Student topics Flashcards
Antiemetics - Ondansetron - indication and common ADR?
Nausea rt chemo, post op n+v. ADR = constipation
Antiemetics - Cyclizine - indication and common ADR?
indic for motion sickness - causes drowsiness. ADR - addictive effects w alcohol
Antiemetics - metoclopramide - indication and common ADR?
indic short term use. relieves heartburn symptoms w reflux. good w diabetes. ADR - drowsiness
Non pharm management options?
Diet, Exercise, Reg check ups with GP, stress management, smoking cessation managing alcohol intake
x4 L’s with alcohol?
- Liver - causes inflammation (hepatitis) worse if co morbid e.g. hep c. causes scarring and cirrhosis
- Lover - domestic disputes
- Livelihood - poor performance @ work. CNS changes e.g. dementia. depression and anxiety, alcohol affects serotonin binding
- Law
Tips to reduce alcohol harm
0% alts e.g. sodas, 0% beers
Plan drinking time and alcohol free days ea week
Between alcohol drinks drink water or have food
Involve friends and family
Keep accountable - diary
Prepare plan for relapse
Socialise in low/no alc enviros
Why use spacers with inhalers
Reduce side effects and inhaled meds 50% more effective
SABA’s action
bronchodilation for asthma
SSRI’s examples and biggest ADR
fluoxetine, sertraline, citalopram
seritonin syndrome - tremors, shivers, swets, tachy, HTN.
Morphine (A CNS DEPRESSANT) - what obs and type of monitoring are you doing and what ADR’s it can cause
Obs - sedation, pain, and RR. AVPU.
Monitoring - stay by bedside 5 mins after admin. obs recorded at 5 mins then 15 mins
Can cause RR depression, HR less than 50bpm and hypotension
Pt education for morphine paitents
Avoid alcohol and other CNS depressant
No OTC drugs unless approved by physician
Caution with driving
Do NOT breastfeed
Smoking cessation - NRT advice
Gum and patches come in different strengths to suit you, roughly takes 8-12 weeks to ween off dependence, patches deliver background nicotine. NRT is subsidised
VTE - Venous thromboembolism, DVT. Who is at risk for this? Common medication used (remember injection from A5)
Clexane.
Not moving for long time. Post op. Pregnancy. Cancer. Smoking. Birth control pills
Clexane inidcations
Post op - DVT prevention
Tx of pulmonary emboism
Tx of unstable angina and NSTEMI
Risk factors for VTE
Age Immobility/Inactivity Obesity Family hx of clotting disorders Trauma Previous DVT/VTE
Risk factors for CVD
Unhealthy diet Limited exercise Obesity Diabetes Snoking Alcoho Stress Genetics / Maori or PI
GTN. Angina action plan?
- Tell someone how ur feeling. Take 1 puff of GTN spray or 1 tab under tongue
- After 5 mins, take 1 puff of GTN spray, after another 5 mins repeat if symptoms aren’t relieved
- If not relieved call 111 for ambo. chew an aspirin unless advised not to
How long for GTN to take effect?
20-30mins
Action of GTN
Increases blood flow to heart. Heart is working less hard therefore decreased chest pain
Stress lowering techniques
Deep breathing - reduces anxiety ctivates PNS Exercise Sozialise Go into nature Sleep hygiene - low stimuli
GCS - what is it and the categories
6 - motor response
5 - verbal response
4 - eye response
Test to ax brain injury and LOC
Metoprolol what is it what does it do
beta blockers
heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart.
Differnce between RHF and LHF and treatments
LHF - systemic issue, left ventricle fails. blood builds up in pulmonary system causing Pulmonary congestion and oedema - inc RR, SOB
HTN
RHF - dysfunction of right heart structures mainly the right ventricle - oedema, SOB, fatigue
treatmets incl diuretics to remove fluid overload & ace inhibitors to dilate blood vessels
mechanism of GTN? and common side effects
increase blood flow to heart, heart works less and less chest pain
side effects
n+v, ankle oedema, tachy, HTN - due to vasodilation
Adrenaline - how much to administer, what does the person look like in an allergic reaction
0.5mg IM
puffy eyes rash itching SOB anxiety stridor
Nursing considerations on morphine?
ABPU, sedation Sp02, PR above 50, systolic above 100mmhg. vitals at 5 mins then 15 mins for first hour
which diabetics use insulin?
T1DM
For wound dressings - provide examples of dressings
Foams - diabetic/pressure/venous ulcers, is comfortable and absorbent and less frequent changes
transparent - take away and add moisture, easy to see through, allows ventilation
hydrogels - for pressure injuries - replaces and adds moisture
S1 and S2 sounds are?
