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NCLEX Review > Medications > Flashcards

Medications Flashcards

1
Q

Preferred needle gauge for administering blood products

A

18G or higher

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2
Q

Maintenance fluid that can be used for blood administration

A

0.9% NaCl (Normal saline)

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3
Q

Rate used for initial 15 minutes of blood administration

A

5 mL/min

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4
Q

Blood MUST be administered within how many hours?

A

4 hours

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5
Q

How frequently should vital signs be checked when administering blood?

A

Every 15 minutes for at least the first hour

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6
Q

If a transfusion reaction is suspected, the nurse should…

A
  1. STOP TRANSFUSION
  2. Restart NS to maintain IV access
  3. Bag blood and IV tubing and return to blood bank
  4. Draw blood samples and collect urine samples
  5. Monitor for hematuria
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7
Q

What medications can be given for a transfusion reaction?

A
  1. Diphenhydramine
  2. Aspirin
  3. Steroids
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8
Q

Contraindications to receiving autologous blood

A
  1. Acute infection
  2. Chronic disease
  3. Hemoglobin less than 11 g/L, hematocrit less than 33%
  4. Cerebrovascular disease
  5. Cardiovascular disease
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9
Q

Fluid overload transfusion reaction (S/S and interventions)

A
  1. S/S: SOB, rales/crackles

2. Interventions: Administer O2, Slow transfusion, Call MD

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10
Q

Allergic transfusion reaction (Hypersensitivity) (S/S and interventions)

A
  1. S/S: Mild = Uticaria, itching, flushing
    Anaphylaxis = HypoTN, Dyspnea, low O2, flushing
  2. Interventions: Stop blood, O2, NS, antihistamine
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11
Q

Acute Hemolytic Transfusion Reaction (S/S and interventions)

A
  1. S/S (SYSTEMIC): N/V, lower back pain, hypoTN, increase HR, decreased urine, hematuria
  2. Interventions: Stop blood, airway, antihistamines
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12
Q

Febrile transfusion reaction (most common) (S/S and interventions)

A
  1. S/S: Fever, chills, HA, flushing, tachycardia, palpitation
  2. Interventions: Stop blood, ASPIRIN
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13
Q

Bacterial transfusion reaction (S/S and interventions)

A
  1. S/S: Tachycardia, HypoTN, Fever, chills, shock

2. Interventions: Stop blood, obtain culture, antibiotics, steroids

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14
Q

Isotonic solutions

A

Same concentration as body fluids (no shift of fluids)

  1. NS
  2. Lactated Ringers
  3. D5W
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15
Q

Hypotonic solutions

A

Concentration less than body fluids (fluid shift to tissues)

1. 1/2 NS

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16
Q

Hypertonic solutions

A

Concentration greater than body fluids (fluid shift to vessel)

  1. 10-15% dextrose in water
  2. 3% NaCl
  3. Sodium bicarbonate 5%
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17
Q

Main goal of IV therapy

A

Maintain or restore fluid/electrolyte balance

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18
Q

IV insertion procedure STERILE TECHNIQUE

A
  1. Apply tourniquet 4-6” above site
  2. Clean with alcohol swab working from center outward
  3. Repeat cleaning with iodine
  4. Hold skin taunt and stabilize vein
  5. Insert catheter bevel up at 15-20 degrees
  6. Lessen angle and advance watching for blood flash
  7. Once blood is seen, advance another 1/4” and remove tourniquet
  8. Withdraw needle and advance catheter to hub
  9. Secure
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19
Q

How frequently should IV tubing be changed?

A

Every 72 hours

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20
Q

How frequently should IV bags be changed?

A

Every 24 hours (even if not empty yet)

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21
Q

Infiltration from IV therapy (S/S and interventions)

A

Medication goes into tissues
S/S: Edema, pain, COOLNESS, decreased flow rate
Interventions: Discontinue IV, WARM compresses, elevate arm

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22
Q

Extravasation from IV therapy (S/S and interventions)

A

Infiltration with blistering and sloughing of skin

Interventions: Discontinue IV (aspirate as removing), Prevention

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23
Q

Medications that will cause extravasation

A
  1. Gentamycin
  2. Penicillin
  3. Vancomycin
  4. Dilantin
  5. Antineoplastic drugs
  6. Calcium
  7. Potassium
  8. Epinephrine
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24
Q

Phlebitis/Thrombophlebitis from IV therapy (S/S and interventions)

A

Irritation of the vein
S/S: Reddened, WARM, tender, swelling
Interventions: Discontinue IV, WARM, MOIST compress

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25
Q

Hematoma from IV therapy (S/S and interventions)

