Med Competency Flashcards
Acetaminophen
Oral
Indications: Mild Pain
Contraindications: previous hypersensitivity, severe hepatic impairment, acute liver disease
Side effects: nausea, vomiting, diarrhea, constipation, anxiety
Adverse reaction: hepatotoxicity, renal failure, cardiac damage, toxic epidermal necrosis, rash
Nursing considerations: beware when calculating total daily dose since many OTC contain acetaminophen & reduce total daily dose
Patient Teaching: take drug exactly as directed & don’t exceed recommended amount & call doctor if fever lasts for more than 3 days
ACETYLSALICYLIC ACID
ASA
Oral
Indications:
Mild pain, Fever, Inflammatory disorders, prophylaxis for heart attack
Contraindications:
hypersensitivity to aspirin, cross-sensitivity with other
NSAIDs, bleeding disorders
Side Effects: nausea • vomiting • dyspepsia (indigestion) • epigastric distress • abdominal pain
Adverse Reactions: GI Bleeding, anaphylaxis, tinnitus
Nursing Consideration:
For inflammatory conditions, give scheduled doses.
• monitor patient for hypersensitivity reactions
• Monitor salicylate level; severe toxic effects levels >400mcg/mL
IBUPROFEN
Indications:
pain, inflammation, reduce fever
Contraindications:
hypersensitivity, active GI bleeding or ulcer
disease, severe HF
Side Effects:
nausea, vomiting, constipation, abdominal discomfort
Adverse Reactions:
HF, MI, stroke, GI bleeding
Nursing Considerations;
assess pain before and 1-2 hr after administering, assess for S/S GI bleeding, assess for skin rashes
Patient Teachings:
Take drug exactly as directed and don’t exceed recommended amount.
• May cause drowsiness; avoid driving
• avoid drinking alcohol
OXYCODONE
Indications: Moderate to severe pain
Contraindications:
hypersensitivity
respiratory depression
acute or severe bronchial asthma
Side Effects: nausea
• vomiting• constipation • confusion
• sedation
Adverse Reactions: • respiratory depression
• orthostatic hypotension • blurred vision
Nursing Considerations:
• Assess BP, pulse, & RR before and periodically during administration
• assess risk for opioid addiction , abuse, or misuse before administration.
Patient Teachings:
• Instruct patient on how & when to ask for and take pain meds.
• advise patient that this drug is know to abuse potential, protect from theft.
• May cause drowsiness; avoid driving
FENTANYL PATCH
Topical
Indication: Moderrate to severe chronic pain
Contraindications:
- Hypersensitivity,
- acute, mild, intermittent, or pop-up pain,
- respiratory depression
- acute or severe bronchial asthma
Side Effects: nausea • vomiting • constipation • confusion • sedation
Adverse Effects: • apnea • respiratory depression • bradycardia • hypotension • adrenal insufficiency
Nursing Consideration :
• assess BP, pulse, RR before and periodically during administration.
• assess risk for opioid addictions use, or misuse prior to administration.
• assess bowel function routinely
Patient Teachings:
• instruct how and when to ask for and take pain medication.
• instruct correct method for application and disposal of patch.
• avoid grapefruit juice
LIDOCAINE PATCH
Topical
Indications:
• pain due to post-op neuralgia
Contraindications:
• hypersensitivity
• third-degree heart block
• Wolf-Parkinson-White syndrome
Side Effects: • nausea • vomiting • confusion • drowsiness
Adverse Effects:
• seizure
• cardiac arrest
Nursing Consideration:
• monitor ECG continuously. BP & Respiratory status frequently during administration
• monitor for pain intensity periodically during therapy
Patient Teaching:
• May cause drowsiness; avoid driving
• explain purpose of lidocaine to patient
• avoid contact with water since patch may not stick
AMLODIPINE
Oral
Indication:
• hypertension
• angina pectoris
• vasospastic angina
Contraindications:
• hypersensitivity
• systolic BP <90mmHg
Side Effects: • nausea • dizziness • fatigue • flushing
Adverse Reactions
• peripheral edema • angina
• bradycardia
• hypotension
Nursing Considerations:
• monitor BP & pulse before therapy and periodically during therapy
• monitor intake & output ratios and daily weight
• monitor signs for heart
failure
Patient Teachings:
• Take drug exactly as directed and don’t exceed recommended amount.
