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comprehensive material Flashcards

1
Q

interacts w/ other meds

A

herb supplement use considerations

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2
Q

improves mental disorder & nerve pain & even improves depression

CANNOT TAKE WITH OTHER MEDS

A

St. John’s Wort

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3
Q

slower kidney function decreased BUN level= smaller doses of medication

A

geriatric considerations w/ med administration

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4
Q

necessary for clotting
Deficiency = bleeding risk

  • Patient education: don’t increase your dose without talking to your PCP
  • We can use it as an antidote for an oral anticoagulant overdose (warfarin). We would administer it to prevent bleeding out.
  • If the levels are way too high = excessive blood clots forming à stroke
  • If the levels are way too low = patient is at risk for bleeding out
  • Babies are deficient of it so this is why they are given an injection immediately after birth (they are lacking those clotting factors at first)
  • educate parents on why the baby needs this injection
A

vitamin K

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5
Q

leafy green veggies = main food source

liver, cheese, egg yolk

A

food sources of vitamin K

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6
Q

mineral

vital for hemoglobin regeneration

  • Food and antacids decrease absorption of it- vitamin C enhances absorption
  • If patient becomes pregnant = needs will increase and she will need supplements during pregnancy and following delivery for - months
  • A patient with anemia = fatigued, weak, shortness of breath, pale in color.
    RBC’s carry oxygen to the body’s tissues so this is why you see some of these symptoms when the body isn’t’ getting enough oxygenated blood where it needs to be.
  • it will not correct anemia immediately so patient needs to know this isn’t a quick fix
  • Don’t leave in reach of children because it does look like candy- worried about overdose
  • If given IM give via z-track method to avoid leaking of it into subcutaneous tissues
  • Take between meals with 8oz juice or water
    After taking sit up for 30 minutes to avoid reflux
    Do not take it within 1 hour of antacids, milk or milk products like yogurt or icecream
    No OTC herbal products before asking PCP

Constipation is a side effect so increase fluid intake, increase fiber intake

  • If drinking liquid preparation, use straw to avoid staining of teeth
    Stool will be turned dark green or harmless black color as side effect
    You can overdose so only take as prescribed
    GI upset is common side effect
A

Iron

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7
Q

liver, egg yolks, dried beans, green vegetables, fruit, lean meats

A

food sources rich in iron

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8
Q

provides energy, promotes growth and development

A

nutrition

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9
Q

w/o it, metabolic processes of the body begin to either delay or stop

A

nutritional support

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10
Q

malnutrition and anorexia, could cause decreased organ function, decreased immunity

A

inadequate nutrition

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11
Q

could be affected by stress, illness, finances, and employment issues

supplemental intakes: puddings, bars, and supplemental nutritional drinks

A

oral feeding

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12
Q

straight to the GI tract, can be short or long term, given by NG tube or PEG tube

A

enteral feeding

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13
Q
  • during feeding, HOB should be 30 - 45 degrees
  • after feeding, keep bed elevated for at least 30 - 60 min

make sure patient has audible bowel sounds by performing GI assessment w/ auscultation to ensure their GI tract is functioning

  • You must ALWAYS verify placement of tube before initial use for gastrostomy tube
    -You must ALWAYS verify placement of a NG tube before every use
    verify placements using x-ray
  • before each feeding, check for movements of tubing and listen for gurgle sounds after inserting air for tubing

-Always flush the tubes before and after giving medications or bolus feedings to prevent clotting

-Always assess gastric residual volumes every 4-6 hours or more often depending on when the providers orders

-Change feeding bag per policy

-Priorities: positioning, aspiration risk, residual volumes, and tube position

A

safety and considerations of enteral feeding

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14
Q
  • aspiration pneumonitis
  • dehydration
  • diarrhea
  • constipation
A

complications of enteral feeding

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15
Q

one of the most life-threatening complications of tube feedings

it happens when contents of the tube feeding go into the lungs of the patient from the GI tract

