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Nursing 450 Med Exam > Drug Info > Flashcards

Drug Info Flashcards

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1
Q

Acetaminophen with Codeine 30 mg PO

A

high alert
Class//codeine: opioid agonist, antitussive
acetaminophen: non-opioid analgesic, antipyretic

Use // mild to moderate pain

s/e A/R // confusion, sedation, hypotension, constipation, nausea, vomiting, HEPATOTOXICITY, SJS, TEN, ACUTE GENERALIZED EXANTHEMATOUS PUSTULOSIS

Critical Nursing Responsibilities //
no more than 4g total acetaminophen/day from all sources

assess BP, pulse, RR, LOC, and pain before and after admin - hold if RR is less than 10

assess bowel function frequently

increased bilirubin, LDH, AST, ALT, and prothrombin time may indicate hepatotoxicity

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2
Q

Albuterol (Salbutamol) neb, MDI

A

Class // bronchodilator, adrenergic

Use // Treatment or prevention of bronchospasm in patients with reversible obstructive airway disease; prevention of exercise- induced bronchospasm

s/e A/R // nervousness, restlessness, tremor, PARADOXICAL BRONCHOSPASM, chest pain, palpitations

Critical Nursing Responsibilities //
monitor for paradoxical bronchospasm (wheezing)

Have pt wait 1 minute between doses and rinse mouth after use

When giving with a corticosteroid, give bronchodilator first

assess lung sounds, pulse, and BP before and at 60-90 minutes l

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3
Q

Amlodipine

A

Class // antihypertensive, calcium channel blocker

Use // hypertension, angina pectoris, vasospastic (prinzmetal’s) angina

s/e A/R // peripheral edema, dizziness, fatigue

Critical Nursing Responsibilities //
monitor BP and pulse before therapy, during dose adjustment, and periodically during therapy

monitor ins/outs, observing for peripheral edema

assess for signs of HF (peripheral edema, rales/crackles, dyspnea, wt gain, jugular venous distention)

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4
Q

Acetylsalicylic acid (cardiac use)

A

Class // non-opioid analgesic, antipyretic, salicylate

Use // prophylaxis of transient ischemic attacks and MI

s/e A/R // GI BLEEDING, dyspepsia, epigastric distress, ANAPHYLAXIS, LARYNGEAL EDEMA

Critical Nursing Responsibilities //
monitor for bleeding (may cause prolonged prothrombin time)

monitor for signs of toxicity: tinnitus, headache, hyperventilation, agitation, mental confusion, lethargy, diarrhea, and sweating

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5
Q

Atorvostatin

A

Class // lipid lowering agent, hmg coa reductase inhibitor

Use // Management of primary high cholesterol and mixed dyslipidemia and for primary prevention of coronary heart disease (MI, stroke, angina)

s/e A/R // abdominal cramps, constipation, diarrhea, flatus, heartburn, rashes, RHABDOMYOLYSIS, ANGIOEDEMA

Critical Nursing Responsibilities //
monitor for muscle tenderness, if pt develops check CPK levels (if more than 10 times normal, d/c use)

monitor for signs of immune-mediated necrotizing myopathy (proximal muscle weakness and increased serum creatine kinase)

monitor serum cholesterol and triglyceride levels before and 2-4 weeks into therapy, periodically there after

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6
Q

Budesonide (pulmicort) neb

A

Class // corticosteroid, steroidal anti-inflammatory

Use // locally acting anti-inflammatory that can decrease symptoms of asthma (not a rescue)

s/e A/R // headache, otitis media, ANAPHYLAXIS, bronchospasm

Critical Nursing Responsibilities //
monitor respiratory status and lung sounds

periodic monitoring of adrenal function using hypothalamic-pituitary-adrenal axis suppression for chronic therapy

advise pt to rinse mouth after use to decrease risk of candidiasis

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7
Q

Cefazolin IV

A

Class //1st generation cephalosporin, anti-infective

Use // infection (pneumonia, septicemia, bacterial endocarditis, bone and joint, genital, biliary tract, urinary tract, skin and skin structure)

prophylaxis for dental, upper respiratory and perioperative procedures

s/e A/R // SEIZURES, CDAD, diarrhea, nausea, vomiting, STEVENS-JOHNSON SYNDROME, rash, phlebitis at IV site, ANAPHYLAXIS

