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Practical Nursing 101 > Exam II > Flashcards

Exam II Flashcards

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1
Q

The higher the guage the _______ the needle

A

smaller

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2
Q

Regular syringe

A

Used for IM or subQ injections
Calibrated in milliliters
1- ,3- , 5-mL syringes for most injections

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3
Q

Tuberculin syringe

A

Holds 1 mL
Good choice for small precise volumes of meds such as those for newborns and infants
Good for TB skin test

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4
Q

Insulin syringe

A

Similar to TB syringe
Can hold 0.3, 0.5, and 1 mL
Tiny gauge, short, permanantly attatched needle

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5
Q

Prefilled syringes

A

Single does ready to use, disposable syringe cartridges.
can have needle attatched or not
Contains specific dosages

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6
Q

ID injections

A

Used mostly for diagnostic tests (TB test)
should be 1/4-5/8 in
25-30 g
Bevel up at 15 degree angle
Between layers of dermis
Do not apply pressure or massage injection site

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7
Q

SubQ injections

A

For medications that need to be absorbed slowly
3/8-7/8 in
24-29g
administer at 45 degree angle, can differ depending on amount of fat
1-2 mL syringe

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8
Q

when giving a SubQ med in the abdomen know that…

A

it absorbs faster here than other subq sites

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9
Q

Sub Q injection sites

A

back of upper arms, abdomen, anterior thighs, area of back just below scapulae, upper buttocks

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10
Q

Trough level

A

Lowest concentration of medication in blood.

Take before next dose regarless of route

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11
Q

Peak level

A

Highest concentration of medication in blood

Peak level depends on drug

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12
Q

Theraputic index for PO meds

A

between 1-3 hrs after administration

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13
Q

Theraputic index for IV meds

A

10 mins after administration

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14
Q

Do not give diabetic medications _____ hours prior to contrast testing because ________

A

48

It can cause lactic acidosis

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15
Q

Potassium rich foods

A 
Artichoke
Avacados
bananas
Cantaloupe
cassava
dried fruits
grape fruits
honey dew
jack fruit
kiwi
kohlrabi
lima beans
mango
meats
milk
dried peas and beans
nuts
oranges/orange juice
papaya
peaches
pears
plaintains
pomegranate
Potatoes
punes/prune juice
Pumpkin
rhunarn
salt substitute
spinach
sunflower seeds'swiss chard
tomatoes
vegetable juice
winder squash
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16
Q

tyramine foods

A 
Aged cheese
american processed cheese
avacados
bananas
bean curd
beer and ale
caffine containing beverages
caviar
chocolate
distilled spirits
fermented sausage
liver
meats tenderized
miso soup
over ripe fruit
peanuts
rasins
raspberries
red wine
sauerkraut
sherry
shrimp paste
smoked or pickled fish
soy sauce
vermouth 
yeasts yogurt
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17
Q

Neuropletic malignant syndrome

A

A rare but life-threatening reaction to any and/or all antipsychotics drugs or tranquilizers

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18
Q

Extrapyrimidial reactions

A

Involuntary movements

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19
Q

Steven johnson syndrome

A

a rare but serious disorder of the skin and mucous membranes. Its usually a reaction to medication that starts as flu like symptoms, followed by a painful rash that spreads and blisters. Ibuprofen can cause this in children

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20
Q

Half life

A

the time for the medication in the body to drop by 50% Liver and kidney function affect half-life. It usually takes four half-lives to achieve steady blood concentration.

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21
Q

Serotonin syndrome

A

too much serotonin, can because by antidepressants or pain medications.

