Final Review Flashcards
Complications of diuretics
Electrolyte imbalance (potassium - hypokalemia)
Dehydration
Hypertension
Fluid loss
Define muscular atrophy - what is it, what does it look like
Breakdown of muscle tissue
Not using muscles enough
Paralysis, coma, bed rest could cause it
Compare to opposite side of the body - smaller
Intended use and side effects of steroids
Intended use - reduce inflammation
Side effects - infection, bulking up/weight gain, buffalo hump, moon face
Complications of peptic ulcer disease
Fistulas Common from H.pylori, overuse of aspirin Hematemesis (vomiting blood) Weight loss if severe Pain
What does Warfarin do and what does too much Warfarin look like
Blood thinner
Prevents clots from forming
Slower than Heparin
Monitor PT
Use electric razor, no contact sports, watch for excessive bruising
Avoid grapefruit juice (it contains Vitamin K which could decrease the effects)
Sympathomimetic bronchodilators
Mimics sympathetic nervous system - beta 2
Bronchodilate before giving steroids
Asthma, exacerbation of COPD
Side effects: increased HR, increased BP, restlessness
If your patient has been newly diagnosed with COPD, what medications would you see them taking
Bronchodilators if they’re having exacerbation
Steroids to decrease inflammation
Mucolytics to reduce mucous
Encourage coughing and deep breathing
Some things that cause constipation
Opioids Some foods Dehydration Lack of exercise/movement Menopause To decrease constipation - increase fluids, exercise, laxatives/stool softeners
What might cause a patient to be in a fluid volume overload/deficit
Fluid overload - renal disease, ineffective cardiac output, drinking too much fluid, SIADH
Fluid deficit - diabetes insipidus, diuretics, dehydration
Patient education for patient going home on a diuretic
Increased urination Monitor urine output Daily weight check - notify doctor if greater than 3 lbs a day Take in fluids but don’t over hydrate Take diuretics in the morning Hypernatremia, hyperkalemia Main electrolyte to monitor is potassium Monitor for signs of hypotension - dizziness, lethargy, fatigue, bounding pulse
What are some side effects of narcotics
CNS depression
Respiratory depression
Altered levels of consciousness
Consideration to keep in mind when prescribing meds to an elderly patient
Decreased kidney and liver function Decreased drug excretion Toxic high levels in body Adverse effects of meds Start low, go slow with prescription
What is the normal range for sodium in the body
135-145
Hyponatremia - excess fluid
Hypernatremia - dehydration
First signs and symptoms are neuro: HA, confusion, and altered consciousness
What medications would you give to someone who has the common cold (URI)
Antitussive - suppress cough
Decongestant - pseudoephedrine
- too much can cause rebound congestion
- increased HR and BP
Potential physiologic changes with GERD
Barrett’s esophagus - acid damaging lining of tissue of esophagus
Aspiration
Patient education to consider if sending someone home on a corticosteroid inhaler
Rinse mouth after - can cause thrush an decrease normal flora of the mouth
Use a spacer
Not an emergency inhaler
Localized - don’t have to worry about Cushing’s
What would you teach your patient who is taking a drug that is treating high cholesterol (statin)
GI upset
If your patient has gone to surgery who is oversedated, what do you do
Check for respiratory depression
Give Narcan
Antacids
Stabilize pH in the stomach Used for GERD Some drug to drug interactions Can be taken as a calcium supplement Problems - electrolyte imbalance, heart failure (depending on type of antacid), could be masking a deeper problem
If you give someone medication for pain, how do you assess them afterwards
Pain level, where it is located, if it’s radiating, when it started, quality of pain
Last time they received the medication
Opioids - respiratory depression, CNS depression
Levothyroxine (Synthroid)
Thyroid medication for hypothyroidism
Take first thing in the morning
Slow to work
Signs of a functioning thyroid
Effects of glargine lantus insulin
Long acting (24 hours) Onset 1 hour “1 day is 24 hours” Take first thing in the morning No peak Type 2 diabetes
Categories of drugs
Schedule I — most potential for abuse and dependence, no medicinal qualities (Heroin, LSD, Marijuana, Ecstasy, Peyote)
Schedule II — high potential for abuse and dependence, some medicinal qualities (Vicodin, Cocaine, Meth, OxyContin, Adderall)
Schedule III — moderate potential for abuse/dependence, acceptable medicinal qualities, doctor’s prescription required (Tylenol w/ Codeine, Ketamine, Steroids, Testosterone)
Schedule IV — low potential for abuse/dependence, acceptable medicinal qualities, prescription required but fewer refill regulations (Xanax, Darvan, Valium, Ativan, Ambien, Tramadol)
Schedule V — lowest potential for abuse/dependence, acceptable medicinal qualities, prescription required, fewest refill regulations (Robitussin AC, Lomotil, Motofen, Lyrica)
If you have a patient with a disease such as TB, what are some assessments/treatments
Bacterial infection of the lungs
Drug to treat is INH (antibiotic), Rifampin (can cause liver failure, urine to turn orange)
Airborne precautions
Stays dormant in lungs, immunosuppression will reactivate it (steroids)
