Nursing Implications for Medications Flashcards
1
Q
Statin
A
- Avoid with liver disease (alcohol), myopathy (check labs), hepatitis; peripheral neuropathy
- Caution with elderly, debilitated, CRF
- Interactions: grapefruit juice <1 qt. daily
2
Q
Surfactant Laxatives
A
- Avoid with obstruction, impaction or acute surgical abdominal (perforation); ulcerative colitis and diverticulitis
- Increase fiber in diet, and exercise
3
Q
NSAIDS
A
- Contraindications: Pregnancy; PUD; bleeding disorders; hypersensitivity
- Cautious use
4
Q
Beta Blocker
A
-Adjust to position changes
-Do not crush
-Pulse >60 bpm; check bp; can mask tachycardia
-Cautious use with heart failure (SOB, edema, fatique)
- Baseline ECG; D/C over 1-2 wks; NOT with asthma; Diabetes (inhibits glycogenolysis needed for low BG)
- Check glucose
Routes: PO, or IV
5
Q
Antidiabetic (biguanide drug): Metformin (Glucophage)
A
- Give 2x daily or 1x with SR
- Check SE severity
- Lactic acid risks w/ alcohol
- Avoid with iodine contrast media (acute renal failure)
- Check glucose
6
Q
Antibiotic: Penicillin G
A
- Prior allergies (monitor 1st 30 mins IM/IV PCN;
- Check creatinine, cardiac and electrolytes, esp. K+
- Check client report (rash, itching, hives)
- IM - avoid nerve or artery
7
Q
Antiparkison
A
- Give with food and small doses 1st
- Dec. dose if dyskinesias
- Check BP, inform clients of potential drop getting up (lightheadedness, dizziness) & notify MD for cardiac effects
- Antipsychotic meds as prescribed
- Diagnosis of skin lesions
- Not within two weeks of MAOI use
- Lower doses w/ carbidopa (dec. SE of levodopa)
8
Q
Short acting insulin drug
A
- Watch for S/S low glucose: give 15 g CHO if conscious; parenteral glucose IV, SC/IM glucagon
- Rotate injection sites
- Show patients how to monitor and plan for sick days; diet and exercise
- Routes: SC, IV, Continuous SC
- Use insulin syringes
- Storage of Insulin
9
Q
Bronchodilator
A
- Advise clients to notify provider if these occur: chest, jaw, or arm pain or palpitations
- Check pulse- report if increase of pulse of 20-30 bpm
- Avoid caffeine
- Tremors usually resolve w/ continued med use
10
Q
Loop Diuretic
A
- Check for dehydration: thirst, dry mouth, UO, 1-2 lbs weight loss in 24 hours
- Check electrolytes
- Tinnitus
- Thrombosis/embolis: headache, chest, calf or pelvic pain
- Routes: oral, IV, IM
11
Q
Calcium Channel Blockers
A
- Check HR hold if <60 bpm
- Check swelling in legs and notify provider
- Check BP and HR
- Equipment for cardioversion and pacer
- Avoid with heart block, hypotension, HR ,60 , arortic stenosis, or severe heart failure
12
Q
Digitalis Glycosides
A
- Check HR hold if ,60 bpm
- Check potassium: dec K+; NV, abdominal pain
- Vision changes: diplopia, blurred vision, yellow-green or white halos around objects
- Avoid: ventricular tachycardia, fibrilation; heart block
13
Q
Parenteral Anticoagulants
A
- Observe S/S of bleeding ( inc. HR, dec. BP, bruising, petechiae, hematomas, black tarry stools)- Protamine sulfate slowly
- Avoid aspirin
- Dec. platelets <100,000
- Avoid during or after some surgeries; hemophilia , dissecting aneurysm, PUD, severe HTN, renal or liver disease, threatened abortion
- Route: SC/IV ; check dose/rate!!!