A

S/S: ecchymosis, swelling, leakage of blood at insertion

Interventions: Apply pressure, COOL compress/ICE

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26
Q

Clotting from IV therapy (S/S and interventions)

A

S/S: Decreased flow rate, back flow of blood into tubing

Interventions: Discontinue IV, Urokinase

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27
Q

Interventions that should NOT be performed if clotting occurs during IV therapy

A
  1. Irrigation or milking of tubing
  2. Increase of IV flow rate
  3. Aspiration of clot
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28
Q

Length of time a PICC can remain in place

A

Up to 6 months

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29
Q

S/S to look for to prevent PICC complications

A
  1. SOB
  2. Pain with respiration
  3. Decreased movement of arm
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30
Q

Length of time a MLC can remain in place

A

1-8 weeks

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31
Q

Triple lumen catheter lumen uses

A
  1. Distal lumen = Infuse or draw blood
  2. Middle lumen = TPN
  3. Proximal lumen = Infuse/draw blood, medications
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32
Q

If resistance is met when trying to flush a triple lumen catheter, the nurse should…

A

Call the HCP. NEVER FORCE FLUSH!!

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33
Q

Dressing change procedure for a triple lumen catheter

A
  1. Low-fowler’s
  2. Masks for both nurse and patient
  3. Alcohol and iodine to clean site
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34
Q

Adrenergic medications (ENDD)

A
  1. Epinephrine
  2. Norepinephrine
  3. Dopamine
  4. Dobutamine
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35
Q

Common side effects of adrenergic medications

A
  1. Dysrhythmias
  2. Tremors
  3. Anticholinergic reaction (dry mouth, urinary retention)
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36
Q

Nursing interventions for adrenergic medications

A
  1. Monitor BP
  2. Monitor peripheral pulses
  3. Monitor output
  4. Maintain safety (can cause drowsiness)
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37
Q

Benzodiazepines medications (Suffix specific)

A
  • PAM or -LAM suffix

* *expect for Chlordiazepoxide

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38
Q

Non-benzodiazepine medications

A
  1. Buspirone

2. Hydroxyzine

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39
Q

Herbal antianxiety medications

A
  1. Kava

2. Melatonin

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40
Q

Most important to remember for patient taking benzodiazepines

A

CNS DEPRESSION! (sedation, confusion, hepatic dysfunction) - Avoid alcohol!

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41
Q

Teaching regarding antianxiety medications

A
  1. Discontinue slowly (no abrupt stopping)
  2. Changes in smoking/caffeine intake will affect effectiveness of medication (HX IMPORTANT!)
  3. Avoid alcohol (CNS depression)
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42
Q

Antacid medications (One word specific)

A

HYDROXIDE

  1. Aluminum hydroxide
  2. Magnesium hydroxide
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43
Q

Side effects of antacids

A
  1. Constipation or diarrhea
  2. Acid rebound between doses
  3. Metabolic acidosis
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44
Q

Administration timing for antacids

A

1-2 hours AFTER eating and/or other medications

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45
Q

General side effects of antibiotics

A
  1. Allergy (not necessarily after first dose)
  2. Superinfection
  3. Organ toxicity (specifically kidney and liver)
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46
Q

General teaching when administering antibiotics

A
  1. Take until gone!!
  2. Always do a culture and sensitivity FIRST before administering
  3. Encourage fluids (3000 ml/day)
  4. Generally taken 1 hour BEFORE or 2-3 hours AFTER meals (2 exceptions)
  5. Check expiration dates! (can be toxic if expired)
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47
Q

Aminoglycoside medications (Suffix specific)

A

Antibiotics; -MYCIN suffix

**EXCLUDES erythromycin, azethromycin, vancomycin

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48
Q

Aminoglycoside specific side effects

A
  1. Ototoxicity (8th cranial nerve)

2. Nephrotoxicity

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49
Q

Cephalosporin medications (Prefix specific)

A

Antibiotics; CEF-/CEPH- prefix

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50
Q

Cephalosporin specific side effects

A
  1. Rash
  2. Bone marrow suppression
  3. False positives for protein or glucose in urine
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51
Q

Cephalosporin specific patient teaching

A
  1. TAKE WITH FOOD

2. Cross allergy with penicillin

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52
Q

Fluoroquinolone medications (Suffix specific)

A

Antibiotics; -FLOXACIN suffix

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53
Q

Macrolide medications (exception -mycin’s)

A

Antibiotic

  1. Erythromycin
  2. Azethromycin
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54
Q

Macrolide specific side effects

A
  1. Confusion

2. Increased effectiveness of warfarin and theophylline

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55
Q

Penicillin medications (Suffix specific)