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22
Q

Anticholinergic syndrome

A

delirium following tx with anticholinergics

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23
Q

Chvostek’s sign

A

tap the face in front of the ear and below the zygomatic bone. Facial twitching constitutes a positive sign and hypocalemia

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24
Q

troussue’s sign

A

Inflate blood pressure cuff and if flexion of wrist occurs then pt trousseau’s sign is positive and indicates hypocalemia

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25
Q

Milk alkali syndrome

A

characterized by high blood calcium and metabolic alkalosis caused by taking in too much calcium and absorbable alkali

26
Q

Sodium Docusate

A

Colace
o Laxative- makes stool softer
o Can be give PO
o For clients who should not strain: pt’s who have had an MI, rectal surgery, or cardiac surgery.
o Can cause vagal response, which could cause the client to have hypotension and or bradycardia, which could cause the patient to fall and/or pass out.
o Can be taken with fluids or on an empty stomach…empty stomach inhibits fast results.
o Teach pt to be cautions when taking another laxative.
o Should be used short term only.
o Pt should be taught to have a high fiber diet and drink plenty of fluids if the provider permits.
o Pt’s who have had nausea, vomiting, abdominal pain, and fever should contact their physician. Should not be given for following symptoms.
o May take 3-5 days to work PO. Rectal within 2-15 mins

27
Q

Enoxaparin

A

Lovenox
o High alert med (there have been serious complications with this medication)
o Given biased by weight in kg
o Anti coagulant
o Does not break up blood clots; keeps clots from forming.
o Given subq in fatty tissue; needs to be given in the abdomen or love handles to be absorbed slow. DOES NOT GO IN THE ARMS.
o Do not rub it in.
o Sometimes started before Warfarin (Coumadin) because warfarin can take several days to be effective in preventing clots.
o Clotting times (PTT &PTNINR) should be checked before administration (refer to appendix B) If labs are high pt may need an antidote. If labs are too low, pt may require more lovenox.
o Antidote is protamine sulfate
o Pt should be monitored for and taught to monitor for any unusual bleeding and to avoid contact sports.
o Nurses should ask if clients have reactions to pork products.
o Clients may go home on this medication
o Nurses need how to clean and rotate the injection sites and need to be taught why.

28
Q

Fentanyl

A

Duragesic
o High alert med (there have been serious complications with this medication)
o Given biased by weight in kg
o Anti coagulant
o Does not break up blood clots; keeps clots from forming.
o Given subq in fatty tissue; needs to be given in the abdomen or love handles to be absorbed slow. DOES NOT GO IN THE ARMS.
o Do not rub it in.
o Sometimes started before Warfarin (Coumadin) because warfarin can take several days to be effective in preventing clots.
o Clotting times (PTT &PTNINR) should be checked before administration (refer to appendix B) If labs are high pt may need an antidote. If labs are too low, pt may require more lovenox.
o Antidote is protamine sulfate
o Pt should be monitored for and taught to monitor for any unusual bleeding and to avoid contact sports.
o Nurses should ask if clients have reactions to pork products.
o Clients may go home on this medication
o Nurses need how to clean and rotate the injection sites and need to be taught why.

29
Q

Lasix

A

Furmoside
o Diuretic- reduces fluid in the body
o Should be given in the morning, because clients my need to urinate a lot after taking. The latest it should be given is 5 PM so clients are not up all-night urinating. Know pt schedule…Don’t tell a third shift worker to take it in the AM
o Helps with edema, can be used in clients with heart failure, or hepatic dysfunction.
o The client should be taught to monitor their weight to see of the client is losing fluid or if the fluid if being reduced too much. Notify PCP if they gain too much weight in one day.
o Pt should monitor fluid intake and measure it as ordered
o Pt needs to have their blood pressure and heart rate assessed to ensure they are not dehydrated. A drop in both can lead to falls.
o Check the skin for rashes that may develop
o Lab work should be done prior to starting and during treatment
o Potassium levels can be affected which can affect muscle function, think about the heart
o Glucose levels elevate do diabetics need to be taught that their diabetic medications may need to be adjusted.
o Can increase chance of Dig toxicity

30
Q

Gabapentin

A

Neurotin
o Analgesic
o Anticonvulsant
o Mood stabilizer for behavioral health clients
o Safety for behavioral health clients is always a concern; nurses need to assess these clients for suicidal thoughts prior to and during administration.
o Client/care giver should be taught to keep track of the seizures, the duration, and to see if the medication is improving seizure activity
o Clients who take this for pain need to be taught not to increase the dose without a doctor’s order.
o Should not be stopped suddenly, may cause seizures.