Critical Nursing Responsibilities //
monitor bowel function for diarrhea, abdominal cramping, fever, and bloody stools which could indicate CDAD

assess pt for skin rash during therapy (SJS)

assess infection before and during therapy, including C and S

monitor for signs of anaphylaxis

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8
Q

Ceftriaxone IV

A

Class // 3rd generation cephalosporin, anti-infective

Use // treatment of infection (skin and skin structure, bone and joint, UTIs, uncomplicated gynecological infections, gonorrhea, lower respiratory tract infection, intra-abdominal infections, SEPTECEMIA, MENINGITIS, OTITIS MEDIA)

perioperative prophylaxis

s/e A/R // SEIZURES, CDAD, phlebitis, ANAPHYLAXIS

Critical Nursing Responsibilities //
monitor bowel function for diarrhea, abdominal cramping, fever, and bloody stools which could indicate CDAD

assess infection before and during therapy, including C and S

monitor for signs of anaphylaxis

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9
Q

Ciprofloxacin IV

A

Class // fluroquinolone, anti-infective

Use // treatment of infection (skin and skin structure, bone and joint, intra-abdominal, urinary tract, chronic bacterial prostatitis, lower respiratory tract infections, acute bacterial sinusitis, NOSOCOMIAL PNEUMONIA, FEBRILE NEUTROPENIA)

s/e A/R // ELEVATED ICP, SEIZURES, SUICIDAL THOUGHTS, HEPATOTOXICITY, CDAD, diarrhea

Critical Nursing Responsibilities //
monitor bowel function for diarrhea, abdominal cramping, fever, and bloody stools which could indicate CDAD

monitor neurological/CNS changes/effects

watch for signs of hepatotoxicity

assess infection before and during therapy, including C and S

monitor for signs of anaphylaxis

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10
Q

Nitroglycerin SL/spray

A

Class // antianginal, nitrate

Use // angina and prophylactic treatment of angina before exercise

s/e A/R // dizziness, headache, hypotension, tachycardia,

Critical Nursing Responsibilities //
assess location, duration, intensity, and precipitating factors of pt’s anginal pain

monitor BP and pulse before and after each administration

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11
Q

Digoxin PO/IV

A

high alert
Class // anti-arrhythmic, inotropic, digitalis glycoside

Use // heart failure, atrial fibrillation and atrial flutter (slows ventricular rate), paroxysmal atrial tachycardia

s/e A/R // fatigue, ARRHYTHMIAS, bradycardia, anorexia, nausea, vomiting

Critical Nursing Responsibilities //
take apical pulse for 1 full minute before administration, hold if HR is less than 60 for adult, 70 for child, 90 for infant

monitor ECG throughout IV administration and 6 hours after each dose

monitor for signs of toxicity: abdominal pain, anorexia, nausea, vomiting, visual disturbances, bradycardia, arrhythmias

monitor serum electrolytes, especially calcium, magnesium, and potassium

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12
Q

Diltiazem PO

A

Class // anti-anginal, anti-arrhythmic, anti-hypertensive, calcium channel blocker

Use // hypertension, angina pectoris and vasospastic (prinzmetal’s) angina, supraventricular tachyarrhythmias and rapid ventricular rates in atrial flutter or fibrillation

s/e A/R // ARRHYTHMIAS, peripheral edema, STEVENS-JOHNSON SYNDROME

Critical Nursing Responsibilities //
Monitor ins/outs and wt daily

monitor BP and pulse

assess for signs of HF (peripheral edema, rales/crackles, dyspnea, wt gain, jugular venous distention)

assess for rash (SJS)

monitor ECG continuously during administration for arrhythmias, report bradycardia or hypotension immediately

