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XIO > Skills final - meds > Flashcards

Skills final - meds Flashcards

1
Q

metapropolol

A

beta blocker

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2
Q

metoprolol MOA

A

blocks stimulation of beta 1 (increases heart rate) and adrenergenic (proteins) receptors. Adrene binds to epinephrine and releases it from sympathetic nerve endings. does not usually affect beta 2. causes the heart to beat more slowly and with less force, which lowers blood pressure

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3
Q

metoprolol succinate: dose (100 at the meta)

A

Initially 100 mg, Effects of daily dose beyond 400 mg aren’t known.

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4
Q

Metoprolol succinate - adverse effects (withdrawals, fat, and depressed at the met)

A

bradycardia, pulmonary edema. CNS:fatigue,dizziness,depression,headache
CV:hypotension

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5
Q

Metoprolol succinate generic and trade name (the met is low depressor)

A

Metoprolol succinate - generic
Lopressor - Toprol XL - trade

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6
Q

Metoprolol - high alert or not?

A

high alert. if giving IV, have 2nd nurse check. Abrupt withdrawal may cause heart attack.

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7
Q

Metoprolol onset peak duration (no peak at the met)

A

15 min, peak unknown, 6-12 hours

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8
Q

Metoprolol teaching (met withdrawals and what do you do before you adminster it???)

A

same time every day, check pulse, may cause drowsiness, notify provider if taking any meds, or pregnant, and take with food. don’t stop abruptly. edema

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9
Q

Furosimide - action (furious about my sodium and choloride and my swelling)

A

slows sodium and chloride reabsorption in the loop of henley. Increases excretion of water and sodium, mag, potassium, ca, cl. for pulmonary edema. helps treat edema and swelling.

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10
Q

Furosimide - dose (furious at 20)

A

20 to 80 mg PO daily in the morning. up to 600 mg daily

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11
Q

Furosimide - adverse effects: (Furious about stevens johnson and anemia)

A

headache,dizziness, hypotension, Stevens-Johnson syndrome, anemia.

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12
Q

metroprolol hold

A

if systolic BP is less than 110 or apical is less than 60 bmp

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13
Q

furosemide generic and trade

A

furosemide generic
lasix trade

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14
Q

furosemide - use caution with what patients?

A

renal impairment, diabetes, hypotension, hearing loss, dehydration, hyponatremia, hypokalemia, aplastic anemia

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15
Q

furosemide O/P/D (my 30s were a furious 1, then I turned 68)

A

30 - 60 min, peak 1-2 hours, duration, 6-8 hrs.

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16
Q

furosemide teaching (furious about my weight gain and alcohol)

A

may cause ortho hypo, do not use alcohol, don’t exercise in hot weather, advise if weight gain more than 3 lbs in 1 day, OTC meds, pregnancy, muscle cramps

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17
Q

lisinopril trade name (Lisin, zesty princess)

A

Prinivil and Zestril

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18
Q

lisinopril MOA

A

treats high BP. ACE inhibitor. stops the conversion of angiotensin I to the vasoconstrictor substance, angiotensin II. Angiotensin II also stimulates aldosterone secretion by the adrenal cortex. Lowers BP.

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19
Q

lisinopril adverse affects (kalema loves to lisin to angie)

A

hypotension, rash, hyperkalemia, angioendema

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20
Q

lisinopril dose (listen I’ll be there at 10:40)

A

10 mg a day, up to 20 - 40 mg

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21
Q

lisinopril O/P/D (listen to KROQ from 16 - 24)

A

1 hr, 6 hr, 24 hrs.

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22
Q

lisinopril patient teaching (lisin I’ll teach you about no salt)

A

take at same time every day, do not disconitue, avoid salt subistiues containing potassium or sodicum. chang poisition slowly to avoid hypotension. advise dr. of any OTC. notify dr of rash, sore throat, chest pain. quit smoking.