A

aspiration pneumonitis

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16
Q

diarrhea leads to this complication

can be caused by high-protein formulas

hyperosmolar solutions draws water out of the cells that leads to serum osmolality

fluid intake must be monitored

for fluid balance, 30 to 35 mL should be maintained unless contraindicated

A

dehydration

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17
Q

complication that is caused by:

  • rapid administrations of feeding
  • contamination of formula
  • low-fiber formulas
  • tube movement
  • specific drugs: check them all!!!

it can be managed by reducing the rate of infusion, dilating solution w/ water, changing solution, discontinuing drug, increasing daily water intake, administering enteral solutions that contains fiber

A

diarrhea

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18
Q

another common complication of EN

corrected by changing formula, increasing water, or requesting a laxative

A

constipation

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19
Q
  • continuous feeding
  • intermittent feeding
  • bolus feeding
  • cyclic method
A

types of enteral feedings

20
Q

for those who are ill and who receive feedings into the small intestine

over 24 hrs

A

continuous feeding

21
Q

every 3-6 hrs over 30-60 min

given by gravity drip or infusion pump

A

intermittent feeding

22
Q

very first method was used for enteral feeding

250-400 mL administered via syringe into the tube (a lot at a time)

4-6 times a day

ensure to flush tube before and after feedings, same w/ meds

A

bolus feeding

23
Q

another enteral feeding method

infused over 8-16 hrs

A

cyclic method

24
Q

given via IV

  • a.k.a. TPN or PN
  • If enteral nutrition cannot be used, we would use this route
  • Nutrition is administered intravenously-Amino acids, carbs, electrolytes, fats, trace elements, vitamins, and water provided

(PN is individualized)-Dietician, physician, nurse, and pharmacist needed

  • High glucose concentrations are irritating to the veins so we need to administer PN through a PICC line or a central venous catheter
A

parenteral feeding

25
Q

-Assess access site frequently

-Always administer PN via pump

-Change tubing according to protocol

-Assess daily weights

-Assess vitals (looking especially at temperature)

-Monitor labs (same as for EN)

-Keep PN not in use in the fridge

-Monitor glucose routinely!!

-PN can promote wound healing and help speed up recovery

-if your bag of PN runs out and you are waiting on pharmacy to send another bag, hang dextrose 10% to avoid Hypoglycemia.
We don’t want to abruptly stop all fluids b/c their glucose will bottom out most likely

-when changing tubing, always clamp tubing so air cannot get into line.
You can have patient perform Valsalva maneuver to prevent air from entering (hold breath and bear down)

-use sterile technique when performing central line dressing changes

A

nursing considerations w/ parenteral nutrition

26
Q
  • hyperglycemia
  • hypoglycemia
  • air embolism
  • infection
  • hypervolemia
A

complications of parenteral feeding

27
Q

occurs when infusion rate is too high

A

hyperglycemia

28
Q

fluid abruptions

too much insulin being administered

A

hypoglycemia

29
Q

when air goes into central line catheter system

A

air embolism

30
Q

contamination and lack of treatment of aseptic technique, catheter, and solution

A

infection

31
Q

excessive fluid volume

increased IV rate, renal dysfunction, heart and hepatic failure

A

hypervolemia

32
Q

prevents air embolism during dressing, cap, and tubing changes

have patient turn their head in the opposite direction of insertion site and take a deep breath, hold it, and bear down

ALWAYS keep clamp on central line tubing closed unless it’s being used

A

Valsalva maneuver

33
Q

are used synonymously

A
  • parenteral feeding
  • total parental nutrition
  • hyperalimentation
34
Q

Class: Anticholinergic
for motion sickness and nausea
transdermal patch

Apply patch to a hairless area behind the ear 4 hours before travel
change patch every 3 days, alternate sites, wash hands after applying patch, only wear one patch at a time

A

Scopolamine

35
Q

dry mouth, dizziness, drowsiness, headache, blurred vision, orthostatic hypotension, constipation

