Brainscape's Knowledge GenomeTM

Browse over 1 million classes created by top students, professors, publishers, and experts.


See full index

MSII Medication Review > Lewis 51 - AKI and CKD > Flashcards

Lewis 51 - AKI and CKD Flashcards

1
Q

MOA/Class

Insulin (regular)

A

Facilitates transport of glucose and electrolytes across cell membrane and stimulates metabolic processes

Short-acting Insulin

Tucker 38

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
2
Q

Side Effects

Insulin (regular)

A

hypoglycemia, lipodystrophy, hypokalemia

Tucker 38

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
3
Q

Nursing Considerations

Insulin (regular)

A

Regular insulin is the only insulin that may be given IV (DKA or hyperkalemia).
Give with concurrent dose of dextrose if given for hyperkalemia to prevent hypoglycemia.
General insulin considerations: Check glucose levels before administering insulin. Beta blockers may decrease/mask s/s of hypoglycemia. Insulin needs may increase with corticosteroid therapy. May require double RN verification.
Onset: 30-60 minutes; Peak: 2-4 hours; Duration: 6-12 hours

Tucker 38

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
4
Q

Indications

Insulin (regular)

A

Hyperglycemia; hyperkalemia

Tucker 38

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
5
Q

MOA/Class

sodium bicarbonate

A

neutralizes acid; promotes shift of potassium into cells

Antacid/alkalinizing agent

Tucker 57

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
6
Q

Side Effects

sodium bicarbonate

A

metabolic alkalosis, hypokalemia

Tucker 57

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
7
Q

Nursing Considerations

sodium bicarbonate

A

Observe IV site closely; monitor EKG

Tucker 57

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
8
Q

Indications

sodium bicarbonate

A

Acidosis; hyperkalemia

Tucker 57

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
9
Q

MOA/Class

calcium gluconate

A

Regulates transmission of nerve impulses and contraction of cardiac, skeletal, and smooth muscle.
Raises threshold for cardiac excitation thus decreasing risk for dysrhythmias

Electrolyte supplement

Tucker 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
10
Q

Side Effects

calcium gluconate

A

Phlebitis

Tucker 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
11
Q

Nursing Considerations

calcium gluconate

A

Observe IV site closely; monitor EKG

Tucker 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
12
Q

Indications

calcium gluconate

A

Hypocalcemia
Hyperkalemia, magnesium toxicity

Tucker 60

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
13
Q

MOA/Class

sodium polystyrene sulfonate (Kayexalate)

A

Exchanges sodium for potassium in the intestine

cationic exchange resin

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
14
Q

Side Effects

sodium polystyrene sulfonate (Kayexalate)

A

hypokalemia, constipation, fecal impaction, intestinal necrosis

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
15
Q

Nursing Considerations

sodium polystyrene sulfonate (Kayexalate)

A

Not to be used in emergent situations due to delayed therapeutic effects
Given PO or via enema

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
16
Q

Indications

sodium polystyrene sulfonate (Kayexalate)

A

Hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
17
Q

MOA/Class

patiromer (Veltassa)

A

Increases fecal excretion of potassium by binding to potassium in the GI tract

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
18
Q

Side Effects

patiromer (Veltassa)

A

Hypokalemia, diarrhea

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
19
Q

Nursing Considerations

patiromer (Veltassa)

A

Not to be used in emergent situations due to delayed therapeutic effects

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
20
Q

Indications

patiromer (Veltassa)

A

hyperkalemia

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
21
Q

MOA/Class

lisinopril, enalapril, captopril, etc.

A

Prevents conversion of angiotensin 1 to angiotensin 2 (causing vasodilation)

Angiotensin-Converting Enzyme (ACE) Inhibitor

Tucker 43

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
22
Q

Side Effects

lisinopril, enalapril, captopril, etc.

A

Dry cough
Hyperkalemia
First-dose hypotension, orthostatic hypotension
Angioedema

Tucker 43

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
23
Q

Nursing Considerations

lisinopril, enalapril, captopril, etc.

A
  • NSAIDs may decrease therapeutic effect and contribute to kidney injury
  • Monitor other medications that strongly depend on fluid/electrolyte balance (digoxin, lithium, etc.)
  • Avoid potassium supplements
  • Note: While ACE inhibitors have some effect on all portions of the cardiac system (“pump, pipes, and volume”), they are most effective on the “pipes” portion.

Tucker 43

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
24
Q

Indications

lisinopril, enalapril, captopril, etc.

A

Hypertension; Decrease cardiac workload; Prevent/limit ventricular remodeling

Tucker 43

How well did you know this?
1
Not at all
2
3
4
5
Perfectly
25
Q

MOA/Class

losartan, valsartan, etc.

A

Blocks the binding of A2 to receptors

Angiotensin II Receptor Blocker (ARB)

Tucker 43

26
Q

Side Effects

losartan, valsartan, etc.

A

Hypotension
Hyperkalemia (less common than ACEIs, but still need to monitor)
Less dry cough than ACEIs

Tucker 43

27
Q

Nursing Considerations

losartan, valsartan, etc.

A

Avoid potassium supplements
Like ACEIs, most important to monitor BP

Tucker 43

28
Q

Indications

losartan, valsartan, etc.

A

Hypertension; Decrease cardiac workload; Prevent/limit ventricular remodeling

Tucker 43

29
Q

MOA/Class

calcium acetate; calcium carbonate (Tums)

A

Neutralize stomach acid
Control of hypophosphatemia (binds to phosphate within the GI tract for elimination)

Antacid/phosphate binder

Tucker 60

30
Q

Side Effects

calcium acetate; calcium carbonate (Tums)

A

Constipation

Tucker 60

31
Q

Nursing Considerations

calcium acetate; calcium carbonate (Tums)

A

Take with meals when used as a phosphate binder; monitor calcium and phosphate levels.

