Pharmacology CMS Flashcards
nursing intervention to do when removing nitroglycerin ointment
remove prior dose before applying the new one
after measuring nitroglycerin ointment dose with the applicator paper, how many inch should you spread it over the paper
2.5-3.5 inches
What should you avoid doing when apply nitroglycerin ointment
avoid touching the ointment with your hands
Where should you apply the nitroglycerin ointment
clean, hairless area over the body, then cover w/ a clear plastic wrap
how do you administer enteric-coated medication
swallowed whole, NEVER CRUSH IT!
What is Rifampin for?
Antibiotic to treat TB given in combination with another antituberculosis med to help prevent antibiotic resistance
What are complications of Rifampin?
- Orange color of the urine, saliva, sweat, or tears
- Jaundice, fatigue, mild abdominal discomfort (anorexia)
How should you administer Rifampin?
1 hour before or 2 hours after meal with a full glass of water
Contraindications for Rifampin?
- Pregnancy/lactation
- Liver dysfunction
What should be monitored when taking Rifampin?
- Liver function
- PT/INR
Patient education when taking Rifampin?
- Avoid alcohol
- Monitor for anorexia, fatigue, and malaise
- When taken with food it decreases the absorption of the medication
What happens when Rifampin interacts with an HIV medication?
The HIV medication dose increases
How will you know Rifampin was effective?
- Clear breath sounds
- No night sweats
- Increased appetite, decreased temp
- 3 negative cultures for TB
How will you administer multiple medications through an enteral feeding tube
Administer each medication separately, do not mix the medications with enteral feeding
How to crush medications through an enteral feeding tube
Dissolve crushed medications in 15 to 30 ml of sterile water priority tp administration via enteral feeding tube
How to prevent clogging with an enteral feeding tube
Flush the tube before/after each medication with 15 to 30 ml of warm sterile water
What to do after administering ALL medications through enteral feeding tube
Flush with another 30 ml of warm sterile water
What is Enoxaparin
An anticoagulant, used to treat/prevent DVT and pulmonary embolism
What should you not do when drawing Enoxaparin in a syringe
Do not expel the air bubbles unless dose adjustment needs to be made
If Enoxaparin prefilled syringe is not available, what size gauge should you use to withdraw the medication?
20-22
After withdrawing Enoxaparin medication you should then change to what size needle to inject?
25-26, ½-⅝ long
Where should you administer Enoxaparin subcutaneously
In the abdomen, two inches from the umbilicus, do not aspirate and you should always rotate sites
What should be monitored when administering Enoxaparin subcutaneously
- Bleeding
- Bruising
- Abdominal pain
- Coffee ground emesis
- Tarry stool
What should be avoided when taking Enoxaparin
- NSAIDs
- Aspirin
- Anything containing salicylates
How to shave a patient taking Enoxaparin
Use an electric razor
What toothbrush should a patient taking Enoxaparin use
Soft-bristled toothbrush
What is levothyroxine used for
Hypothyroidism
What are complications of Levothyroxine
- Tachycardia, chest pain, nervousness, palpitations
- Anxiety, tremors
- Fever, diaphoresis, weight loss
- Abdominal cramping
What is a contraindication when taking Levothyroxine
Myocardial infarction
What reduces the absorption of Levothyroxine
Binding agents
What should be used cautiously when interacting with Levothyroxine
Catecholamines (neurotransmitter)
What increases the risk of hypoglycemia in a patient taking Glyburide
Concurrent use of insulin, glipizide, glimepiride with Glyburide
What can taking Glyburide cause
Hypoglycemia
How should you store nitroglycerin tablets
Original bottle, in a cool dark place
What is Fexofenadine for
Seasonal allergies such as rhinitis, motion sickness, anaphylaxis, insomnia
(blocks histamine)
What are side effects of Fexofenadine
- GI discomfort (constipation)
- Tachycardia
- Sedation, dry mouth
- Urinary retention, pupil dilation
What is a contraindication for Fexofenadine
Pregnancy
What are negative interactions with Fexofenadine
CNS depression, therefore avoid alcohol
What is a nursing intervention of fexofenadine
Be aware of sedating effects and instruct the patient to avoid driving
When should the patient take Fexofenadine
At night to decrease daytime side effects
How should a patient treat the negative side effect of dry mouth when taking Fexofenadine
Suck on sugarless candy
Patient education about fluids in a patient taking Fexofenadine
Take sips of water and maintain 2 to 3 liters of water a day
How will you know Fexofenadine was effective
- Relief of motion sickness (decreased nausea, vomiting)
- Improvement of allergic reaction (absence of urticaria, rhinitis)
