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NCLEX > Medications Pt 2 > Flashcards

Medications Pt 2 Flashcards

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1
Q

what is erythropoietin alfa and used for

A

treat anemias associated with renal failure and chemotherapy

used to reduce the need for blood transfusion in clients with planned surgeries

ex: erythropoietin alfa

naturally occurring substance in body that is excreted by kidneys in response to hypoxia

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2
Q

erythropoietin alfa contraindications

A

reaction

those who have uncontrolled hypertension

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3
Q

erythropoietin alfa common side effects

A

arthralgia
muscle weakness

flu-like symptoms

injection site reactions
dizziness
tachycardia

nausea
vomiting

these meds: linked to

  • seizures
  • strokes
  • thromboembolic events
  • heart failure
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4
Q

erythropoietin alfa considerations

A

evaluate iron level, BP and hemoglobin level

monitor side effects

have hemoglobin levels assessed regularly

  • if at home, inject these meds at home
  • should be taught the method for injection
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5
Q

what is filgrastim and used for

A

prevent or treat low leukocyte levels associated with cancer treatment, congenital or idiopathic neutropenia

ex: filgrastim

stimulates the formation of neutrophil progenitor cells

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6
Q

filgrastim contraindications

A

hypersensitivity reaction

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7
Q

filgrastim common side effects

A 
arthralgia
myalgia
headache
rash
complain of injection site pain

thrombocytopenia
splenomegaly
splenic rupture

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8
Q

filgrastim considerations

A

obtains baseline data:

  • CBC
  • Hct
  • platelet levels

monitor response to medication
- nurse should assess for ecchymosis and spleen enlargement

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9
Q

what are immunosuppressants and used for

A

used to suppress the immune system

common indications including preventing transplant rejection

used in autoimmune diseases

ex:

  • cyclosproine
  • tacrolimus
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10
Q

immunosuppressants contraindications

A

reaction
dont use pregnancy or when breastfeeding

caution should be used with clients that have severe renal impairment or that have neoplasms

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11
Q

immunosuppressants common side effects

A 
headache
gum hyperplasia
tremors
hypertension
kidney dysfunction

secondary infections
bone marrow suspensions

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12
Q

immunosuppressants nursing considerations

A

baseline data

  • BP
  • pregnancy status
  • hx of neoplasms

nurse should verify renal function

teach about infection preention

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13
Q

laxatives used for

A

treat or prevent constipation

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14
Q

softener laxative

A

docusate

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15
Q

chemical stimulant laxative

A

cascara
senna
bisacodyl

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16
Q

bulk stimulant laxative

A

lactulose
magnesium citrate
polyethylene glycol
psyllium

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17
Q

lubricant laxative

A

mineral oil

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18
Q

laxative contraindications

A

use with caution if client is a diabetic

do not use in client with acute bowel illness or diarrhea

laxatives should be used with caution in client with a hix of cardiovascular disease

and for those who are pregnancy

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19
Q

laxative common side effects

A

nausea, vomiting

abdominal cramping
fecal incontinence

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20
Q

laxatives nursing considerations

A

baseline data
- bowel movement patterns and abdominal assessment

laxative should not be used as a weight loss plan

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21
Q

what is HMG- CoA reductase inhibitors and used for

A

reduce blood lipids in an effect to reduce the morbidity and mortality of cardiovascular disease

lipid lowering agent

should be used in conjunction with diet and exercise

ex:

  • atorvastatin
  • rosuvastatin
  • simvastatin
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22
Q

HMG- CoA reductase inhibitors contraindications

A

reaction
pregnancy and breastfeeding
active liver disease

caution should be used when administering these meds to diabetics

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23
Q

HMG- CoA reductase inhibitors common side effects

A

constipation
decreased absorption of fat soluble vitamins
abdominal pain
arthralgia

rhabdomylosis
upper resp tract infections

simvastatin has been linked to cataracts

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24
Q

HMG- CoA reductase inhibitors nursing considerations

A

baseline data

  • liver function tests
  • renal functions tests

monitor for liver dysfunction, muscle pain and renal function

use this conjunction with diet and exercise

notify HCP for muscle pain, decrease urination or sings of resp infection

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25
Q

bile acid sequestrates and used for

A

used in conjunction with diet and exercise resume serum

lipid lowering agents

choelsterol levels

ex
- cholestyramine
used to treat pruritus associated with partial biliary obstruction

increases the livers cholesterol to make more bile acids, resulting in a decreased serum cholesterol level

