Kaplan Material Flashcards
pediatric dosage formulas
child’s age in months or weight in pounds/ 150 pounds or months * usual adult dose= child appropriate dose.
60 months/150 months * 1mg=
whatever the answer is ____mg
Carbamazepine
mood stabilizer/anti-convulsant
treats bipolar disorder, seizure disorders.
can cause blood dyscrasias (anemia, leukopenia, thrombocytopenia); vision issues (nystagmus, diplopia), and a rash.
–> ofc, we want to monitor the CBC levels and listen for complaints of vision problems, or excessive bruising.
valproic acid
mood stabilizer/anti-convulsant
treats bipolar disorder, seizure disorders.
Can cause hepatotoxicity
“if you value your liver, be careful when taking valproic acid.”
–>so, ofc monitor the liver functions.
methylphenidate
stimulant
used for adhd
Only those >5 years can begin taking this.
NEVER give before bedtime, this can cause insomnia. Also causes weight loss, and a loss of appetite.
take holidays, where the medication is not used, to give the body a break.
Bupropion (Wellbutrin)
treats depression–nonbenzodiazepine anxiolytic
used in smoking cessation
inhibits reuptake of norepinephrine and dopamine
can cause insomnia, HA, weight loss.
Messes with the seizure threshold, so don’t take with seizure disorders.
DOES NOT cause a decrease in libido.
contraindicated in bulimia, anorexia, and with alcohol use.
Benzodiazepines
-zolam
-zepam
chlordiazepoxide
treats anxiety and seizure disorders.
can cause sedation, respiratory depression (don’t give with opioids).
Used with alcohol withdrawal.
Can create tolerance/dependency (refer to the loyalty pamphlets in the pixorize scene.)
Budesonide and Cortisone Acetate
glucocorticoids
susceptibility to infections
symptoms of infection masked
swelling
sleeping changes
sugar (hyperglycemia)
stomach (peptic ulcer)
sanity (psychosis)
-nightmares the first sign.
stress (increases need for steroids)
super low potassium and calcium
-d/t salt retention and osteoporosis.
soft bones (osteoporosis)
sight (risk for cataracts)
sad (depression)
salt (water and salt retention–potassium excreted)
suddenly (never stop taking suddenly!)
tumS (take with antacids)
used for adrenal insufficiency (like Addison’s)–overdose causes Cushing’s.
GIVE SINGLE DOSE BEFORE 9am. Give multiple doses in evenly spaced intervals.
aluminum hydroxide (gel)
calcium carbonate
magnesium trisilicate
magnesium hydroxide
antacids
phosphate depletion (look for malaise, weakness, tremors, bone pain)
can have constipation that leads to impaction (laxative effect in Al hydroxide and Mg hydroxide)
lots of sodium in this, encourage fluids, beware of renal diets.
***absorption of tetracyclines, quinolones, phenothiazines, iron preparation, isoniazid all decreased with antacid use.
atropine sulfate
anticholinergic medications
used for bradycardia–the T in atropine means tachycardia, so we want to increase the HR.
-make sure pt voids before use.
-give 30 min before meals if PO.
CHECK FOR HX OF GLAUCOMA, ASTHMA, HTN.
Avoid heat
AEs
tachycardia
HA, blurred vision
insomnia, dry mouth
urinary retention
angina, mydriasis
confusion and sedation possible with other anticholinergic medications.
benztropine
used with Parkinson’s
taper before d/c
orthostatic hypotension precautions
cholinergic AEs.
Scopolamine is used for what, and contraindicated in what?
motion sickness/ nausea
acute angle glaucoma
Anticoagulants
Heparin used while warfarin is warming up.
dabigatran–for strokes, dvt, pe prophylaxis when afib is present.
never use with NSAIDs, garlic, ginger, gingko with warfarin.
ginseng, alfalfa, anise, chamomile should also not be used with anticoagulants.
phenytoin sodium
anticonvulsant
give with water or w/meals to decrease GI upset.
10-20 narrow therapeutic range
gingival hypertrophy (not a reason to stop drug)
nystagmus
ataxia
blurred vision
slurred speech
-Don’t give by IV
Pink or red-brown discoloration of sweat or urine may occur
take with Vitamin D
never take with any other drug
phototherapy
remove mask every 3 hours–more so, if baby can breastfeed.
feed every 2-3 hours
reposition every 2 hours
CHECKING ACTIVITY IS VERY IMPORTANT, ESPECIALLY WITH BILIRUBIN RISK IN MIND.
autonomic dysreflexia
from a spinal cord injury
severe nasal congestion because of vasoconstriction
really high BP, low HR
diaphoretic
normal cuff pressure for mechanical ventilation
20-25
plus, if they gag and bite tube, there is not enough sedation, because unless it’s clear oxygenated is affected, they should not be awake.
2.5% dextrose in water
hypotonic
encourages fluid to leave blood into cells.
long bone fracture
risk for fat embolism syndrome
hypoglycemia in newborns
normals 40-80
spontaneous jerky movements often means hypoglycemia (could also mean low Ca+)
always check BG before calling the provider!