A

Antibiotics; -CILLIN suffix

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56
Q

Penicillin specific side effects

A
  1. Breakdown of mouth and GI tract (stomatitis and gastritis)
  2. Biggest allergy reaction**
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57
Q

Penicillin specific teaching

A
  1. Take yogurt or buttermilk if diarrhea develops

2. DON’T double doses if dose is missed

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58
Q

Sulfonamide medications (Prefix specific)

A

Antibiotics; SULF- prefix

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59
Q

Sulfonamide specific side effects

A
  1. Peripheral neuropathy
  2. Crystalluria/proteinuria
  3. Photosensitivity
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60
Q

Sulfonamide specific teaching

A
  1. Protect from sun exposure

2. Take with food

61
Q

Tetracycline medications (Suffix specific)

A

Antibiotics; -CYCLINE suffix

62
Q

Tetracycline specific side effects

A
  1. Discoloration of primary teeth in fetus if taken during pregnancy! (or early in life)
  2. PhotoTOXIC reaction
63
Q

Tetracycline specific teaching

A
  1. SPECIAL NOTE TO EXPIRATION DATE
  2. Use additional contraceptive in addition to oral contraceptives
  3. SUN EXPOSURE PREVENTION!
64
Q

Nitrofurantoin (Usage, side effects, interventions)

A

Used to treat UTI’s
Side Effects: Asthma attacks
Interventions: Avoid acidic foods (i.e. cranberry juice, prunes)

65
Q

Phenazopyridine (Usage, side effects, interventions)

A

Used as an urinary tract analgesic
Side Effects: HA and vertigo
Interventions: Urine will be bright ORANGE

66
Q

Anti-impotence medication (Suffix specific)

A

Used to treat erectile dysfunction; -AFIL suffix

67
Q

Anti-impotence specific teaching

A
  1. No grapefruit juice

2. NEVER use with nitrates or alpha-blockers (could be fatal)

68
Q

Anticholinergic medications (STrIP BAT)

A
  1. Scopolamine
  2. Trihexyphenydil (Psych)
  3. Iprotropium (Resp.)
  4. Propantheline
  5. Benzotropine (Psych)
  6. Atropine
  7. Tiotropium (Resp.)
69
Q

Anticholinergic specific side effects

A
  1. Dry mouth
  2. Blurred vision
  3. Urinary retention
70
Q

Anticholinergic specific teaching

A
  1. Do NOT use with glaucoma, paralytic ileus, or BPH

2. 30 minutes before meals or 2 hours after

71
Q

Anticoagulant medications

A
  1. Heparin
  2. Enoxaparin
  3. Warfarin
72
Q

Heparin therapeutic range

A

1.5-2.5x normal PTT (normal 20-45 seconds)

73
Q

Warfarin therapeutic range

A

1.5x normal PT (normal 9-12 seconds)

74
Q

Antidote for heparin

A

Protamine sulfate

75
Q

Antidote for warfarin

76
Q

Foods that should be avoided when taking Warfarin

A

Anything high in vitamin K!

  1. Green vegetables
  2. Pork
  3. Rice
  4. Yogurt
  5. Cheeses
  6. Fish
  7. Milk
77
Q

Clients on anti-coagulation therapy should avoid…

A
  1. IM injections
  2. Aspirin
  3. NSAID
78
Q

Herbal interactions with warfarin (3 G’s)

A
  1. Ginger
  2. Ginkgo
  3. Garlic
79
Q

Anti-convulsant medications

A
  1. Clonazepam* (Benzo)
  2. Diazepam (Benzo)
  3. Fosphenytoin
  4. Levetricetam
  5. Phenytoin sodium*
  6. Phenobarbital*
  7. Magnesium sulfate (OB)
  8. Valproic acid*
  9. Carbameazepine*
  10. Gabapentin*
  11. Lamotrigine*
  12. Topiramate*
80
Q

Anti-convulsant side effects

A
  1. CNS depression (NO ALCOHOL)
  2. Ginigival hypertrophy (overgrowth of gums)
  3. Agranulocytosis
  4. Aplastic anemia
81
Q

Anti-convulsant nursing interventions

A
  1. Do NOT discontinue abruptly

2. Use caution when giving these medications with MAOI’s (lower seizure threshhold)

82
Q

Phenytoin specific side effects

A
  1. Cardiac arrest can occur when given IV

2. Turns urine pink

83
Q

Valproic acid specific side effects

A

Don’t take with carbonated beverages

84
Q

MAOI medications (PIT)