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26
Q

bile acid sequestrates contraindications

A

reaction
total biliary obstruction or impaired renal function

used if med is warranted during pregnancy

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27
Q

bile acid sequestrates common side effects

A

headache
fatigue
drowsiness
gastrointestinal irritation

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28
Q

bile acid sequestrates nursing considerations

A

baseline data

  • bowel patterns
  • biliary patency
  • pregnancy status
  • abdominal assessment

monitor sxs of biliary obstruction

teach client on how to prevent constipation
report any right upper quadrant pain
-use with dietary changes and exercise

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29
Q

migraine-specific drugs and used for

A

used to treat acute migraine attacks

ex:
- sumatriptan

not used for prevention of migraine headaches

metabolized in the liver and excrete in urine

cross the placenta and have shown toxic effects to fetus

also enter breast milk

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30
Q

migraine-specific drugs contraindications

A

reaction
acute myocardial infarction

diagnosed with coronary artery disease

caution when giving to clients of advanced age and those that have renal or liver impairment

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31
Q

migraine-specific drugs common side effects

A

paresthesia
burning sensation
weakness
muscle pain

vertigo
BP changes
angina

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32
Q

migraine-specific drugs nursing considerations

A

baseline data

  • BP
  • cardiac history
  • renal and liver function

monitor for angina
BP changes and renal or liver impairment

teach to take meds at first sign of migraine
- report any chest tightness or tingling of extremities to their HCP

do not take if pregnancy or lactating

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33
Q

atropine and used for

A

treat bradysystolic cardiac arrest and to correct bradycardia

used when treating life-threatening exposure to nerve agents

used in small doses, atropine decreases salivary and bronchial secretions by acting on exocrine glands

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34
Q

atropine contraindications

A

glaucoma
asthma
gastrointestinal or urinary obstruction

high doses of atropine should be used with caution as they can cause hallucinations, coma and death

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35
Q

atropine common side effects

A

agitation
diplopia
dry mouth

dizziness
altered taste
urinary retention

tachycardia
muscle twitching
photophobia

mydriasis
increase in intraoocular pressure

shallow breathing
decrease in sweating ability

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36
Q

atropine nursing considerations

A

baseline data

  • BP
  • reaction to atropine
  • HR
  • hx of urinary retention, prostate enlargement or cardiac dysfunction

notify HCP if abdominal pain, urinary retention, blurred vision or heart palpitation

avoid strenuous activity and overheating

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37
Q

urinary antispasmodic and used for

A

treat bladder hyperactivity including symptoms of urgency
frequency
nocturia
incontinence

ex:

  • oxybutynin
  • tolteradine
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38
Q

urinary antispasmodic contraindications

A

reactions
with other meds that have an anticholinergic action
- antihistamines

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39
Q

urinary antispasmodic common side effects

A

dry mouth
drowsiness
constipation

urinary retention
blurred vision
nausea
vomiting

decrease in sweating abilities

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40
Q

urinary antispasmodic considerations

A

baseline data
- urinary frequency

monitor intake and output

  • urinary retention
  • bowel activity

avoid alcohol

avoid activities that require alertness

take surgarless candy to treat dry mouth
avoid strenuous activity and overheating

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41
Q

non-opioid analgesics and used for

A

used to control inflammation, mild to moderate pain and fever

aspirin
- used to inhibit platelet aggregation

first gen:

  • aspirin
  • ibuprofen
  • ketorolac

second gen
- celecoxib

acetaminophen

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42
Q

non-opioid analgesics contraindications

A

peptic ulcer disease
used with caution in Helicobacter pylori infection

ketorolac is contraindicated in clients with hx of severe kidney disease

second gen NSAIDs

  • used with caution in clients that have cardiovascular disease
  • for client that have an allergy to drugs containing sulfa
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43
Q

non-opioid analgesics common side effects

A

abdominal pain and nausea
may lead to bleeding ulcers

NSAIDs associated with eight cranial nerve stimulation

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44
Q

non-opioid analgesics nursing considerations

A

baseline data

continually monitor amount of medication

acetylcysteine is used as an antidotes to an acetaminophen overdose

teach:
appropriate use of med
meds that mask sxs

aspirin toxicity may progress from ringing in ear and fever to coma and resp depression
- limit amount of acetaminophen to less than 4,000mg/day in adults

