NCLEX RN ATI REVIEW.

Nonpurging

Compensate for binge eating through other means, such as excessive exercise

Nursing interventions protective isolation

Follow STANDARD PRECAUTIONS Institute MAXIMUM protection, which may include the use of STERILE LINENS, FOOD, and other SUPPLIES MINIMIZE EXPOSURE to microorganisms found on the outer layers of FRESH FLOWERS, FRUITS, and VEGETABLES Wear sterile GLOVES and GOWN/MASK when in contact with client MAXIMUM protection will require ventilated/positive pressure room

Side/Adverse Effects of Insulin

Hypo/Hyperglycemia Lipodystrophy

Trousseau and Chvostek's signs observed in

Hypocalcemia

Adverse Reaction to Furosemide (Lasix)

Hypokalemia

Bipolar II

Hypomanic episodes associated with euphoria alternate with major depression with higher risk of suicide. Psychosis is not present

Side/Adverse Effects for Posterior Pituitary Hormones/Antidiuretic Hormones

Hyponatremia Seizures Coma

Side/Adverse Effects of Nifedipine

Hypotension Fatigue Nausea Flushing Uteroplacental perfusion complication

shock

Hypotension, tachypnea, tachycardia

Behavior of Industry vs Inferiority Stage

Feeling competent in activities and work vs feelings of low self-esteem

Symptoms Rape Trauma syndrome

Feelings of numbness Disbelief Fear Denial Flashbacks Emotional lability

Thyroid storm

HOT (hyperthermia)

Apgar measures

HR RR Muscle tone, reflexes, skin color. Each 0-2 points. 8-10 ok, 0-3 resuscitate

Perceptual Disturbances in Mental Status Examination

Hallucinations Delusions

CRE nursing considerations

Hand hygiene Contact precautions

Clostridium difficile nursing considerations

Hand hygiene PPE (enteric precautions) if in contact with potentially contaminated materials Only soap and water

Therapeutic Use for Verapamil and Diltiazem

May be used for atrial fibrillation, atrial flutter, or supraventricular tachycardia

Therapeutic Uses for Guanfacine (Intuniv)

May be used in the treatment of Asperger's syndrome

Side/Adverse Effects for Tamsulosin

May cause decreased libido Reduced ejaculate

List of Thiazide Diuretics

Hydrochlorothiazide Chlorothiazide

Two-point gait

Move left crutch and right foot forward together Move right crutch and left foot forward ahead together

Four-point alternating gait

Move right crutch forward Move left foot forward Move left crutch forward move right foot forward

Action of Antiemetics

Multiple classification of medications that affect the GI tract or the "vomiting center" of the brain to reduce nausea/vomiting

Treatment for chronic respiratory disorders often includes:

Multiple drug therapies when administered as inhalation therapies.

Treatment of Lumen Occlusion with Central Venous Catheters

Use 10 mL syringe with a pulsing motion

Liver biopsy

administer Vitamin K, NPO morning of exam 6 hrs. Give sedative. Teach pt to expect to be asked to hold breath for 5-10 sec. supide position, lateral with upper arms elevated. Post--position on RIGHT side. frequent VS. report severe ab pain STAT. no heavy lifting 1 wk

MMR and varicella immunizaions

after 15 months!

PVC's

can turn into V fib.

CVA

cerebriovascular accident. brain tissue dies.

After endoscopy

check gag reflex

DKA

kussmal's breathing (deep rapid)

Ibandronate is administered:

monthly or every 3 months

Cushing's

moon face, buffalo hump

bowel obstruction

more important to maintain fluid balance than to establish a normal bowel pattern (they cant take in oral fluids)

multiple sclerosis

motor s/s limb weakness, paralysis, slow speech. sensory s/s numbness, tingling, tinnitis cerebral s/s nystagmus, atazia, dysphagia, dysarthia

Liver biopsy (prior)

must have lab results for prothrombin time

post spelectomy

pneumovax 23 is administered to prevent pneumococcal sepsis

DM

polyuria, polydipsia,polyphagia

Cleft Lip

position on back or in infant seat to prevent trauma to the suture line. while feeding hold in upright position.

Cushings ulcers

r/t brain injury

cholera

rice watery stool

Six rights of medication administration

right client right drug right dose right route right time right documentation

typhoid

rose spots on the abdomen

pneumonia

rusty sputum

five interventions for psych patients

safety setting limits establish trusting relationship meds least restrictive methods/environment

cystic fibrosis

salty skin

dunlap traction

skeletal or skin

Myxedema/ hypothyroidism

slowed physical and mental function, sensitivity to cold, dry skin and hair.

Considerations for use of Etonogestrel, ethinyl estradiol vaginal ring (Nuvaring)

Placed deep into the vagina once every 3 weeks

Herpes zoster nursing considerations

Persons who have not had chickenpox or the vaccine should not provide care

Monoamine Oxidase Inhibitors (MAOIs)

Phenelzine Tranylypromine

Precautions/Interactions for Montelukast

Phenobarbital will decrease circulating levels

Antidote/Reversal Agent for Warfarin

Phytonadione (Vitamin K)

Purging

Self-induced vomiting, laxatives, diuretics, and enemas to lose or maintain weight

Behavior of Integrity vs Despair Stage

Sense of accomplishment in life vs feeling dissatisfied with life

Action/Therapeutic Uses for pheresed granulocytes

Severe neutropenia Neonatal sepsis Neutrophil dysfunction

VRE reservoir

Stool body sites from which VRE is isolated

Rh mothers receive Rhogam

to protect next baby

gtt per min

total volume x gtt/mL in administration set/total number of minutes

Number of hours

total volume/mL/hr

TIA

transient ischemic attack....mini stroke, no dead tissue.

Peritoneal Dialysis (when outflow is inadequate)

turn pt from side to side BEFORE checking for kinks in tubing

nitrazine paper

turns blue with alkaline amniotic fluid. turns pink with other fluids

sickle cell crisis

two interventions to prioritize: fluids and pain relief.

cryptorchidism

undescended testicles! risk factor for testicular cancer later in life. Teach self exam for boys around age 12--most cases occur in adolescence

Meningococcal duration of precautions

until 24 hr therapy continuous

VRE duration of precautions

until three negative cultures from infectious site (1 week apart)

for phobias

use systematic desensitization

Tensilon

used in myesthenia gravis to confirm diagnosis

Parathyroid relies on

vitamin D to work

ventriculoperitoneal shunt

watch for abdominal distention. watch for s/s of ICP such as high pitch cry, irritability and bulging fontanels. In a toddler watch for loss of appetite and headache. After shunt is placed bed position is FLAT so fluid doesn't reduce too rapidly. If presenting s/s of ICP then raise the HOB 15-30 degrees

Tamoxifen

watch for visual changes--indicates toxicity

clozapine s/e

weight gain, hypotension, hyperglycemia, agranulocytosis

the best indicator of dehydration?

weight---and skin turgor

Cerebral angio prep

well hydrated, lie flat, site shaved, pulses marked. Post--keep flat for 12-14 hr. check site, pulses, force fluids.

asthma

wheezing on expiration

COPD and O2

with COPD baroreceptors that detect CO2 level are destroyed, therefore, O2 must be low because high O2 concentration takes away the pt's stimulation to breathe.

pancreatic enzymes are taken

with each meal!

Myesthenia Gravis

worsens with exercise and improves with rest

Immunizations for children at 19-23 months

yearly influenza Hepatitis A

What adverse effects do both typical and atypical antipsychotics share? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Agranulocytosis • Extrapyramidal effects ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What do NSAIDs do with lithium carbonate? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• ↑ lithium levels ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Side/Adverse Effects of Ginseng

Insomnia Nervousness

Medications of Autistic Disorder

Antipsychotics Selective Serotonin Reuptake Inhibitors

Restricting

Drastically restricts food intake and does not binge or purge

CSF meningitis

HIGH protein LOW glucose

Contraindications for Measles, Mumps, and Rubella (MMR) vaccine

Allergy to gelatin and neomycin Immunocompromised

Action of Anticholinergic medications for overactive bladder

Antispasmodic actions to decrease detrusor muscle spasms and contractions

-tidine

Antiulcer or histamine-2 antagonist

-vir

Antiviral

Toxic Drug Levels for Acetaminophen

greater than 250 mcg/mL

Sexual abuse

Any form of sexual contact or exposure without consent Often referred to assault when referring to adults

Toxic Drug Levels for Phenytoin (Dilantin)

greater than 30 mcg/mL

Sublimation

Directing unacceptable behaviors into a socially acceptable area. This is always adaptive.

Sexual Assault

Any type of sexual activity to which the victim does not consent, ranging from inappropriate touching to penetration

-pam, -lam

Benzodiazepine

List of Anti-Parkinson's Drugs

Benztropine Carbidopa/Levodopa Levodopa

List of Sympatholytics

Beta Adrenergic Blockers Alpha Adrenergic Blockers

-olol

Beta blocker

Herb/Medication Interactions for Melatonin

Beta blockers Warfarin Steroids

Factors that influence choice of a contraceptive include:

Age and health status, including risk for STI Religion and culture Plans for future contraception Frequency of intercourse Number of sexual partners Personal concerns about availability, spontaneity, ease of use

Contraindications for Haemophilius influenza type B vaccine

Age younger than 6 weeks

Symptoms of serotonin syndrome

Agitation Confusion Hallucinations

Action of Opioid Analgesics

Bind with opiate receptors in the CNS to alter the perception of and emotional response to pain

Action of Methadone

Binds with opiate receptors in CNS to produce analgesic and euphoric effects

Action of Antilipemic Medications

Aid in lowering low-density lipoprotein (LDL) levels and increase high-density lipoprotein (HDL) levels. Therapy includes diet, exercise and weight control.

draw up regular and NHP?

Air into NHP, air into Regular. Draw regular, then NHP

Toxic Drug Levels for Salicylate

greater than 300 mcg/mL

Toxic Drug Levels for Phenobarbital

greater than 40 mcg/mL

Three phases of treatment and recovery

1. Acute: focus reducing depressive symptoms and lasts 6-12 weeks 2. Continuation: focus on prevention of a relapse through pharmacotherapy, education and psychotherapy and lasts 4-9 months 3. Maintenance: focus on prevention of further episodes and lasts 1 year or more

Offer General Leads

"And then?"

False reassurance

"Everything is going to be fine."

Success of Identity vs Role Confusion Stage

"I am fine with who I am."

Crisis of Identity vs Role Confusion Stage

"I belong to a gang because I am nothing without them."

Disapproval

"I disagree with that."

Success of Integrity vs Despair Stage

"I have led a happy and productive life."

Success of Generativity vs Stagnation Stage

"I will be taking a leave of absence for 3 months to stay with my mother who is terminally ill."

Offer Self

"I would like to spend time talking with you."

Crisis of Integrity vs Despair Stage

"I'm not ready to die. The doctors are wrong."

dehydration

-hypovolemia - elevated urine specific gravity

Oral Stage

0 to 1 year

Trust vs Mistrust stage

0 to 1 year infancy

Therapeutic Drug Level for Lithium

0.4 - 1.4 mEq/L

Therapeutic Drug Level for Gentamicin

0.5 - 0.8 ng/ml

Therapeutic Drug Level for Digoxin

0.8 - 2.0 ng/ml

Onset of Long-acting insulin

1 hour

Time Specimen is drawn after administration of intramuscular medication for peak level

1 hour

1 kilogram of body weight is approximate to how much fluid?

