Hematologic Medications and GI Medications Flashcards

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1
Q

Whole blood completion time

A

2-4 hours

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2
Q

Whole blood therapeutic use

A

Restore volume

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3
Q

Whole blood reaction monitoring (6)

A
  • Acute hemolytic
  • Fever
  • Anaphylactic
  • Mild allergic
  • Hypervolemia
  • Sepsis
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4
Q

Packed RBCs completion time

A

2-4 hours

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5
Q

Packed RBCs therapeutic uses (5)

A
  • Increases available RBC
  • Severe anemia
  • Hemoglobinopathies
  • Hemolytic anemias
  • Erythroblastosis fetalis
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6
Q

Packed RBCs reaction monitoring (5)

A
  • Acute hemolytic
  • Fever
  • Anaphylactic
  • Mild allergic
  • Sepsis
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7
Q

Platelets completion time

A

15-30 minutes

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8
Q

Platelets therapeutic uses (5)

A
  • Increased platelet count
  • Active bleeding
  • Thrombocytopenia
  • Aplastic anemia
  • Bone marrow suppression
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9
Q

Platelets reaction monitoring (2)

A
  • Fever
  • Sepsis
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10
Q

FFP completion time

A

30-60 minutes

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11
Q

FFP therapeutic uses

A

Replace clotting factors

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12
Q

FFP reaction monitoring (6)

A
  • Acute hemolytic
  • Fever
  • Anaphylactic
  • Mild allergic
  • Hypervolemia
  • Sepsis
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13
Q

Pheresed granulocytes completion time

A

45-60 minutes

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14
Q

Pheresed granulocytes therapeutic use (3)

A
  • Severe neutropenia
  • Neonatal sepsis
  • Neutrophil dysfunction
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15
Q

Pheresed granulocytes reaction monitoring (6)

A
  • Acute hemolytic
  • Febrile
  • Anaphylactic
  • Mild allergic
  • Hypervolemia
  • Sepsis
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16
Q

Albumin 5% completion time

A

1-10ml/min

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17
Q

Albumin 25% completion time

A

4ml/min

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18
Q

Albumin therapeutic use (6)

A
  • Expand volume by oncotic changes
  • Hypovolemia
  • Hypoalbuminemia
  • Burns
  • Severe nephrosis
  • Hemolytic disease in newborns
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19
Q

Albumin reaction monitoring (2)

A
  • Hypervolemia
  • Pulmonary edema
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20
Q

Nursing interventions for blood product administration (6)

A
  • Verify patient’s ID, name, blood type by 2 nurses
  • Obtain baseline vitals
  • IV access with 18-20 gauge catheter
  • Prime tubing with 0.9% sodium chloride
  • Stay with patient for first 15 minutes to monitor for signs of a reaction
  • Complete infusion within 4 hours
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21
Q

Blood product reaction management (4)

A
  • Stop infusion and take vitals
  • Infuse 0.9% sodium chloride
  • Notify provider
  • Follow protocol for sending urine sample, CBC, bag/tubing to lab for analyzing
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22
Q

Hematopoietic growth factor action

A

Stimulate bone marrow to make specific blood cells

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23
Q

Hematopoietic growth factor medications (4)

A
  • Epoietin alfa
  • Filgrastim
  • Pegfilgrastim
  • Oprelvekin
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24
Q

Epoeitin alfa therapeutic use (2)

A
  • Stimulate RBC production
  • Anemia from chronic kidney disease, Retrovir therapy, chemo
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25
Q

Epoietin alfa side/adverse effects

A
  • HTN
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26
Q

Epoietin alfa nursing interventions (3)

A
  • Give subQ or IV
  • Don’t agitate vial
  • Monitor hematocrit/hemoglobin
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27
Q

Filgrastim/pegfilgrastim therapeutic uses (2)

A
  • Stimulate WBC production
  • Neutropenia due to cancer
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28
Q

Filgrastim/pegfilgrastim side/adverse effects (2)

A
  • Bone pain
  • Leukocytosis
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29
Q

Filgrastim/pegfilgrastim nursing interventions (3)

A
  • SubQ/IV
  • Don’t agitate vial
  • Monitor CBC
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30
Q