31
Q

Haloperidol

A

Haldol
o Antipsychotic
o Acute or chronic use
o Can be used for nausea and vomiting after surgery for some clients
o The nurse should verify if the client is having any hallucinations
o The clients BMI should be indicated as this med can cause weight gain
o Can cause constipation teach adequate fluid intake
o Cannot be stopped suddenly as it can cause withdrawal symptoms
o Unusual movements (smacking lips, tremors, etc.)
o Change positions slowly to prevent falls
o PCP should be contacted if there is a change in the urine or bowel movements
o Teach pt ways to prevent dry mouth, dry mouth can cause poor dentition

32
Q

Heparin

A

o Anti coagulant
o High alert drug
o Does not break up clots, but prevents them from forming
o Subq- can be given in the fatty tissue of the arm unlike lovenox
o Clients APTT and PTNINR should be checked. If levels are too high client may need antidote. If levels are too low, client may need more heparin.
o Nurses need to teach clients about signs and symptoms of bleeding including bowel changes. Guiac testing
o Can cause HIT- Heparin Induced Thrombocyteopnea, (Low platelet count) weakens ability to clot
o Can be given by client but nurse must educate how to give it and the cleaning of the injection site.
o Teach to monitor for signs and symptoms of bleeding

33
Q

Hydrochlorothiazide

A

HCTZ or Microzide
o Diuretic- helps reduce edema or as an anti-hypertensive
o Can be combined with other anti-hypertensive
o Pt still needs to be taught appropriate diet such as salt intake if this is a med for blood pressure
o Pt should be taught to manually take BP; if pt has a machine to measure it at home it must be brought in to ensure it takes the BP accurately.
o Pt should know to weight themselves bi-weekly. If too much is gained or lost in one day it should be reported to PCP
o Pt should be taught to take this first thing in the morning
o Lab work should be done first thing in the morning to measure electrolytes, and to assess body systems such as the kidney which is their renal function. Potassium is a concern esp on this medication this med can lower the potassium which increases the chance of a heart attack.
o Review Appendix K for potassium rich foods
o Teach Pt low fat diet, low cholesterol diet, and still exercise

34
Q

Hydrocodone

A

Norco or Vicodin
o Used for a pain but also for a cough
o Addictive physically and psychologically
o The respiratory rate and BP should be monitored when first starting this.
o No alcohol should be used when taking this it can make one sleepy and dizzy…can cause falls
o Ask pt about his/her job; driving may be a concern if on this medication.
o It can slow down the bowel system so pt may have complaints of constipation. Teach the pt ways to prevent this such as fluid intake and diet.
o Do not crush if EC or ER

35
Q

Hydromorphone

A

Dilaudid
o Similar to Hydrocodone
o Can be used for allergy relief
o Addictive
o Nurses need to ask if pt has been on any MAO inhibitors before starting this medication.
o No alcohol
o Respirations, heart rate, and blood pressure need to be assessed esp if giving by IV
o Bowels can be slowed like other opioids, know ways to prevent constipation
o PT on any kinds of opioids should not smoke

36
Q

Coenzyme Q 10

A

Helps wit heart damage due to cancer treatment. Do not take with anticoags

37
Q

Cranberry Juice

A

Helps with UTI’s but do not take with anticoags

38
Q

Melatonin

A

help with sleeping; interacts with sleeping pill, analgesics, and opioids. Can interfere with blood sugar.