• teach patient how to monitor pulse.
• Contact healthcare professional if HR <50bpm.
• May cause drowsiness; avoid driving
HYDROCHLOROTHIAZIDE
Oral
Indications:
• mild to moderate hypertension
• edema (heart failure, renal dysfunction)
Contraindications:
• hypersensitivity
• intolerance to tartrazine • anuria
Side Effects:
Side Effects: • nausea • vomiting • dizziness • drowsiness
Adverse Reactions:
• Stevens-Johnson syndrome (skin disorder)
• hypotension
• pancreatitis
Nursing Considerations:
• monitor BP, intake/output, daily weight
• assess for skin rash frequently during therapy
Patient Teachings:
• Take medication at the same time each day
• motor weight biweekly; call doctor if significant changes
• change positions slowly to minimize orthostatic hypotension
LISINOPRIL
Oral
Indications:
• hypertension
• heart failure
Contraindications:
• hypersensitivity
• history of angioedema with
previous use of ACE inhibitors
Side Effects:
• nausea • vomiting
• diarrhea • cough
Adverse Reactions:
• hypotension
• impaired renal function
Nursing Considerations:
• monitor BP & pulse periodically throughout therapy.
• assess patient for signs of angioedema
Patient Teachings:
• Take medication at the same time each day even if felling well.
• call doctor if rash, sore throat, fever occur
• change positions slowly to reduce orthostatic hypotension
LOSARTAN
Oral
Indications:
• hypertension
Contraindications:
• hypersensitivity
• bilateral renal artery
stenosis
Side Effects:
• nausea • diarrhea
• dizziness • fatigue
Adverse Reactions: • chest pain • angioedema • hypotension • hypoglycemia
Nursing Considerations:
• assess patient for signs of angioedema
• assess BP & pulse throughout therapy
Patient Teachings:
• call healthcare professional immediately if swelling of faces eyes, lips occur
• May cause drowsiness; avoid driving
• change positions slowly to reduce orthostatic hypotension
METOPROLOL
ORAL
Indications:
• hypertension
• angina pectoralis (small
chest pain)
Contraindications:
• HF
• Pulmonary edema
• bradycardia
Side Effects: • nausea • vomiting • diarrhea • fatigue
Adverse Reactions:
• HF
• Pulmonary edema
• bradycardia
Nursing Considerations: • monitor BP, ECG & pulse throughout therapy • monitor intake/output & daily weight
Patient Teachings: • call healthcare professional if slow pulse, difficult breathing, wheezing, dizziness occurs
TIMOLOL
EYE DROP
Indications: • hypertension • prevention of MI • prevent migraine headaches
Contraindications: • Uncompensated HF • pulmonary edema • cardiogenic shock • bradycardia or heart attack
Side Effects: • nausea • constipation • fatigue • weakness • ED
Adverse Reactions: • Arrhythmias • bradycardia • HF • pulmonary edema • anaphylaxis
Nursing Considerations: • monitor intake/output ratios & daily weight. • assess patient routinely for evidence of fluid overload
Patient Teachings:
• Call healthcare professional immediately if slow pulse, difficulty breathing, wheezing. • May cause drowsiness; avoid driving
DEXTROMETHORPHAN
ORAL
Indications: • coughs caused by upper respiratory tract infections • chronic nonproductive coughs
Contraindications: • hypersensitivity • chronic productive coughs • taking MAO inhibitors or SSRIs
Side Effects:
• nausea
• vomiting
Adverse Reactions:
• stomach pain
• sedation
Nursing Considerations:
• monitor cough type and
frequency
Patient Teachings: • Take drug exactly as directed and don’t exceed recommended amount. • instruct patient to cough effectively • avoid drinking alcohol • call doctor if cough lasts >1week
GUAIFENESIN
ORAL
Indications:
• coughs caused by upper
respiratory tract infections
Contraindications:
• hypersensitivity
• intolerance to alcohol
Side Effects:
• nausea
• vomiting
• diarrhea
Adverse Reactions:
• urticaria
• stomach pain
Nursing Considerations:
monitor cough type &
frequency
Patient Teachings: • instruct to cough effectively. • May cause drowsiness; avoid driving
METFORMIN
ORAL
Indications:
• type 2 diabetes
Contraindications:
• hypersensitivity
• diabetic ketoacidosis
• severe renal impairment
Side Effects: • nausea • vomiting • diarrhea • bloating
Adverse Reactions:
• lactic acidosis
Nursing Considerations: • observe S/S of hypoglycemic reactions • patients with severe renal impairment are >risk for lactic acidosis
Patient Teachings: • Take medication at the same time each day • drug helps control hyperglycemia and is usually long term therapy • follow prescribed diet and exercise
INSULIN
SUBCATANEOUS
Indications:
• diabetes
Contraindications:
• hypersensitivity
• hypoglycemia
Side Effects:
• swelling
• pruritus (itching)
Adverse Reactions:
• hypoglycemia
• hypersensitivity reactions
Nursing Considerations: • assess periodically for symptoms of hypoglycemia and hyperglycemia • monitor body weight periodically
Patient Teachings: • instruct on proper technique of administration • explain that this medication controls hyperglycemia and is long term therapy • emphasize the importance of compliance with nutritional guidelines and regular exercise as directed
DIPHENHYDRAMINE
ORAL
Indications:
• relief of allergic symptoms
• mild nighttime sedation
• prevents motion sickness
Contraindications:
• hypersensitivity
• acute asthma attacks
• known alcohol intolerance
Side Effects:
• nausea
• drowsiness
• dizziness
Adverse Reactions: • tinnitus • blurred vision • hypotension • dysuria
Nursing Considerations: • this drug has multiple uses. determine why it was ordered and assess symptoms • for anaphylaxis: assess urticaria and patient airway • for insomnia: assess sleep patterns • for motion sickness: assess nausea, vomiting, bowel sounds
Patient Teachings: • Take drug exactly as directed and don’t exceed recommended amount. • May cause drowsiness; avoid driving • May cause dry mouth; frequent oral rinses • teach sleep hygiene techniques (dark-quiet room, limit daytime naps)
LORATADINE
ORAL
Indications:
• seasonal allergies
• hives
Contraindications:
hypersensitivity
Side Effects:
• drowsiness
• confusion
• dry mouth
Adverse Reactions:
• blurred vision
• GI upset
Nursing Considerations:
• assess allergy symptoms
• assess lung sounds &
bronchial secretions
Patient Teachings: • Take drug exactly as directed. • May cause drowsiness; avoid driving • avoid drinking alcohol
PREDNISONE
ORAL
Indications:
• inflammation
•immunosuppression
• endocrine disorder
Contraindications:
• active untreated infections
Side Effects: • nausea • vomiting • acne • depression
Adverse Reactions:
• peptic ulceration
• thromboembolism
• hypertension
Nursing Considerations: • assess for signs of adrenal insufficiency before and periodically during therapy • monitor intake/output ratios & daily weights • observe for peripheral edema
Patient Teachings: • Take medication as directed • Do not stop taking suddenly or adrenal insufficiency may occur • contact healthcare professional if severe abdominal pain or tarry stools occur
ENOXAPARIN
SUBCUTANEOUS
Indications:
• prevention of venous
thromboembolism (VTE),
DVT, and PE
Contraindications:
• hypersensitivity
Side Effects: • nausea • vomiting • dizziness • headache
Adverse Reactions: • bleeding • anemia • alopecia • edema