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13
Q

Dimenhydrinate IV

A

Class //anti-emetic, anti-histamine

Use // nausea, vomiting, dizziness and vertigo accompanying motion sickness

s/e A/R // drowsiness, anorexia

Critical Nursing Responsibilities //
assess nausea, vomiting, bowel sounds, and abdominal pain before and after administrations

monitor ins and outs including emesis

watch for signs of dehydration (excessive thirst, dry skin and mucous membranes, tachycardia, increased specific gravity of urine, poor skin turgor)

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14
Q

Diphenhydrimine IV

A

Class// anti-histamine, antitussive, cold/allergy/cough remedy

Use // relief of allergic symptoms caused by histamine release including anaphylaxis, allergic rhinitis, allergic dermatoses, Parkinson’s disease and dystonic reactions from medications, mild nighttime sedation, prevention of motion sickness

s/e A/R //drowsiness, anorexia, dry mouth

Critical Nursing Responsibilities //
monitor confusion and sedation, especially in older adults

monitor effectiveness in preventing/treating allergic reaction

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15
Q

Enoxaparin SC

A

high alert
Class //low molecular weight heparin, anti-coagulant, anti-thrombotic

Use // DVT, prevention of DVT/PE in surgical or medical patients, prevention and treatment of ischemic complications from unstable angina and non-ST-segment elevation MI

s/e A/R // bleeding, anemia

Critical Nursing Responsibilities //
monitor for signs of bleeding or hemorrhage

assess for additional or increased thrombosis symptoms

assess PQRSTU for those with angina

monitor CBC, platelet count, clotting times (aPTT)

monitor injection site for hematoma, ecchymosis, inflammation

antidote is protamine sulfate

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16
Q

Fentanyl patch transdermal

A

high alert
Class// opioid analgesic, opioid agonist, analgesic adjunct

Use // moderate to sever chronic pain in opioid-tolerant patients requiring round-the-clock long-term opioid treatment for which extended release alternatives are not adequate

s/e A/R // confusion, sedation, APNEA, RESPIRATORY DEPRESSION, anorexia, constipation, dry mouth

Critical Nursing Responsibilities //
assess BP, pulse and respiration before and periodically during use. hold or d/c if RR is less than 10

monitor LOC

wear gloves while handling patch

make sure to remove previous patch and dispose of properly (sharps)

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17
Q

Fluoxetine PO

A

Class// anti-depressant, SSRI

Use //major depressive disorder, OCD, bulimia nervosa, panic disorder, acute treatment of depressive episodes in bipolar 1, treatment resistant depression (with olanzapine)

s/e A/R // NEUROLEPTIC MALIGNANT SYNDROME, SEIZURES, SUICIDAL THOUGHTS, anxiety, drowsiness, headache, insomnia, nervousness, TORSADES DE POINTES, sexual dysfunction, diarrhea, SEROTONIN SYNDROME, tremor

Critical Nursing Responsibilities //
monitor mental status, especially suicidal tendencies and mood changes

watch for signs of neuroleptic malignant syndrome (fever, respiratory distress, tachycardia, seizures, diaphoresis, arrhythmias, hypertension or hypotension, pallor, tiredness, severe muscle stiffness, loss of bladder control)

watch for signs of serotonin syndrome: mental changes (agitation, hallucinations or coma), autonomic instability (tachycardia, labile BP, hyperthermia), neuromuscular aberrations (hyperreflexia, incoordination), and GI symptoms (nausea, vomiting, diarrhea)

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18
Q

Fluticasone MDI

A

Class // steroidal anti-inflammatory, corticosteroid

Use // maintenance and prophylactic treatment of asthma, delay of pulmonary damage from chronic asthma, decrease amount or need for systemic corticosteroids

s/e A/R // headache, ANAPHYLAXIS, LARYNGEAL EDEMA, URTICARIA, hydration, BRONCHOSPASM, CHURG-STRAUSS SYNDROME