1 liter

How much protamine sulfate should be given for heparin toxicity?

1 mg per 100 units of heparin

Time Specimen is drawn after administration of oral medication for peak level

1 to 2 hours

Anal stage

1 to 3 years

Autonomy vs Shame and Doubt Stage

1 to 3 years Early childhood

Time for 5% Albumin to be completed

1-10 mL/min

Onset of Intermediate-Acting Insulin

1-2 hours

Projection

Blaming one's thoughts or actions on another

1 kg

2.2 lbs

How much of body fluids is intracellular?

2/3

Intimacy vs Isolation Stage

20 to 35 years Young adult

COPD patients and O2

2LNC or less. They are chronic CO2 retainers expect sats to be 90% or less

Duration of Rapid-acting Insulin

3 to 4 hours

Phallic Stage

3 to 6 years

Initiative Vs Guilt Stage

3 to 6 years preschooler

Adaptive use of regression

A 5-year-old begins sucking his thumb when a new sibling is born

Mental Illness

A clinically significant behavioral or psychological syndrome marked by the client's distress, disability, or the risk of suffering disability or loss of freedom

Autistic Disorder

A complex neurobiological and developmental disability that typically appears before age 3 years

Rett's Syndrome

A disorder that is diagnosed exclusively in girls before age 4 years.

Group Therapy

A group of individuals interacting together with a shared purpose

Considerations for the use of Emergency contraception

A larger-than-normal dose of oral contraceptive Taken no later than 72 hours after unprotected sex Second dose is repeated 12 hours later Antiemetics may be needed

Oppositional defiant disorder

A nurse assesses a child defiantly communicating to the caregiver

ADHD

A nurse assesses a child fidgeting and not paying attention during an interview

-pril

ACE inhibitior

Working Phase of Nurse-Client Relationship

Allows for a strong working relationship Maintain client relationship Gather further data Promote client's problem-solving skills Facilitate behavioral change Overcome resistance behaviors Evaluate problems and goals Promote practice and expression of alternative adaptive behaviors

Exploring

Allows the nurse to examine ideas and experiences in more depth "Tell me more about..."

Restating

Allows the nurse to mirror overt and covert messages Client: "I can't focus." Nurse: "You are having problems focusing?"

-zosin

Alpha Adrenergic Blockers

List of Antianxiety Medications

Alprazolam Buspirone Chlordiazepoxide Clonazepam Diazepam Lorazepam

List of Thrombolytic Medications

Alteplase Tenecteplase Reteplase

List of Antacids

Aluminum hydroxide Magnesium hydroxide Sodium Bicarbonate

Factor Dementia

Alzheimer's disease Neurological disease Vascular disease Alcohol use disorder Head trauma

List of Aminoglycosides

Amikacin Vancomycin Gentamicin Streptomycin

-mycin

Aminoglycoside

List of Methylxanthines

Aminophylline Theophylline (Theo-Dur, Theolair, Theo-42)

List of Tricyclic Antidepressants

Amitriptyline Clomipramine Doxepin Imipramine

List of Penicillins

Amoxicillin Ampicillin

Maladaptive use of regression

An employee who is not promoted begins missing appointments and showing up late for meetings

Therapeutic Use of Acetaminophen

Analgesic Antipyretic

Side Effects for Hepatitis A or Hepatitis B vaccine

Anaphylaxis

Side/Adverse Effects of Carbamazepine

Anemia Leukopenia Stevens-Johnson Syndrome

-caine

Anesthetics

Therapeutic Use for Calcium Channel Blockers

Angina Hypertension

Adverse Reaction to ACE Inhibitiors

Angioedema

Side/Adverse Effects for angiotensin II receptor blockers (ARBs)

Angioedema Hypotension Should not be used in second and third trimester of pregnancy

Side/Adverse Effects for Dabigatran (Pradaxa)

Bleeding GI discomfort

Toxic Drug Levels for Amitriptyline

greater than 500 ng/mL

If IV fluids are not infused within 24 hours, what should the nurse do?

Discard unused portion to prevent infection

Action of Antipsychotic Medications

Block dopamine, acetylcholine, histamine, and norepinephrine receptors in the brain and periphery

Action of Angiotensin II Receptor Blockers (ARBs)

Block the binding of angiotensin II to AT1 receptors found in tissues

Action of Angiotensin-Converting Enzyme (ACE) Inhibitors

Block the conversion of angiotensin I to angiotensin II

Action of Tricyclic Antidepressants

Blocks reuptake of norepinephrine and serotonin

Hep B reservoir

Blood and body fluids

CRE reservoir

Blood and body fluids Feces

AIDS/HIV RESERVOIR

Blood and body fluids including breast milk

Toxic Drug Levels for Magnesium sulfate

greater than 9 mg/dL

Side/Adverse Effects of Antiglaucoma Medications

Blurred vision Photophobia Dry eyes May have systemic effects of beta blockade

Side/Adverse Effects for Scopolamine

Blurred vision Sedation Anticholinergic effects

MRSA reservoir

Body fluids and sites contaminated with MRSA

Side/Adverse Effects for Filgrastim injection and Pegfilgrastim IV

Bone pain Leukocytosis

Cluster B

Borderline Antisocial Narcissistic Histrionic

Side/Adverse Effects for Amiodarone (Cordarone)

Bradycardia Cardiogenic shock Pulmonary disorders

Therapeutic Use for Atropine

Bradycardia Known exposure to chemical nerve agent (AtroPEN)

Side/Adverse Effects for Beta Adrenergic Blockers

Bradycardia Nasal stuffiness AV block Rebound myocardium excitation if stopped abruptly Bronchospasm

Nursing Considerations for Ginkgo biloba

Discontinue 2 weeks prior to surgery May cause seizures with overdose Keep out of the reach of children

Medication AD

Donepezil Galantamine Memantine Citalopram Paraxetine Lorazepam Oxazepam

Dosage on hand (H)/mL

Dosage desired (D)/mL

Side/Adverse Effects for Promethazine

Drowsiness Anticholinergic effects Extrapyramidal symptoms Potentiates effects when given with narcotics

Side/Adverse Effects for Metoclopramide

Drowsiness Anticholinergic effects Restlessness Extrapyramidal symptoms Tardive dyskinesia

Side/Adverse Effects of Valerian Root

Drowsiness Anxiety Hepatotoxicity from long-term use

S & S Bulimia Nervosa

Bradycardia, hypotension Electrolyte imbalances Erosion of teeth Esophageal tears from vomiting Normal to slightly low body weight Muscle weakening Calluses/scars on hand from self-induced vomiting

Adverse Effects for Oral contraceptives

Breast tenderness Bleeding Nausea/vomiting

Precautions for Nitrofurantoin

Broad-spectrum Contraindicated in renal dysfunction Urine will have brown discoloration

Therapeutic Use for Fluoroquinolones

Bronchitis Chlamydia Gonorhea Pelvic Inflammatory Disease Urinary tract infections Pneumonia Prostatitis Sinusitis

-phylline

Bronchodilator

Adverse Reaction to Beta Blockers

Bronchospasm

Norepinephrine Dopamine Reuptake Inhibitors (NDRI)

Bupropion

Hypocalcemia

CATS Convulsions, Arrythmias, Tetany, spasms and stridor

Hypo-parathyroid

CATS---Convulsions, Arrhythmias, Tetany, Spasms, Stridor. (decreased calcium) give high calcium, low phosphorus diet

Side/Adverse Effects for Antianxiety Medications

CNS depression Insomnia Excitation Euphoria Withdrawal symptoms, except with Buspirone Risk of abuse and potential for overdose

Side/Adverse Effects for MAOIs

CNS stimulation Orthostatic hypotension Hypertensive crisis with intake of tyramine, SSRIs, and tricylics

Side/Adverse Effects of Tricyclic Antidepressants

Anticholinergic effects Sedation Toxicity Decreased seizure threshold

Side/Adverse Effects for Anticholinergic medications for overactive bladder

Anticholinergic symptoms Drowsiness Dyspepsia

-arin

Anticoagulant

-azine

Antiemetic

-zine

Antihistamine

-statin

Antilipidemic

Therapeutic Use of Oxytocin

Antepartum for contraction stress test Intrapartum for induction or augmentation of labor Postpartum to promote uterine involution

Adverse Reaction to Benzodiazepines

Anterograde amnesia

Action of Medications for Adrenal Hormone Replacement

Anti-inflammatory suppresses immune response

-cycline

Antibiotic

Client Education for Oral Contraceptives

Antibiotic therapy reduces effectiveness Avoid smoking

Side/Adverse Effects for Antihistamines

Anticholinergic effects Drowsiness

APGAR

Appearance (all pink, pink and blue, blue (pale) Pulse (>100, <100, absent) Grimace (cough, grimace, no response) Activity (flexed, flaccid, limp) Respirations (strong cry, weak cry, absent)

Standard precautions

Applies to ALL BODY FLUIDS, NONINTACT SKIN, and MUCOUS MEMBRANES

Client Education for Ethinyl estradiol and norelgestromin contraceptive patch

Apply patch to buttocks, abdomen, upper torso, upper/outer arm Period will begin on week 4 (no patch)

Nursing Interventions for Vasodilators

Apply protective cover to container Discard unused fluid after 24 hours Provide continuous ECG and blood pressure monitoring

Action of Antidysrhythmic Agents

Are complex agents with multiple mechanisms of action. They are classified according to their effects on the electrical conduction system of the heart (Class I, II, III, or IV)

Cognitive Symptoms of Schizophrenia

Are revealed through the client's thought process that interferes with performing daily functions. This could manifest as impaired judgment, impaired memory or illogical thinking

List of Atypical Antipsychotic Medications

Aripiprazole Clozapine Olanzapine Paliperidone Quetiapine Ziprasidone

List of Antiplatelet medications

Aspirin Abciximab Clopidogrel Ticlopidine Pentoxyfilline Dipyridamole

Nursing intervention major depressive

Assess symptoms. Depressed mood, anhedonia, and anergia are most common Evaluate client's risk of harm to self or others Evaluate client's use of drugs and alcohol Assess client's history of depression Assess client's support system Encourage activities that raise self-esteem Encourage exercise Encourage problem-solving Work with client to identify cognitive distortion

Side/Adverse Effects for Sodium bicarbonate

Constipation

List of Posterior Pituitary Hormones/Antidiuretic Hormones

Desmopressin (DDAVP): oral, intranasal, subcutaneous, IV Pitressin (Vasopressin): intranasal, subcutaneous, IV

Stage 2 (AD)

Deterioration become evident, and cannot remember a home address or date Memory gap occur, hygiene suffers, and clothing may be put incorrectly Mood swings occur, moments of paranoia, anger, jealously and apathy Care and supervision become a full-time job

Nursing interventions on chemical and Radiation

Determine type and amount of radiation used Place a sign on door. "Caution Radioactive Material." Wear monitoring badge to record amount of exposure Dispose of items removed from the room in appropriate containers Never handle any type of radioactive agent with bare hands

Considerations for the use of the rhythm method

Develop "fertile awareness" by noting cervical mucus changes, menstrual cycle pattern, and basal temperature

Transference

Develops when the client experiences feelings toward the nurse or therapist that were originally held toward significant others

Paranoid

Distrust and suspiciousness of others

Semi-Fowler's

Head of bed elevated to 30

Fowler's

Head of bed elevated to 45

High-Fowler's

Head of bed elevated to 90

Side/Adverse Effects of Echinacea

Headache Epigastric pain Constipation

Side/Adverse Effects for Ondansetron

Headache Extrapyramidal symptoms

Side/Adverse Effects for Sexual Dysfunction Medications

Headache Heartburn Diarrhea Flushing Nosebleeds Difficulty falling asleep or staying asleep Paresthesias Muscle aches Changes in color vision Sensitivity to light

Side/Adverse Effects of Chondroitin sulfate

Headache Hives Photosensitivity Hypertension Constipation

Side/Adverse Effects of Organic Nitrates

Headache Orthostatic Hypotension Reflex Tachycardia Tolerance

Side/Adverse Effects for St. John's Wort

Headache Sleep disturbances Hepatotoxicity from long-term use Constipation

Precautions/Interactions for Alpha Adrenergic Blockers

Increased risk of hypotension and syncope if given with other antihypertensives, beta blockers, or diuretics NSAIDs may decrease the effect of prazosin.

