Exam 5 Notes Flashcards

1
Q

normal aPPT

normal on anticoags

A

25-35 s

40-70 s

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2
Q

normal INR

normal on warfarin

A

<1.1

1.3-2 OR 2-3 seconds higher than pt baseline

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3
Q

anticoag nursing care

A
  • Look at hx for clotting issues
  • Monitor labs, VS
  • Caution with trauma pts
  • Pt teaching
    • s/s of bleeding
    • Soft toothbrush
    • Electric razor
    • Do not smoke - increases need for warfarin
    • Consistent vitamin K consumption
    • Avoid aspirin, NSAIDs
    • Medic alert bracelet
    • Stop therapy 7-10 days prior to medical procedures
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4
Q

thrombolytics nursing care

A
  • Monitor for bleeding; reperfusion dysrhythmias; allergic reaction
  • Bleeding may occur up to 24 hours after surgery
  • Teach pt s/s of hemorrhage
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5
Q

4 major functions of renal system

A
  • Mantain volume and composition of body fluids - clear nitrogen waste; maintain pH balance; maintain electrolyte balance; excrete drugs
  • Regulate vitamin D & calcium levels
  • Regulate blood pressure through RAAS
  • Regulate RBC production - produce erythropoietin
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6
Q

hyperphosphatemia leads to…

A

leads to Ca+ loss

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7
Q

diuretics indications

A
  • HF
  • HTN
  • Kidney failure
  • Cirrhosis
  • Pulmonary edema
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8
Q

diuretics nursing care

A
  • I & O
  • Lab values
  • Sx of electrolyte imbalance, dehydration
  • Take pulse & BP
  • Compliance with drugs
  • Teach Na+ and K+ intake rules
  • Fluid restrictions as needed
  • Take drugs in a.m.
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9
Q

what does kayexalate cause

A

large BM, K+ excreted in stool

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10
Q

nursing care for upper RT disease

A
  • Monitor temp
  • Prevent spread of infection
  • Hydrate pt
  • Don’t drive if drowsy
  • Get adequate rest
  • Watch OTC meds that have multiple ingredients
  • Teach medication use
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11
Q

long and short acting asthma drugs

A
  • Quick relief meds - use a metered dose inhaler (MDI)
    • Short acting beta 2 adrenergics
    • Anticholinergics
    • Corticosteroids
  • Long acting medications
    • Corticosteroids
    • Leukotriene modifiers
    • Long acting beta 2 adrenergics
    • Methylxanthines
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12
Q

nonpharm tx for gastric acid disorders

A
  • No tobacco and alcohol
  • Lose weight (obesity ↑ intra-abdominal pressure)
  • Avoid hot, spicy, greasy foods
  • Avoid caffeine, chocolate, citric acids
  • Elevate HOB; don’t eat before bed
  • Wear loose-fitting clothing
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13
Q

H pylori tx combos

usually composed of?

A

antacids + antibacterials

  • omeprazole (Prilosec) + clarithromycin (Biaxin) + amoxicillin (Amoxil)
  • omeprazole (Prilosec) + clarithromycin (Biaxin) + metronidazole (Flagyl)
  • omeprazole (Prilosec) + bismuth subsalicylate (Pepto-Bismol) + metronidazole (Flagyl) + tetracycline
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14
Q

nursing care for gastric acid disorders

A
  • Teach nonpharm methods; report sx of GI bleeding; tx may take a few weeks for results
  • Avoid giving drugs with antacids or other oral drugs
  • Older pts may need reduced doses of acid blockers
  • Caution in renal failure pts who take antacids containing aluminum & sodium
  • Monitor F & E balance
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15
Q

promote evacuation of entire colon

A

cathartics

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16
Q

laxatives nursing care

A
  • Assess history of BM pattern
  • Monitor bowel sounds, VS
  • Monitor for F & E loss
  • Patient teaching
    • ↑ water intake
    • ↑ fiber intake
    • Risk of laxative dependence
    • Proper admin
    • Report rectal bleeding
17
Q

antidiarrheal nursing care

A
  • ID and tx underlying cause
  • Monitor for F & E loss, VS
  • Patient teaching
    • Avoid fried food, milk products until diarrhea stops
    • Avoid alcohol
    • Proper hand washing & handling of food
18
Q

vomiting nonpharm tx

A
  • Rest
  • Weak tea
  • Flattened carbonated beverages
  • Gatorade, pedialyte
  • Crackers, dry toast
19
Q

OTC vs Rx drugs used for vomiting

A
  • OTC
    • Dimenhydrinate (Dramamine)
    • Diphenhydramine (Benadryl)
    • Bismuth subsalicylate (Pepto-Bismol)
  • Rx
    • Anticholinergics & antihistamines
    • Lorazepam (Ativan)
    • Phenothiazines
    • Serotonin antagonists
    • Corticosteroids
      • Dexamethasone (Decadron)
      • Methylprednisolone (SoluMedrol)
    • Cannabinoids - marijuana
20
Q

antiemetics nursing care

A
  • ID & tx cause of vomiting
  • Monitor VS, F & E balance
  • Use nonpharm methods
  • Encourage rest
  • Replace lost fluids & electrolytes
  • Avoid alcohol
  • Safety precautions if driving, etc