med admin/pharm Flashcards
when do you use a PICC line?
when several weeks of antibiotics is required
for clients who have a cast, what should you not do?
do not put anything under cast. no cream, no water, don’t itch it. if it does itch, put a fan/blowdryer close to it or under it, but don’t apply anything under the cast
when should you change a PICC line?
every 7 days
nurse and client should wear a mask during dressing change
when should you not administer heparin
low platelets (under 25,000)
normal is 150k - 400k
normal aPTT is 30 - 40 seconds
don’t confuse w/ PT & INR; those are for warfarin
antidote for the anticoagulant apixaban or rivaroxaban
andexanet: will help stop bleeding or reduce adverse effect of apixaban
FFP
liquid part of blood where RBC and platelets have been removed. helps in clotting.
helps pt who are at risk of bleeding.
what nutrition can you give a pt who is on NPO?
IV fluids and parenteral nutrition (TPN)
Parenteral nutrition does not affect the GI tract.
ng tube decompresses the bowels, not used for feedings. enteral feedings affect GI tract, pt cannot be NPO.
internal disasters
sudden cessation of internal communication
loss of electrical power to the facility
a toxic chemical spill in the lobby of the facility.
medical errors are not considered to be internal disasters
antidote for benzos
flumazenil
antidote for heparin
protamine sulfate
neutropenia
avoid fresh flowers, fruits, meds are given rectally, catheters are used.
assigned clients to a private room, not semi private.
antidote for warfarin
vitamin K
you can also give fresh frozen plasma in combination.
avoid excess leafy greens and organ meats (liver, kidney, etc..)
leafy greens: spinach, kale, broccoli
adenosine
can treat cardiac arrhytmias
preferred drug for SVT: supraventricular tachycardia
amiodorone is indicated for
preferred drug for VTACH & AFIB
all ulcers worsened w/
hot compresses
polycythermia
increase w/ red blood cells
which med can you give for pain in deep partial thickness and/or full thickness
opiods (morphine sulfate)
oral cycloogenase cox 2 inhibitor (nsaid) will not work
esmolol for abdominal aortic aneurysm and develops flank pain
esmolol is a beta blocker that reduces heart rate and hypertension. it is given in AAA to control blood pressure.
if the patient develops flank pain, that can indicate that the aneurysm has ruptured, immediate surgical intervention required.
nitroglycerin side effects and indication
for chest pain, you may give every 5mn up to 3x.
if chest pain does not improve 5mn after 1 dose, call 911
headache, shortness of breath, fainting, blurred vision, heart arrhytmia, rapid heart rate, weakness.
if BP is under 90/60, stop transfusion
headache is an expected adverse effect, so give acetaminophen but continue w/ the nitroglycerin
what are some meds that can be given to sedate patient during endotracheal tube procedure (pt requiring intubation usually icu patient)?
propofol: an IV anesthetic given for sedation.
can be given to sedate an individual requiring ventilation (to provide comfort and prevent them from fighting the procedure, its very painful)
alternative to it is midazolam, lorazepam, benzo med that has rapid onset
what muscle relaxer can be used for MS
baclofen
can also be given for chronic back pain
side effects: diarrhea, dizziness, blurred vision, etc..
what meds can be given for tourettes, shrizophrenia and delirium?
haldol
first gen antipsychotic
side effects: diarrhea, weight gain, dizziness, slow movement
adverse effects: extrapyrimidal symptoms like tardive dyskenia, neuroleptic malignant syndrome
what is Prednisone for?
PREDNISONE IS A STEROID, it may raise blood pressure since steroids raises BP(sodium retention), (may Dec. K+ mildly as well overtime), it raises blood sugar as well. and it may make the ind. gain weight
it can be given for arthritis, blood disorders, inflammation, severe allergies, etc..
its best to take this medication in the morning.
don’t take this med w/ nsaids since it inc. risk for an ulcer tremendously when combined w/ an nsaid.
medication for siadh
diuretic
conivaptan, tolvaptan: these meds deplete water
conivaptan can treat low sodium levels caused by siadh
methylphenidate is indicated for?
ADHD
chemotherapy meds
cisplatin
makee sure IV patency
hypoglassal
tongue
damage is tongue deviation
how to reduce performance bias
get feedback from peers, other nurses, etc..
haloperidol symptoms
poor muscle coordination, stooped posutre, slow movements (extrapyrimidal symptoms)
tardive dyskinesia, dystonia, akathissia
nifedipine
CCB for htn
also used to stop preterm labor (terbutaline & itrhacin as well)
name 9 blood pressure meds
prazosin: treats htn and ptsd
clonidine: can cause rebound htn if one dose missed or more
lisonopril
nifedipine: treat high BP and stop preterm labor (tocolytic drugs). magnesium sulfate also manage preterm labor
tardive dyskinesia
side effects of long term meds like antipsychotics
tardive refers to slow onset of movements
grimacing, eye blinking, slow movements or chorea, eye blinking, buldging cheeks
when does regular insulin peak
2 - 4hrs
while NPH peaks in 4 - 12hrs
when giving intradermal injection, position the needle
15 degrees
subcue and intramuscular degrees
subcue: 45 or 90 but 45 preferred
90 degrees if you can pinch 2 inches of skin
intramuscular or IM: 90 degrees only
1 ounce is how many gallons
1 inch is how many cm
1 ounce or 1 oz = 30ml
1 inch = 2.5cm
how to administer albuterol or triptomium bromide
ensure that the client holds their breath for at least 10 seconds after inhaling the medication then breathe out slowly.
