Mark K lecture 6 Flashcards
- Lithium Use
(antimania drug), used for mania in bipolar
Lithium Therpidic level, toxic level, grey area
Therapeutic level: 0.6 to 1.2
* Toxic level: >2.0
* Notice gray area: 1.3 to 2
Lanoxin or Digoxin use
Used to treat A-Fib and CHF
Lanoxin or Digoxin Therpidic level, toxic level, grey are
Therapeutic level: 1 to 2
* Toxic level: >2
Aminophylline use
muscle spasm relaxer for the airway
Aminophylline Therpidic level, toxic level,
- Compound of the bronchodilator theophylline
- Therapeutic level: 10 to 20
- Toxic level: >20
- Non-therapeutic level: <10 … if it is not therapeutic, increase dose of medication, and assess for compliance
Dilantin (phenytoin) use
- Seizure medication
Dilantin (phenytoin) Therpidic level, toxic level,
- Therapeutic level: 10-20
- Toxic level: >20
Bilirubin
*Breakdown product of Red Blood Cells
The normal level for Bili for adults
Normal level in adults: 0.2 to 1.2
Bili levels in newborns
o Elevated level: 10 to 20
o Toxicity: >20
When do physicians want to hospitalize these newborns?
o When bilirubin level is about 14 to 15
Patterns
- 1s and 10s
- 2s and 20s
o 2s: Low # (Lithium and Lanoxin)
o 20s: High # (Aminophylline, Dilantin
and Bilirubin)
Kernicterus
Excess bilirubin in the brain
* Occurs when level in the blood gets >20
* In the brain, it may cause aseptic (sterile) meningitis or encephalopathy (don’t need to know)
* It can be DEADLY
Opisthotonos
- Position the newborn assume due to irritation of the meninges from kernicterus
- Presentation: hyperextended posture … (Is a medical emergency)
In what position do you place an opisthotonic newborn?
- Put newborn on the side
Pathological vs. Physiological Jaundice
- If the newborn comes out yellow, something is wrong = Pathologic jaundice
- If the newborn turn yellow 2 to 3 days postpartum, that’s ok = Physiologic jaundice
Hiatal Hernia
- Regurgitation of gastric acid upward or backward into the esophagus. Because the stomach herniates up.
- “Like a cow with 2 stomachs,” gastric contents go in wrong direction at the correct rate
S&S of Hiatal Hernia
similar to GERD (Heartburn and indigestion)
* S/Sx of hiatal hernia = S/Sx of GERD when lying down after a meal
o In other words, Heartburn, Indigestion on lying down after eating
Treatment for HH
o Can do 3 things, as shown below
1.Elevate HOB (head of bed) during and 1 hour after meals
2.Increase the amount of fluids with meals
3.Increase the amount of Carb content
o These cause the stomach to empty quickly so its content doesn’t back up
o High-atal Hernia … Everything high
Dumping Syndrome
- Gastric contents are dumped too quickly into duodenum
o Right direction but at wrong rate
S/Sx of dumping syndrome
o Drunk: Staggering gate, impaired judgment, labile—all blood gone to gut
o Also get Shock: cold/clammy, tachycardia, pale
o Now add Acute abdominal distress: n/v, diarrhea, cramping, guarding, borborygmi,
bloating, distention
* Dumping syndrome = Drunk, Shock, Acute Abdominal Distress
Treatment of Dumping Syndrome
- Can do 3 things, as shown below
1.Lower HOB (head of bed) during meals and turn pt on the side
2. Decrease the amount of fluids 1 or 2 hours before or after meals
3. Decrease the amount of Carb content
o These 3 things prevent the stomach to empty quickly or dump its content into the
duodenum - Dumping syndrome … Everything low
Memorize these 3 sentences
- Kalemias do the same as the prefix (hypo-, hyper-), except for HR and urine output which
go opposite
2.Calcemias do the opposite as the prefix - Magnesemias do the opposite as the prefix
* Natremias
o HypoNatremia = Volume overload … HyperNatremia = Dehydration
Kalemia(s)