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45
Q

opioid analgesics and used for

A

manage moderate to severe pain

ex:
codeine
hydrocodone
hydromorphone
meperidine
morphine
oxycodone
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46
Q

opioid analgesics contraindications

A

reaction
resp depression
paralytic ileus

upper airway obstruction

used cautiously in client who also take CNS depressants like alcohol

caution with advanced age and those that suffer from chronic resp conditions

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47
Q

opioid analgesics common side effects

A

nausea, vomiting
resp distress
orthostatic hypotension

bradycardia
impaired cognitive capabilities

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48
Q

opioid analgesics nursing considerations

A

meds should not be administered if respiratory tracts are lower than 12 breaths per minute

monitor resp status and breathing patterns

withdrawal symptoms may occur
keep this med in a safe space
- never combine other CNS depressants with these meds

antidote for opioids is an opioid antagonist called naloxone
- repeated doses may be needed to rapidly reverse opioid meds

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49
Q

sedative hypnotic and used for

A

short term treatment of insomnia

ex:
zolpidem
zaleplon
eszopiclone

50
Q

sedatives contraindications

A

reaction
before bedtime prevent client from getting 6-8 hours of sleep

should be used with caution if other CNS depressants are being taken

caution in clients with advanced age or those suffering from depression

51
Q

sedative hypnotics common side effects

A

drowsiness
amnesia
behavioral changes

blurred vision
constipation

after beginning these meds, a worsening of depression, hallucinations or suicidal ideation can occur

52
Q

sedative hypnotics nursing considerations

A 
baseline data
monitor sxs
- dizziness
- liver and kidney function
- bowel patterns

teach client to avoid using alcohol or other CNS depressant during usage

take meds when 6-8 hours of sleep is possible

53
Q

skeletal muscle relaxants and used for

A

treat spasticity associated with spinal cord disease like:

  • cerebral palsy
  • multiple sclerosis
  • lesions

used in conjunction with other modalities to reduce muscle spams and pain

  • rest
  • heat
  • physical therapy

ex:
cyclobenzaprine
baclofen

54
Q

skeletal muscle relaxants contraindications

A

caution in clients with advnaced age
those with renal disease
cardiac dysfunction or heart failure

55
Q

skeletal muscle relaxants common side effects

A 
headache
dizziness
drowsiness
confusion
insomnia
cyclobenzapine:
drowsiness dizziness
fatigue 
dry mouth
constipation
headache

baclofen:
increased urinary frequency
seizures

56
Q

skeletal muscle relaxants considerations

A

baseline data
avoid other CNS depressants like alcohol

avoid activities that require mental alertness until reaction to these medications

57
Q

skeletal muscle relaxants drug specific considerations

A

those taking cyclobenzaprine may experience anticholinergic effects like dry mouth and urinary retention

those taking baclofen, should be instructed to take it with food
- discontinuing used of baclofen, abruptly can cause severe adverse reactions

58
Q

thyroid hormone replacement and used for

A

used to treat low levels or absent levels of thyroid hormones, myxedema coma

ex:
levothyroxine
desiceated thyroid

59
Q

thyroid hormone replacement contraindications

A

hypersensitivity

caution when administering these meds to breastfeeding mothers and clients that suffer from addison disease

medications should not be stopped during pregnancy
- dosages are often increased during pregnancy

NOT approved for weight loss

60
Q

thyroid hormone replacement common side effects

A 
palpitations
dysrhythmias
tremors
anxiety
insomnia
61
Q

thyroid hormone replacement nursing considerations

A

baseline data
monitor for sxs
teach client to take meds 30 min before breakfast
- not abruptly stop the med without discussing with HCP

62
Q

urate lowering drugs (antigout agents) and used for

A

treat primary gout and hyperuricemia

also used to treat secondary hyperuricemia related to cancer and recurrent calcium oxalate calculi

