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NCLEX Mark K > Drug Toxicities, HH vs DS, electrolytes > Flashcards

Drug Toxicities, HH vs DS, electrolytes Flashcards

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1
Q

Lithium
(Antimania)

Indications: Bipolar disorders - for Manic episodes not for depression

Therapeutic level
Toxic level
Other

A

Therapeutic level: 0.6 - 1.2
Toxic level: > 2
Other Gray area 1.3 - 2

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2
Q

Lithium
(Antimania)

Therapeutic level: 0.6 - 1.2
Toxic level: > 2
Other Gray area 1.3 - 2

What is it used for

A

Manic episodes for Bipolar disorder

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3
Q

Lanoxin/ Digoxin

Indications: A-fib, CHF

Therapeutic level:
Toxic level:
Others:

A

Therapeutic level:1 - 2
Toxic level: >2
Others:

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4
Q

Lanoxin / Digoxin

Therapeutic level:1 - 2
Toxic level: >2
Others:

Indications:

A

Indications: A-fib & CHF

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5
Q

Aminophylline
(Compound of bronchodilator theophylline)

Indications: Muscle Spasm relaxer for airway

Therapeutic:
Toxic level:
Other:

A

Therapeutic: 10 - 20
Toxic level: >20
Other: Non-therapeutic level <10 (in this case, increase dose and assess for compliance)

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6
Q

Aminophylline
(Compound of bronchodilator theophylline)

Therapeutic: 10 - 20
Toxic level: >20
Other: Non-therapeutic level <10 (in this case, increase dose and assess for compliance)

Indications;

A

Indicaciones: Muscle spams relaxer for airway

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7
Q

Dilantin (Phenytoin)

Indication Seizure Medicine

Therapeutic level:
Toxic level:

A

Therapeutic level: 10 - 20
Toxic level: >20

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8
Q

Dilantin (Phenytoin)

Therapeutic level: 10-20
Toxic level: >20

Indications:

A

Seizure Medication

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9
Q

Bilirubin

Indication: Breakdown produce of RBC’s

Therapeutic level:
Toxic:
Other:

A

Therapeutic level: 0.2 - 1.2 for adults, higher for newborns
Toxic: elevated newborn 10 - 20 & Toxic level for newborn is >20

Other: Hospitalize newborns if bili is > 14

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10
Q

Jaundice for excess bilirubin

Pathological: Jaundice within first 24 hrs of birth (concerning/ normal)

Physiological: Jaundice 2 to 3 days postpartum (concerning/ normal)

A

Pathological: Jaundice within first 24 hrs of birth concerning

Physiological: Jaundice 2 to 3 days postpartum normal

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11
Q

Kernicterus; Excess bilirubin in the brain (bili>20) may cause aseptic/sterile ____ or ______

A

Meningitis/ Encephalopathy

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12
Q

For Drug Toxicity

Pathological: Jaundice within first 24 hrs of birth (concerning/ normal)

Physiological: Jaundice 2 to 3 days postpartum (concerning/ normal)

A

Pathological: Jaundice within first 24 hrs of birth concerning

Physiological: Jaundice 2 to 3 days postpartum normal

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13
Q

Toxicity levels

Lithium (Antimania)
Lanoxin/ Digoxin

&

Aminophylline, Dilantin, Bilirubin

A

Lithium (Antimania)
Lanoxin/ Digoxin
>2

&

Aminophylline, Dilantin, Bilirubin
>20

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14
Q

Opisthotonos…

A

Hyperextended posistion that the new born assumes d/t irritation of the meninges from kernicterus

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15
Q

A newborn is in the Opisthotonos ( severe backward archingposition) from being kernicterus (bilirubin encephalopathy)

Which position would you put him in

A

On their side

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16
Q

Hiatal Hernia (does what)

Vs

Dumping Syndrome

A

regurgitation of acid into the esophagus, upper part of stomach herniates through diaphragm
Right rate but wrong direction

Follows gastric surgery
Gastric contents dump too quickly into duodenum.
Right direction wrong rate

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17
Q

Hatial Hernia S &S

A

GERD

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18
Q

It is a Haital Herina not just GERD if…

A

You eat & lay down then get GERD symptoms

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19
Q

Dumping Syndrome S&S

A

Drunk, Shock, Acute Abdominal Drestress

Drunk

Slurred, staggering, impaired, reaction time, liable

Shock

Hypotension, Tachycardia,
Skin: Pale, Cold, Clammy

Acute Abdominal Distress

Cramping, Pain, Guarding, Diarrhea, Boborigmi

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20
Q

Hiatal Hernia

Interventions

A

3 things (Elevate Everything)

Elevate HOB 1h post meals
Increase fluid with meals
Increase Carbs / Decrease Protein
(Protein stays in stomach longer)

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21
Q

Dumping Syndrome

Interventions

A

3 things (Lower Everything)

Lower HOB & turn pt on the side
Decrease fluid amount 1 to 2 hrs before and after meals
Decrease Carbs/ Increase Protein
(Protein prevents the stomach from emptying too quickly

22
Q

Memorize

Kalemia (K+) do the same as the prefix except for HR & U/O

A

Hyperkalemia:
Seizures, Agitation, Irritability, Tented T Wave, ST elevation, Tachypnea, Diarrhea, borborygmi, spasticity, increased tone, hyperreflexia BRADYCARDIA / OLIGURIA

Hypokalemia:
Lethary, bradypnea, paralytic ileus, Constipation, muscle flaccid, hyporeflexia, 0,1, TACHYCARDIA, POLYURIA

23
Q

How to memorize Hyper & Hypo Kalemia S & S

A

S & S go in same direction as Prefix

Except for HR and UO urine output

24
Q

Obtunded

A

characterized by diminished responsiveness to stimuli, often due to a state of reduced consciousness:

25
Q

Paralytic ileus(or adynamic ileus)

A

Motor Paralysis of the digestive tract secondary to neuromuscular failure

26
Q

Clonus…

A

is involuntary and rhythmic muscle contractions caused by a permanent lesion in descending motor neurons.