Side/Adverse Effects for Methotrexate

Increased risk of infection Bone marrow suppression GI ulceration

Precautions/Interactions for Antidiarrheals

Increased risk of megacolon for clients who have IBS May cause drowsiness or dizziness

Precautions for Antimalarials

Increased risk of psoriasis Monitor for drug-induced retinopathy

Action of Bethanechol

Increases detrusor muscle tone to allow strong start to voiding for clients with postoperative urinary hesitancy

Action of Atropine

Increases firing of the sinoatrial node (SA) and conduction through the atrioventricular node (AV) of the heart, opposes the actions of the vagus nerve by blocking acetylcholine receptor sites

Action of Monoamine Oxidase Inhibitiors

Increases norepinephrine, dopamine, and serotonin by blocking MAO-A

-pium

Inhaled Anticholinergics

Active Listening

Observing the client's nonverbal behaviors Understanding and reflecting on the client's verbal messge

Obsessive-Compulsive Disorder

Obsessions and compulsions occur together and rituals become time consuming, interfering with normal routines and relationships

Symptoms of Obsessive compulsive disorder

Obsessions are persistent intrusive thoughts Compulsions are repetitive behaviors that a client feels driven to perform hand washing

Contraindications for Diphtheria, tetanus, and pertussis. (DTap) vaccine

Occurrence of seizures within 3 days of the vaccine

Mild Anxiety

Occurs in normal experience of everyday life, and promotes a sharp focus of reality

Maladaptive use of defense mechanisms

Occurs when one or several are used in excess disallowing goals to be acheived

Therapeutic Use of Guaifenesin

Often combined with other agents to manage respiratory disorers

Nursing interventions contact precautions

PRIVATE ROOM preferred; may COHORT with client who has infection with SAME ORGANISM GLOVES and GOWN worn by caregivers and visitors DISPOSAL of INFECTIOUS dressing material into NONPOROUS BAG DEDICATED EQUIPMENT for the patient or disinfect after each use Client to leave room only for essential clinical reasons

McBurney's point

Pain in RLQ with appendicitis

Murphy's sign

Pain with palplation of gall bladder (seen with cholecystitis)

Therapeutic Use for NSAIDs

Provide rapid, symptomatic relief of inflammation and pain

Action of Antirheumatics

Provide symptomatic relief and delay in disease progression by inhibiting or modulating inflammatory processes

Therapeutic Use for Glucocorticoids for Antirheumatic purposes

Provide symptomatic relief of inflammation and pain

Reflecting

Provides a means to assist the client to better understand his thoughts and feelings. Client: "What should I do about my son's addiction?" Nurse: "What do you think you should do?"

List of Stool Softeners/Laxatives

Psyllium Docusate sodium Bisacodyl Magnesium Hydroxide

Tube feeding with decreased LOC

Pt on Right side (promotes emptying of the stomach) Head of bed elevated (prevent aspiration)

Action of Mannitol

Pull fluid back into the vascular and extravascular space by increasing serum osmolality to promote osmotic changes

Side/Adverse Effects for Mannitol

Pulmonary edema Fluid and electrolyte imbalances Thirst, dry mouth

Therapeutic Uses for Diuretics

Pulmonary edema caused by heart failure Edema unresponsive to other diuretics

Type Bulimia Nervosa

Purging Nonpurging

-floxacin

Quinolone antibiotic

Fire response

R-Rescue: protect and evacuate clients in immediate danger A-Alarm: Activate the alarm and report the fire C-Contain: Close doors or windows E-Extinguish: use correct fire extinguisher to exliminate the fire "RACE"

Sprain or Strain

RICE Rest Ice Compress Elevate

Speech Delirium

Rapid Inappropriate Incoherent

Negative Symptoms of Schizophrenia

Refer to diminished or absent characteristics of normal function such as blunted affect, social withdrawal, or loss of motivation

Peak Levels

Reflect the HIGHEST CONCENTRATION

Short-Acting Insulin

Regular (Humulin or Novolin R)

Action of Methylxanthines

Relaxation of bronchial smooth muscle, resulting in bronchodilation

Prognosis Delirium

Reversible with treatment

Regression

Reverting to an earlier developmental level

Therapeutic Use of RhoD Immune Globulin (RhoGAM)

Rh factor incompatibility to prevent sensitization for subsequent pregnancies

Non Dairy calcium

Rhubarb sardines collard greens

Cor pumonae

Right sided heart failure caused by left ventricular failure (edema, jugular vein distention)

Monitor for reaction with Albumin

Risk for hypervolemia and pulmonary edema

Side/Adverse Effects for Glucocorticoids for Antirheumatic purposes

Risk of infection Osteoporosis Adrenal suppression Fluid retention GI Discomfort Hyperglycemia Hypokalemia

Indication modifies Trendelenbury

Shock

Therapeutic Use of Sedative/Hypnotic Medications

Short-term insomnia Difficulty falling or staying asleep

Precautions/Interactions for Antilipemic Medications

Should be discontinued during pregnancy Use with caution in renal dysfunction

Client Education for Emergency contraception

Should discuss options with provider Should never be used as the primary method of birth control

Dorsal Recumbent

Supine with knees flexed

Modifies Trendelenbury

Supine with the legs elevated

Action of Antitussives

Suppress cough through action in the central nervous system

Action of RhoD Immune Globulin (RhoGAM)

Suppresses the stimulation of active immunity by Rh-positive foreign red blood cells that enter the maternal circulation at the time of delivery

Stabilization Phase of Schizophrenia

Symptoms diminish and client progresses toward previous level of functioning

Intoxication Stimulants

Tachycardia Dilated pupils Elevated Blood Pressure Grandiosity Impaired judgement Paranoia with delusion

Termination Phase of Nurse-Client Relationship

The final phase of nurse-client relationship Summarize the goals achieved Discuss new coping strategies Renew situations that occurred during the relationship Exchange memories and validate experiences of the relationship to promote closure

Countertransference

The health care worker's unconscious, personal response to the client

Physiological Needs

The most basic needs are food, oxygen, water, sleep, sex, and a constant body temperature. If all needs were deprived, this level would take priority.

Disorganized Schizophrenia

The most socially impaired form, with dominant symptoms of disorganized speech and behavior, as well as inappropriate affect

Antianginal Medications

The use of organic nitrates, beta adrenergic blockers, and calcium channel blockers to treat pain related to imbalances between myocardial oxygen supply and demand.

Symptom Management group

These group assist clients with a common symptom that results in a disorder such as anger or anxiety

Support/Self-Help group

These groups are designed to maintain or enhance personal and social functioning through life's challenges. Examples can include bereavement and survivors of cancer.

-glitazone

Thiazolidinediones

Purpose of the six rights of medication administration

To PROTECT the SAFETY of the CLIENT and follow the SCOPE of PRACTICE to maintain PROFESSIONAL LICENSURE

Ask open ended questions

To elicit client responses. "What do you perceive as your biggest stressor right now?"

What is the purpose of encouraging iron preparations to be taken with vitamin C?

To facilitate absorption

Crisis of Autonomy vs Shame and Doubt Stage

Toddler shows signs of doubt in being able to toilet train

Success of Autonomy vs Shame and Doubt Stage

Toddler shows signs of self-control as in toilet training

Nursing Interventions for Nitro-Bid (topical ointment)

Wear gloves for administration Do not massage or rub area Apply to area without hair (chest, flank, or upper arm preferable) Cover the area where the patch is placed with clear plastic wrap and tape in place Gradually reduce the dose and frequency of application over 4-6 weeks

Signs of therapeutic response for Thyroid Hormone Antagonists

Weight gain Decreased pulse Blood pressure T4 Levels

Side/Adverse Effects of Selective Serotonin Reuptake Inhibitors

Weight gain Sexual dysfunction Fatigue Drowsiness

Manifestations of isotonic dehydration

Weight loss Dry mucous membranes Increased heart rate and respirations Thready pulse Capillary refill less than 3 seconds Weakness Fatigue Orthostatic hypotension Poor skin turgor

Do not delegate

What you can EAT E-evaluate A-assess T-teach

Staphylococcus aureus durations of precautions

duration illness

MRSA duration of precautions

duration of illness

Salmonella duration of precautions

duration of illness

Shigellosis duration of precautions

duration of illness

Basophils reliease histamine

during an allergic response

Cardinal sign of ARDS

hypoxemia

Thyroid storm

increased temp, pulse and HTN

downs syndrome

protruding tongue

What are adverse effects of ARBs? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Angioedema • Hypotension • ø 2nd & 3rd trimester. ○ Poss. hyperkalemia (potassium must be monitored). ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of scopolamine? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Anticholinergic effects • Blurred vision • Sedation ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of filgrastim? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Bone pain • Leukocytosis ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of pegfilgrastim? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Bone pain • Leukocytosis ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of beta blockers? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Bradycardia • Nasal stuffiness • AV Block • Rebound myocardium excitation if stopped abruptly • Bronchospasm ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of loop & thiazide diuretics? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Hypovolemia • Ototoxicity (Loop) • Hypokalemia • Hyponatremia • Hyperglycemia • Digoxin toxicity • Lithium toxicity ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of methylxanthines? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Irritability & restlessness • Toxicity: . . . ○ tachycardia . . . ○ tachypnea . . . ○ seizures ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are unique effects of promethazine in antiemetics? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Narcotic effects potentiatied • <2yr: Resp. Depression ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Can you get persistent nonproductive cough with valsartan? ATI Comprehensive NCLEX-RN Review: Pharmacology

• No, ACE inhibitors do. ATI Comprehensive NCLEX-RN Review: Pharmacology

Can you get persistent nonproductive cough with nifedipine? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• No, ACE inhibitors do. ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Can you get leukopenia from calcium-channel blockers? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• No, centrally acting alpha2 agonists do. ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Can you get leukopenia from diltiazem? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• No, centrally acting alpha2 agonists do. ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are adverse effects of ACE Inhibitors? ATI Comprehensive NCLEX-RN Review: Pharmacology Adverse Effects

• Persistent nonproductive cough • Angioedema • Hypotension • ø in 2nd & 3rd trimester. ○ Poss. hyperkalemia (potassium must be monitored). ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What is an adverse effect of pilocarpine? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Retinal detachment ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What unique effects do typical antipsychotics have? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Sedation • Anticholinergic effects • Tardive dyskinesia • Neuroleptic malignant syndrome • Seizures ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Does disulfiram have a metallic taste? ATI Comprehensive NCLEX-RN Review: Pharmacology Effect

• Yes ATI Comprehensive NCLEX-RN Review: Pharmacology Effect

Time for 25% Albumin to be completed

4 ml/min

Action of Tocolytics

Act on uterine muscle to cease contractions

dumping syndrome?

use low fowler's to avoid. limit fluids

TPN given in

subclavian line

Herpes zoster (shingles)-disseminated or localized in clients who are immunocompromised precautions

Standard airborne contact

VRE precautions

Standard contact

Rubella precautions

Standard droplet

MRSA precautions

Standard contact

AIDS/HIV

Standard precautions

Hep C precautions

Standard-additional precautions specific to hemodialysis unit

Short-Term Therapeutic Uses for IV Glucocorticoids

Status asthmaticus

Nursing Interventions for Oprelvekin

Administer within 6-24 hours after chemotherapy Subcutaneous

Nursing Interventions and Client Education for Mannitol

Monitor daily weight, I&O, and electrolytes Monitor for signs of hypovolemia Monitor neurological status

List of Calcium Channel Blockers

Nifedipine (Adalat, Procardia) Verapamil (Calan) Diltiazem (Cardizem) Amlodipine (Norvasc)

List of Vasodilators

Nitroglycerin (Nitrostat IV) Enalaprilat (Vasotec IV) Nitroprusside (Nipride) Hydralazine (Apresoline)

List of Organic Nitrates

Nitrostat (sublingual) Nitrolingual (Translingual spray) Nitro-Bid (topical ointment) Nitro-Dur (Transderm patch)

Should a nurse administer medications through IV tubing that has been used for blood administration?