14
Q
Antiemetic Serotonin Antagonist : Zofran
A
- For headaches, give non-opoid anaglesics
- Monitor stool pattern for constipation
15
Q
Cephalosporins
A
- Stop if sx of allergy- urticaria, rash, dec BP, dyspnea
- Check history
- Bleeding (NOT if on anticoagulants, observe for bleeding)
- Rotate injection sites; diluted intermittent infusion; IM in deep large muscles
- Diarrhea- stop and tell MD/provider
16
Q
Thiazide Diuretics
A
- S/S dehydration: dry mouth, thrist, minimal UO, weight loss
- Check potassium levels
17
Q
Oral anticoagulant
A
- S/S of bleeding (inc, HR, dec BP, bruising, tiny red spots on skin, hematomas, black or tarry stools)
- Check liver enzymes/jaundice
- Give Vit K if toxicity (if IV- give slowly & diluted; prefer other routes)
- Avoid: w/ dec platelets; after some surgeries; dec vitamin K or liver or alcoholism; PUD; severe hypertension; hemophilia
18
Q
Corticosteriods
A
- Take calcium supplements and Vit D
- Increase dose with stress
- Lower dose slowly
- Check GI symptoms of bleeding (coffee ground emesis, bloody or tarry stools, abdominal pain- notify provider)
- Avoid exposure to communicable diseases (check for fever)
- Route: Oral , IV
19
Q
Intermediate Antidiabetic Drug
A
- Check dec. glucose: give 15 g. CHO if conscious
- Rapid: inc HR, palpitations, sweating, shakiness
- Slow: headache, tremors, weakness
- Injectable dose (IV, SC/IM) Glucagon rotate injection sites
- Teach how: monitor and plan for sick days; diet and exercise; storage of insulin
- Routes: intermediate given SC only; use insulin syringes
20
Q
Aminoglycosides
A
- Check hearing loss: tinnitus- ringing in ears, headache, N, dizziness, vertigo
- inc. BUN and creatinine ; dec output
- Monitor w/ myasthenia gravis, use of skeletal m. relaxants, general anesthesia
- Other: allergic symptoms; tingling/numbness, vision
21
Q
Antivirals
A
- Rotate IV sites; check sites for swelling, tenderness, warmth, redness
- infuse slowly over 1 hr
- Assure enough hydration during & 2 hrs after infusion (protect kidneys)
- Oral- Check symptoms and notify MD
- CBC and platelets
- Cautious: kidney impairment; topical (wear rubber gloves); symptomatic treatment
- Refrain from sexual contact while lesions present
22
Q
Antidepressant
A
- Initial weight/ BMI
- CV: BP and pulse rate & rhythm; check EKG
- Mental status: orientation, mood, behavior, suicidal thoughts
- Check sexual dysfunction
- Fall safety; labs
23
Q
Long Acting Insulins
A
- Route: SC (NOT IV)
- Check for dec. glucose (Rapid: inc, HR, palpitations, sweating, shakiness; Gradual: HA, tremors, weakness)
- For dec. glucose, give 15 g CHO only Med alert
- Rotate SC; how to check BS; diet and activity
- Clear do not mix
- Insulin syringes only; storage
24
Q
Sulfonylureas: glyburide (Micronase)
A
- Check glucose
- check for sulfa allergy
- Watch if on beta blockers
- Avoid if non- diabetic or other need for insulin: infections, stress, fever, trauma, etc.
25
Q
Antiemetic: Phenergan
A
- Share SE with clients & report to provider
- Check BP, avoid with activities that require alertness (ex: driving)
- Increase fluids and physical activity
- Suck on hard candy or chew gum for dry mouth
- Treat constipation or take preventive (stimulant laxative or softener)
26
Q
ARBS
A
- For angioedema: skin wheals, swelling of tongue- call provider and D/C
- Treat severe effects with SC epinephrine
- Avoid in 2/3 trimesters
- Avoid if renal stenosis in kidneys; cautious if angioedema w/ ACE inhibitor
27
Q
Opiods
A
- RR <12/min
- Routes (oral, SC, IM, rectal, IV, epidural, and intrahecal)
- CNS depression (alertness); safety from falls; check driving or other hazards
- Voiding (retention)
- Hx biliary colic
- Be prepared w/ antagonist (naloxone)
- Check dose w/2nd RN
- IV rate slowly 4-5 min; check accuracy of PCA
28
Q
Nitrates
A
- Treat headache ( aspirin or acetaminophen)_ notify provider as needed
- sit or lie down if dizzy or faint; change positions slowly
- Check heart rate may need a beta blocker
- If given daily- need free period w/long acting form ( about 8 hours)
- Use lowest effective dose
29
Q
ACE inhibitor
A
- Low BP - stop diuretic 2-3 days before ACE inhibitor
- 1st dose; check bp for 2 hr w/1st dose; change positions slowly
- Cough - D/C and call provider
- K + >5 mEq
- Angioedema - D/C (epinephrine if severe)
- Check WBC and fever, sore throat- D/C
30
Q
Corticosteriods (Inhalation):
A
- Use spacer with multi- dose inhaler; rinse mouth or gargle w/ water after use
- Report s/s candidasis: oral redness, sores, white patches
- Avoid: after live virus vaccine; systemic fungal infections
- Avoid w/: Diabetes, HTN; PUD, kidney disorder
- Cautious w/ NSAIDS