27
Q

Calcemia does the (opposite / same) of the Prefix

A

Oppsite

28
Q

Select All that Apply

S & S of Hyperkalemia

Adynamic Illeus
Obtunded
+1 reflex
Colonus (involuntary, rhythmic muscle contractions)
U wave
Depressed ST wave
Polyuria
Bradycardia

A

Adynamic Illeus: NO
Obtunded: NO
+1 reflex: NO
Colonus: YES
U wave: NO
Depressed ST wave: NO
Polyuria: NO
Bradycardia: YES

29
Q

Calcium goes low, everything goes (high/ low)

Calcium goes high, everything goes (high / low)

A

Calcium goes low, everything goes high

Calcium goes high, everything goes low

30
Q

(Hypercalcemia/ Hypocalcemia)
Bradycardia
Bradypenea
Flaccid muscles
Constipation
Hyporeflexia

(Hypercalcemia/ Hypocalcemia)
Tachypnea
Tachypnea
Colonus
Diarrhea
Hyperreflexia

A

Hypercalcemia
Bradycardia
Bradypenea
Flaccid muscles
Constipation
Hyporeflexia

Hypocalcemia
Chvostek’s sign (twitching of facial muscles in response to tapping over the facial nerve)

Trousseau’s sign Carpopedal spasm induced inflated sphygmomanometer cuff.

Tachypnea
Tachypnea
Colonus
Diarrhea
Hyperreflexia

31
Q

Which 2 signs / test indicate Hypocalcemia when positive

A

Chvostek’s sign (twitching of facial muscles in response to tapping over the facial nerve.

Trousseau’s sign (carpopedal spasm induced by inflated sphygmomanometer cuff.)

32
Q

Magnesium does the (oppsite / same) as the prefix?

Low magnesium = (High/ Low) S&S
High magnesium = (High/ Low) S&S

A

Magnesium the oppsite as the prefix

Low magnesium = High S&S
High magnesium = Low S&S

33
Q

Incase of a Tie in Electrolytes

(Pick / Don’t Pick ) Mg

If Skeletal Muscle or Nerve Blame it on (Ca, K, Na)

For every thing else select

A

Don’t Pick Mg; Why, not a major player

If Skeletal Muscle or Nerve Blame it on: Ca

For every thing else select: K

34
Q

Patient has diarrhea, which causes it

A. Hyperkalemia
B. Hypokalemia
C. Hypomagnesemia
D. Hypocalcemia

A

A. Hyperkalemia

Because it isn’t Skeletal/ nerve muscle

35
Q

Patient has tetany, which is the cause

A. Hyperkalemia
B. Hypokalemia
C. Hypocalcemia
D. Hypomagnesemia

A

C.

Because it is skeletal/ nerve muslce

36
Q

Hyponatremia (Dehydration/ Fluid Overload)

Hypernatremia (Dehydration/ Fluid Overload)

A

Hyponatremia Fluid Overload

Hypernatremia Dehydration

37
Q

LPN says “ I just ran a whole L in 10 min of D5W “

RESULT: Hypo / Hypernatremia

A

Hyponatremia

38
Q

Which patient’s get Fluid Restrictions & Laskis

Hyponatremia/ Hypernatremia

A

Hyponatremia

39
Q

Which patient’s are given lots of fluids

Hyponatremia/ Hypernatremia

A

Hypernatremia

40
Q

Hot Flushed dry skin S & S

Hyponatremia/ Hypernatremia

A

Hypernatremia

41
Q

DKA

These two electrolyte problem

A

Hyperkalemia & Hypernatremia

42
Q
  1. Fluid volume excess
  2. SIADH
  3. DI
  4. HHNK

Hyponatremia / Hypernatremia

A
  1. Hyponatremia
  2. Hyponatremia
  3. Hypernatremia
  4. Hypernatremia (HHNK = Dehydration)
43
Q

Earliest sign of any electrolyte imbalance is

A

(Paresthesia)
Numbness & Tingling

44
Q

Universal Sign of Electrolytes Imbalance

A

Paresis Muscle Weakness

All electrolyte imbalance cause this

45
Q

Paresis

Paresthesia

Numbness & Tingling

Muscle Weakness

A

Paresis: Muscle Weakness

Paresthesia: Numbness & Tingling

46
Q

At which level of potassium does you push an IV

A

Never push a potassium IV

47
Q

What is the maximum mL of K per liter you can give without calling the Dr. To verify order

A

40mL

48
Q

Fastest way to lower K

A

D5W with Regular insulin

Drives Potassium back into cells from the bloodstream

49
Q

Kayexalate (Full of sodium) goes into the gut and exchanges itself for (this electrolyte) which will then be pooped out

A

K potassium

50
Q

What is the upside / downside to treating hypekalemia with…

D5W & Insulin

Kayexalate

A

D5W & Insulin
Upside: Immediate Actinf
Downside: Temporarily Fix, K is still inside body (in the Cells)

Kayexalate
Upside: Permanent Fix (K left the body)
Downside: Takes longer to work

51
Q

Kernicterus

A

also known as bilirubin encephalopathy, is a rare but serious complication of untreated jaundice
in babies.

NCLEX Mark K (9 decks)

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