Critical Nursing Responsibilities //
watch for signs of adrenal insufficiency (anorexia, nausea, weakness, fatigue, hypotension, hypoglycemia)

monitor respiratory status and lung sounds

monitor bone mineral density

monitor growth rate in children

advise pt to flush mouth with water after use

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19
Q

Furosemide PO/IV

A

Class // loop diuretic

Use // edema due to HF, hepatic impairment, renal disease, hypertension

s/e A/R // hypotension, hypocalcemia, hypochloremia,hypokalemia, hypomagnesemia, hyponatremia, hypovolemia, metabolic acidosis, ERYTHEMA MULTIFORME, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS, dehydration,

Critical Nursing Responsibilities //
monitor ins/outs and daily weights

monitor location and amount of edema

monitor lung sounds, skin turgor and mucous membrane

monitor BP and pulse before and during

monitor pt for tinnitus and hearing loss, using audiometry for pts receiving prolonged or large dose IV therapy

watch for skin rash

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20
Q

Gabapentin PO

A

Class// anticonvulsant. mood stabilizer, analgesic adjunct

Use // partial seizures, neuropathic pain, posthereptic neuralgia, restless leg syndrome, bipolar type, anxiety

s/e A/R // SUICIDAL THOUGHTS, confusion, RHABDOMYOLYSIS, ataxia, ANAPHYLAXIS, ANGIOEDEMA, MULTIORGAN HYPERSENSITIVITY REACTIONS

Critical Nursing Responsibilities //
monitor closely for changes in behaviour that could indicate worsening of suicidal thoughts or behaviour or depression

in those with seizures, assess location, duration, and characteristics of seizure activity

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21
Q

Heparin SC

A

high alert
Class // anti-coagulant, anti-thrombotic

Use // prophylaxis and treatment of thromboembolic disorders including VTE, PE, A.fib with embolization, acute and chronic consumptive coagulopathies, peripheral arterial thromboembolism

s/e A/R // BLEEDING, HEPARIN-INDUCED THROMBOCYTOPENIA (with or without thrombosis), alopecia

Critical Nursing Responsibilities //
assess for signs of bleeding and hemorrhage

monitor platelet count, watching for Heparin-induced thrombocytopenia which will mean low thrombocyte levels that persist

22
Q

Humulin R SC

A

high alert
Class // insulin, pancreatic, hormone

Use // diabetes

s/e A/R // hypoglycemia

Critical Nursing Responsibilities //

monitor for symptoms of hypoglycemia (or hyperglycemia)

monitor blood glucose Q6H and as needed

overdose symptoms are hypoglycemia - mild may be treated with oral glucose, severe should be treated with IV glucose, glucagon, or epinephrine

23
Q

Humulin N SC

A

high alert
Class // insulin, pancreatic, hormone

Use // diabetes

s/e A/R // hypoglycemia

Critical Nursing Responsibilities //

monitor for symptoms of hypoglycemia (or hyperglycemia)

monitor blood glucose Q6H and as needed

overdose symptoms are hypoglycemia - mild may be treated with oral glucose, severe should be treated with IV glucose, glucagon, or epinephrine

24
Q

Hydromorphone PO/IV

A

high alert
Class // opioid analgesic, opioid agonist, antitussive

Use // moderate to severe pain, moderate to severe chronic pain in opioid-tolerant pts,

s/e A/R // confusion, sedation, RESPIRATORY DEPRESSION, hypotension

Critical Nursing Responsibilities //
assess BP, pulse and respirations before administration and at 5min, 15min, 30min and 1 hr for IV and at 30 min, 1 hr for PO

monitor LOC

hold if RR below 10 or unable to rouse

assess pain before and after administration

25
Q

Ibuprofen PO

A

Class // NSAID, non-opioid analgesic, antipyretic, antirheumetic

Use // mild to moderate pain, fever, treatment of inflammatory disorders (rheumatoid arthritis, osteoarthritis), dysmenorrhea

s/e A/R // headache, constipation, dyspepsia, nausea, vomiting, HF, MI, STROKE, SJS, TEN, EXFOLIATIVE DERMATITIS, GI BLEEDING, HEPATITIS