What is Prednisone
A steroid
What is Prednisone for
- Prevents inflammation
- Reduction in airway mucosal edema
What can happen if prednisone is administer for more than 10 days
- Adrenal glands become suppressed
- Bone loss, infection
- Myopathy, peptic ulcer disease
- Hyperglycemia, glycosuria (reduced glucose in urine)
- Increased appetite, weight gain
How long is Prednisone used for
Short term use
What should be monitored when taking prednisone
Blood glucose, the dose should be tapered when weaning off of the medication
What should be administered with prednisone
Food such as an increase with calcium and vitamin D
What should the patient report if they experience when taking prednisone
- Muscle weakness
- They should perform weight-bearing exercises
What are S/S of aspirin toxicity
Tinnitus and hearing loss
What can increase the absorption of aspirin
Caffeine
When a patient is taking aspirin when will they be able to take an NSAID
2 hours after taking the aspirin
What is a contraindication of taking aspirin
- Feverfew
- Garlic, ginger, glucosamine
- Ginkgo biloba
- Saw Palmetto
THESE ALL INCREASE THE RISK OF BLEEDING W/ ASPIRIN
What can happen when taking a corticosteroid with Aspirin
- Increase aspirin excretion
- Decrease the aspirin’s effect
- Increase GI bleeding
What are complications when taking acetaminophen
- Liver damage
- Sweating, coma, death
- Abdominal discomfort (nausea, vomiting, diarrhea)
Contraindications when taking acetaminophen
- Liver, kidney impairment
- Chronic alcohol use disorder
- Malnutrition
What is the dose that should not be exceeded in a day when taking acetaminophen
- 4 grams
- 3 grams for malnourished patient
- 2 grams for alcohol use
What is diphenhydramine used for
Cough suppression, seasonal allergys
Contraindication when taking diphenhydramine
Lactation
How will you know that diphenhydramine was effective
- Improvement of allergic reaction (rhinitis, urticaria)
- Relief of cough nausea and vomiting
What to watch for when taking diphenhydramine
- Sedating effects
- Do not drink
(Same as fexofenadine)
Adverse effects of diuretics
- Dehydration
- Hypotension
- Hyponatremia (decreased sodium)
- Hypokalemia (decreased calcium)
- Hypochloremia (decreased chloride)
- Hypomagnesemia (decreased magnesium)
- Hyperglycemia (increased glucose)
- Hyperuricemia (increased uric acid)
- Increase LDL levels
- Hirsutism (excessive growth of dark hair)
- Ototoxicity
What is captopril
ACE inhibitor
What does captopril treat
- Hypertension
- HF, MI
Complications of captopril
- Hypotension
- Hyperkalemia
- Neutropenia
- Angioedema, rash, dysgeusia (altered taste)
- First dose orthostatic hypotension, cough
Contraindications for captopril
Pregnancy, lactation
What to monitor for when taking captopril
Blood pressure after first dose for 2 hours for hypotension
When should you take captopril with food
One hour before meals
When should the patient notify the provider when taking captopril
Development of cough, rash, dysgeusia
What should the patient do when taking captopril
Rise slowly when sitting
What activities should be avoided when a patient is taking captopril
Activities that require alertness until the effects of captopril are known
What medication is a contraindication for hypertension
-Decongestants such as phenylephrine,
Ephedrine
Naphazoline
Pseudoephedrine
-Antihistamines which end in -INE plus dimenhydrinate
What is Furosemide
Diuretic
What does furosemide treat
Fluid retention and swelling caused by heart failure, kidney/liver disease, hypertension
Contraindication for furosemide
- Pregnancy, lactation
- Auria (no urine output)
Complications of Furosemide
- Dehydration
- Hyponatremia, hypotension, hypokalemia, hypomagnesemia, hypocalcemia, hypochloremia
- Hyperglycemia, ototoxicity
What can occur if hypokalemia occurs in a patient taking Furosemide
Digoxin toxicity
When taking furosemide with lithium carbonate what can happen
Increased lithium carbonate
What happens when you take furosemide with an NSAID
Decreases blood flow to the kidney
When should you notify the provider and a patient taking Furosemide
Chest pain, calf pain, pelvic pain occurs
What should you monitor for in a patient taking Furosemide
Dehydration, lightheadedness, dizziness (postural hypotension)
What medication should be avoided in a patient taking Furosemide
Ototoxicity medication such as gentamicin
What should a patient notify the provider that has occurred when taking Furosemide
Tinnitus
What should a patient monitor when taking Furosemide
Blood glucose
What are signs of hypokalemia that should be reported in a patient taking Furosemide
- Nausea, vomiting, fatigue
- Leg cramps, weakness
How will you know furosemide has been effective
- Decrease in edema
- Decrease in blood pressure
- Weight loss
- Decreased calcium level
- Increase in urine output
