Exam 5 Notes Flashcards
1
Q
normal aPPT
normal on anticoags
A
25-35 s
40-70 s
2
Q
normal INR
normal on warfarin
A
<1.1
1.3-2 OR 2-3 seconds higher than pt baseline
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
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
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
6
Q
hyperphosphatemia leads to…
A
leads to Ca+ loss
7
Q
diuretics indications
A
- HF
- HTN
- Kidney failure
- Cirrhosis
- Pulmonary edema
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.
9
Q
what does kayexalate cause
A
large BM, K+ excreted in stool
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
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
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
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
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
15
Q
promote evacuation of entire colon
A
cathartics
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