Critical Nursing Responsibilities //
assess for skin rash and d/c use at first sign due to risk of SJS, TEN

monitor for symptoms of GI bleeding, renal dysfunction (elevated BUN and serum creatinine or decreased urine output), hepatic impairment (elevated liver enzymes or jaundice)

other assessment directly related to use (pain - assess before and 1 hr following// arthritis assess pain and ROM prior and 1 hr following// fever assess temp before and continue t monitor for temp, diaphoresis, tachycardia and malaise)

26
Q

Insulin Glargine (Lantus) SC

A

high alert
Class // hormone, antidiabetic, pancreatic

Use // diabetes

s/e A/R // HYPOGLYCEMIA, hypokalemia

Critical Nursing Responsibilities //
assess for symptoms of hypoglycemia

monitor blood glucose q6h or more frequently

antidote is oral glucose for mild hypoglycemia and IV glucose, glucagon, or epinephrine

27
Q

Levothyroxine PO

A

Class // hormone, thyroid preparation

Use // hypothyroidism

s/e A/R // insomnia, headache, arrhythmia, tachycardia, angina, wt loss

Critical Nursing Responsibilities //
assess apical pulse and BP prior to and periodically during therapy

assess for tachyarrhythmias and chest pain

antidote to acute overdose is induction of emesis or gastric lavage

28
Q

Lispro (Humalog) SC

A

high alert
Class // antidiabetic, hormone, pancreatic

Use // diabetes

s/e A/R // HYPOGLYCEMIA, hypokalemia

Critical Nursing Responsibilities //
assess for symptoms of hypoglycemia

monitor blood glucose q6h or more frequently

A1C may be monitored q3-6months

overdose symptoms are hypoglycemia - mild may be treated with oral glucose, severe should be treated with IV glucose, glucagon, or epinephrine

29
Q

Lorazepam SL

A

Class // benzodiazepine, sedative/hypnotic, antianxiety agent, analgesic adjunct

Use // anxiety, sedation, insomnia

s/e A/R // dizziness, drowsiness, lethargy, APNEA, CARDIAC ARREST

Critical Nursing Responsibilities // for anxiety - assess degree and manifestation of anxiety as well as mental status prior to and during terapy

if overdose occurs, flumazenil (romazicon) is antidone

30
Q

Magnesium Sulphate IV

A

high alert
Class // mineral and electrolyte replacements/supplements

Use // treatment/prevention of hypomagnesaemia, treatment of hypertension, prevention of seizures associated with severe eclampsia, pre-eclampsia, or acute nephritis

s/e A/R // diarrhea, drowsiness, bradycardia, hypotension, decreased respirator rate, arrhythmias

Critical Nursing Responsibilities //
monitor BP, respirations, ECG

respirations should be 16/min or more before each dose

monitor neurological status before and throughout therapy

patellar reflex should be tested before parenteral doses - none should be administered if reflex not present

urine output should be maintained at 100mL/4hr or more

monitor serum magnesium and renal function periodically

31
Q

Meropenem IV

A

Class // anti-infective, carbapenem

Use // intra-abdominal infections, bacterial meningitis, skin and skin structure infections

s/e A/R // diarrhea, nausea, vomiting, SEIZURES, APNEA, CDAD,

Critical Nursing Responsibilities //
assess infection including C and S before and during treatment

monitor hematologic, hepatic and renal function periodically during therapy

periodically monitor BUN, AST, ALT, AST, LDH, serum alkaline phosphatase, bilirubin, and creatinine as measure of hepatic and renal function

monitor hematological function via hemoglobin and hematocrit (may drop)

monitor bowel function

32
Q

Metformin PO

A

Class // anti-diabetic, biguanide

Use // management of type 2 diabetes

s/e A/R // abdominal bloating, diarrhea, nausea, vomiting, metallic taste, LACTIC ACIDOSIS

Critical Nursing Responsibilities //
monitor blood glucose and A1C

renal function should be tested before initiating and at least annually

monitor for symptoms of lactic acidosis (chills, diarrhea, dizziness, low BP, muscle pain, sleepiness, slow pulse, dyspnea, weakness)