The first heart sound (S1) representsclosure of the atrioventricular (mitral and tricuspid) valves
The second heart sound (S2) representsclosure of the semilunar (aortic and pulmonary) valves
where is the dorsal pedal pulse?
top of foot
where is the posterior tibial pulse?
INSIDE OF ANKLE at the back of ball
what two assessments would u use for wounds
TIME and CDHB wound ax tool
TIME wound ax stands for
tissue
infection
moisture
edges
pressure injury stages?
1 - erythema
2 - partial thickness skin loss
3 - full thickness skin loss
4 - full thickness tissue loss
stages of wound healing plus explain
- haemostasis - start of clotting
- inflammatory response - vasodilation and WBC arrive to clean debris
- periphelation - start of fibrin mesh
4 - maturation - collagen fills space, scar tissue forms
slough, looks like puss, whats important to do when wound dressing
remove the slough prior to redressing
clinical manifestations in anaphylaxis - what is the response in skin neuro cgastro resp cardiac
skin - vasodilation sweating hives rash
resp - bronchoconstriction, cyanosis, weezing, stridor
xcardiac - peripheral vasodilation(inflammatory), tachy(high pr)and hypoxaemia
gastro - n+v, loose bowels
neuro - visual changes, dec LOC, confusion, seizures, anxiety,
apart from adrenaline whats another way to manage anaphyhlaxis
give saline to increase bp
02 to compensate for hypoxaemia
reduce anxiety, breathing exercises
stop any procedure/exposure to allergen to limit the response
antihistamines - help releive allergy symptoms
what is preclampsia and what are signs and symptoms
pregnancy complication characterized by high blood pressure and signs of damage to another organ system, most often the liver and kidneys
weight gain, HTN, oedema
ectopic pregnancy - signs of this what is it and nursing management
when a pregnancy forms outside of the uterus, vaginal bleeding an pelvic pain.
monitor n+v, bleeding measuring, fluids, anxiety, pre o testing knowing what her blood type is incase of neecing blood transfusion
breastfeeding complications - mastitis what is this
inflammation and swelling of breast tissue rt infection
breastfeeding complications - how would you provide pt ed
wear comfortable fitted bras
empty out milk fully when breastfeeding
apply cool compresses or ice packs to breasts after feeding
normal temp range
36.1-37.2
patho of anaphylaxis
antigen binds to antibodies on mast cells and basophils causing systemic release of inflammatory mediators which cause the anaphylactic response
what are the associated factors
family hx medical hx past surgeries, traumas alcohol drugs OTC exercise diet ALLERGIES smoking/vaping occupation habits/sleeping/bowels/ stress relieving activities
describe auscultory areas for cardiac
Aortic area 2nd ICS on R side of pt
Pulmonic area 2nd ICS on L side of pt
BOTH CLOSE TO STERNUM
tricuspid area 5th ICS close to sternum on R of pt
mitral area is where apical is.
pre-elampsia risk factors - there is no cause for preclampsia its still being explored
\what are the 3 essentials for diagnosis of preclampsia
risk factors
obesity, diabetes, family hx of preclampsia, htn, over 35 and first pregnancy
diagnosis
proteinuria
high BP
oedema
what are the tx options for preclampsia
rest
hospitalisation fo ronitoring of bp etc
delivery of baby
medication eg aspirin - decreased risk of symptoms and abruption of placenta
patho of breastfeeding
prolactin reflex promotes milk production, assisted by nerve impulses from sucking
oxytocin reflex promotes milk ejection, also known as let down reflex
why is breastfeeding promoted by WHO
effective in child health and survival, contains antibodies which protects child from common childhood illnesses
difference between mastitis and breast abcess
mastitis is inflammation of breast tissue mainly in milk ducts in breastfeeding women
abcess is a painful build up of pus in the breast caused by infection - hard red fluid mass on breast
predisposing factors of mastitis
smoking, hx of mastitis, not appropriate fitting bras, sore or cracked nipples
recommendation for women with mastitis
wear loss clothes and well fitted bras
feed from infected breast first as baby will suck more vigorously
see gp if any lumps
four stages of emergency delivery
one - onset of contractions
two - full dilation delivery of fetus
3 - expulsion of placenta and membrane
4 - post delivery 48 hrs
DVT patho
a blood clot forms in the deep vein which partially or fully blocks the vein, blocking blood flow to the heart