Ex:
allopurinol

63
Q

urate lowering drugs (antigout agents) contraindications

A

presence of a reaction

caution when administering to client with history of renal or liver impairment

64
Q

urate lowering drugs (antigout agents) common side effects

A 
drowsiness
chills
peripheral neuoropathy
nausea
vomiting
65
Q

urate lowering drugs (antigout agents) nursing considerations

A

prior to giving:
obtain CBC and uric acid
- review renal and liver function tests prior to administration

monitor sxs

teach:

  • take med after meals
  • drink enough water to produce 2 liters of urine a day
  • adhere to a low purine diet to prevent uric acid
  • report any abnormal bleeding and bruising
  • during first months of use, an increase in gout “flare ups” may occur

client should contact HCP for this but should not discontinue use

66
Q

biphosphonates and used for

A

treat osteoporosis and increase bone mass

alendronate

thought these meds reduce bone remodeling and thus bone reposition

  • leads to gradual increase in bone mass
  • meds do not undergo metabolism and are excreted in the urine
67
Q

biphosphonates contraindications

A

hypersensitivity reaction
hypocalcemia
inability to sit upright for 30 minutes after taking med

esophageal emptying difficulties such as strictures

meds can cause esophageal irritation and preliminary studies
caution should be used in clients with renal impairment

68
Q

biphosphonates common side effects

A

headache
vertigo
new or worsening bone pain
diarrhea

esophageal irritation and erosion

69
Q

biphosphonates nursing considerations

A

baseline assessment

  • serum calcium level
  • ability to sit upright
  • hypersensitivity reaction

should not be given with food, antacids, calcium or iron a
- will cause decrease in absorption

monitor for sxs of side effects, renal impairment and hypocalcemia

teach:

  • take med in morning with water
  • sit upright or stand for 30 minutes after taking
  • take calcium and vitamin D supplement
70
Q

bronchodilators and used for

A

dilate airways for relief of narrowed airways and difficulty breathing associated with asthma and COPD

albuterol
ipratropium
theophylline

beta 2 adrenergic agnonist work by targeting beta 2 receptors in the bronchial smooth muscles

71
Q

bronchodilators contraindications

A

not be used in client that have:

  • heart disease
  • hypertension
  • hypothyroidism
  • seizure disorder

hypersensitivity reaction

conditions that would be exacerbated by anticholinergic effect of this drug

allergy to soy or peanuts due to methods used to prepare the drug

72
Q

bronchodilators common side effects

A 
albuterol:
nervousness
restlessness
tremor
headache

insomnia
hyperactivity
nausea
vomiting

hypergylcemia
hypokalemia

ipratropium:
dry mouth
dizziness
headache
fatigue
palpitations
urinary retention
theophylline:
restlessness
palpitation
sinus tachycardia
dizziness
anorexia
vomiting
headache
insomnia

adverse effects are more likely to occur at theophylline serum levels greater than 20 meq/mL

73
Q

bronchodilators nursing considerations

A

when clients use both inhaled steroids and inhaled bronchodilators
- should use bronchodilator first to open up airways

then wait few minutes and use the steroid so it can be more effective

rinse and spit after using inhalers

74
Q

albuterol drug specific considerations

A

assess lung sounds, pulse and BP before administration and during peak of medication

pulmonary function tests before initiating therapy and periodically during therapy

observe for paradoxical bronchospasm - wheezing
- if this condition occurs, withhold the medication and notify the HCP immediately

teach how to monitor HR
avoid caffeine
teach proper inhaler use

75
Q

theophylline drug specific considerations

A 
alcohol caffeine and smoking are prohibited
contact provide if:
- nausea
- vomiting
- anxiety
- insomnia
- convulsions

draw peak serum theophylline levels 15-30 min after an administering IV loading dose

ensure that dizepam is readily available

76
Q

anti-inflammatory bronchodilators and used for

A

dilate airways

treat or prevent inflammatory process that leads to narrowing of airways

budesonide - inhaled steroids
zafirlukalst
montekulast
- these are leukotriene receptor antagonists

inhaled steroid:
decrease inflammatory process in airways by decreasing effects of inflammatory cells

leuotriene receptor antaonigsts:
block receptors that increase the production of leukotrienes
action that block the inflammatory process associated with asthma