A

Antidepressant

  1. Phenelzine sulfate
  2. Isocarboxazide
  3. Tranylcypromide
85
Q

MAOI specific side effects

A
  1. Hypertensive crisis!!
  2. Photosensitivity
  3. Weight gain
86
Q

MAOI nursing considerations/teaching

A
  1. No tyramine containing foods
  2. Takes up to 4 weeks to work
  3. Discontinue 10 days before general anesthesia
87
Q

Tyramine containing foods

A
  1. Aged cheese
  2. Bologna
  3. Pepperoni
  4. Salami
  5. Figs
  6. Bananas important to know if taking Lasix as well
  7. Raisins
  8. Beer/red wine
88
Q

A patient presents with a severe headache, palpitations, diaphoresis, and a stiff neck and states they are taking isocarboxazide. What are they presenting with?

A

Hypertensive crisis

89
Q

SSRI medications (Suffix specific)

A

Antidepressant; -PRAM, -INE suffix

**EXCEPT amitryptyline and imipramine

90
Q

SSRI specific teaching

A
  1. Take in the morning
  2. Monitor for suicide!!
  3. Do NOT administer with MAOI’s! (Serotonin syndrome risk)
91
Q

Tricyclic medications (exception -INE’s)

A

Antidepressant

  1. Amitriptyline
  2. Imipramine
92
Q

Tricyclic specific side effects

A
  1. Orthostatic hypotension

2. Anticholinergic effects

93
Q

Tricyclic specific teaching

A
  1. Take dosage at night to decrease sedative effects
  2. Do NOT stop abruptly
  3. Avoid exposure to sunlight
94
Q

Heterocyclic medications (Suffix specific)

A

Antidepressant/smoking cessation; -ON/ONE suffix

  1. Buproprion
  2. Trazodone
95
Q

Side effects of Buproprion include…

A
  1. Insomnia

2. Agitation

96
Q

Side effects of trazadone include…

A
  1. Sedation

2. Orthostatic hypotension

97
Q

Rapid acting insulin (Types, Onset, Peak)

A

Types: Lispro, Aspart
Onset: within 15 minutes
Peak: 1-3 hours

98
Q

Short-acting insulin (Types, Onset, Peak)

A

Types: Regular
Onset: 30-60 minutes
Peak: 1-5 hours

99
Q

Intermediate-acting insulin (Types, Onset, Peak)

A

Types: Isophane (NPH)
Onset: 1-2 hours
Peak: 6-14 hours

100
Q

Long-acting insulin (Types, Onset, Peak)

A

Types: Glargine
Onset: 3-4 hours
Peak: None

101
Q

Type of insulin that can be used in insulin pump

102
Q

Oral hypoglycemic medications

A
  1. Glimepiride, Glipizide, glyburide
  2. Metformin
  3. Arcarbose, Miglitol
  4. Rosiglitazone, Pioglitazone
  5. Repaglinide
  6. Sitagliptin
  7. Exanatide
103
Q

Drugs that will interact with oral hypoglycemic medications and increase risk for hypoglycemic events

A
  1. MAOI
  2. Aspirin
  3. Alcohol
  4. Sulfonamides
  5. Oral contraceptives
104
Q

When should oral hypoglycemic agents be taken?

A

Before breakfast

105
Q

Medication used to reverse hypoglycemia

106
Q

Once glucagon has been administered, it’s important for the nurse to administer what if they client is CONSCIOUS?

A

Carbohydrates to prevent secondary hypoglycemic reaction

107
Q

Important nursing assessments for anyone taking diabetic agents

A
  1. Nutrition
  2. Exercise
  3. Stress
  4. Pregnancy
108
Q

Antidiarrheal medication (BOID)

A
  1. Bismuth subsalicylate
  2. Optium alkaloids
  3. Ioperamide
  4. Diphenoxylate hydrochloride and atropine sulfate
109
Q

Common side effects of antidiarrheals

A
  1. Constipation

2. Anticholinergic effects

110
Q

Nursing considerations for antidiarrheals

A
  1. Monitor for urinary retention (anticholinergic action)

2. Do NOT administer for abdominal pain of unknown origin

111
Q

Antiemetic medications (Suffix specific)

A
  • AMIDE, -AZINE endings (plus 3 additional)
    1. Ondansetron**
    2. Dimenhydrinate**
    3. Droperidol**
112
Q

Major side effect if using antiemetics in conjunction with a viral infection

A

Reye’s syndrome

113
Q

Antifungal medications

A
  1. Amphotericin B
  2. Nystatin
  3. Flucanozal
  4. Metronidazole
114
Q

Major side effect of antifungal medications

A

Hepatotoxicity

115
Q

Nursing considerations for antifungal medications

A
  1. Give with food to decrease GI upset

2. Always check hepatic functioning!

116
Q

Antigout medications (CAP)

A
  1. Colchicine
  2. Allopurinol
  3. Probenecid
117
Q

Which antigout medication will increase the action of ciprofloxacin?