No

Glaucoma

No atropine

List of Glucocorticoids

Prednisone Prednisolone

Client Education for Glucocorticoids

Teach symptoms to report Do not take with NSAIDs Teach client about gradual reduction of dose to prevent Addisonian crisis

Imprisonment

Telling the client you cannot leave the hospital

Treatment of venous spasm with IV infusion

Temporarily slow infusion rate apply warm compress

Adverse Reaction to Ciprofloxacin (Cipro)

Tendon rupture

Cycle of Violence

Tension-building stage Battering stage Honeymoon stage

List of Tocolytics

Terbutaline sulfate Ritodrine HCl Nifedipine Magnesium Sulfate

Nursing Interventions for Methylergonovine

Continuously monitor blood pressure Assess uterine bleeding and uterine tone

Tetrology of Fallot

DROP (Defect, septal, Right ventricular hypertrophy, Overriding aortas, Pulmonary stenosis)

List of Childhood Immunizations

DTap, Tdap Haemophilius influenza B Rotavirus IPV MMR Varicella Seasonal influenza Hepatitis A, B Meningococcal vaccine HPV - up to age 26

How often should the nurse weigh a patient who is on TPN?

Daily

Action of Antihistamines

Decrease allergic response by competing for histamine receptor sites

Action of Glucocorticoids for Antirheumatic purposes

Decrease inflammation by suppressing leukocytes and fibroblasts and reversing capillary permeability

Side/Adverse Effects for Histamine-2 Receptor Antagonists

Decreased libido/impotence Lethargy Depression Confusion

Therapeutic Uses for Psyllium

Decreases diarrhea because it is bulk-forming

Action of Thiazolidinediones

Decreases insulin resistance

Action of Biophosphonates

Decreases the number and action of osteoclasts, resulting in bone resporption

Antidote/Reversal Agent for Iron

Deferoxamine (Desferal)

Orientation phase of group development

Defines the purpose of the group

Cluster C

Dependent Avoidant Obsessive-compulsive

Oral Hypoglycemics

Used in conjunction with diet and exercise to control glucose levels in clients who have type 2 diabetes mellitus

Cardiac Glycosides

Used in the treatment of clients who have cardiac failure or ineffective pumping mechanism of the heart muscle

Protective Isolation

Used to protect clients who have an increased susceptibility to INFECTIONS, are receiving CHEMOTHERAPY, or are IMMUNOSUPPRESSED or NEUTROPENIC

Skin infection

VCHIPS Varicella zoster Cutaneous diptheria Herpes simplez Impetigo Peduculosis Scabies

Rape Trauma Syndrome

Variant of PTSD that can lasts for weeks following rape

Symptoms of Major depressive disorder

Depressed mood most of the day Anhedonia Greater than 5% of weight loss or gain in 1 month Insomnia or hypersomnia Anergia Feelings of worthlessness Decreased concentration

Uses of St. John's Wort

Depression Seasonal affective disorder Anxiety

infants IM site

Vastus lateralis

Serotonin Norepinephrine Reuptake Inhibitors (SNRIs)

Venlafaxine Duloxetine

Staphylococcus aureus reservoir

body fluids and sites contaminated with MRSA

Hypervolemia

bounding pulse, SOB, dyspnea, rales/crackles, peripheral edema, HTN, urine specific gravity <1.010. semi fowler's

Nursing Considerations for Chondroitin sulfate

Do not administer Chondroitin sulfate to women who are pregnant or breastfeeding Often used in combination with glucosamine Allow extended time to see effects

IVP requires

bowel prep so bladder can be visualized

when phenylaline increases

brain problems occur

antiplatelet drug hypersensitivity

bronchospasm

Addison's

bronze like skin pigmentation

Lymes disease

bullseye rash

Precautions/Interactions for Bethanechol

Do not administer IV or IM Contraindicated for clients with hypotension or decreased cardiac output

sle (systemic lupus)

butterfly rash

Thorazine and Haldol

can cause EPS

Precautions/Interactions of Cholinesterase inhibitors

Do not administer if systolic blood pressure less than 90 mm Hg

Precautions/Interactions for Labetalol

Do not administer in the same IV line with furosemide

Class C

Electrical fires

Elevate one or more extremities

Elevate legs/feet or arms/hands by adjusting or supporting with pillows

Hodgkin's disease

cancer of the lymph. very curable in early stages

Side/Adverse Effects for Leukotriene Modifiers

Elevated liver enzymes Warfarin and theophylline toxicity

Therapeutic uses of Glucagon

Emergency treatment of severe hypoglycemia

retino blastoma

cat's eye reflex

Anger

Emotional response to frustration of desires and can be expressed in a healthy way Problem begin to occur when anger is expressed through violence

Hepatitis A

Ends in a vowel, comes from the bowel

Binge eating-purging

Engages in binge eating and purging behaviors

Action of Mucolytics

Enhance the flow of secretions in the respiratory tract

during Continuous Bladder Irrigation (CBI)

catheter is taped to the thigh. leg must be kept straight.

Action of sexual dysfunction medications

Enhances the effect of nitric oxide to promote relaxation of penile muscles, allowing increased blood flow to produce an erection

Side Effects for Diphtheria, tetanus, and pertussis. (DTap) vaccine

Fever Irritability Seizures

Onset for Albuterol (Proventil, Ventolin)

Few minutes

Class B

Flammable liquids Gases

Isoniazid

causes peripheral neuritis

Addison's

causes sever hypotension!

Turner's sign

Flank--greyish blue. (turn around to see your flanks) Seen with pancreatitis

Herpex simplex Reservoir

Fluid from lesions

Isotonic dehydration

Fluid intake is less than needed to meet body requirements.

Fluid Volume deficit (FVD)

Fluid intake is less than needed to meet body requirements. The most common type is isotonic dehydration.

Side/Adverse Effects of Betamethasone

Fluid retention Elevated blood pressure

Side/Adverse Effects for Oprelvekin

Fluid retention Papilledema Cardiac dysrhythmia

Antidote/Reversal Agent for Benzodiazepines

Flumazenil (Romazicon)

Prevention of Lumen Occlusion with Central Venous Catheters

Flush promptly with normal saline between, before, and after each medication

Side/Adverse Effects for Adenosine (Adenocard)

Flushing Nausea Bronchospasm Prolonged asystole

SIADH (increased ADH)

change in LOC, decreased deep tendon reflexes, tachycardia. N/V HA administer Declomycin, diuretics

Secondary prevention

Focus is on early identification of illness, providing treatment, and conducting activities geared to prevent a worsening health status.

Tertiary prevention

Focus is on preventing long-term consequences of chronic illness or disability and supporting optimal functioning.

Primary prevention

Focus is on promoting health and preventing disease.

Antidote/Reversal Agent for Ethylene poisoning

Fomepizole (Antizol)

Route for Formoterol (Foradil) and Salmeterol (Serevent)

Inhaled, long-acting

Route for Albuterol (Proventil, Ventolin)

Inhaled,short-acting

Action of Antimicrobials

Inhibit growth, destroy or otherwise control replication of microbes

Action for NSAIDs

Inhibit prostaglandin synthesis resulting in decreased inflammatory responses

Action of Selective Serotonin Reuptake Inhibitors

Inhibit serotonin reuptake

Substance Dependence

Maladaptive pattern of substance use leading to distress manifested by tolerance to the drug, withdrawal syndrome, or lack of success at controlling use

Personality disorder

characteristics of inflexibility and difficulties in interpersonal relationships that impair social or occupational functioning

Hypomania

characterized by a disturbance in mood observed by others and does not require hospitalization

Delirium

characterized by a disturbance of consciousness and a change in cognition that develop over a short period of time

nephrotic syndrome

characterized by massive proteinuria caused by glomerular damage. corticosteroids are the mainstay

before IV antibiotics?

check allergies (esp. penicillin) make sure cultures and sensitivity has been done before first dose.

acid ash diet

cheese, corn, cranberries, plums, prunes, meat, poultry, pastry, bread

bryant's traction

children <3 y <35 lbs with femur fx

Toxic Drug Levels for Lithium

greater than 2.0 mEq/L

Toxic Drug Levels for Digoxin

greater than 2.4 ng/mL

Toxic Drug Levels for Aminophylline

greater than 20 mcg/mL

Toxic Drug Levels for Theophylline

greater than 20 mcg/mL

Substance Abuse

Maladaptive pattern of substance use negatively impacting obligations (work, school, parenting), judgement (driving), relationships, and/or continued use despite personal problems

List of Osmotic diuretics

Mannitol

Toxic Drug Levels for Lidocaine

greater than 5 mcg/mL

Restraints

Manual method to prevent client movement with the intention to protect the client from self-harm or assaulting others

burns rule of Nines

head and neck 9% each upper ext 9% each lower ext 9% front trunk 18% back trunk 18% genitalia 1%

Hematocrit may be high in isotonic dehydration due to:

hemoconcentration

-glinide

Meglitinides

Therapeutic Uses of Cholinesterase inhibitors

Myasthenia gravis

Therapeutic Uses for Antilipemic Medications

Primary hypercholesterolemia Prevention of coronary events Protection against myocardial infarction and stroke in clients with diabetes

Therapeutic Use of Alpha Adrenergic Blockers

Primary hypertension

Therapeutic Use of Beta Adrenergic Blockers

Primary hypertension Angina Tachydysrhythmias Heart failure Myocardial Infarction

Therapeutic use for Centrally Acting Alpha-2 Agonists

Primary hypertension - may be used in combination with diuretics or other antihypertensives Hypertensive crisis Severe cancer pain (parenteral administration via epidural)

PPE Droplet precautions

Private room Mask

Action of Bipolar Disorder Medications

Produce neurochemical changes in the brain to control acute mania, depression, and incidence of suicide

Side/Adverse Effects for Antiplatelet medications

Prolonged bleeding Gastric bleeding Thrombocytopenia

-prazole

Proton pump inhibitor

Nursing Interventions for Oral Hypoglycemics

Teach signs and symptoms of management for hypoglycemia, especially with sulfonylureas Encourage diet and exercise to follow American Diabetes Association recommendations Monitor glycosylated hemoglobin (HbA1C) Refer to diabetic nurse educator

Hyper reflexes absent reflexes

upper motor neuron issue (your reflexes are over the top) Lower motor neuron issue

What is an adverse effect of latanoprost? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Brown discoloration of the iris ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of calcium-channel blockers? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Constipation • Reflex tachycardia • Peripheral edema • Toxicity ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What unique effect do Anti-Parkinson's medications have? ATI Comprehensive NCLEX-RN Review: Pharmacology Effect

• Dark urine • Muscle twitching ATI Comprehensive NCLEX-RN Review: Pharmacology Effect

Panic disorder

"What do you believe brings on your episodes of chest pain and difficulty breathing?"