33
Q

Metoprolol PO

A

high alert
Class // beta blocker, antianginal, antihypertensive

Use // hypertension, angina pectoris, prevention of MI and decreased mortality in pts with recent MI, management of HF

s/e A/R // BRADYCARDA, HF, PULMONDARY EDEMA, fatigue, weakness, erectile dysfunction

Critical Nursing Responsibilities //
take apical pulse before administering and if less than 50 bpm or arrhythmia noted, hold

monitor BP, ECG, and pulse during dose adjustment and periodically during therapy

monitor ins/outs and daily wts

monitor for signs of HF

in angina pts assess frequency and characteristics of angina attacks

34
Q

Metronidazole IV

A

Class // anti-infective, antiprotozoal, antiulcer agent

Use // perioperative prophylactic agent in colorectal surgery, anaerobic infections (endocarditis, septicemia, CNS, bone/joint, lower respiratory tract, skin/skin structure, intra-abdominal)

s/e A/R // SEIZURES, dizziness, aseptic meningitis, encephalopathy headache, abdominal pain, anorexia, nausea, SJS

Critical Nursing Responsibilities //

monitor neurological status

assess infection, including C and S before and during therapy

monitor ins/outs

assess for signs of SJS, rash accompanied by fever, malaise, fatigue, muscle/joint aches, blisters, conjunctivitis

35
Q

Morphine IV/PO

A

high alert
Class // opioid analgesic, opioid agonist

Use // moderate to severe pain or chronic pain, pulmonary edema, pain associated with MI

s/e A/R // RESPIRATORY DEPRESSION, confusion, sedation, hypotension, constipation

Critical Nursing Responsibilities //
assess LOC, BP, pulse, and RR before and following admin

hold if RR less than 10

assess pain before and following admin at 5//15//30//1hr

36
Q

Naproxen PO

A

Class // NSAID, non-opioid analgesic, antipyretic

Use //relief of mild to moderate pain, dysmenorrhea, suppression of inflammation, reduction of fever

s/e A/R // dizziness, drowsiness, headache, HF, MYOCARDIAL INFARCTION, STROKE, DRUG-INDUCED HEPATITIS, GI BLEEDING, constipation, dyspepsia, nausea, ANAPHYLAXIS, STEVENS0-JOHNSON SYNDROME

Critical Nursing Responsibilities //
assess pain and fever before and after administration

monitor BUN, serum creatinine, CBC, liver function periodically

37
Q

Ondansetron IV

A

Class // anti-emetic, 5 HT3 antagonist

Use // prevention and treatment of (postoperative) nausea

s/e A/R // SEROTONIN SYNDROME, headache, TORSADE DE POINTES, constipation, diarrhea, STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS

Critical Nursing Responsibilities //
assess for nausea, vomiting abdominal distention and bowel sounds

assess for extrapyramidal effects (involuntary movements, facial grimacing, rigidity, shuffle walking, trembling hands)

monitor for signs of serotonin syndrome

38
Q

Oxycodone PO

A

high alert
Class // opioid analgesic, opioid agonist, opioid agonist nonopioid analgesic combination

Use // moderate to severe pain (acute or chronic)

s/e A/R // confusion, sedation, RESPIRATORY DEPRESSION, constipation

Critical Nursing Responsibilities //
assess BP, pulse, pain, and respirations before administration. hold if RR less than 10 and pt sedate

monitor bowel function

39
Q

Pantoprazole PO/IV

A

Class // proton pump inhibitor, antiulcer agent

Use // erosive esophagitis associated with GERD, maintenance and healing of erosive esophagitis, pathologic gastric hypersecretory conditions

s/e A/R // CDAD, hypomagnesemia, headache, vitamin B12 deficiency

Critical Nursing Responsibilities //
monitor bowel function for signs of CDAD (abdominal cramping, fever, bloody stools)

assess routinely for epigastric or abdominal pain and for frank/occult blood in stool, emesis, or gastric aspirate

periodic monitoring of serum magnesium

40
Q

Penicillin G IV

A

Class // anti-infective, penicillin

Use // treatment of infection including pneumococcal pneumonia, streptococcal pharyngitis, syphilis, gonorrhea, treatment of enterococcal infections, prevention of rheumatic fever

s/e A/R // SEIZURES, diarrhea, epigastric distress, nausea, vomiting, rash, phlebitis at IV site, ANAPHYLAXIS, SERUM SICKNESS, CDAD

