Vitamins, Minerals, and Supplements

Question 1

What is the therapeutic action of Iron preparations?

Answer 1

promote RBC development and to treat iron deficiency anemia, often used in pregnancy for anemia

Question 2

What are some adverse effects of iron preparations and some nursing considerations for them?

Answer 2

GI (constipation, nausea) - try to take on an empty stomach 1 hour before meals (taking on empty stomach can cause nausea), but can be taken with food if needed at regular intervals, fluids and fiber

Teeth staining - sip through a straw to avoid contact with teeth, dilute liquid preparation in water or juice

tissue staining - administer using the Z-track technique, inject deep IM

Stool color changes - harmless (blackish green)

Question 3

What is the therapeutic outcome of iron preparations?

Answer 3

increased hemoglobin of 2 g/dl 1 month after beginning therapy, BUT THERAPY MAY LAST A FEW MONTHS

nomal: 12-15 women and 13-17 men

Question 4

What is the therapeutic outcome of vitamin B12 (cyancocobalamin)?

Answer 4

necessary to convert folic acid from inactive form to active form, B12andfolic acid are crucial in preventing megaloblastic anemia.

Question 5

What is an adverse effect of vitamin B12 supplements and some nursing considerations for it?

Answer 5

hypokalemia - monitor potassium levels and report, may need potassium supplements

Question 6

Should a vitamin B12 deficiency be treated with folic acid alone? Why?

Answer 6

NO NO NO

may lead to neurological damage because vitamin B12 deficiency can cause neuro damage

If B12 is part of the reason for megaloblastic and it is only treated with folic acid, the vitamin B12 levels will not rise and neurological damage will continue

Question 7

What labs should be monitored while taking vitamin B12 supplements?

Answer 7

Vit B12

H&H

folate levels (folic acid)

RBC

reticulocyte count (premature RBCs)

Question 8

How can cyancocobalamin (vitamin B12) be administered?

Answer 8

Itranasally, oral, IM, SQ

Question 9

What are some signs of vitamin B12 deficiency?

Answer 9

beefy red tongue, pallor, neuropathy

Question 10

What are some things to remember about administering potassium IV?

Answer 10

never give undiluted

administer on a pump

give slowly at 10 meq/hr

perform cardiac monitoring

assess IV site for inflammation, phelbitis, infiltration, pain

monitor for hyperkalemia

Question 11

What are some things to remember about administering potassium supplements PO?

Answer 11

mix powder in 4oz of liquid

take with full glass of water

do not crush extended release pills

If patient cant swallow pill consider using powder or sustained release forms

Question 12

`What is the normal range of magnesium?

Answer 12

1.3-2.1

Question 13

When is magnesium particularly used?

Answer 13

pre-term labor to stop contractions

code situations for particular dysrhythmias

Question 14

What are some things to look out for when giving magnesium supplements?

Answer 14

Hypermagnesemic effects - muscle weakness, flaccid paralysis, painful muscle contractions, cardiac disorders, respiratory depression, absent or diminished DTRs

Question 15

What is important to monitor during IV replacement of magnesium?

Answer 15

cardiac and neuromuscular status

Question 16

What is the antidote for magnesium toxicity?

Answer 16

calcium gluconate

ALWAYS HAVE INJECTABLE SOLUTION OF THIS READY WHEN GIVING MAGNESIUM SULFATE IV

Question 17

What does Echinacea do? What medications can this herb decrease the effectiveness of?

Answer 17

enhances immune system: can decrease effects of HIV, TB, or cancer medications

Question 18

What does Garlic do?

Answer 18

anticoagulant, reduces BP, reduces cholesterol

Question 19

What can garlic, Glucosamine, Gingko Biloba, and Saw Palmetto do to people taking anticoagulants/NSAIDS?

Answer 19

increase bleeding potential

Question 20

When taking oral hypoglycemic agents/insulin, how can garlic effect these?

Answer 20

can increase hypoglycemic effect

Question 21

What does Saw Palmetto do?

Answer 21

decreases prostate symptoms of hyperplasia, can decrease PSA (prostate-specific antigen) results (BAD FOR DETECTION OF PROSTATE CANCER)

Question 22

What pregnancy category is Saw Palmetto?

Answer 22

X (most womendont take this anyways)

Question 23

What does St. Johns Wort do?

Answer 23

increases serotonin to reduce depression

Question 24

What does st. johns wort increase the risk of?

Answer 24

serotonin syndrome in people taking SSRIs, MAOIs, and TCAs.

ALSO CAN DECREASE THE EFFECTIVENESS OF MANY OTHER MEDICATIONS

Question 25

What does glucosamine do?

Answer 25

stimulates cells to make cartilage and synovial fluid, good for joints!

Question 26

What does Gingko Biloba do?

Answer 26

improves memory, circulation, and decreases platelet aggregation