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23
Q

lispro (a rapid lisp is l for log, but you must eat afterwards) and food when?

A

humalog - rapid. must eat meal afterwards

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24
Q

aspart (a spartan is rapid novel log)

A

novolog (brand name) - rapid.

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25
Q

glulisine (glide into rapid apid)

A

apidra - rapid

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26
Q

rapid acting - how adminstered?

A

SC or continous SC pump - NOT IV

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27
Q

regular insulin (to be short and regular is humalin) And how administered? (check the human part)

A

humalin - short-acting. ONLY ONE that can be given IV bolus, IV infusion, or IM.

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28
Q

short-acting - how fast?

A

onset 30 to 60 min

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29
Q

rapid-acting - how fast?

A

5 -15 min

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30
Q

isophane (NPH) and clear or cloudy? (NPR is boring and intermediate)

A

neutral protamine hagedorn - intermediate acting. CLOUDY.

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31
Q

glargine (gargle clear lantus for a long time) and clear or cloudy?

A

lantus - long-acting. clear. referred to as basal insulin. 2 hrs/24

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32
Q

determir (mir and levimir are long and clear)

A

levemir - long-acting. clear. referred to basal insulin. 2/24

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33
Q

insulin pt teaching

A

have meals ready, Avoid spots w/scar tissue, moles, swelling, divide into 4 quadrants, can turn into fat deposits, be aware of signs and symptoms of hypoglycemia and hyperglycemia, proper storage - refrigerate, needle disposal, roll intermediate insulin between hands, no cure for diabetes,

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34
Q

NPH clear or cloudy?

A

cloudy

35
Q

insulin high alert

A

need 2nd nurse

36
Q

insulin MOA

A

stimuates glucose uptake in skeletal muscle and fat. inhibits glucose production in liver. enhances protein synthesis.

37
Q

aspart dose

A

.5 - 1 units/kg/day

38
Q

reasons for a foley

A

surgery involving abdomen, pelvis, bladder after child birth
enlarged prostate in men
neurogenic bladder
critically ill pts
Assist in healing open sacral/ perineal wound in incontinent pts
Provide improved comfort for end-of-life care
Prolonged patient immobilization
cancer

39
Q

braden scale (SNMAMF)

A

sensory perception
nutrition
mobility
activity
moisture
friction and shear

40
Q

teaching for diabetes

A

signs of hypo and hyper.
carry glucose with you.
medical alert bracelet.
lifestyle - exercise and diet.
foot care.
use of glucose monitor.
techniques for injection and rotation of sites.

41
Q

SBAR

A

Background: Vital signs, mental and code status, list of medications, and lab results

I - intro - Amanda, nursing student
S - calling about ellen scheduled for surgery. She’s having doubts.
B - admitted yesterday, positive for cancer. history.
A - more than just gitters
R - should I hold the pre-op?
R - I understand you want me to hold the pre-op meds.

42
Q

what is furosemide for?

A

diruetic. used to treat high BP and edema.

43
Q

what is metroprolol used for?

A

beta blocker - high PB.

44
Q

what is lisinipril used for?

A

ace inhibitor. high PB.

45
Q

sterile dressing change - important to check (think big wound)

A

need pain meds before you do dressing change. ambulate, position, check if patient has been to bathroom at least every hour. if it’s not w ritten as sterile change, no need for sterile gloves. Braden if they are a pressure risk

46
Q

equipment for NG tube

A

tube, connector - clear, pen light, tongue depressor, tape, water, basin, pad, tissues, lubricant, measure suction thing, ph test kit.

47
Q

with NG tube, don’t forget to

A

check gag reflex and measure tube!!!