Nursing Considerations: • assess for signs of bleeding & hemorrhage • assess patient for evidence of additional or increase thrombosis • monitory patients hypersensitivity reaction
Patient Teachings: • instruct patient correct technique for self-injection, care, and disposal • advise patient to report any symptoms of unusual bleeding or bruising, dizziness, itching, rash • advise patient not to take aspirin, naproxen, or ibuprofen without talking to doctor
HEPARIN
SUBCUTANEOUS
Indications: • thromboembolic disorders (venous thromboembolism, pulmonary emboli, Afib, etc)
Contraindications: • hypersensitivity • uncontrolled bleeding • Hx heparin-induced thrombocytopenia • open wounds
Side Effects: • fever • anemia • rash • pain at injection site
Adverse Reactions: • bleeding • heparin-induced thrombocytopenia (HIT) • alopecia • osteoporosis
Nursing Considerations: • assess for signs of bleeding & hemorrhage • monitory for hypersensitivity reactions • asess patient for additional or increased thrombosis
Patient Teachings: • advise patient to report any symptoms of unusual bleeding or bruising immediately • instruct patient not ro take medications containing aspirin or NSAIDs while on therapy • caution patient to avoid IM injections and activities leading to injury. • Use soft toothbrush & electric razor during therapy
BACITRACIN
TOPICAL
Indications:
• localized infections due to
susceptible organisms
Contraindications:
• hypersensitivity
• renal impairment
Side Effects: • nausea • vomiting • rash • pain at injection site
Adverse Reactions:
• pseudomembradnous
colitis
• renal failure
Nursing Considerations:
• assess lesions prior to and
periodically during therapy
Patient Teachings: • Take drug exactly as directed. • caution to notify healthcare professional if fever and diarrhea occur, especially if it contains blood, pus, mucus.
CEFTRIAXONE
IV
Indications:
• infections
Contraindications:
• hypersensitivity
Side Effects:
• diarrhea
• rash
Adverse Reactions:
• seizures
• C. Diff associated diarrhea
• anaphylaxis
Nursing Considerations: • assess for infection at beginning & throughout therapy • obtain specimen for culture& sensitivity before therapy
Patient Teachings: • report signs of superinfection and allergy • notify health care professional if fever and diarrhea develop especially if diarrhea contains blood, mucus, or pus.
CIPROFLOXACIN
IV
Indications:
• infections
Contraindications:
• hypersensitivity
• Hx myasthenia gravis
(muscle weakness)
Side Effects:
• nausea
• diarrhea
• rash
Adverse Reactions: • seizures • C. Diff associated diarrhea • anaphylaxis • suicidal thoughts
Nursing Considerations: • assess for infection at beginning & throughout therapy • obtain specimen for culture& sensitivity before therapy
Patient Teachings: • take medication as directed, finish therapy even if feeling better • notify health care professional if fever and diarrhea develop especially if diarrhea contains blood, mucus, or pus.
DOXYCYCLINE
IV
Indications:
• infections
Contraindications:
• hypersensitivity
Side Effects: • nausea • vomiting • diarrhea • rash
Adverse Reactions:
• C. Diff associated diarrhea
• pancreatitis
• hepatotoxicity
Nursing Considerations: • assess for infection at beginning & throughout therapy • obtain specimen for culture & sensitivity before therapy • monitor bowel function • assess for rash periodically during therapy
Patient Teachings: • take medication as directed, finish therapy even if feeling better • notify health care professional if fever and diarrhea develop especially if diarrhea contains blood, mucus, or pus.
