M.K. Review Flashcards
What are the nursing considerations after a hemiarthroplasty?
Abduct leg using abduction splints / wedge or 2-3 pillows between legs
Flex hip no more than 90 degrees
Elevate HOB no more than 45 degrees
Prevent complications r/t immboility with early ambulatory
Use fracture bed pan/ elevate toilet seat to prevent 90 degree flex ion.
Steps for CPR
- Check for unresposiveness
- Call for help
- Check breathing / pulse
- Initiate CPR (30 compressions, followed by 2 rescue breaths)
Zolpidem is also known as ______. ADRS:
Monitor for ______
Ambien
Worsen depression / sleep driving / side effects increase with prolonged use
Monitor for suicidal thoughts / behavior
Nursing considerations: Lithium
Check serum levels 2x/week during treatment - q2-3 months on maintenance
Draw blood AM prior to dose
Take with meals to avoid GI upset
Encourage 10-12 glasses of water / day and MODERATE (6-10g/day) salt intake
Target serum lithium levels: treatment and maintenance
How long until onset of therapeutic effects?
0.5 - 1.5 mEQ/L
0.6 - 1.2 mEq/L
1-2 weeks
Early signs of Alzheimers
Short term memory loss
Forgetful
Cannot retain new information
Loss of concentration
Physical appearance / personal hygiene
Night time confusion
Later signs of Alzheimers
Loss of judgement
Communication difficulties
Memory loss
Language difficulties
Personality Changes
Night time wandering
Decreased motor functioning
Nursing considerations for Alzheimers
- Safety (bathroom assist every 2-4 hrs to prevent falls)
Exercise programs to delay mobility issues
Meds for Alzheimers
Cholinesterase Inhibitor Meds (improve cholinergic transmission)
- Donepezil
- Galatamine
- Rivastigmine
ADRs: livery toxicity + GI upset
NMDA:
- Memantine
ADRs: sleepiness and confusion + GI upset
Why is otittis media more common in children?
Shorter eustachian tube + more narrow
Tx for RA
NSAIDs or Salicylates
Corticosteroids
Meds for gout + ADRs
Colchicine
Probenecid
Allopurinol
Agranulocytosis
Aplastic anemia
GI upset
Renal calculi
Side effects of antihistamines
Drowsiness
Dry mouth
GI upset
Bronchospasm (contraindicated with acute asthma attack / hx of asthma)
What should you do with a pt who has Wernicke’s?
How can you keep it from getting worse?
Is it reversible? Do they have to stop drinking?
Redirect them - DON’T confront them or present reality
B1 or Thiamine
Yes reversible, don’t have to stop drinking
Two drugs for alcohol aversion therapy
Disulfiram
Naltrexone
What pt ed for Disulfirum or Naltrexon?
Takes 2 weeks to get into the system
Avoid alcohol products including:
- Mouthwash
- Aftershave
- Perfumes/cologne
- Insect repellant
- Alcohol hand sanitizer
*** they can have red wine vinaigrette
Should you assume intoxication or withdrawl at birth in a newborn?
Intoxication
** baby needs 24 hrs to be in withdrawal
S/s of newborn withdrawing
Difficult to console
Exaggerated startle reflex
Seizure risk
Shrill high pitch cry
At ____ hrs a pt withdraws from alcohol. At ___ hrs they can have DT.
24
72
Nursing considerations DT
3 meds
NPO/clear liquids
Private room near nurses station
Strict bed rest / need bed pans and urinals
Vest or 2 point locked leathers (opposite arm and leg) - rotate q2h
Meds:
- Anti-HTN
- Tranquilizer
- B1
Which type of meds are ototoxic ?
Amnioglycocides - mycin
Your pt is getting an amino-glycoside, what should you monitor for?
Hearing, tinnitus, vertigo/dizziness
Nephrotoxicity
How are aminoglycosides administered?
q8h
Route: IM or IV - DON”T GIVE PO for infection
What two meds can be used to sterilize the bowel?
Neo can! NEOmycin and CANomycin
When should the trough of a med be drawn that’s IV/SL/IM/SQ/PO?
30 min prior to the next dose
When does an IV med peak?
IM?
15-30 min AFTER drug is finished
30-60 min AFTER drug finished
What do CCB’s do for your heat?
How do they work?
calm your heart - weaken, slow down, depress the heart (cardiac depressant)
Negative inotrope
What do CCB’s treat? What does it NOT treat?
Anti-HTN
Anti-angina
Anti-atrial-arrhythmia
(treats everything atrial)
DOES NOT treat SVT
Side effects of CCBs (2)
When should it be held?
HA
Hypotension
If systolic is below 100, hold
Names of CCBs
“dipine”
Verapamil
Cardizem
V-fib will look like
chaotic squigly line. NO PATTERN.
What will V-tach look like?
Sharp peak and jags
QRS depolarization, the answer ill always be ______
P wave, the answer will always be ________
Lack of P wave, answer will always be ______
Lack of QRS, the answer will be ______
Ventricular
Atrial
Ventricular
Asystole
A flutter looks like
Saw tooth
Chaotic is always a word to describe _______ (heart)
Bizarre is always the word used for _____ (heart)
Fibrillation
Bizarre
What is the different between low priority and moderate priority PVCs?
LOW:
- Premature ventricular contraction (PVC)
- A bunch of PVC’s is like a short run of V-Tach
Moderate Priority:
- If more than 6 PVC’s in a minute or row and/or if PVC falls on the T wave of
the previous beat. They never are high priority!
What meds are given for SVTs?
ABCD’s
Adenosine
Beta Blockers
CCBs
Digoxin / Digitalis (Lanoxin)
What would you give adenosine for? What should you warn the pt about?
How fast to push it?
SVT
Asystole
Push in 8 seconds (two nurses, one pushes quickly the other flushes quickly)
Your pt is in asystole, what meds are given?
Epi and Atropine (in that order)