A

side effects of Scopolamine

36
Q

Class: Serotonin-Receptor Antagonist
Given PO or IV
For nausea and vomiting (related to post-op
status or chemo)

They do not block dopamine receptors, so this class does not cause EPS

A

Ondansetron

37
Q

drowsiness, dizziness, urine retention, constipation, headache, hypotension, fatigue

A

side effects of Ondansetron

38
Q

Class: Osmotic (Saline) Laxative
For constipation or having ammonia in brain
(Hepatic Encephalopathy)

nursing interventions: kidney and liver functions

A

Lactulose

39
Q

diarrhea, abdominal pain

A

side effects of Lactulose

40
Q

Class: bulk forming laxative
Helps w/ constipation
Need to take w lots of water

  • May take up to 3 days before medication is effective
  • it comes in a powder and you must mix it
  • Mix in water immediately and stir well, give to patient to drink and offer a full glass of water to patient following medication
  • If you do not give the patient enough water to drink after giving them this med, intestinal obstruction will occur due to giving them something to add lots of bulk and the med solidified in the GI tract w/o having enough water to help liquify it and keep it moving in the GI system

*cannot give if someone is impacted with stool, GI bleeding, dysphagia (aspiration risk), GI obstruction,

side effects include diarrhea, N/V, esophageal or intestinal obstruction

A

Psyllium

41
Q
  • These medications are used for peptic ulcer disease and GERD
  • Inactivate pepsin and enhance mucosal protection but they do not coat the ulcer
  • These medications should be taken on a regular schedule, some are prescribed to be taken 1 hour before and 3 hours after each meal and at bedtime
  • Goal is to increase gastric pH to reduce acidity
  • Antacid tablets should be chewed thoroughly and followed with a glass of water or milk
  • Liquid preparations should be shaken before dispensing
  • Allow at least 1 hour between taking an antacid and other medications
A

Antacids in general

42
Q

-A sore that develops on the lining of the esophagus, stomach, or small intestine.

-Ulcers occur when stomach acid damages the lining of the digestive tract.

Common causes include the bacteria H. Pylori and anti-inflammatory pain relievers including aspirin.

-Upper abdominal pain is a common symptom.

-Treatment usually includes medication to decrease stomach acid production. If a bacteria is the cause, antibiotics may be needed.

A

Peptic Ulcer Disease

43
Q
  • end in “-zole”
  • suppresses gastric acid production
  • Treats peptic ulcers, GERD, & Zollinger-Ellison Syndrome
  • Can reduce risk of bleeding in critically ill patients
  • Used in combination with antibiotics to treat H.Pylori
  • Highly protein bound
  • Taken 1 HOUR before 1st meal of the day for 8-16 weeks
  • SLOW IV push if given via IV
  • Zollinger-Ellison syndrome: rare condition in which one or more tumors form in your pancreas or the upper part of your small intestine (duodenum).
    These tumors, called gastrinomas (tumors in pancreas and duodenum), secrete large amounts of the hormone gastrin, which causes your stomach to produce too much acid.

this is not a forever drug. There is a possible risk of cancer with prolonged use

We have to monitor kidney and liver function while on therapy.

A

Proton Pump Inhibitor (PPI) education

44
Q

GI upset, vitamin b12 deficiency (leads to anemia), GI bleeding , electrolyte imbalances

Assess for signs of bleeding in stool, assess dietary habits, assess BMP (lab that shows you what each electrolyte value is)

A

side effects of PPI

45
Q

Pepsin Inhibitor (antiulcer)
Treats Duodenal Ulcers
Caution use w renal disease and dysphagia

  • it treats duodenal ulcers by forming protective covering over ulcer surface and allowing it to heal.
  • take 4 times a day (1 hour before meals, and at bedtime)
A

Sucralfate

46
Q

increases fluid due to risk for constipation

A

nursing interventions for Sucralfate

Pharm final (5 decks)

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