Critical Nursing Responsibilities //
assess infection before onset of therapy

monitor bowel function for signs of CDAD

watch for signs of anaphylaxis

41
Q

Perindopril PO

A

Class //ACE inhibitor, antihypertensive

Use // hypertension, reduction of risk for death from cardiovascular causes

s/e A/R // hypotension, ANGIOEDEMA, impaired renal function

Critical Nursing Responsibilities //
monitor BP and pulse

assess for signs of angioedema (swelling face, extremities, eyes, lips, tongue, difficulty swallowing or breathing)

42
Q

Phenobarbital IV

A

Class // anticonvulsant, sedative, hypnotic, barbituate

Use // seizures, preoperative sedation, sedation, hypnotic

s/e A/R // hangover, LARYNGOSPASM, hypotension, ANGIOEDEMA, SERUM SICKNESS, depression, excitation, vertigo

Critical Nursing Responsibilities //
monitor respiratory status, pulse, and BP

watch for signs of angioedema (swelling of lips, face, throat, dyspnea)

symptoms of toxicity include confusion, drowsiness, dyspnea, slurred speech, staggering

monitor respiratory status, pulse, BP, watch for signs of angioedema, monitor serum folate concentrations

43
Q

Phenytoin (Dilantin) IV

A

Class // antiarrhythmic, anticonvulsant, hydantoin

Use // treatment/prevention of seizures; unlabeled use as an antiarrhythmic and for neuropathic pain

s/e A/R // ataxia, diplopia, hypotension, gingival hyperplasia, nausea, hypertrichosis, rash, SUICIDAL THOUGHTS, ACUTE HEPATIC FAILURE, SETEVENS-JOHNSONS SYNDROM, TOXIC EIDERMAL NECROLYSIS, AGRANULOCTOSIS, APLASTIC ANEMIA, DRUG REACTION WITH EOSINOPHILI AND SYSTEMIC SYMPTOMS

Critical Nursing Responsibilities // monitor mental status and behavior, monitor CBC, serum calcium, albumin, and hepatic function before and during therapy

monitor for change in behavior, suicidal thoughts/behaiviours

watch for signs skin reactions and d/c at first sign due to risk of of Stevens-Johnson or toxic epidermal necrolysis

monitor CBC, serum calcium, albumin and hepatic function tests before and for first several months of thearpy

encourage oral hygiene to avoid gingival hyperplasia

44
Q

Potassium Chloride PO/IV

A

IV is HIGH ALERT

Class // mineral and electrolyte replacement or supplement

Use // treatment or prevention of potassium depletion, for arrhythmias due to digoxin toxicity

s/e A/R // ARRHYTHMIAS, confusion, restlessness, weakness, abdominal pain (PO), diarrhea (PO), hyperkalemia

Critical Nursing Responsibilities // IV: monitor pulse, BP, and ECG during therapy; monitor for signs of hyperkalemia

antidote: sodium bicarbonate to correct acidosis, dextrose and insulin to facilitate passage of potassium into cells, calcium salts to correct cardiac rhythm effects, sodium polystyrene

45
Q

Prednisone PO

A

Class // steroidal anti-inflammatory, immune modifier

Use // chronic diseases (inflammatory, allergic, hematologic, neoplastic, autoimmune)

s/e A/R // depression, euphoria, hypertension, PEPTIC ULCERATION, anorexia, nausea, decreased wound healing, ecchymosis, fragility, hirsutism, petechiae, adrenal suppression, THROMBOEMBOLISM, muscle wasting, osteoporosis, cushingoid appearance (moon face, buffalo hump)

