Common Test Flashcards
rationale for administering IV NACL
to restore circulating volume and to replace volume loss to increase tissue perfusion levels to the kidneys
rationale for administering IV Calcium Gluconate
Regulates action potential threshold thus preventing cardiac toxicity
rationale for administering actrapid with dextrose
insulin shifts potassium into the cells while dextrose is given to prevent hypoglycaemia
rationale for administering IV sodium bicarbonate
Drug dissociated to provide bicarbonate ion, which neutralizes hydrogen ion concentration and raises blood and urinary pH to correct acidosis/ shifts extracellular potassium into the cells
rationale for monitor vital signs including HR, Bp, RR, and Sp02 (os ordered)
Establish baseline data and monitor for decreasing BP and HR which indicates a decrease in circulating blood volume
rationale for monitor HR and rhythm continuously
Potassium excess depresses myocardial
conduction.
Decreasing HR can indicate
bradycardia which can progress to cardiac
fibrillation and arrest.
rationale for monitor serum potassium level closely
To monitor for normalisation of serum potassium
levels which indicates the effectiveness of
treatment.
rationale for monitor for i/o strictly and take note of fluid balance
fluid replacement needs are based on the correction of current deficits and ongoing losses
Adverse effect of sodium bicarbonate (alkalinising agent)
metabolic alkalosis
fluid overload
extravasation
hypokalaemia
Adverse effect of calcium gluconate/chloride (electrolytes)
hypercalcemia
extravasation
Adverse effect of insulin and dextrose
hypokalaemia/ delayed hypoglycaemia
Rationale for monitor-ing for signs of hypokalaemia such as muscle weakness and fatigue, muscle cramps and pains and cardiac dysrhythmia
These symptoms may be indicative of hypokalemia. Inform the doctor to review the patient.
Rationale for monitor blood glucose levels closely
To monitor for the adverse effects of hypoglycaemia and hyperglycaemia due to the effects of insulin and dextrose 50%
Rationale for Monitor for signs of hypercalcemia, such as
weakness, confusion, fatigue, headache, nausea
and vomiting, and constipation
These are symptoms of hypercalcemia. Inform the
doctor to review the drug dose
Rationale for Administer bolus slowly not exceeding 200
mg/min, unless in an emergency situation.
Rapid administration of calcium injection may
result in vasodilation, hypotension, bradycardia
and arrhythmia, syncope and cardiac arrest
Rationale for Monitor the intravenous site for extravasation.
The drug causes irritation at the site of
infusion/injection. Inform doctor and administer
appropriate antidote (hyaluronidase / sodium
thiosulfate) if needed
rationale Monitor for signs of hypokalemia such
as muscle weakness and fatigue, muscle
cramps and pains and cardiac
dysrhythmias.
These symptoms may be indicative of
hypokalemia. Inform the doctor to review
the patient.
Monitor for signs of fluid overload such
as shortness of breath, excessive weight
gain or swelling of arms or legs ( 1, any 1
example)
The sodium content may predispose the
patient to fluid overload, especially those
with heart, renal and hepatic failure. Inform
doctor to review the drug
Monitor arterial blood gas before and
during treatment
To determine the patient’s response to
therapy and to minimize the possibility of
over dosage and resultant metabolic
alkalosis
Monitor intravenous site for
extravasationDrug cause irritation at the
infusion/injection site.
Inform doctor and
administer appropriate antidote
(hyaluronidase) if needed
Rationale for Administer IV Pantoprazole
80mg BD stat, followed by 8
mg/hr
To bind irreversibly (inhibit) to the
proton pump in the gastric parietal
cells resulting in reduced gastric
acid secretion.
Administer IV Packed Cells 1
pint over 4 hours stat (1)
To replace blood loss
Monitor vital signs hourly
including heart rate, respiratory
rate, blood pressure,
temperature and SpO2 (PUD)
To establish baseline data and monitor for disease progress. Tachycardia and hypotension may indicate the development of hypovolemic shock.
To prepare for urgent
Oesophago-Gastro-Duodenoscopy (OGD)
To identify the source of bleeding
and to achieve haemostasis.
Pharm class magnesium trisilicate
antacids
Pharm goals of magnesium trisilicate
To provide immediate relief of symptoms
Pharm class of pantropazole
Proton pump inhibitor
Pharm goals of pantropazole
to promote healing of the ulcer
pharm goals of amoxicillin/ clarithromycin
To prevent further reoccurrence
of the disease
Pharm class of amoxicillin
penicillin
Pharm class of clarithromycin
macrolides
why does pt need to complete all of his pantroprazole and atibiotics?
The whole course of antibiotics (Amoxicillin and Clarithromycin) should be completed
to maintain therapeutic range and effectiveness of antibiotics (1). Prematurely
stopping antibiotic therapy allows some pathogens to survive, thus promoting the
development of resistant strains (1).
As healing of peptic ulcer takes 6-8 weeks (1) , pantoprazole is given to reduce
gastric acid secretion and allow the healing of the peptic ulcer to take
place (1).
rationale Administer IV Omeprazole 40mg BD
stat and OM
To bind irreversibly to proton pump in the gastric
parietal cells resulting in reduced gastric acid secretion.
rationale Administer IV Octreotide 50mcg stat
followed by 50 mcg/hr
To decrease hepatic venous pressure
Administer IV Ofloxacin 200 mg BD
Inhibit DNA synthesis and prevents bacterial infection
and re-bleeding.