Tucker 60

32
Q

Indications

calcium acetate; calcium carbonate (Tums)

A

Acid reflux, hyperphosphatemia

Tucker 60

33
Q

MOA/Class

sevelamer

A

Increases fecal excretion of phosphate by binding to phosphate in the GI tract

Phosphate binder

34
Q

Side Effects

sevelamer

A

Diarrhea, vomiting

35
Q

Nursing Considerations

sevelamer

A

Used when calcium-based phosphate binders cannot be used.
Take with meals.
May not be taken with other medications as will impair absorption of those medications

36
Q

Indications

sevelamer

A

Hyperphosphatemia

37
Q

MOA/Class

cholecalciferol, calcitriol

A

Required for calcium absorption from the GI tract
Inactive form may be used when patient has some activating function left
Active form required if kidney can no longer activate vitamin D

cholecalciferol (Inactive form) calcitriol (Active form)

Vitamin D analog

Tucker 37

38
Q

Side Effects

cholecalciferol, calcitriol

A

No significant concerns

Tucker 37

39
Q

Nursing Considerations

cholecalciferol, calcitriol

A

Ensure adequate intake of calcium through diet or supplement

Tucker 37

40
Q

Indications

cholecalciferol, calcitriol

A

Hypocalcemia

Tucker 37

41
Q

MOA/Class

cinacalcet

A

Increases sensitivity of calcium-sensing receptors in the parathyroid gland
- Increase sensitivity decreases release of PTH in the presence of hypocalcemia
- Decreased release of PTH decreases bone degeneration in CKD-MBD

Calcimimetic agent

Tucker 37

42
Q

Side Effects

cinacalcet

A

Nausea/vomiting
Dysrhythmias, prolonged QT interval

Tucker 37

43
Q

Nursing Considerations

cinacalcet

A

Monitor calcium levels and EKG

Tucker 37

44
Q

Indications

cinacalcet

A

Secondary hyperparathyroidism (often due to CKD)

Tucker 37

45
Q

MOA/Class

epoetin alfa; darbapoetin alfa

A

Mimics effects of erythropoietin to stimulate bone marrow production of RBCs

Erythropoiesis Stimulating Agents

Tucker 49

46
Q

Side Effects

epoetin alfa; darbapoetin alfa

A

Hypertension, thromboembolism, rash

Tucker 49

47
Q

Nursing Considerations

epoetin alfa; darbapoetin alfa

A

Contraindicated when Hgb level >10 g/dL or with uncontrolled HTN
May require increased intake/supplement iron and/or folic acid

Tucker 49

48
Q

Indications

epoetin alfa; darbapoetin alfa

A

anemia

Tucker 49

49
Q

MOA/Class

Ferrous fumarate, ferrous sulfate (PO)
Iron dextran, ferrous gluconate, iron sucrose (IV or IM)

A

Required for RBC production

Supplement

Tucker 49

50
Q

Side Effects

Ferrous fumarate, ferrous sulfate (PO)
Iron dextran, ferrous gluconate, iron sucrose (IV or IM)

A

Dark stool; constipation

Tucker 49

51
Q

Nursing Considerations

Ferrous fumarate, ferrous sulfate (PO)
Iron dextran, ferrous gluconate, iron sucrose (IV or IM)

A

PO absorbed best with vitamin C; avoid giving with calcium products (causes decreased absorption)
Ingest PO liquid formulations with straw to prevent staining of teeth
Remain upright for 30 minutes after injection to prevent heartburn
IM given Z-track
Food sources: red meats, legumes, dark leafy green vegetables, whole-grain and enriched breads and cereals, beans

Tucker 49

52
Q

Indications

Ferrous fumarate, ferrous sulfate (PO)
Iron dextran, ferrous gluconate, iron sucrose (IV or IM)

A

iron deficiency

Tucker 49

53
Q

MOA/Class

atorvastatin, simvastatin, rosuvastatin

A

Decreased cholesterol production by the liver

HMG-Co-Enzyme A (HMG-CoA) Reductase Inhibitor (Statin)

Tucker 47

54
Q

Side Effects

atorvastatin, simvastatin, rosuvastatin

A

Hepatotoxicity, myopathy/rhabdomyolysis, GI upset

Tucker 47

55
Q

Nursing Considerations

atorvastatin, simvastatin, rosuvastatin

A

Avoid grapefruit juice
Monitor LFTs
May be most effective when taken at bedtime

Tucker 47

56
Q

Indications

atorvastatin, simvastatin, rosuvastatin

A

Hypercholesterolemia
(may be part of stroke or MI prophyaxis regimen)

Tucker 47

57
Q

MOA/Class

fenofibrate, gemfibrozil

A

Inhibits synthesis of triglycerides in the liver. Activates enzymes responsible for breaking down cholesterol.

Fibrate/Fibric acid derivative

Tucker 47

58
Q

Side Effects

fenofibrate, gemfibrozil

A

GI upset, rash, increased PT, hepatotoxicity, myalgia/rhabdomyolysis

Tucker 47

59
Q

Nursing Considerations

fenofibrate, gemfibrozil

A

May increase bleeding risk when used with anticoagulants

Tucker 47

60
Q

Indications

fenofibrate, gemfibrozil

A

Hypercholesterolemia

Tucker 47

MSII Medication Review (13 decks)

Brainscape helps you reach your goals faster, through stronger study habits.
© 2024 Bold Learning Solutions. Terms and Conditions