Phobias

"Where would you like to begin our discussion regarding your fear of flying?"

Posttraumatic stress disorder

"You are having difficulty sleeping due to the flashbacks of your previous deployment?"

Generalized anxiety disorder

"You have mentioned a lot of stressors that have been occurring for several months. Which situation is causing the greatest stress for you?"

Giving premature advice

"You should leave your home immediately."

Focus

"You've mentioned many events. Let's talk about your wanting to end it all again."

Making value judgments

"Your wife is dying of lung cancer, and you smoke?"

Addison's disease: Cushing's syndrome:

"add" hormone have extra "cushion" of hormone

ALS

(amyotrophic lateral sclerosis) degeneration of motor neurons in both upper and lower motor neuron systems

After infratentorial surgery

(incision at the nape of neck) position pt flat and lateral on either side.

After supratentorial surgery

(incision behind hairline on forhead) elevate HOB 30-40 degrees

Kawasaki disease

(inflammation of blood vessles, hence the strawberry tongue) causes coronary artery aneurysms.

Woman in labor (un-reassuring FHR)

(late decels, decreased variability, fetal bradycardia, etc) Turn pt on Left side, give O2, stop pitocin, Increase IV fluids!

To prevent dumping syndrome

(post operative ulcer/stomach surgeries) eat in reclining position. Lie down after meals for 20-30 min. also restrict fluids during meals, low CHO and fiber diet. small, frequent meals.

Autonomic Dysreflexia

(potentially life threatening emergency!) HOB elevate 90 degrees, loosen constrictive clothing, assess for full bladder or bowel impaction, (trigger) administer antihypertensives (may cause stroke, MI, seizure)

°F

(°C x 9/5) + 32

°C

(°F-32) x (5/9)

Therapeutic Drug Level for Lidocaine

1.5 - 5.0 mcg/ml

How much of body fluids is extracellular?

1/3

Duration of Long-acting insulin

10 1/2 to 24 hours

Therapeutic Drug Level for Aminophylline

10-20 mcg/mL

Therapeutic Drug Level for Phenytoin (Dilantin)

10-20 mcg/mL

Therapeutic Drug Level for Theophylline

10-20 mcg/mL

Therapeutic Drug Level for Phenobarbital

10-30 mcg/mL

Therapeutic Drug Level for Salicylate

100-250 mcg/mL

1 kg

1000 g 2.2 lb

1 L

1000 mL

1 g

1000 mg

1 g (gram)

1000 mg

1 mg

1000mcg

Identity vs Role Confusion Stage

12 to 20 years Adolescence

Genital stage

12 years to young adult

1 tbsp

15 mL 3 tsp

Onset for Formoterol (Foradil) and Salmeterol (Serevent)

15-20 minutes, lasts 12 hours

Time for platelets to be completed

15-30 minutes

1 lb

16 oz

I lb

16 oz

anterior fontanelle closes by...posterior by..

18 months, 6-8 weeks

Duration of Intermediate-Acting Insulin

18-24 hours

Kidney glucose threshold

180

1 pint

2 cups

1 quart

2 pints

Peak of Short-Acting Insulin

2 to 3 hours

Developmental

2-3 months: turns head side to side 4-5 months: grasps, switch and roll 6-7 months: sit at 6 and waves bye bye 8-9 months: stands straight at 8 10-11 months: belly to butt 12-13 months: 12 and up, drink from a cup

How long should you infuse Pegfilgrastim IV?

2-4 hours

Time for Whole Blood to be completed

2-4 hours

Time for packed RBCs to be completed

2-4 hours

Therapeutic Drug Level for Qunidine

2-5 mcg/mL

1 oz

30 mL

Time Specimen is drawn after administration of intravenous medication for peak level

30 minutes

Onset of Short-Acting Insulin

30 minutes to 1 hour

Peak of Rapid-acting Insulin

30 minutes to 1 hour

Time for fresh frozen plasma to be completed

30-60 mintues

Generativity vs Stagnation Stage

35 to 65 years Middle adult

Therapeutic Drug Level for Magnesium sulfate

4 - 8 ng/mL

Peak of Intermediate-Acting Insulin

4-12 hours

Time for pheresed granulocytes to be completed

45-60 minutes

1 tsp

5 mL

Therapeutic Drug Level for Tobramycin

5-10 mcg/mL

Therapeutic Drug Level for Carbamazepine

5-12 mcg/ml

Duration of Short-Acting Insulin

5-7 hours

hungtington's

50% genetic autosomal dominanat disorder.. s/s uncontrolled muscle movements of face, limbs and body. no cure

What percentage of total body weight is water in adults?

50-60%

Latency stage

6 to 12 years

Industry vs Inferiority Stage

6 to 12 years school age

Alzheimer's

60% of all dementias, chronic, progressive degenerative cognitive disorder.

1 gr

60mg

Integrity vs Despair Stage

65 years and older Older adult

Rubella duration of precautions

7 days after onset of rash

Tidal volume is

7-10 ml/kg

Stranger anxiety is greatest at what age?

7-9 months..separation anxiety peaks in toddlerhood

What percentage of total body weight is water in infants?

75-80%

1 cup

8 oz

37.0°C

98.6°F

Autistic disorder

A nurse assesses and documents a child's lack of speech

Conduct disorder

A nurse assesses drug screen results for an adolescent who has been in juvenile detention.

Rett's Syndrome

A nurse assesses for impaired head growth and notes a seizure disorder in the client's history

TB

A positive Mantoux test indicates pt developed an immune response to TB. Acid-fast bacilli smear and culture:(+suggests an active infection) the diagnosis is CONFIRM by a positive culture for M TB A chest x-ray may be ordered to detect active lesions in the lungs QuantiFERON-TB Gold: DIAGNOSTIC for infection, whether it is active or latent

Crisis of Initiative Vs Guilt Stage

A preschooler took candy without paying for it and knew it was wrong

Behavior of Identity vs Role Confusion Stage

A sense of self vs becoming confused about self

Signs and symptoms of Mild Anxiety

Heightened perceptual field Alert and can grasp what is going on Restlessness Irritability or impatience Foot or finger tapping

Nursing Interventions of Mild Anxiety and Moderate Anxiety

Help the client identify the anxiety Anticipate anxiety-provoking situations Demonstrate interest in client by leaning forward and maintaining eye contact. Ask questions to clarify what is said Encourage problem-solving

Side/Adverse Effects for Heparin and Enoxaparin

Hemorrhage Heparin-induced thrombocytopenia Toxicity/overdose

Side/Adverse Effects for Warfarin

Hemorrhage Toxicity/Overdose

Immunizations for children at 1-2 months

Hepatitis B

Immunizations for children at birth

Hepatitis B

Immunizations for children at 18 months

Hepatitis B Diphtheria, tetanus, and pertussis. (DTap) Polio vaccine (IPV) Yearly influenza Hepatitis A

Immunizations for children at 2 months

Hepatitis B Diphtheria, tetanus, and pertussis. (DTap) Rotavirus (RV) Haemophilius influenza B (Hib) Pneumococcal conjugate vaccine (PCV) Polio vaccine (IPV)

Immunizations for children at 6 months

Hepatitis B Diphtheria, tetanus, and pertussis. (DTap) Rotavirus (RV) Haemophilius influenza B (Hib) Pneumococcal conjugate vaccine (PCV) Polio vaccine (IPV) Yearly influenza

Immunizations for children at 12 months

Hepatitis B Haemophilius influenza B Pneumococcal conjugate vaccine (PCV) Polio vaccine (IPV) Yearly influenza Measles, mumps, and rubella (MMR) Hepatitis A

Side/Adverse Effects for Valproic Acid

Hepatotoxicity Teratogenic effects Pancreatitis

Abraham Maslow

Hierarchy of needs

Precautions for Aminoglycosides

High risk for ototoxicity and nephrotoxicity Monitor creatinine and BUN Peak and trough levels Therapeutic range: gentamicin: 4-12 mcg/mL; vancomycin 20-40 mcg/mL

Precautions/Indications for Thiazolidinediones

High risk of congestive heart failure due to fluid retention

Precautions/Interactions for Zileuton or zafirlukast

High risk of liver disease Increased warfarin effects Theophylline toxicity

Contraindication for Meningococcal vaccine

History of Gullian-Barre syndrome

if HR is <100 (children)

Hold Dig

Client Education for Centrally Acting Alpha-2 Agonists

Instruct never to skip a dose. Take at bedtime to minimize effects of hypotension Notify prescriber of any involuntary jerky movements, prolonged dizziness, rash, or yellowing of skin

Lithotomy

Lying on the back with hips and knees flexed at right angles and feet in stirrups

Contact precaution

MRS WHISE protect visitors & caregivers when 3 ft of the pt. Multidrug-resistant organisms RSV, Shigella, Wound infections, Herpes simplex, Impetigo, Scabies, Enteric diseases caused by micro-organisms (C diff), Gloves and gowns worn by the caregivers and visitors Disposal of infectious dressing material into a single, nonporous bag without touching the outside of the bag PMGG= Private room/ share same illness, mask, gown and gloves

Airborne precautions

MTV or My chicken hez tbSmeasles(Rubeola), chickenpox (varicella) Herpes zoster/shingles TB

Hyperkalemia

MURDER Muscle weakness, Urine (olig, anuria) Resp depression, decreased cardiac contractility, ECG changes, reflexes

Nursing intervention anger/violence

Maintain a calm approach Use short, simple sentences Avoid verbal struggles/conflict Assess for stressors Use nonaggressive posture Maintain client's self-esteem/dignity Maintain a large personal space

Nursing intervention Avoidant

Maintain a friendly, accepting reassuring approach Do not push client into social situation

Nursing Interventions of Severe Anxiety and Panic Anxiety

Maintain calm manner Remain with client Minimize environmental stimuli Use clear, simple statements Use low-pitched voice Listen for themes in communication Attend to physical and safety needs

Nursing Interventions for Dinoprostone cervical gel

Maintain client on bed rest for 1-2 hours after insertion Monitor and record maternal vital signs and fetal heart rate Monitor for uterine contractions Remove by gently pulling the netted string and discard Oxytocin augmentation may be initiated as needed Assess Bishop score for 6 and greater to begin induction

Prevention of Bloodstream Infection with Central Venous Catheters

Maintain sterile technique

Nursing Considerations for St. John's Wort

Many medications interactions and should not be taken with other medications Should not be used to treat severe depression Should only be used with medical guidance

PPE airborn precautions

Mask (N95 respirator for known or suspected TB) Negative pressure room Private room

Precautions/Interactions for Histamine-2 Receptor Antagonists

May cause toxicity for clients taking phenytoin, warfarin, theophylline, and lidocaine Cimetidine promotes increased risk for infection; use with caution in COPD

Herb/Medication Interactions of Ginseng

May decrease effectiveness of anticoagulants and antiplatelet aggregates May increase effectiveness of antidiabetic agents and insulin

Herb/Medication Interactions of Glucosamine

May increase resistance to antidiabetic agents and insulin

Herb/Medication Interactions of Ginkgo biloba

May increase the effects of MAOIs, anticoagulants, and antiplatelet aggregates May reduce the effectiveness of insulin

Herb/Medication Interactions of Chondroitin sulfate

May increase the effects of anticoagulants

Herb/Medication Interactions Omega-3 fatty acids

May increase the risk of vitamin A or D overdose

Precautions/Interactions for Propranolol

May mask effects of hypoglycemia in clients with diabetes mellitus

Nursing Interventions for Nitroprusside

May not be mixed with any other medication

Herb/Medication Interactions for Echinacea

May reduce the effects of immunosuppressants May increase serum levels of alprazolam, calcium channel blockers, and protease inhibitors

Herb/Medication Interactions for St. John's Wort

May reduce the effects of theophylline, HIV protease inhibitors and non-nucleoside reverse transcriptase inhibitors, cyclosporine, diltiazem and nifedipine

Purpose of therapeutic drug monitoring

Measures blood drug levels to determine EFFECTIVE MEDICATION DOSAGES and PREVENT MEDICATION TOXICITY. The test may also be used to IDENTIFY NONCOMPLIANCE with medication regimens.