NSAIDs
nephrotoxic
can’t call another nurse manager (if you are one) to have things done, you need to go up the chain of command. Who would you call?
nursing supervisor
myasthenia gravis
sudden difficulty talking, tingling in face–>you have to be concerned about the airway.
multiple sclerosis
hemiparesis
one sided weakness
thyroid storm
high bp/pulse/RR/temp
aspirin contraindicated
give d5w (they’re using up all the glucose)
use antithyroid meds and steroids, beta blockers
peritonitis can happen within ______of a procedure
a few hours
salicylates
short-term use can cause GI bleeding and heart burn.
prolonged high dose: metabolic acidosis, respiratory alkalosis, dehydration, fluid and electrolyte imbalance, tinnitus, salicylism.
*give with milk, water, or food, or use enteric-coated tablets to minimize gastric distress.
DO NOT TAKE IN GI disorders, severe anemia, or vitamin K deficiency.
NSAIDs
ibuprofen
naproxen
ketorolac
indomethacin
give with food.
beware if pt has aspirin allergy.
HA, dizziness, epigastric distress.
peptic ulcer disease
GI bleeding, renal impairment.
beware with ketorolac, decrease dose with older pts.
neutropenic precautions
no fresh salads, unpeeled fruits and vegetables.
meticulous IV and body hygiene care.
no fresh flowers or standing water.
people with a cold or sore throat are not allowed near patient.
eczema (atopic dermatitis)
onset 2-3M, can outgrow by 2-3y
may be precursor to adult asthma or hay fever.
get rid of milk, eggs, wheat, citrus fruits, and tomatoes to see if this is the cause.
cotton clothing is best, not wool.
avoid soap and prolonged or hot baths/showers.
lotion!
topical steroids, antihistamines.
hyperkalemia (Emergent)
calcium gluconate or sodium bicarbonate by IV.
regular insulin and dextrose can shift potassium into the cells.
peaked T waves
cardiac changes (dysrhythmias, vfib, heart block, cardiac arrest)
muscle twitching and weakness
nausea/diarrhea
hypokalemia
diuretics and steroids, gastric suction can cause.
anorexia, n/v
muscle weakness, paresthesia, decreased DTRs
impaired urine concentration
shallow respirations
ventricular dysrhythmias
potential or digitalis toxicity
foods high in potassium: raisins, bananas, apricots, oranges, beans, potatoes, carrots, celery.
allopurinol
lowers uric acid
treats tumor lysis syndrome
Steven Johnson Syndrome can occur
staying well hydrated can prevent kidney stones or gout attacks from occurring.
Isocarboxazid
MAOI
Iced Carbonated-xiazid
Phenelzine
MAOI
fennel on a plate brought by the crying waitress.
Tranylcypromine
MAOI
waitress in training
Tetracyclines
antibiotic
doxycycline
teratogenic
photosensitivity
teeth discoloration in young children.
Don’t take with milk or antacids.
Don’t take before bedtime, may cause esophageal irritation or ulceration.
Fluroquinolones
ciprofloxacin (shown through the woman holding a floss container called “flox”)
–the scene is a flower garden. An older woman hits her elbow on a table and knocks a bunch of stuff over.
photosensitivity->sunburn easily. (She forgot her sunscreen while working in her flower garden)
Don’t take with calcium (milk), antacids (TUMS), or iron (rusty sheers)
Can cause tendon rupture (we see rusted sheers falling off table to cut this woman’s Achilles tendon)
Can cause drug interactions (glass of pills spilling off table and jumbling together)
aminophylline
side effect of tachycardia
meds that need blood glucose monitoring
beta-blockers
glucocorticoids (prednisone)
statins
Pt had an overdose of aspirin. What would you do? Select all that apply.
1. determine when the pt took the aspirin.
2. Administer protamine sulfate.
3. Administer vitamin K
4. Obtain an arterial blood gas.
5. obtain the client’s temperature.
1, 4, 5
Charcoal can be given if the overdose was within 2 hours.
Severe acid-base imbalances so ABGs is needed.
Hyperthermia is a common occurrence with salicylate overdose.
cisplatin
antineoplastic
at risk for ototoxicity and nephrotoxicity.
other obvious side effects include: bone marrow suppression, nausea, vomiting, stomatitis, alopecia, gonadal suppression.
What should ferrous sulfate not be given with?
coffee
late decelerations
placental insufficiency
Position on left side (P for placental insufficiency–doesn’t happen with variable decels)
you could stop Pitocin
give oxygen
give fluids
LION PIT
left side
increase iv fluids
oxygen
notify provider
discontinue Pitocin
oral hypoglycemic medications
taken as prescribed, once or twice a day, and definitely not taken at each meal.
dumping syndrome can cause what?
hypovolemic shock
This is from the dump of highly concentrated food in the intestines causing a dramatic drop in blood pressure.
autonomic dysreflexia kaplan interventions
assess for distended bladder
(no cooling blanket if fever is not apparent)
assess for fecal impaction
administer hydralazine 20mg IV (220/124 BP)
assess for signs of skin breakdown
ibuprofen s/s to report to provider
flank pain
hematemesis
ecchymosis of the extremities
Should ambulation be encouraged after open-heart surgery?
yes. Usually by 2 days post-op.
epidural has the possible side effect of?
vasodilation
so make sure to check BP as the nurse when it is first given.
you want to sit or lie down for 30-60 minutes after eating in which condition?
GERD
increased pressure in the atrium
seen in mitral regurgitation
pulmonary regurgitation would also be a problem with mitral regurgitation.
widened pulse pressure
aortic regurgitation