77
Q

anti-inflammatory bronchodilators contraindications

A

avoided in clients that have history of reaction
none are used to treat acute asthma attack or status asthmaticus

inahled steroids should be used cautiously when clients have an active infection of respiratory tract

leukotriene receptor antagonists used cautiously with hepatic or renal impairment

78
Q

montekulast side effects

A 
dizziness
headache
upper resp infection
fever
pharyngitis

cough
Gi upset
otitis media

runny nose
sinusisits

79
Q

leukotriene receptor antagonists side effects

A

dizziness
headache
nausea
diarrhea

fever
injection
myalsiga

80
Q

anti-inflammatory bronchodilators considerations

A 
assess baseline
monitor for:
- infection
- headache
- dizziness
- generalized pain

meds are not used for acute attacks
therapeutic effects may take weeks to achieve

81
Q

anti-inflammatory bronchodilators drug specific considerations

A

montekulast may increase:

  • hallucination
  • aggression
  • anxiousness
  • suicidal behavior
  • tremors
82
Q

calcium channel blockers and used for

A 
treat hypertension
decreased cardiac workload
angina 
abnormal heart rhythms
- afib
- paroxysmal supra ventricular tachycardia

used to treat post myocardial infarction client who cannot tolerate beta-blockers

amlodipine
diltiazem
felodipine
verapamil

slows the rate at which calcium passes into vessel walls
- relaxes the vessel and allows blood to flow more easily through them

verapamil and diltiazem = work by blocking the calcium channels in the myocardium

83
Q

calcium channel blockers contraindications

A

reaction
can have toxic effect on liver
- clients with liver impairment should not take meds

hypotension
having an acute MI

symptomatic heart failure and heart bloc

84
Q

calcium channel blockers common side effects

A 
headache
dizziness
fatigue
nausea
vomiting

flushing
rash
constipation
abdominal pain

85
Q

calcium channel blockers considerations

A

baseline data

  • BP
  • HR
  • vitals
  • liver function

teach:

  • do not consume grapefruit when taking meds
  • change positions slowly to decrease dizziness and possible syncope
  • discuss any OTC meds with HCP
  • importance of monitoring their HR
86
Q

central nervous system stimulants

A

to improve concentration and focus for those with ADD

can be used to decrease appetite and promote weight loss

lisdexamfetamine
methylphenidate

increase physical activity, mental alertness and attention span

87
Q

central nervous system stimulants contraindications

A

anxiety
tension headaches
glaucoma

hx of seizures

88
Q

central nervous system stimulants common side effects

A

headache
resp infection
hyperhidrosis

decreased appetite
visual disturbances

abdominal pain
cough
nausea
insomnia
restlessness
89
Q

central nervous system stimulants nursing considerations

A

obtain important baseline data
monitor side effects

teach to monitor their weight
- take meds in the morning

dose must be tapered off to avoid withdrawal syndrome

90
Q

corticosteroids and used for/examples

A

treat inflammation and pain associated with arthritis and autoimmune disease

91
Q

glucocorticoids

A

methylprednisolone
prednisolonne
dexamethasone
betamethason

92
Q

mineralcorticoids

A

cortisone
fludrocortisone
hydrocortisone

93
Q

corticosteroids contraindications

A

infection
at high risk for infection

used with caution in clients that have diabetes

94
Q

corticosteroids common side effects

A

headache
vertigo
impaired wound healing
increased appetite

weight gain and increased appetite

long term use of corticosteroids cushings syndrome is common
- truncal weight gain

95
Q

corticosteroids nursing consideration

A

baseline data to see no active infections are present

sodium and potassium levels
should not receive live vaccines
- call HCP if exposed to chicken pox or measles

take prescribed dose in morning
- maintain a low sodium, higher potassium diet

avoid grapefruit

96
Q

loop diuretics (potassium-wasting) and used for

A

treat edema and hypertension

bumetanide
furosemide

97
Q

loop diuretics (potassium-wasting) contraindications

A

suffering from electrolyte depletion and anuria

should not use loop diuretics during pregnancy or if they have severe liver or kidney disease

hx of diabetes should expect an increase in blood sugar

98
Q

loop diuretics (potassium-wasting) common side effects

A

hypotension
hypovolemia
photophobia

hypokalemia
ototoxicity and even deafness
- especially when giving large doses IV too quickly

