglycemia
Insulin may be needed if surgery or infection
Take with first bite of 3 main meals

22
Q

Amputation: Pathophysiology

A
  • an acute injury may result in partial or full amputation
  • All or part of extremity may be surgically re-attached to body
  • In chronic condition such as PVD, blood flow to the tissues of the extremities is interrupted, resulting in venous pooling and edema
  • Edema further reduces blood flow and causes skin damage, often resulting in ulceration and infection
  • Progressive infection leads to further tissue damage and ultimately causes tissue death
  • Extremity will have to be removed to prevent tissue death to other body parts
23
Q

Most common amputations…

A

are of the lower extremities due to tissue damage from PVD

24
Q

Closed amputations:

A
  • Suturing a flap of skin over the amputation site
  • Compression dressings used to reduced edema and facilitate use of prosthetic device
25
Q

Expected outcomes for limb amputation:

A
  • Once swelling subsides, client is prepared to immediately wrap the residual limb or slip on a custom fitted elastic residual limb shrinker
  • client inspects the residual limb carefully each day using a mirror
  • Rub the res. limb with alc daily to toughen the skin looking for any irritated skin
  • Massage the res. limb toward the suture line to mobilize scar and prevent its adherence to bone
  • Avoid exposing the skin around the res. limb to excessive perspiration, and be aware of possible need to change bandages/elastic socks
  • Prevent contractures
  • Prep res. limb for prosthesis
26
Q

Amputation: Before surgery

A
  • Reinforce HCP’s explanation of procedure
  • Answer Q’s
  • Provide support as client comes to grips with emotions surrounding limb loss
27
Q

Amputation: Following surgery

A
  • Give pain meds etc.
  • Splint and support the affected area, elevating to reduce edema
  • Be prepared to care for the cast or elastic wrap that the HCP applies around the residual limb
  • Assess wound and report excessive bleeding or infection
  • Turn and reposition frequently and provide ROM exercises
28
Q

Amputation: following surgery teach pt:

A
  • What to do if cast slips off
  • To report drainage through cast, warmth, tenderness, or foul smell
  • Anxiety and pain reduction: Relaxation, visualization, deep breathing
  • To care for skin
  • Use elastic wraps
  • Massage site after wound heals
  • Prevent hip contracture by performing ROM
  • Active listening to support pt
29
Q

Adrenergic Agonist: What it is and action

A
  • Adrenergic agonists bind to adrenergic receptors throughout the body
  • Mimics the function of the sympathetic nervous system
  • Norepinephrine and phenylephrine
  • These vasoconstrict peripheral blood vessels. And Activates receptors in arterioles of:
  • Skin
  • Viscera
  • Mucous membranes
30
Q

Norepinephrine: Action

A
  • Increases blood pressure and cardiac output
31
Q

Norepinephrine: Use

A
  • Cardiogenic, septic, and anaphylactic shock
  • Cardiac arrest
  • Anaphylaxis
32
Q

Norepinephrine: Adverse

A
  • HA
  • Palpitations
  • Nervousness
  • Epigastric
33
Q

Norepinephrine: Nursing care

A
  • Reflex bradycardia with rise in BP
  • Constant attendance
  • Monitor BP and UO
  • Should not be used in shock d/t low blood volume
  • Infuse with dextrose solution, not saline
  • Tissue extravasation if given IV
  • Monitor IV site. Infusions should be in large blood vessel only.
  • Protect med from light
34
Q
A

A. NCLEX (6 decks)

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