if you are suppose to use more than 1 puff, wait 1 minute before inhaling the second puff
medication to resolve respiratory acidosis
theophyline is a bronchodilor that treats respiratory acidosis. it promotes the exhalation of co2.
lumbar puncture
position? risks?
risks: bleeding, infection (has to be sterile, nerve damage)
also known as a spinal tap. position: sitting up or left lateral recumbent position. local anesthetics given.
s/s: headache, pain around the injection side, should go away. pain meds should help. headache may go away when you lie down.
csf sample is used to determine presence of medical conditions.
also used to inject meds into the fluids around the CNS.
void before because you have to lie after procedure for 30mn
you may be asked to stop anticoagulants, warfarin, aspirin & clopidogrel (super aspirin), rivarozaban, dabigatran, tinzaparin
cut ileostomy allowing 1/16th of an inch of room around it
interventions: stress incontinence, urge incontinence
stress incontinence: sneezing, pregnancy
urge incontinence: have the pt hold their urine or pee at time intervals
what happens when you place water in a sterile field
its no longer sterile
even if its sterile water, its no longer sterile.
strabismus med
atropine, Botox injections, glasses, eye patch (on good eye)
are pain and smell psychological or physiological?
pain and smell are PSYCHological
ex: the psychology of pain
stoma problems or risk
pale and gray stoma: poor circulation
impaired skin integrity: risk of irritation, infection, especially when skin around stoma is red.
My wafer should be cut ⅛ inch larger than my stoma.”
The skin around the stoma should be cleansed and patted dry.
“The clamp should be applied to the bag prior to securing it to the wafer.
“I will apply pressure for about 30 seconds to ensure the wafer is secured around my stoma.
treatment for neuroleptic malignant syndrome?
diazepam, muscle relaxer
diazepam is also a treatment for alcohol withdrawal (benzos)
amitriptyline is used for
treat depression in older adults
also treats chronic pain, neuropathic pain, ex; fibromylgia
how many ml to irrigate wound and what size gauge to use?
30 - 60ml of sterile irrigation syringe. use 18 - 19 gauge
placing suppository
which position?
minimum age?
instructions
older than 3: place client in Sims position (side lying position)
guide it along the rectal wall
must be past external and internal sphincter
hold buttocks together after applying
what type of med is celecoxib
nsaids: pain meds
with nsaids: take with meal to avoid gastric irritation, notify if tarry stool or bloody stool, etc..
avoid nsaids in coronary artery disease, petic ulcer disease, renal failure etc..
other nsaids are ketorolac, ibuprofen, naproxen.
expect aspirin who can also thin blood while reducing risk of thromboembolic events
ezetimibe
SUFLAZINIDE
EZETIMIBE: anticholesterol med.
sulfa antibiotocs: sulfazinide, avoid too much sun.
drawing up NPH and regular insulin, how to?
add air into nph
add air into regular insulin and draw up the require dose into the syringue
go back to the NPH, and draw up the require dose into the synrgingue
now the synrige has both regular and NPH insulin
but regular should be drawn up before NPH b/c NPH is cloudy.
remember RN: regular before nph
amphotericin b
indication and side effects
antifungal med
side effects: hypotension, fever, chills, nephrotoxic (kidney injury)
if giving blood transfusion, wait till its finished before giving IV amphotericin b, side effects and adverse effects are similar and as a nurse, we wanna be able to distinguish
glusiline
rapid acting, give meal within 30mn - 1hr.
regular insulin: 2-4hrs
rapid acting like lispro, aspart
NPH peak at 4-6hr
determine and glargine pretty much has no peak. but i’d say determine 13hr, glargine 20h, no need to eat right away.
electronvulsive therapy
1. a bite block is administer during the therapy in case seizure occurs, to prevent injury
during seizure you cannot place anything in the person’s mouth. but during ect therapy a bite block is given to prevent injury.
lamotrigine
indication
name an adverse effect
epilepsy medication.
Cameron Boyce and Liv: Liv for lamotrigine
adverse effect: Steven Johnson syndrome
multiple sclerosis med
interferons, muscle relaxers, steroids
MIS: I for interferons
MS: muscle relaxers, steroids.
med that causes Steven johnson
FLu like symptoms, painful rashes, that may invade oral mucosa
med that can cause that: allopurinol, phenytoin, lamotrigine, phenobarbital
metformin
indication
contraindication
side effects
for hyperglycemia, diabetes
contra: no CT contrast, renal failure, liver failure,
side effects: diarrhea,
dizziness, headache, GI issues
heartburn
adverse: lactic acidosis, hypoglycemia
it can cause lactic acidosis by inhibiting first step in gluconegogenesis
rule surrounding antacids
-do not give antacids w/ other medications
they reduce the other meds effect. other meds can be given 1 hour before or 2 hours after antacids.
percutaneous coronary intervention: they put a needle or catheter in through a major artery (femoral, radial, or brachial) to fix something inside the vessel.
the pt is not cut open but at risk for bleeding through the procedure site
abciximab: anti-clotting (blood thinner, antiplatelet), can be given during this procedure to prevent clot.
-assess invasive procedures sites for bleeding,
-check hemoglobin & platelet
place client on continuous monitoring
report black tarry stools
copper iud
non-hormonal iud
-prevents implantation
iud causes heavier menses and more menstrual cramping
-iud doesn’t stop periods, periods are heavier
-you may have cramping or spotting for a short time after iud insertion
check iud strings once a month
if you see a nbr in a sata question, unless you’re really sure, don’t select it