A

Probenecid

118
Q

Antigout medications affect the production of…

119
Q

Major side effect of antigout medications

A

Renal calculi

120
Q

Nursing considerations for antigout medications

A
  1. Force fluids (3000 mL per day)

2. Give with milk, antacids, or food

121
Q

Antihistamine medications (Suffix specific)

A

-MINE, -ZINE, -DINE suffix

122
Q

Common antihistamine side effects

A
  1. Sedation/Drowsiness
  2. Bronchospasm respiratory effects
  3. Anticholinergic effects
123
Q

Nursing considerations for antihistamines

A
  1. Administer with food
  2. Promote hard candies for dry mouth
  3. Avoid alcohol
124
Q

Antilipemic Medications (Prefix or Suffix specific)

A

Affect cholesterol levels; CHOLE- prefix or -STATIN suffix

125
Q

Nursing considerations for antilipemic medications

A
  1. May cause fat-soluble vitamin deficiencies
  2. Take at night or 30 minutes before meals
  3. Will inhibit absorption of other medications if taken together
126
Q

ACE Inhibitors (Suffix specific)

A

Antihypertensive; -PRIL suffix

127
Q

Side effects specific to ACE inhibitors

A
  1. Rash, pruitis
  2. Persistent, dry, nonproductive cough
  3. GI irritation
128
Q

Nursing considerations specific to ACE inhibitors

A
  1. Give 1 hour before meals or 2 hours after (food decreases absorption)
  2. Increases K levels - monitor labs!
129
Q

Beta Blocker Medications (Suffix specific)

A

Antihypertensive; -OLOL suffix

130
Q

Side effect specific to Beta Blockers

A

BRONCHOSPASM!

131
Q

Nursing considerations specific to Beta Blockers

A
  1. Do NOT discontinue abruptly (can cause rebound HTN)
  2. Take WITH meals
  3. May block signs of hypoglycemia (monitor glucose closely)
  4. Decreased effectiveness in African Americans
132
Q

Calcium Channel Blocker Medications (Suffix specific)

A

Antihypertensive; -IPINE suffix plus 2 different

  1. Verapamil*
  2. Diltiazem*
133
Q

Calcium Channel Block specific nursing considerations

A
  1. Avoid grapefruit juice
134
Q

ARB medications (Suffix specific)

A

Antihypertensive; -SARTAN suffix

135
Q

Main antihypertensive side effect and nursing consideration

A

Hypotension/Orthostatic hypotension

Monitor vital signs and ensure patient safety!

136
Q

Alpha-1 Adrenergic Blocker Medications (Suffix specific)

A

Antihypertensive; -AZOSIN suffix

137
Q

Side effects specific to Alpha-1 Adrenergic Blockers

A
  1. Reflex tachycardia

2. Nasal congestion

138
Q

Main nursing consideration when giving an Alpha-1 Adrenergic Blocker

A

Administer first dose at bedtime to avoid fainting

139
Q

Centrally acting Alpha Adrenergic medications

A

Antihypertensive

  1. Clonidine
  2. Methyldopa
140
Q

Nursing consideration specific to Centrally Acting Alpha Adrenergic medications

A

Don’t discontinue abruptly

141
Q

Direct acting vasodilator medications

A

Antihypertensive

  1. Hydralazine
  2. Minoxidil
142
Q

Direct acting vasodilator specific side effects

A
  1. Increased hair growth

2. Tachycardia

143
Q

Nursing consideration when administering direct acting vasodilators

A

Check pulse BEFORE taking medication

144
Q

Bipolar Disorder Medications

A
  1. Lithium
  2. Carbamazepine
  3. DIvalproex sodium
145
Q

Target therapeutic level for lithium

A

1 to 1.5 mEq

146
Q

Patients taking lithium should have a daily fluid intake of at least…

A

2500-3000 mL per day

147
Q

Common side effects of bipolar medications

A
  1. Tremors

2. Polydipsia, polyuria (DI)

148
Q

Prefixes and Suffixes related to antibiotics

A 
-MYCIN
CEF-
-FLOXACIN
-CILLIN
SULF-
-CYCLINE
149
Q

Suffixes related to antihypertensives

A
  • PRIL
  • OLOL
  • IPINE
  • SARTAN
  • AZOSIN

NCLEX Review (2 decks)

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