Types of Groups

Medication Education Dual Diagnosis Symptom Management Stress Management Support/Self-Help

Medications pregnancy

Medications CROSS the PLACENTAL BARRIER INCREASING RISK of TERATOGENICITY ALL medications given with extreme CAUTION to ensure SAFETY to the DEVELOPING FETUS

Medications for the Respiratory System

Medications used to treat chronic inflammatory conditions caused by asthma, bronchitis, and emphysema

Opiates

Meperidine Heroin Fentanyl Hydromorphone "Me and Hero Fent Hydro"

List of Biguanides

Metformin (Glucophage)

List of Thyroid Hormone Antagonists

Methimazole Propylthiouracil (PTU)

List of Disease-modifying antirheumatic drugs (DMARDs)

Methotrexate Hydroxychloroquine Etanercept Infliximab Adalimumab

Antidote/Reversal Agent for Cyanide poisoning

Methylene Blue

Stimulant Medications for Attention deficit disorder and attention deficit hyperactivity disorder

Methylphenidate Amphetamine and dextroamphetamine

List of Cardioselective Beta 1 Medications

Metoprolol (Lopressor) Atenolol (Tenormin) Metoprolol Succinate (Toprol XL)

List of Antiprotozoal medications

Metronidazole

Levels of Anxiety

Mild Moderate Severe Panic

Client: "I wish I were dead." Nurse: "I know what you mean."

Minimizing feelings

Tension building stage

Minor incidents such as pushing and verbal abuse Victim often accepts blame

RhoGAM is administered as an injection after any event where fetal cells can mix with maternal blood. Nursing Interventions for RhoD Immune Globulin (RhoGAM)

Miscarriage Ectopic pregnancy Induced aborption Aminocentesis Chorionic villus sampling (CVS) Abdominal trauma

Action of Heparin

Modify or inhibit clotting factors or cellular properties to prevent clot formation

Nursing Interventions for Nifedipine

Monitor BP Avoid concurrent use with magnesium sulfate Monitor contractions and fetal heart tones Prevent complication with hypotension

The client shows a flattened affect

Negative schizophrenia symptom

The client stops speaking to everyone.

Negative schizophrenia symptom

The client does not complete a task.

Negative schizophrenia symtpom

List of Cholinesterase inhibitors

Neostigmine Ambenonium Edrophonium

Side Effects of Terbutaline sulfate and Ritodrine HCl

Nervousness Tremulousness Headache Nausea and vomiting Hyperglycemia Severe palpitations Chest pain Pulmonary edema

Action of Antacids

Neutralize gastric acid and inactivate pepsin

Nursing Interventions for Leukotriene Modifiers

Never abruptly substitute for corticosteroid therapy If using oral granules, pour directly into mouth or mix with cold soft foods, never liquids Use open packets within 15 minutes

what to check with pregnancy

Never check the monitor or machine as a first action. Always assess the patient first. Ex.. listen to fetal heart tones with stethoscope.

Rape

Nonconsensual vaginal, anal, or oral penetration obtained by force or by threat of bodily harm, or when consent is unobtainable

Peak of Long-acting insulin

None

Antidepressant Medications for Attention deficit disorder and attention deficit hyperactivity disorder

Nortriptyline Bupropion

Prognosis Dementia

Not reversible

Precautions/Interactions for Warfarin

Not safe for use during pregnancy Decreased effects with phenobarbital, carbamazepine, phenytoin, and oral contraceptives Food sources high in vitamin K may decrease effects

Private room

ONLY transport client OUTSIDE of the room as MEDICALLY NECESSAY

Contributing factors Fall

Older age Impaired mobility Cognitive and/or Sensory impairment Bowel and bladder dysfuntion Side effects of medications History of falls

What are the late signs of isotonic dehydration?

Oliguria Decreased central venous pressure Flattened neck veins

List of Proton Pump Inhibitors

Omeprazole Lansoprazole Rabeprazole sodium Esomeprazole

Precautions/Interactions for Proton Pump Inhibitors

Omeprazole promotes increased risk for infection; use with caution in clients with COPD Digoxin levels may be increased with omeprazole Long-term therapy has increased risk of gastric cancer and osteoporosis

Pneumococcal vaccination for adults

Once after age 65 Recommended for immunocompromised, COPD, living in long-term care facility

Safety and Security needs

Once physiological needs are met, the safety needs emerge. These needs include security, protection, freedom from fear, and the need for law and order

Measles, mumps, and rubella vaccination for adults

One or two doses at ages 19 to 49

Client Education for Etonogestrel, ethinyl estradiol vaginal ring (Nuvaring)

One size fits most women If falls out, rinse in warm water and replace within 5 hours Remove ring during week 4; menses should begin

Precautions/Interactions with Antitussives, Expectorants, and Mucloytics

Only saline solutions should be used in children younger than 2 years Opioid antitussives have potential for abuse Caution with OTC medications - potentiate effects

Acute Phase of Schizophrenia

Onset or exacerbation of symptoms with loss of functional abilities

5 stages of development according to Sigmund Freud

Oral Anal Phallic Latency Genital

-ide

Oral hypoglycemic

Route for Terbutaline (Brethine)

Oral, long-acting

Phases of Group Development

Orientation phase Working phase Termination phase

Cognition in Mental Status Examination

Orientation to time, place, and person Level of consciousness Remote and recent memory Judgment

Side/Adverse Effects Opioid Analgesics

Orthostatic hypotension Constipation Urinary retention Blurred vision Respiratory depression Abstinence syndrome

Adverse Reaction to Tobramycin

Ototoxicity

Herpes zoster vaccination for adults

Over age 60

Precautions/Interactions for Levothyroxine (Synthroid)

Overmedication can result in signs of hyperthyroidism

List of Anticholinergic medications for overactive bladder

Oxybutynin Tolterodine Darifenacin Solifenacin Trospium Fesoterodine

Consider room placement for client safety

PRIVATE ROOM COHORT

Nursing intervention droplet precautions

PRIVATE ROOM preferred, may COHORT with client who has infection with SAME ORGANISM KEEP DOOR CLOSED DEDICATED MEDICAL EQUIPMENT remain in room MASK is required when working within 3 FEET OF CLIENT

Class A

Paper Wood Cloth Trash

Cluster A

Paranoid Schizoid Schizotypal

Therapeutic Use of Anti-Parkinson's Drugs

Parkinson's disease

Schizoid

Pattern of detachment from social relationships often choosing solitary activities

Antisocial

Pattern of disregard for and violation of the rights of others

Histrionic

Pattern of excessive emotionality and attention-seeking

Narcissistic

Pattern of grandiosity, need for admiration, and lack of empathy

Borderline

Pattern of instability of interpersonal relationships, self-image, and affects

Schizotypal

Pattern of social and interpersonal deficits marked by discomfort with close relationships and perceptual distortions

Avoidant

Pattern of social inhibition, feelings of inadequacy, and hypersensitivity to negative evaluation

Classical Conditioning

Pavlov discovered when a neutral stimulus (a bell) was repeatedly paired with another stimulus (food that triggered salivation), eventually the sound of the bell alone could elicit salivation in dogs

-cillin

Penicillin

Self-Esteem needs

People need to have a high self-regard and have it reflected to them from others

Self-actualization needs

People strive to become everything they are capable of

Therapeutic Uses for Antacids

Peptic Ulcer Disease GERD

CRE duration of precautions

Per CDC: No recommendation can be made for discontinuing contact precautions due to high mortality rate

Nursing interventions Medical Asepsis (Clean Tech.)

Perform HAND HYGIENE FREQUENTLY Use PERSONAL PROTECTIVE EQUIPMENT (PPE) as indicated DO NOT PLACE ITEMS on the FLOOR OF CLIENT'S ROOM DO NOT SHAKE LINENS CLEAN least SOILED are FIRST Place MOIST ITEMS in PLASTIC BAGS EDUCATE client and caregivers

Indication Lithotomy

Perineal Rectal Vaginal

Signs of overdose for Thyroid Hormone Antagonists

Periorbital edema Cold intolerance Mental depression

Side/Adverse Effects for angiotensin-converting enzyme (ACE) inhibitors

Persistent non-productive cough Angioedema Hypotension Should not be used in second and third trimester of pregnancy

Conduct Disorder

Persistent pattern of behavior in which the rights of others are violated and age-appropriate societal norms and rules are disregarded.

Posttraumatic Stress Disorder

Persistent re-experiencing of a highly traumatic event that involved actual or threatened death or serious injury to self or others to which the individual responded with intense fear, helplessness or horror

Symptoms of Posttraumatic stress disorder

Persistent re-experiencing of a highly traumatic event through dreams, flashbacks, thoughts and images

Presenting Symptoms of Oppositional Defiant Disorder

Persistent stubbornness Argumentativeness Limit testing Unwillingness to negotiate Quick annoyance Refusal to accept blame

Phobias

Persistent, irrational fear of a specific object, activity or situation that leads to avoidance

Nursing considerations chickenpox

Persons who are PREGNANT or have NOT had CHICKENPOX or the VACCINE should NOT care for the client

List of Decongestants

Phenylephrine (Sudafed) Ephedrine Naphazoline (Privine) Phenylpropanolamine

Neglect

Physical or emotional in providing basic needs, educational in failing to make provisions for a child, and medical in failing to provide needed care

Considerations for the use of Oral contraceptives

Pill is taken daily

Treatment of Air Embolism

Place client in left lateral Trendelenburg administer oxygen

Walking down stairs

Place the affected leg and the crutches down on the step below; support weight by leaning on the crutches and the stair rail Bring the unaffected leg down Remember the affected leg goes down first and the crutches move with the affected leg "BAD GO TO HELL"

Environmental guidelines for Suicide Prevention

Plastic eating utensils Unbreakable glass windows Locked doors on unit Screening of all potentially harmful gifts (flowers in a glass vase) Injury-proof rooms and bathrooms Remove all possessions from client that could lead to injury One-on-one constant supervision

Therapeutic Uses for Penicillins

Pneumonia Upper respiratory infections Septicemia Endocarditis Rheumatic fever GYN infections

Complications of Central Venous Catheters

Pneumothorax during insertion air embolism lumen occlusion bloodstream infection

The client states she feels spiders crawling all over her body.