48
Q

steps to set up pump (prime, feed, flush)

A
  1. prime pump (top button) - goes to next screen and choose “hold to prime flush” also press “hold to prime feed” (button below that one. Hold tube over basin here, it’s when water will come out. Press done.
  2. adjust feed - 2nd button on homepage
  3. feed rate (top button) - enter feed rate “200” then enter (top button)
  4. feed VTBD (volume in bag) (2nd button on home page) - enter “1000” enter. done.
  5. adjust flush (3rd button down on home page)
  6. flush volume - “100” enter
  7. flush interval “every 2 hours” enter
  8. then run, and you’re done
49
Q

set up for foley

A

2 kits, trash by bedside

50
Q

ALWays do what with dressing change?

A

intitals on dressing after change

51
Q

heparin MOA

A

binds to antithrombin and makes it active. AT then binds to factor 10 (X), which stops thrombin from converting to prothrombin. Prothrombin creates blot clots.

52
Q

insulin check what before you administer?

A

check blood sugar

53
Q

furosimide is

A

potassium wasting

54
Q

COPD sounds

A

crackles

55
Q

heparin SQ O/P/D (hep was best between 20 and 28)

A

20 - 60 min, 2 hr, 8 - 12 hrs.

56
Q

what to do before heparin? and how soon? (heman on heparin)

A

monitor hematocrit also! draw PTT 30 min before each dose and then periodically during treatment, every 2 - 3 days. may cause hyperkalemia

57
Q

heparin teaching (and what else - think meds)

A

report unusual bleeding, use electric razor, soft toothbrush, do not take NSAIDS. notify if pregnant.

58
Q

heparin high alert - need another nurse to check

A

before adminstering

59
Q

heparin used to treat

A

pulmonary emboli and venous thromboembolism. use caution with liver or kidney impairment.

60
Q

heparin dose

A

5000 units/kg

61
Q

heparin generic and trade (heparin moon)

A

heparine (porcine) = generic
trade = Monoject Flush Syr/Hep Lock

62
Q

Bronchial or Tubular sounds (blowing then whisper)

A

Blowing, hollow sounds. Sound on expiration is longer and lower on expiration

63
Q

Bronchovesicular (combo is medium)

A

Medium-pitched. Inspiration and expiration sounds have similar pitch

64
Q

Vesicular (a blowing whisper)

A

soft, whispering sound. Sound on inspiration is longer

65
Q

diabetes numbers

A

over 126 or 6.5

66
Q

metoprolol antidote

A

glucagon or charcol

67
Q

reasons to take furosemide (keep it simple)

A

heart failure, hypertension, and renal disease

68
Q

heparin adverse effect

A

thromocytopenia (low plaletes), bleeding gums, nose, tarry stools, anemia

69
Q

furosimide treats what?

A

pulmonary edema

70
Q

what treats hypertension?

A

lisinipril and metoprolol

71
Q

lisinipril treats what? So monitor for what? what is the main thing you keep forgetting? Then monitor for what?

A

heart failure - monitor weight for fluid overload, crackles, dyspnea.

72
Q

when to eat after insulin?

A

rapid - within 15 min
short - within 30 min
intermediate - with 30 - 60 min

73
Q

rapid acting insulin o/p/d

A

5 - 15, 1-2, 4-6

74
Q

short acting insulin o/p/d (short at 24 and 68)

A

30 - 60, 2-4, 6-8

75
Q

intermediate acting insulin o/p/d (the middle child is 12, adult is 46, and then 12 again)

A

1-2, 4-6, more than 12 hr.

76
Q

long acting insulin o/d

A

2 hours, 24 hrs.

77
Q

S3 and S4 (my heart fails at 3, and it’s stiff at 4)

A

s3 heart failure
s4 - stenosis

78
Q

abnormal cardiac assessment (the rush is abnormal)

A

abnormal - thrills - rushing vibrations

79
Q

crackles

A

popping - pneumonia

80
Q

course

A

bubbles - HF

81
Q

rhonchi

A

snoring, copd

82
Q

stridor

A

high - obstruction

83
Q

furosmide monitor

A

HR and BP before adminstering

XIO (372 decks)

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