Oprelvekin therapeutic uses (2)

A
  • Stimulate platelet production
  • Thrombocytopenia due to cancer
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31
Q

Oprelvekin side/adverse effects (3)

A
  • Fluid retention
  • Blurred vision
  • Cardiac dysrhythmias
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32
Q

Oprelvekin nursing interventions (2)

A
  • Give 6-24 hours after chemo
  • SubQ
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33
Q

Oral iron nursing interventions (4)

A
  • Dilute liquid with juice/water and give straw/syringe to avoid contact with the teeth
  • Encourage orange juice fortified with vitamin C
  • Avoid antacids, coffee, tea, dairy products, whole grain bread concurrently and 1 hour after giving due to decreased absorption
  • Monitor for constipation and GI upset
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34
Q

IM iron nursing interventions (4)

A
  • Use large bore needle 19-20 gauge 3 inch
  • Change needle after drawing up from vial
  • Z track method in ventrogluteal, never deltoid
  • Don’t massage injection site
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35
Q

IV iron nursing interventions

A
  • Administer small test dose and monitor patient for 15 minutes then slowly give additional dose
36
Q

What to monitor while on heparin

A

aPTT every 4-6 hours

37
Q

Parenteral anticoagulant nursing interventions (4)

A
  • Monitor for signs of bleeding
  • Safety precautions to prevent bleeding
  • SubQ heparin in abdomen 2 inches from umbilicus and don’t aspirate/massage
  • Rotate injection sites
38
Q

Warfarin nursing interventions (5)

A
  • Give once daily
  • Monitor INR/PT can be self-monitored
  • Avoid NSAIDS, medications with aspirin, alcohol
  • Garlic, ginger, ginkgo can increase bleeding
  • Ginseng can decrease effectiveness
39
Q

Antiplatelet medications action

A

Prevent platelets from aggregating by blocking enzymes and factors that normally promote clotting

40
Q

Antiplatelt medications (6)

A
  • Aspirin
  • Abciximab
  • Clopidogrel
  • Ticlopidine
  • Pentoxifylline
  • Dipyridamole
41
Q

Antiplatelet precautions (2)

A
  • Can’t be used in thrombocytopenia
  • Use caution in patients with peptic ulcer disease
42
Q

Antiplatelet side/adverse effects (3)

A
  • Prolonged bleeding
  • Gastric bleeding
  • Thrombocytopenia
43
Q

Thrombolytic medications action

A

Dissolve clots that have already formed by converting plasminogen to plasmin destroying fibrinogen and other clotting factors

44
Q

Antacid action

A

Neutralize gastric acid and inactivate pepsin

45
Q

Antacid medications (3)

A
  • Aluminum hydroxide
  • Magnesium hydroxide (milk of magnesia)
  • Sodium bicarbonate
46
Q

Aluminum hydroxide side/adverse effects (2)

A
  • Constipation
  • Hypophosphatemia
47
Q

Magnesium hydroxide side/adverse effects (3)

A
  • Diarrhea
  • Renal impairment
  • Hypermagnesemia
48
Q

Sodium bicarbonate side/adverse effects

A
  • Constipation
49
Q

Therapeutic uses for antacids (2)

A
  • Peptic ulcer disease
  • GERD
50
Q

Precautions for antacids (2)

A
  • Prolonged use can result in hypophosphatemia
  • Can decrease absorption of certain medications
51
Q

Nursing interventions for antacids (4)

A
  • Patients with renal impairments should only use aluminum-based precautions
  • Take other medications 1 before/after antacids
  • Older adults with poor nutritional status are at higher risk of hypophosphatemia
  • Don’t self-prescribe antacid use longer than 2 weeks
52
Q

Antisecretory/blocking agents action

A

Prevent/block selected receptors within the stomach

53
Q

Antisecretory/blocking agents (2)

A
  • PPIs
  • H2 receptor antagonists
54
Q

Antisecretory/blocking agents therapeutic uses (3)

A
  • Gastric/duodenal ulcers
  • GERD
  • Zollinger-Ellison syndrome
55
Q

Anti-secretory/blocking agents precautions (2)