Positive schizophrenia symptom

The client states that the CIA is spying on his every move

Positive schizophrenia symtpoms

Home Health setting

Post "No Smoking" signs Assess for risk (oxygen therapy, smoking, electrical equipment) Teach client to develop a plan of action in the event of a fire, including a route of exit and a location where family members will meet Instruct client to keep fire extinguisher accessible Review "Stop, Drop, and Roll"

Indication Lateral

Post abdominal surgery Client who is unconscious Seizures (head to side) Postoperative tonsillectomy and adenoidectomy Postoperative pyloric stenosis of the lower scapula and the lateral (right side) Post liver biopsy (right side) Rectal irrigations

Position of the baby by fetal heart sounds

Posterior --heard at sides Anterior---midline by unbilicus and side Breech- high up in the fundus near umbilicus Vertex- by the symphysis pubis.

Meningococcal nursing considerations

Postexposure prophylaxis is recommended to control outbreaks

Therapeutic Uses for Antiemetics

Postoperative Chemotherapy Nausea/vomiting associated with disease process

Therapeutic Use of Methylergonovine

Postpartum hemorrhage

Side/Adverse Effects of Methylergonovine

Potent vasoconstriction Hypertension Headache

Schizophrenia

Potentially devastating brain disorder that affects a person's thinking, language, emotions, social behavior, and ability to perceive relaity accurately

List of Alpha Adrenergic Blockers

Prazosin (Minipress) Doxazosin mesylate (Cardura)

List of Oral Glucocorticoids

Prednisone (Deltasone) Prednisolone (Prelone) Betamethasone (Celestone)

Contraindication for Hepatitis A vaccine

Pregnancy

Contraindications for Varicella vaccine

Pregnancy Allergy to gelatin or neomycin Immunocompromised

Contraindication for HPV vaccine

Pregnancy Allergy to yeast

Nursing Considerations for Melatonin

Pregnant or nursing women should not take melatonin

Preload/Afterload

Preload affects the amount of blood going into Right ventricle. Afterload is the systemic resistance after leaving the heart.

Therapeutic Uses for Bisacodyl

Preprocedure colon evaluation because it is a stimulant

Success of Initiative Vs Guilt Stage

Preschooler may initiate helping set the table for dinner

Ideas of Harming Self or Others in Mental Status Examination

Presence of a plan, means and opportunity to carry out a plan

Positive Symptoms of Schizophrenia

Presence of something that is not normally present such as: Hallucinations are based on the senses Delusions are false fixed beliefs and can be persecutory, grandiose, somatic or religious Bizarre behavior can be seen in inappropriate clothing, aggressive, or repetitive behavior

Therapeutic Uses for Antiseizure medications

Prevent and/or control seizure activity

Therapeutic Uses for Inhaled Anticholinergics

Prevent bronchospasm Manage allergen- or exercise-induced asthma COPD

Action of Cholinesterase inhibitors

Prevent cholinesterase from inactivating acetylcholine, resulting in improved transmission of nerve impulses

Action of Leukotriene Modifiers

Prevent effects of leukotriene resulting in decreased inflammation, bronchoconstriction, airway edema, and mucus production

Action of Glucocorticoids

Prevent inflammatory response by suppression of airway mucus production, immune responses, and adrenal function

Therapeutic Use for Antimalarials

Prevent malarial attacks Rheumatoid arthritis Systemic lupus

Action of Antisecretory/Blocking Agents

Prevent or block selected receptors within the stomach

Action of Antiplatelet Medications

Prevent platelets from aggregating or clumping together by inhibiting enzymes and factors that normally promote clotting

Therapeutic Uses for Mannitol

Prevent renal failure related to hypovolemia Decrease intracranial pressure related to cerebral edema Decrease intraocular pressure

Contact Precautions (Enteric Precautions)

Prevent transmission of infectious agents that are spread by direct or indirect contact with the client or the client's environment. "MRS WEE" M-MRSA R-Respiratory syncytial virus (RSA) S-Skin infection (VCHIPS) W-Wound infections E-Enteric infections (Clostridium difficile) E-Eye infections (conjunctivitis) "VCHIPS" V-Varicella zoster C-Cutaneous diphtheria H-Herpes simplex I-Impetigo P-Pediculosis S-Scabies

Droplet precautions

Prevent transmission of pathogens spread through CLOSE CONTACT with MUCOUS MEMBRANE or RESPIRATORY SECRETIONS Protect against droplets LARGER THAN 5 mcg "SPIDERMAN" S-Sepsis/Scarlet fever/Streptococcal pharyngitis P-Pertussis/ Pneumonia/ Parvovirus B19 I-Influenza D-Diphtheria (pharyngeal) E-Epiglottitis R-Rubella M-Mumps/Meningitis/Mycoplamsa/Mengingococcal pneumonia An-Adenovirus

Therapeutic Uses for Biophosphonates

Prevention and treatment of osteoporosis Paget's Disease Hypercalcemia related to malignancy

Therapeutic Use for Antitubercular Medications

Prevention and treatment of tuberculosis Latent TB: Isoniazid for 6-9 months Active TB: multiple therapy for up to 24 months

Therapeutic Uses for Antiplatelet medications

Prevention of acute myocardial infarction or acute coronary syndromes Prevention of stroke Intermittent claudication

Example tertiary prevention

Prevention of pressure ulcers as a complication of spinal cord injury Promoting independence for a client following stroke

Uses of Echinacea

Prevents and treats the common cold Stimulates the immune system Promotes wound healing

Action of Enoxaparin (Lovenox)

Prevents conversion of prothrombin to thrombin by inactivating coagulation enzymes

Therapeutic Uses for Magnesium hydroxide

Prevents painful elimination (low-dose osmotic) Promotes rapid evacuation (high-dose osmotic)

Action of Warfarin

Prevents the synthesis of coagulation factors VII, IX, X, and prothrombin

Action of Dabigatran (Pradaxa)

Prevents thrombus formation by directly inhibiting thrombin formation

Therapeutic Uses of Methadone

Prevents withdrawal symptoms in clients who are addicted to opiate drugs

Beta 1 Receptors

Primarily found in the cardiac and renal tissues

Beta 2 Receptors

Primarily found in the lungs, gastrointestinal tract, liver, uterus, vascular smooth muscle, and skeletal muscle

Uses of Chondroitin sulfate

Relieves osteoarthritis

Uses of Glucosamine

Relieves osteoarthritis Promotes joint health

Nursing intervention Narcissistic

Remain neutral and avoid power struggles Convey unassuming self-confidence

Nursing Interventions of Withdrawn Catatonic Schizophrenia

Remain objective Avert frustration and anger when client does not participate in activities.

Treatment of Hematoma with IV infusion

Remove IV device and apply light pressure if bleeding monitor for signs of phlebitis and treat

Procedures for inhalation of respiratory therapies

Remove the mouthpiece cap If appropriate for medication, shake container Stand up or sit upright; exhale deeply Place the mouthpiece between teeth and close lips tightly around the inhaler. While breathing in, press down on the inhaler to activate and release the medication Continue breathing in slowly for several more seconds (slow, long, steady inhalation is better than a quick short breath) Hold breath for 5-10 seconds Breathe in/out normally

What laboratory profile should nurses look for in clients taking antihypertensives?

Renal function Coagulation

List of Meglitinides

Repaglinide (Prandin) Nateglinide (Starlix)

Action/Therapeutic Uses for fresh frozen plasma

Replace clotting factors as a result or hemorrhage, burns, or shock Thrombotic thrombocytopenic purpura (TTP) Reverse effects of warfarin

Considerations for the use of Ethinyl estradiol and norelgestromin contraceptive patch

Replace patch each week for 3 weeks

Action/Therapeutic Use for Whole Blood

Replace volume after hemorrhage or surgery Trauma Burns Shock

Major Depressive Disorder

Represents a change in previous functions, symptoms include distress or impaired social, occupational, or other important areas of functioning

Nursing intervention Schizotypal

Respect client's need for social isolation Be aware of client's suspiciousness

Indication High-Fowler's

Respiratory illness with dyspnea: empphysema status asthmaticus pneumothorax cardia problem with dyspnea feeding meal times hiatal hernia during and after meal

CF chief concern?

Respiratory problems

Measles reservoir

Respiratory secretions

Pneumonia Reservoir

Respiratory secretions

RSV reservoir

Respiratory secretions

Rubella reservoir

Respiratory secretions

Clarifying techniques

Restating Reflecting Explorin

Type Anorexia Nervosa

Restricting Binge eating-purging

Side/Adverse Effects for Hydroxychloroquine

Retinal damage (blindness)

Client Rights with Mental Health

Right to receive or refuse treatment Access to stationery and postage Receipt of unopened mail Visits by health care provider, attorney, or clergy Daily interaction with visitors or phone access Right to have and/or spend money Storage space personal items Right to own property, vote, and marry Right to make wills and contracts Access to educational resources Right to sue, or be sued, including challenging one's hospitalization

Nursing Interventions for Ezetimibe

Risk of liver damage increased with combined with statins

Onset Dementia

Slowly Over months to years

Action of Alpha-Glucosidase Inhibitors

Slows carbohydrate absorption and digestion

Action of Adenosine (Adenocard)

Slows conduction time through the AV node, interrupts AV node pathways to restore normal sinus rhythm

Action of Calcium Channel Blockers

Slows movement of calcium into smooth-muscle cells, resulting in arterial dilation and decreased blood pressure

Action of Acetaminophen

Slows production of prostaglandins in CNS

Action of Antiseizure medications

Slows rates of neuronal activity in the brain by blocking specific channels responsible for neuron firing, which results in an elevation of the seizure threshold

Intoxication depressants

Slurred speech Unsteady gait Drowsiness Impaired judgement

List of Anterior Pituitary/Growth Hormone

Somatotropin Somatrem

Indication Trendelenbury

Some surgeries During labor if umbilical cord pressure is trying to be relieved

Indication Supine

Spinal cord injury (no pillow)

List of Potassium Sparing Diuretics

Spironolactone Triamterene

Four stages Alzheimer's disease

Stage 1: Mild Stage 2: Moderate Stage 3: Moderate to severe Stage 4: Late

Hep B precautions

Standard

Chickenpox (Varicella) precautions

Standard Airborne Contact

Carbapenem-resistant enterobacteriaceae (CRE) precautions

Standard Contact

Clostridium difficile precautions

Standard Contact

Herpex simplex (recurrent oral, skin, genital)

Standard Contact

Hep A precautions

Standard Contact if client has fecal incontinence

Salmonella precautions

Standard contact

Therapeutic Uses for Epoetin alfa

Stimulate RBC production Anemia related to chronic kidney disease, retrovir therapy, or chemotherapy

Therapeutic Uses for Filgrastim injection and Pegfilgrastim IV

Stimulate WBC production Neutropenia related to cancer

Action of Decongestants

Stimulate alpha-1 adrenergic receptors, causing reduced inflammation of nasal membranes

Action of Centrally Acting Alpha-2 Agonists

Stimulate alpha-adrenergic receptors, alpha-2, in the brain to reduce peripheral vascular resistance, heart rate, and systolic and diastolic blood pressure

Therapeutic Uses for Oprelvekin

Stimulate platelet production Thrombocytopenia related to cancer

Action of Immunizations

Stimulate production of antibodies to prevent illness

Action of Betamethasone

Stimulate production of surfactant in fetus between 24-34 weeks gestation

Action of Hematopoietic Growth Factors

Stimulate the bone marrow to synthesize specific blood cells

Action of Levothyroxine (Synthroid)

Stimulates metabolism of all body systems by accelerating the rate of cellular oxygenation

Action of Oxytocin

Stimulates uterine contractions for the purpose of induction or augmentation of labor

Predictors violence

Stone silence Alcohol or drug intoxication Pacing and restlessness Jaw clenching, rigid posture Verbal abuse Loud voice Intense or avoidance of eye contact

Mental Health

A state of well-being in which each individual is able to realize his own potential, cope with the normal stressors of life, work productively and fruitfully, and contribute to the community

Example of Sublimation

A student who is angry with a faculty member writes a short story of a hero

Anxiety

A universal human emotion that is considered the most basic of human emotions. Mild anxiety provides needed energy to achieve life's goals.

