NUR 325 exam 3 Flashcards
hyponatremia solution
sodium replacement
sodium replacement side effects
neurologic damage, osmotic demyelination syndrome
sodium replacement nursing considerations
SLOWLY
orally or IV
sodium replacement treatment depends on…
cause (fluid restriction or normal saline)
sodium bicarbonate moa
bicarb ion neutralizes ion concentration
raises blood and urine pH
sodium bicarbonate indications
hyponatremia, metabolic acidosis
sodium bicarbonate side effects
edema, cerebral hemorrhage, hypernatremia, electrolyte imbalance, metabolic alkalosis, flatulence, tetany, heart failure exacerbation
sodium bicarbonate nursing considerations
po or iv
monitor cardiac, bag, electrolytes
monitor iv patency
-lots of drug interactions
-vesicant at high concentrations (pick preferred)
hypernatremia treatment
depends on the cause
fluid deficient = add fluid
too much salt = remove salt
potassium chloride indication
hypokalemia (when dietary measures are inadequate)
potassium chloride side effects
phlebitis/pain (pick preferred)
if UNDILUTED- ventricular fibrillation (will KILL your patient)
potassium chloride contraindications
renal failure, dialysis
potassium chloride nursing considerations
NEVER iv push
check renal function/kidney output
major gi disturbances with oral liquid
sodium polystyrene sulfonate class
cation exchange resin
sodium polystyrene sulfonate moa
binds to K+ ions in digestive tract
replaces K+ for Na+
sodium polystyrene sulfonate indication
hyperkalemia
sodium polystyrene sulfonate side effects
patients don’t like because it makes them poop
constipation, diarrhea, n/v
hypokalemia
intestinal obstruction/necrosis
sodium polystyrene sulfonate routes
oral suspension
oral/rectal
powder
rectal enema
sodium polystyrene sulfonate nursing considerations
only for patients with normal bowel function
D50/insulin moa
temporarily shifts K+ into the cell
D50/insulin indication
emergent hyperkalemia
D50/insulin nursing considerations
check blood sugar first and periodically after
D50/insulin normal formula
10 units regular insulin with 1 ampule D50
magnesium sulfate and magnesium oxide moa
replaces magnesium
magnesium sulfate and magnesium oxide indication
hypomag
prevents seizures in pre-eclampsia
treat cardiac rhythm disturbances
magnesium sulfate and magnesium oxide side effects
hyper mag
burns when given through iv
magnesium oxide
antacid
given for long term low magnesium
nystatin class
polyene
nystatin indications
superficial candida infection
in mouth, oral mucosa, vagina, skin
nystatin side effects
mild skin irritation
n/v/d when taken orally
poor gi absorption
nystatin routes
cream, powder, topical, vaginal, oral
too toxic for iv
amphotericin B class
polyene antifungal
amphotericin B moa
binds to ergosterol in fungal cell membranes
fungal cells leak
cell wall is destroyed
amphotericin B indications
systemic mycoses
amphotericin B infusion symptoms
fever, pain, nausea, headache
amphotericin B routes
po or iv
amphotericin B nursing considerations
high alert drug (dilute, diffuse slowly, monitor cre, bun, cardiac)
given every other day for several months
flucytosine class
pyrimidine
flucytosine moa
inhibits fungal DNA synthesis
flucytosine indication
lowers the necessary dose of amphotericin B
flucytosine nursing considerations
decreases side effects related to amphotericin B
fluconazole class
azoles
fluconazole moa
interrupts integrity of the cell wall
fluconazole indication
superficial and less serious systemic fungal infections
fluconazole advantages
rapidly absorbed orally
less toxic than amphotericin
fluconazole disadvantages
narrow spectrum
many drug interactions (cyp450)
fluconazole topical side effects
redness, burning, itching
fluconazole systemic side effects
severe gi upset (n/v/d), liver toxicity
fluconazole nursing considerations
2 hours apart from antacids
do not mix with other iv meds
griseofulvin moa
inhibits fungal mitosis
binds to keratin
(does NOT effect cell wall or membrane)
griseofulvin indications
resistant dermatophyte infection of the scalp, skin, or nails
griseofulvin side effects
bone marrow suppression, rash, cns changes, n/v/d, anorexia
filgrastim class
g-csf
filgrastim moa
promotes proliferation, differentiation, and activation of cells that make granulocytes
filgrastim indications
malignancies
chemo-induced leukopenia
bone marrow transplant
harvesting of hematopoietic stem cells
chronic neutropenia
filgrastim side effects
bone pain, leukocytosis
filgrastim route
iv or subq
pegfilgrastim moa
increase production of neutrophils
pegfilgrastim side effects
bone pain
pegfilgrastim nursing considerations
long acting derivative of filgrastim
pegfilgrastim route
subq
pegylated
delayed excretion by the kidneys
increases half-life by 1/2