A
  • Can’t be used while lactating
  • Use caution in patients with COPD
56
Q

Anti-secretory/blocking agents side/adverse effects (3)

A
  • Increase risk of osteoporosis with long term use, pneumonia in COPD, acid rebound (PPI)
  • Decreased libido/impotence (H2 blocker)
  • Lethargy, depression, confusion (H2 blocker)
57
Q

Mucosal protectant medication

A

Sucralfate

58
Q

Sucralfate action

A

Adhere to injured gastric ulcers upon contact with gastric acids, protective action for up to 6 hours, has no systemic effects

59
Q

Sucralfate use (2)

A
  • Gastric/duodenal ulcers
  • GERD
60
Q

Sucralfate precaution

A
  • Chronic renal failure
61
Q

Sucralfate interventions (2)

A
  • Give on empty stomach at least 1 hour before meals
  • Don’t give 30 minutes of antacids
62
Q

Antiemetic medications (4)

A
  • Promethazine
  • Metoclopramide
  • Ondansetron
  • Scopolamine
63
Q

Promethazine side/adverse effects (5)

A
  • Drowsiness
  • Anticholinergic effects
  • Severe respiratory depression in kids younger than 2
  • EPS
  • Potentiate effects when given with narcotics
64
Q

Promethazine precautions (2)

A
  • Cardiovascular disease
  • Hepatic disease
65
Q

Promethazine nursing interventions (3)

A
  • Monitor vitals
  • Implement safety precautions
  • For IM use large muscle
66
Q

Metoclopramide side/adverse effects (5)

A
  • Drowsiness
  • Diarrhea
  • Restlessness
  • EPS
  • Tardive dyskinesia
67
Q

Metoclopramide precautions (3)

A
  • Seizures
  • Cardiovascular disease
  • Pheochromocytoma
68
Q

Metoclopramide nursing interventions (2)

A
  • Teach patient about rapid GI emptying
  • Stop if experiencing EPS
69
Q

Ondansetron side/adverse effects (2)

A
  • Headache
  • EPS
70
Q

Ondansetron nursing intervention

A
  • Give tablets 30 minutes before chemo and 1 hour before radiation
71
Q

Ondansetron precautions (2)

A
  • Risk for dysrhythmias
  • Not for patients with prolonged QT interval
72
Q

Scopolamine side/adverse effects (3)

A
  • Blurred vision
  • Sedation
  • Anticholinergic effects
73
Q

Scopolamine precautions (2)

A
  • Increased mydriatic effect causing increased ocular pressure
  • Use caution in patients with glaucoma
74
Q

Scopolamine nursing interventions (2)

A
  • Apply patches behind the ear
  • Use lubricating eye drops
75
Q

Anti-diarrheal action

A

Activate opioid receptors in GI tract to decrease intestinal motility and increase absorption of fluid and sodium in the intestine

76
Q

Anti-diarrheal medications (3)

A
  • Diphenoxylate plus atropine
  • Loperamide
  • Paregoric
77
Q

Anti-diarrheal precautions (2)

A
  • Increased risk of mega colon for patients with IBS
  • Paregoric can’t be used in patients with COPD
78
Q

Anti-diarrheal side/adverse effects (4)

A
  • Constipation
  • Drowsiness
  • Dry mouth
  • Blurred vision
79
Q

Anti-diarrheal nursing interventions (2)

A
  • Monitor fluid/electrolytes
  • Avoid caffeine as it increases motility
80
Q

Stool softeners/laxatives medications (4)

A
  • Psyllium
  • Docusate sodium
  • Bisacodyl
  • Magnesium hydroxide
81
Q

Psyllium use

A

Decrease diarrhea, bulk-forming

82
Q

Docusate sodium use

A

Relieve constipation, surfactant

83
Q

Bisacodyl use

A

Pre-procedure colon evacuation, stimulant

84
Q

Magnesium hydroxide use (2)

A
  • Prevent painful elimination, low-dose osmotic
  • Promote rapid evacuation, high-dose osmotic
85
Q

Stool softener/laxative precautions

A
  • Can’t be used in patients with fecal impaction, bowel obstruction, ulcerative colitis, diverticulitis