Critical Nursing Responsibilities // assess for sings of adrenal insufficiency (hypotension, weight loss, weakness, nausea, vomiting, anorexia, lethargy, confusion, restlessness); monitor for edema, wt gain, rales/crackles, or dyspnea

46
Q

Ramipril PO

A

Class // antihypertensive, ACE inhibitor

Use // hypertension; reduce risk of MI, stroke, or death from CV causes in patients greater than 55 years

s/e A/R // hypotension, ANGIOEDEMA, cough, hyperkalemia

Critical Nursing Responsibilities // monitor BP and pulse, monitor for angioedema

47
Q

Rivaroxaban PO

A

Class // anticoagulant, antithrombotic, factor xa inhibitor

Use // prevention of DVT and PE following knee/hip replacement surgery, treatment/reduction in risk of recurrence of DVT/PE, reduce risk of stroke and systemic embolism in pts with nonvalvular a.fib

s/e A/R // syncope, BLEEDING, extremity pain, muscle spasm

Critical Nursing Responsibilities // monitor for signs of bleeding and hemorrhage, INR and PT; advise pt not to take OTC especially those with aspirin, NSAIDs, or St.John’s wort

antidote: prothrombin concentrate complex to reverse bleeding

48
Q

Spironolactone PO

A

Class // potassium-sparing diuretic

Use // hyperaldosteronism; edema associated with HF, cirrhosis, and nephrotic syndrome; essential hypertension; hypokalemia

s/e A/R // hyperkalemia, sexual dysfunction, dizziness, DRUG RASH WITH EOSINOPHILIA AND SYSTEMIC SYMPTOMS (DRESS), STEVENS-JOHNSON SYNDROME, TOXIC EPIDERMAL NECROLYSIS

Critical Nursing Responsibilities // monitor ins/outs and daily weights, BP, serum potassium prior to and during treatment, ECGs, monitor for skin rash

49
Q

Tazocin IV (pipercillin and tazobactam)

A

Class // anti-infective, extended spectrum penicillins

Use // appendicitis, peritonitis, skin/skin structure infections, gynecological infection, pneumonia caused by piperacillin resistant, beta-lactamase-producing bacteria

s/e A/R // SEIZURES (high doses), CLOSTRIDIUM DIFFICILE-ASSOCIATED DIARRHEA (CDAD), diarrhea, pain, phlebitis at IV site, rashes, STEVENS-JOHNSON SYNDROM, TOXIC EPIDERMAL NECROLYSIS, ANAPHYLAXIS, SERUM SICKNESS, pseudomembranous colitis

Critical Nursing Responsibilities // assess for infection before and during therapy; monitor for diarrhea, abdominal cramping, fever, and bloody stool - can indicate CDAD and can occur after cessation of therapy; assess/monitor for skin rashes, monitor renal and hepatic function

50
Q

Vancomycin

A

Class // anti-infective

Use // staphylococcal enterocolitis, clostridium difficile, endocarditis, meningitis, osteomyelitis, pneumonia, septicemia, soft-tissue infections for those allergic to penicillin

s/e A/R // nephrotoxicity, phlebitis, ANAPHYLAXIS, ototoxicity

Critical Nursing Responsibilities // assess infection before and during therapy, monitor IV site for necrosis or pain, BP, Ins/Outs, assess renal function, monitor for casts/albumin/cells in urine or for decrease in specific gravity, bowel status, monitor 8th cranial nerve via audiometry in older pts

should only be given orally for staph. enterocolitis or C.dff - not effective for other infections if given PO

51
Q

Warfarin

A

HIGH ALERT
Class // anticoagulant, coumarin

Use // prophylaxis and treatment of VT, PE, A.fib with embolization; management of MI, prevention of thrombus formation/embolization after prosthetic valve placement

s/e A/R // BLEEDING, cramps, nausea, dermal necrosis

Critical Nursing Responsibilities // monitor for bleeding or tarry stools; monitor aPTT and INR, assess for additional or increased thrombosis; advise pt not to have alcohol or OTC like aspirin or NSAIDS

antidote: Vitamin K and whole blood plasma

Nursing 450 Med Exam (6 decks)

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