PIPERACILLIN/TAZOBACTAM
IV
Indications:
• infections
Contraindications:
• hypersensitivity
Side Effects: • nausea • vomiting • diarrhea • rash
Adverse Reactions:
• seizures
• C. Diff associated diarrhea
• anaphylaxis
Nursing Considerations: • assess for infection at beginning & throughout therapy • obtain specimen for culture & sensitivity before therapy • monitor bowel function • assess for rash periodically during therapy
Patient Teachings: • report signs of superinfection and allergy • notify health care professional if fever and diarrhea develop especially if diarrhea contains blood, mucus, or pus.
VANCOMYCIN
IV
Indications:
• infections
Contraindications:
• hypersensitivity
Side Effects:
• nausea
• vomiting
• rash
Adverse Reactions:
• hypotension
• anaphylaxis
• nephrotoxicity
Nursing Considerations: • assess for infection at beginning & throughout therapy • obtain specimen for culture & sensitivity before therapy • Monitor BP throughout IV infusion
Patient Teachings: • report signs of hypersensitivity, tinnitus, vertigo, or hearing loss • notify health care professional if no improvement is seen in a few days
ALBUTEROL
INHALER
Indications:
• asthma & COPD
• prevention of exerciseinduced
bronchospasm
Contraindications:
• hypersensitivity
Side Effects: • nausea • vomiting • nervousness • restlessness • tremor
Adverse Reactions: • paradoxical bronchospasm (wheezing) • chest pain • palpitations • angina • arrhythmias
Nursing Considerations: • observe for (wheezing), withhold and notify healthcare professional immediately if it occurs • assess lung sounds, pulse, BP before and during peak of medications • monitor pulmonary function tests before initial therapy & periodically during therapy
Patient Teachings: • Take drug exactly as directed and don’t exceed recommended amount. • Contact healthcare professional immediately if SOB is not relieved by medication • inform patient that it may cause unusual or bad taste • avoid smoking an other respiratory irritants
FLUTICASONE PROPIONATE
INHALER
Indications:
• chronic asthma
Contraindications:
• hypersensitivity
Side Effects: • nausea • vomiting • diarrhea • headache • dizziness
Adverse Reactions: • conjunctivitis • epistaxis (nosebleed) • pharyngitis • laryngitis
Nursing Considerations: • observe patient carefully for evidence of systemic corticosteroid effects • monitor patient, especially post-op, during period of stress or severe asthma attack
Patient Teachings: • Take drug exactly as directed and don’t exceed recommended amount. • Call doctor if medication doesn’t improve asthma episodes • Advise patient to report all adverse reactions
IPRATROPIUM
INHALER
Indications:
• reversible airway
obstruction due to COPD &
asthma
Contraindications:
• hypersensitivity
• avoid during acute
broncospasm
Side Effects: • nausea • cough • rash • headache • dizziness
Adverse Reactions: • blurred vision • hypotension • palpitations • epistaxis (nosebleed) • allergic reactions
Nursing Considerations:
• assess respiratory status
before administering and
peak of medication.
Patient Teachings: • Instruct patient of proper use of inhaler and to take as directed. • advise parent to rinse mouth after using inhaler and have food oral hygiene • caution patient not to exceed 12 doses within 24hr.
ALPRAZOLAM
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
ATORVASTATIN CALCIUM
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
DOCUSATE SODIUM
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
FAMOTIDINE
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
FERROUS SULFATE
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
FUROSEMIDE
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
GABAPENTIN
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
LEVOTHYROXINE
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
ONDANSETRON
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
POTASSIUM CHLORIDE
ORAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
NITROGLYCERIN PATCH
TOPICAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
PANTOPRAZOLE
IV
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
CYANOCOBALAMIN
IM
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
LATANOPROST OPTHALMIC SOLUTION
EYE DROP
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
HYDROCORTISONE CREAM
TOPICAL
Indications:
Contraindications:
Side Effects:
Adverse Reactions:
Nursing Considerations:
Patient Teachings:
