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Fundamentals > Med Cards for Exam 4 > Flashcards

Med Cards for Exam 4 Flashcards

plus lab card information too

1
Q

metamucil

A

laxative

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2
Q

expected pharmacological action: metamucil

A

Combines with water in the intestinal contents to form an emollient gel or viscous solution that promotes peristalsis and reduces transit time.

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3
Q

therapeutic use: metamucil

A

relief and prevention of constipation

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4
Q

complications: metamucil

A

bronchospasm, cramps, intestinal or esophageal obstruction, nausea, vomiting

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5
Q

contraindictions/precautions: metamucil

A

Hypersensitivity; Abdominal pain, nausea, or vomiting (especially when associated with fever); Serious adhesions; Dysphagia.

Use Cautiously in: Some dosage forms contain sugar, aspartame, or excessive sodium and should be avoided in patients on restricted diets

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6
Q

interactions: metamucil

A

May decrease absorption of oral medications

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7
Q

nursing interventions: metamucil

A

Assess client for abdominal distension, prescence of bowel sounds, and usual pattern of bowl movements.

Assess the stool for color, consistency, and how much stool was produced.

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8
Q

evaluation of med effectiveness: metamucil

A

A soft, formed bowel movment, usually within 12-24 hrs after administration. May require up to 3 days of taking it to see these results

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9
Q

client education: metamucil

A

Encourage client to also use other forms of bowel regulation, such as exercise, hydration, eating more food. Make sure the client knows what a normal bowel pattern is for them so they know if it is returning to abnormal

Advise not to take if client has any abdominal pain, vomiting, or nausea

report constant diarhea

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10
Q

docusate sodium

A

surfactant laxative/stool softner

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11
Q

therapeutic use: docusate sodium

A

Constipation
* Prevention of fecal impaction, straining during defecation, painful
elimination of hard stools

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12
Q

adverse drug reactions: docusate sodium

A

Diarrhea, mild abdominal cramps
* Throat Irritation
* Rashes

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13
Q

interventions: docusate sodium

A
  • Monitor for abdominal distention severe diarrhea and dehydration.
  • Administer with a full glass of water or juice, on an empty stomach for
    best results
  • Assess stool color, consistency, and amount
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14
Q

admin: docusate sodium

A

give orally with at least 8 oz of fluid

expect soft stools serveral days after initiating therapy

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15
Q

client instructions: docusate sodium

A

Report severe diarrhea and stop taking the drug.
* Drink plenty of fluids.
* Advise clients to increase exercise and fluid intake (at least 2 to 3 L/day)
and consume high-fiber foods (bran, fresh fruits/vegetables).

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16
Q

contraindictions: docusate sodium

A

Gastrointestinal obstruction, perforation
* Concurrent use of mineral oil
* Fecal impaction
* Nausea, vomiting
* Undiagnosed abdominal pain

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17
Q

precautions: docusate sodium

A

Use cautiously with clients prone to developing a laxative dependency

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18
Q

interactions: docusate sodium

A

Do not administer within 2 hr of any other laxative, esp. mineral oil.

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19
Q

bisacodyl

A

laxative

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20
Q

expected pharma action: bisacodyl

A

Stimulating enteric nerves to cause peristalsis

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21
Q

therapeutic use: bisacodyl

A

To treat and help with constipation in SHORT term

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22
Q

complications: bisacodyl

A

nausea, vomiting, diarrhea, tetany, alkalosis, a sensation of buring of the recal mucosa and mild proctitis

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23
Q

med admin: bisacodyl

A

PO and rectally

PO: 5-15 mg

Rectally: 10 mg

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24
Q

contraindications/precautions: bisacodyl

A

Hypersensitivity to drug, intestinal obstruction, gastroenteritis, appendicitisUse cautiously in: hypersensitivity to tannic acid severe cardiovascular disease, anal or rectal fissures, pregnant or breastfeeding patients.

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25
Q

nursing interventions: bisacodyl

A

Do not give medication within 1 hours of consumption of dairy products or antacid; continue to assess stools for frequency and consistency; continue to monitor client for hydration status and electrolyte levels

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26
Q

interactions: bisacodyl

A

antacids and dairy products can cause gastric irritation, dyspepsia

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27
Q

client ed: bisacodyl

A

Do not take medication within 1 hour of consumption of dairy products or antacids
This is short term thearpy
Educate ways to allow good bowel movements, such as hydration, exercise, increase food in diet.

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28
Q

evaluation of med effect: bisacodyl

A

soft, formed bowel movements, typically with in 6-24 hrs post medication administration

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29
Q

gabapentin

A

anticonvulsant

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30
Q

expected pharm action: gabapetin

A

Affect the transportation of amino acids across and stabilize neuronal membranes

31
Q

therapeutic use: gabapentin

A

Decrease of seizures, decrease pain, decrease leg restlessness

32
Q

complications: gabapentin

A

Agitation, seizures, peripheral edema, aphasia, hypotension, hypertension, CNS tumors, delusions, , apathy, anxiety, angina, palpitations,

33
Q

medication administration: gabapentin

A

PO

300 mg (3 times daily) for adults

34
Q

contraindications/precautions: gabapentin

A

Hypersensitivity to gabapentin or to its components

35
Q

nursing interventions: gabapentin

A

Monitor for a change in the client’s mood and interactions that would further indicate behaviors of suicidal thoughts, seizures, and restlessness

36
Q

interactions: gabapentin

A

Hydrocodone- decreased hydrocodone exposure
Antacids- decreased gabapentin bioavailability
Morphine- increased CNS depression
Depressants- increased CNS depression

37
Q

eval of med effect: gabapentin

A

Decrease in seizure frequency, an increase in stability, and an overally decrease in leg restlessness

38
Q

client education: gabapentin

A

Client should take medication as directed, if missed dose, just take immediately.

Try to avoid taking medication with driving and within 2 hours after taking antacid.

39
Q

aspirin

A

NSAID

40
Q

therapeutic use: aspirin

A

Inflammation suppression
* Analgesia for mild to moderate pain
* Fever reduction
* Dysmenorrhea

  • Inhibition of platelet aggregation (aspirin)
41
Q

adverse drug reactions: aspirin

A

Gastric upset, heartburn, nausea, gastric ulceration
* Bleeding (less with non-aspirin NSAIDs)
* Kidney dysfunction
* Salicylism (aspirin)
* Reye’s syndrome (aspirin)
* Thromboembolic events (non-aspirin NSAIDs)

42
Q

interventions: aspirin

A

Monitor for signs of gastrointestinal bleeding (black or dark-colored stools, abdominal pain, nausea, hematemesis).
* Test for and treat Helicobacter pylori infection prior to long-term therapy.
* For clients at high risk for gastric bleeding, recommend a proton pump inhibitor.
* Monitor for signs of bleeding (easy bruising, petechiae, excessive bleeding from
minor injuries).
* Monitor intake and output; watch for low urine output and fluid retention.
* Monitor for rapid rises in BUN and creatinine.
* Monitor for tinnitus, diaphoresis, headache, dizziness, and respiratory alkalosis.
Stop aspirin therapy for clients reporting these symptoms.
* Recommend acetaminophen (Tylenol) and not aspirin or NSAIDs for children and
adolescents under age 18 who have viral infections, particularly chickenpox and
influenza.
* Recommend non-aspirin NSAIDs for short periods and in low doses only.
* Recommend low-dose aspirin to prevent these events if prescribed by provider.
* Monitor for signs of myocardial infarction and cerebrovascular accident.

43
Q

admin: aspirin

A

Make sure clients swallow enteric-coated or sustained-release forms whole and
do not crush or chew them.
* Discontinue 1 week before scheduled surgery.
* Monitor for initial and continued therapeutic effects.

44
Q

nifedipine

A

calcium channel blocker

45
Q

therapeutic use: nifedipine

A

Treats mild to moderate hypertension
* Treats stable (exertional) angina and variant (vasospastic) anginas

46
Q

adverse drug reactions: nifedipine

A

Reflex tachycardia causing increased angina pain in clients with angina
Note: This effect is most likely with faster-acting tablets than the
sustained release form.
* Headache, Lightheadedness, dizziness (caused by vasodilation)
* Facial flushing, perception of heat (caused by vasodilation)
* Peripheral edema of feet and legs
* Arrhythmias
* Gingival hyperplasia (growth of gum tissue, bleeding gums) – rare

47
Q

interventions: nifedipine

A

Give nifedipine along with an ordered beta-blocker to prevent reflex
tachycardia
* Monitor heart rate
* Monitor for and report this effect
* Assist with ambulation as needed
* Inform client that facial flushing may occur
* Monitor for and report edema (a diuretic may be prescribed if edema
occurs)
* Monitor blood pressure carefully as starting dosage is established
* Notify provider and withhold dose for BP below 90 mm Hg systolic or
for prearranged parameter
* Advise regular dental care

48
Q

admin: nifedipine

A

Available for oral use in capsules and sustained-release tablets;
sustained release form is approved to treat hypertension
* Sustained-release form must be swallowed whole and not chewed or
crushed
* To prevent reflex tachycardia, nifedipine may be combined with a betablocker

49
Q

client instructions: nifedipine

A

Report rapid heartbeat, increase in angina pain to provider
* Do not perform hazardous activities such as driving until effects are
known
* Be aware that this side effect may occur
* Report swelling of feet and legs to provider
* Advise client to take as prescribed and not increase dosage
* Report dizziness, syncope to provider
* Report HR less than 50 bpm
* Report bleeding gums, gum tissue growth to provider
* Obtain regular dental care

50
Q

cimetidine

A

histamine h2 antagonist

51
Q

therapeutic use: cimetidine

A

Gastric and duodenal ulcers
* Heartburn, dyspepsia
* Erosive esophagitis
* Gastrointestinal reflux disease (GERD)
* Aspiration pneumonitis
* Hypersecretory disorders such as Zollinger-Ellison syndrome (gastrin),
systemic mastocytosis (histamine)

52
Q

adverse drug reactions: cimetidine

A

Impotence, reduced libido with cimetidine (Tagamet)
* Confusion, aplastic anemia, agranulocytosis, and arrhythmia
* Increased susceptibility to pneumonia

53
Q

interventions: cimetidine

A

For clients who report impotence, reduced libido, or CNS effects,
recommend that they discuss with their provider.
* Monitor older clients for confusion.

54
Q

admin: cimetidine

A

Give orally, IM, or IV.
* Give with or without food (given with meals, immediately afterwards, or
at bedtime does prolong effect).
* Administer IV preparation slowly to avoid bradycardia.
* Do not give antacids within 1 hr of administration.
* Make sure clients dissolve effervescent tablets in water and do not
chew them, swallow them whole, or allow them to dissolve on the
tongue.

55
Q

client instructions: cimetidine

A

Take all medication as prescribed
* Avoid smoking
* Avoid foods or medications that irritate GI tract
* Tell clients to report any signs of obvious or occult gastrointestinal
bleeding, such as coffee-ground emesis.

56
Q

contraindications: cimetidine

A

Known sensitivity
* Some products may contain aspartame so avoid in clients with PKU

57
Q

precautions: cimetidine

A

Hepatic or renal dysfunction
* Acute porphyria
* Older adults

58
Q

interactions: cimetidine

A

Antacids can reduce absorption of histamine H2 receptors.
* Cimetidine increases levels of warfarin, also called Coumadin;
phenytoin, also called Dilantin; lidocaine, also called Xylocaine; and
theophylline, also called Theolair

59
Q

aluminum hydroxide

A

antacid

60
Q

therapeutic use: aluminum hydroxide

A

Peptic ulcer disease
* Gastrointestinal reflux disease (GERD)

61
Q

adverse drug reactions: aluminum hydroxide

A

Constipation (aluminum and calcium antacids)
* Diarrhea (magnesium antacids)
* Hypophosphatemia

62
Q

interventions: aluminum hydroxide

A

Monitor bowel function.
* Administer stool softeners.
* Monitor for severe diarrhea.
* Monitor phosphorus and magnesium levels.

63
Q

admin: aluminum hydroxide

A
  • Administer orally up to four times a day.
  • Make sure clients chew tablets thoroughly and follow with at least 8 oz
    of water
  • Do not give within 1 to 2 hr of administering drugs that interact with
    antacids.
64
Q

client instructions: aluminum hydroxide

A

Increase fluid and fiber intake.
* Increase activity and exercise.
* Report abdominal pain.
* Report severe diarrhea.
* Educate client on monitoring phosphate and sodium intake.
* Tell clients to report any signs of obvious or occult gastrointestinal
bleeding, such as coffee-ground emesis.
* Instruct clients to not take aluminum hydroxide with 1 to 2 hr of other
medications.

65
Q

contraindications: aluminum hydroxide

A

Severe abdominal pain of unknown origin

66
Q

precautions: aluminum hydroxide

A

Hypercalcemia and hypophosphatemia

67
Q

interactions: aluminum hydroxide

A
  • Interferes with absorption of many drugs including: tetracyclines,
    digoxin, fluoroquinolones, iron salts, salicylates, and chlorpromazine
68
Q

diazepam

A

benzodiazepine

69
Q

therapeutic use: diazepam

A

Anxiety and anxiety disorders (alprazolam, diazepam)
* Skeletal muscle spasm and spasticity (diazepam)
* Seizure disorders – treats status epilepticus (diazepam)
* Acute alcohol withdrawal symptoms (diazepam)
* Induction of anesthesia (diazepam)

70
Q

adverse drug reactions: diazepam

A

Drowsiness, slurred speech
* Impaired recall of events
* Paradoxical reaction (confusion, anxiety)
* Hypotension, tachycardia, respiratory depression
* Tolerance and physical dependence (especially with alprazolam)
* Withdrawal symptoms – insomnia, anxiety, tremors, diaphoresis, dizziness, panic, hypertension, seizures
* Overdose/toxicity
* Oral – sedation, confusion
* Parenteral – possibly life-threatening sedation, hypotension, respiratory
depression, cardiac arrest

71
Q

interventions: diazepam

A

Monitor clients to prevent falls and other injury following administration.
* Assess client’s memory following administration.
* Monitor clients, especially older adults, for a paradoxical reaction.
* Monitor vital signs, especially with IV administration.
* Monitor clients for signs of tolerance and dependence.
* Taper over 1 to 2 weeks to prevent or minimize withdrawal.
* Monitor for signs of withdrawal.
* Reverse sedation with IV flumazenil.
* Provide airway and blood pressure support as needed for parenteral
overdose.

72
Q

admin: diazepam

A

Give alprazolam orally.
* Take oral benzodiazepines with food if gastrointestinal symptoms develop.
* Give diazepam orally, rectally, IM, or IV.
* Administer IV diazepam slowly and have emergency resuscitation equip- ment nearby.
* Be aware that IV diazepam precipitates in solution with some diluents
and drugs.
* Do not give the emulsion form IM (IV only).
* Avoid IM diazepam due to inconsistent absorption; if necessary, inject
slowly into a large muscle.

73
Q
A

Fundamentals (20 decks)

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