99
Q

loop diuretics (potassium-wasting) considerations

A

baseline data

  • live and renal function
  • reaction
  • BP

monitor for;

  • dizziness
  • hypotension
  • hypovolemia
  • weight
  • intake and output

eat potassium rich diet and take any potassium supplements

  • weigh in morning
  • use sun protection
100
Q

osmotic diuretics and used for

A

treat intracranial pressure or increased introocular pressure

mannitol

101
Q

osmotic diuretics common side effects

A

fluid and electrolyte imbalance
hypernatremia
hypovolemia

nausea
vomiting
hypotension
shock may occur

leakage of mannitol can cause edema and skin necrosis

102
Q

osmotic diuretics considerations

A

baseline data
monitor BP, intake and output and electrolyte

may crystallize

  • use filter needle to withdraw mannitol from vial
  • in line filter needle with continuous infusion

report any chest pain, breathing, difficulty or pain at IV site
- should also change position slowly to decrease dizziness

103
Q

potassium sparing diuretics and used for

A

treat client with heart failure

spironolactone

works by blocking aldosterone in distal tube

104
Q

potassium sparing diuretics contraindications

A

acute renal insufficiency
addisons disease
hyperkalemia
pregnancy

105
Q

potassium sparing diuretics common side effects

A

dizziness
headache
tinnitus
abdominal pain

impotence
gynecomastia
irregular menses
amenorrhea
hirsutism
deepening of the voice
106
Q

potassium sparing diuretics considerations

A

baseline data

monitor potassium levels, cardiac dysrhythmias, BP, edema status

take med with food or milk
change position slowly

107
Q

potassium and used for

A

transmission of nerve impulses in cardiac and skeletal muscle

108
Q

potassium common side effect

A

abdominal discomfort
dysrhythmias
paresthesia
hyperkalemia

for oral supplements, various forms exist including tablets, effervescent tablets and liquid form
- can be mixed with water and/or juice to aid in swallowing

injectable supplements often cause irritation to the veins
- should be administered slowly after proper dilution

if injected without dilution, potassium can be fatal

109
Q

potassium considerations

A

baseline data
adequate renal function
monitor potassium
- frequent check of IV site and vein should be performed

report;

  • heart rate changes
  • palpitations
  • GI bleeds
110
Q

magnesium and used for

A

cause by malnutrition, alcoholism of magnesium depleting meds

magnesium oxide
magnesium sulfate

require for ATP functions

111
Q

magnesium common side effects

A

decreased reflexes
flatulence
dysrhythmias
dizziness

112
Q

magnesium considerations

A

baseline data

  • magnesium level
  • cardiac hx
  • HR, BP

recognize toxification:

  • bradycardia
  • decreased reflexes
  • double vision
  • trouble breathing
  • excessive diarrhea

calcium gluconate is used to treat mag toxification

113
Q

calcium and used for

A

treat hypocalcemica and as part of cardiac resuscitation

calcium chloride
calcium citrate
calcium gulconate

114
Q

calcium contraindications

A

hypersensitivity to calcium salts or calcium containing meds

115
Q

calcium common side effects

A

dizziness
hypotension
weakness
lethargy

depressed reflexes
anorexia
nephrolithiasis
increased BP

116
Q

calcium nursing considerations

A

monitor chvostek and trousseaus

report any paresthesia or abnormal reflexes

117
Q

erectile dysfunction drugs and used for

A

treat erectile dysfunction and pulmonary artery hypertension

sildenafil

works by increasing effects of nitric oxide, which increases blow flow to penis

118
Q

erectile dysfunction drugs contraindications

A

use of nitrates, like nitroglycerin
- risk of hypotension

used with caution in clients that have hx of diabetes, myocardial infarction or stroke
hepatic or renal impairment

119
Q

erectile dysfunction drugs common side effects

A

dizziness
hypotension
diplopia

120
Q

erectile dysfunction drugs considerations

A

baseline data

sxs for hypotension or a reaction

client suffering from acute myocardial infarction

  • medication protocols change if client reports use of this med
  • should not receive nitroglycerin

teach:
- if nitrates are used with these meds, severe hypotension can occur
- notify HCP if erection lasts longer than 4 hours or off and on
diabetic clients should monitor their blood sugar closely while taking this med

NCLEX (21 decks)

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