39
Q

Soy

A

can help decrease cholesterol and low density lipo proteins. Helps to improve diarrhea. Helps some women with hot flashes. Interacts with Anticoagulats, antiplatelets, anti-inflammatory meds. Interacts with blood pressure and diabetic meds

40
Q

alovera

A

used for skin problems, some people drink for overall health can cause laxative effect when taken orally

41
Q

Capsaicin

A

Used in medicated creams and lotions for tenderness and pain of osteoporosis, fibromyalgia, diabetic neuropathy, and shingles. Do not apply to burns if happens seek medical help

42
Q

Chamomile

A

helps with sleep, anxiety, and upset stomach. DO not take if allergic to ragweed

43
Q

Echinace

A

used as antiviral for flu, colds, and other infections. Slows metabolism of caffeine leads to jittery feelings

44
Q

Feverfew

A

anti-inflammatory, migraine headaches, fever suppression, and menstrual cramps. Interacts with anticoags can lead to bleeding and bruising

45
Q

Garlic

A

Used to help relieve nausea and vomiting during pregnancy in recommended doses for a short period of time. Interacts with blood thinners

46
Q

Ginko

A

used for memory enhancement and dementia. Increases blood flow to the brain. Interacts with meds metabolized in the liver. Should not be used with seizure meds, blood thinners, and diabetic medications

47
Q

Ginseng

A

used to help lower bad cholesterol and protect the heart; also help lower blood sugar for type 2 diabetics. May help boost immune system. May interact with blood thinners, blood pressure meds, and diabetic meds.

48
Q

Peppermint

A

used with caraway oil to treat heartburn. May improve irritable bowel syndrome and decrease spasms of GI tract. Before and after endoscopic procedures. Avoid taking with antibiotics, antifungals, iron supplements, and medications made to reduce stomach acids

49
Q

Saw palmetto

A

used to treat enlarged prostate in men. Helps to improve difficult urination. DOES NOT SHRINK PROSTATE. Do not take med with proscar. Can interact with warfarin, estrogens, and birth control pills.

50
Q

St. John’s wort

A

Used for mild to moderate depression: when used for this purpose studies have shown it to be at least as effective as most Rx drugs. Interacts with certain anti-anxiety meds (do not take with xanax). Should not be taken with valerian or muscle relaxers

51
Q

Valerian

A

used for tx of insomnia. Helps improve quality of sleep. Interacts with muscle relaxers, sleeping medications, pain medicines, and antidepressants

52
Q

Schedule I

A

Highly addictive street drugs

53
Q

Schecule II

A

Highly addictive drugs with a medical use

54
Q

Schecule III

A

Drugs have a potential for being abused but not as much as Schedule I & II

55
Q

Schedule IV

A

Lower risk of being abused than I, II, III.

CNS Depressants

56
Q

Stop these suppplements before surgery due to bleeding

A 
Cayenne
Fevervew
Ginkgo biloba
Ginseng
Omega-3 fatty acids
St. John's wort
Vitamins A and C
Antiplatelets drugs
57
Q

Z- Track method

A

method of IM injections prevents iritating and dark colored medications such as iron dextran, from leaking out of the injection site into sensitive tissues or subQ tissues that my stain.
Also helps reduce inflamation
Pull skin taunt then pierce skin skin swiftly

58
Q

Ventrogluteal Injection site

A

Safest most comfortble site for pt’s over 7 months

Make a ‘v’ with your hand

59
Q

Deltoid

A

Most common site for injection of small volumes.
Only use it in children with adequate muscle mass
Not suitable for newborns and small infants because of lack of muscle development

60
Q

MDI

A

Metered dose inhaler
Most efficient way to get medication into the airways
Do not leave in car
Whipe mouth piece after use to remove excess medication
If spacer is being used rinse daily in warm water and let air dry
Hold 1-2 min from face inhale deeply and hold breath for 10 min then breath out through pursed lips
If second puff ordered wait 1 full minute
Rinse and spit if steroid inhaler
Wait 5 min between if more than one inhaler

61
Q

DPI

A

Dry powder inhaler
rely on force of pt inhalation rather than cannister
Instruct pt not to exhale into inhaler so not to disperse powder medication
Pt’s with asthma may not have enough air flow to succesfully inhale med

Practical Nursing 101 (10 decks)

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