Maladaptive use of projection

A woman who has repressed an attraction toward another women refuses to socialize, fearing other women will make homosexual advances

Adaptive use of projection

A woman who is unconsciously attracted to another man teases her husband about flirting

Maladaptive use of denial

A woman who lost her husband 3 years ago keeps his clothes hanging in the closet and talks about him in the present tense

Alkalosis/ Acidosis and K+

ALKalosis=al K= low sis. Acidosis (K+ high)

Nursing intervention Surgical Asepsis (Sterile Tech.)

AVOID COUGHING, SNEEZING, and TALKING directly OVER FIELD ONLY DRY STERILE item TOUCH the field (1-INCH border is NONSTERILE) KEEP ALL OBJECT ABOVE WAIST WASH HANDS and DON STERILE GLOVES to perform procedure DO NOT REACH ACROSS/ABOVE sterile field DO NOT TURN BACK on sterile field

Behavior of Generativity vs Stagnation Stage

Ability to give and care for others vs self-absorption and inability to grow as a person

Behavior of Initiative Vs Guilt Stage

Ability to initiate activities vs feeling conflicted about what was initiated

Behavior of Intimacy vs Isolation Stage

Ability to love deeply and commit onself in relationships vs remaining uncommitted alone

Onset of Catatonic Schizophrenia

Abrupt

Battering Stage

Abuser releasing built-up tension by beating the victim brutally Victim may try to cover the injury

Complications of Conduct Disorder

Academic failure School suspensions and dropouts Juvenile delinquency Substance abuse and dependency

List of Alpha-Glucosidase Inhibitors

Acarbose (Precose) Miglitol (Glyset)

List of Mucloytics

Acetylcysteine Hypertonic saline

Antidote/Reversal Agent for Acetaminophen

Acetylcysteine (Mucomyst)

Action for Antidiarrheals

Activate opioid receptors in the GI tract to decrease intestinal motility and to increase the absorption of fluid and sodium in the intestine

Action of Methylergonovine

Acts directly on the uterine muscle to stimulate forceful contraction

Therapeutic Use of Antipsychotic Medications

Acute and chronic psychosis Schizophrenia Manic phase of bipolar disorders Tourette's syndrome Delusions and schizoaffective disorders Dementia

Therapeutic Use for Muclolytics

Acute and chronic pulmonary disorders with copious secretions Cystic fibrosis Antidote for acetaminophen poisoning

Therapeutic Uses for Medications for Adrenal Hormone Replacement

Acute and chronic replacement for adrenocortical insufficiency or Addison's disease Inflammation Allergic reactions Cancer

Therapeutic Use of Organic Nitrates

Acute angina attack Prophylaxis of chronic stable or variant angina

Therapeutic Use of Albuterol (Proventil, Ventolin)

Acute bronchospasm

Therapeutic Use of Colchicine

Acute gouty arthritis

Monitor for reactions with Packed RBCs

Acute hemolytic Febrile Anaphylactic Mild Allergic Sepsis

Monitor for reaction with fresh frozen plasma

Acute hemolytic Febrile Anaphylactic Mild allergic Hypervolemia Sepsis

Monitor for reaction with pheresed granulocytes

Acute hemolytic Febrile Anaphylactic Mild allergic Hypervolemia Sepsis

Monitor for Reactions with Whole Blood

Acute hemolytic Febrile Anaphylactic Mild allergic Hypovolemia Sepsis

Therapeutic Uses for Thrombolytic Medications

Acute myocardial infarction Deep-vein thrombosis Massive pulmonary emboli Ischemic stroke

List of Antiretrovirals

Acyclovir Valacyclovir Zidovudine

Precautions for Antiretrovirals

Acyclovir and valacyclovir: administer with food Zidovudine: empty stomach Increased fluid intake Begin therapy with first onset of symptoms

Addison's & Cushings

Addison's = down down down up down Cushings= up up up down up hypo/hypernatremia, hypo/hypertension, blood volume, hypo/hyperkalemia, hypo/hyperglycemia

Herb/Medication Interactions for Saw Palmetto

Additive effect with anticoagulants

Herb/Medication Interactions for Valerian Root

Additive effect with barbiturates and benzodiazepines

List of Antidysrhythmic Agents

Adenosine (Adenocard) Amiodarone (Cordarone) Atropine

Action of Sucralfate

Adheres to injured gastric ulcers upon contact with gastric acids; protective action for up to 6 hours; has no systemic effects

Therapeutic Levels for Disulfiram

Adjunct to maintain sobriety in treatment of alcohol use disorder

Nursing Interventions for Sexual Dysfunction Medications

Administer 1 hour before sexual activity; do not use more than once daily Instruct client to notify provider of all medications currently taken including herbal preparations Instruct client to avoid intake of organic nitrates Instruct client to stop taking medication and notify prescriber immediately for any of the following: erection lasting more than 4 hours, any loss of vision, and unusual bleeding problems

Nursing Interventions for Beta Adrenergic Blockers

Administer 1-2 times daily as prescribed Hold medication and notify provider if systolic blood pressure is less than 100 mm Hg or pulse is less than 60/min Monitor clients with diabetes mellitus for indications of hypoglycemia

Nursing Interventions for Calcium Channel Blockers

Administer IV injection over 2-3 minutes Slowly taper dose if discontinuing Monitor heart rate and blood pressure

Nursing Interventions for Oxytocin

Administer as secondary infusion via infusion pump for induction or augmentation Continuously monitor uterine contractions and fetal heart rate Discontinue oxytocin with any signs of uterine hyperstimulation Administer oxygen via face mask 10 liters for signs of hyperstimulation When used in postpartum, monitor client for uterine bleeding

Nursing Interventions for Stimulant Attention Deficit Hyperactive Disorder Medications

Administer in early morning Do not abruptly discontinue Monitor for signs of abuse Monitor for signs of agitation

Nursing Interventions for Glucagon

Administer medication for unresponsive client Monitor blood glucose levels Instruct client to self-monitor for early signs of hypoglycemia Instruct client to wear medical alert ID Advise client to teach family members how to administer medication Provide carbohydrates when client awakens from hypoglycemic reaction.

Nursing Interventions and Client Education for Biophosphonates

Administer medication in the morning on an empty stomach. Instruct client to consume at least 8 ounces of noncarbonated water Client must remain upright for at least 30 minutes after taking medication Consume adequate amounts of vitamin D

FHR patterns for OB

Think VEAL CHOP! V-variable decels; C- cord compression caused E-early decels; H- head compression caused A-accels; O-okay, no problem L- late decels; P- placental insufficiency, can't fill

Love and Belonging needs

This involves the need for intimate relationships and experiencing love and affection

Mental Health Nursing

This type of nursing employs a purposeful use of self as its art, and a wide range of nursing, psychosocial, and neurobiological theories and research evidence as its science

Obsessions

Thoughts, impulses or images that persist and cannot be dismissed from the mind

Assault

Threatening to give pt. medication putting another person in fear of a harmful or an offensive contact.

Hepatitis B vaccination for adults

Three doses for high-risk clients

Contraindications for Warfarin

Thrombocytopenia Vitamin K deficiency Liver disease Alcohol use disorder

-ase

Thrombolytic

-plase

Thrombolytic Medications

Indication elevate one or more extremities

Thrombophlebitis Application of cast Edema Postoperative surgical procedure on extremity

Adverse Reaction to Valacyclovir (Valtrex)

Thrombotic thrombocytopenic purpura

Half-life

Time required for the body to decrease the medication blood level by 50%

Adverse Reaction to Doxycycline (Vibramycin)

Tooth discoloration

Precautions/Interactions for Antidysrhythmic Agents

Toxicity is a major concern due to additive effects Caution is needed when used with an AV block Caution is needed when using anticholinergic medications.

Therapeutic Use of Anterior Pituitary/Growth Hormone

Treat growth hormone deficiencies Turner's syndrome

Antihypertensives

Treatment for clients with hypertension includes lifestyle modification and medictions

Therapeutic Use of Doxazosin (Cardura)

Treatment of benign prostatic hyperplasia

Long-Term Therapeutic Uses for Oral Glucocorticoids

Treatment of chronic asthma

Short-Term Therapeutic Uses for Oral Glucocorticoids

Treatment of symptoms following an acute asthma attack

Use of Saw palmetto

Treats and prevents benign prostatic hypertrophy "Save Prostatic"

Use of Melatonin

Treats insomnia and jet lag

Adverse Reaction to Lithium (Lithobid)

Tremors

Hypo Mg

Tremors, tetany, seizures, dysthythmias, depression, confusion, dysphagia, (dig toxicity)

Therapeutic Use for Metronidazole

Trichomoniasis and giardiasis Clostridium difficile Amebic dysentery Pelvic inflammatory disease Vaginosis

-tyline

Tricylic antidepressants

List of Sulfonamides

Trimethoprim/Sulfamethoxazole

Success of Trust vs Mistrust stage

Trust should be seen with the primary caregiver

8 stages of growth and development of Erik Erickson

Trust vs Mistrust Autonomy vs shame and doubt Initiative vs Guilt Industry vs inferiority Identity vs Role confusion Intimacy vs isolation Generativity vs stagnation Integrity vs despair

Do Not's

Try to prove abuse Display horror, anger, or shock Place blame or make judgments Force anyone to remove clothing

Varicella Vaccination for adults

Two doses if no history of the disease

Hepatitis A vaccination for adults

Two doses in high-risk clients

Signs and symptoms of panic anxiety

Unable to focus on the environment Feelings of "ceasing to exist" Sleeplessness May have hallucinations or delusions

Stage 3 (AD)

Unable to identify familiar objects or people Repeated instructions are needed to perform simple tasks Wandering begins to occur, become a danger to self Total care

Stage 4 (AD)

Unable to read or write Blunted emotions Cannot recognize familiar objects Loses the ability to talk and walk Stupor and coma, and death is frequently secondary to infection or choking

Denial

Unconscious attempt to escape unpleasant realities

Bulimia Nervosa

Uncontrolled compulsion to consume large amounts of food in a short period (binge eating), followed by a compensatory need to rid the body of the calories consumed

Clients taking oral hypoglycemic agents may require insulin therapy when:

Undergoing diagnostic tests Pregnant Severe kidney or liver disease is present Oral agents are inefficient Treatment of hyperkalemia

Nursing intervention Histrionic

Understand seductive behavior as a response to distress Model concrete, descriptive vs vague language

Hep A duration of precautions

Until 7 DAYS AFTER ONSET OF JAUNDICE

Chickenpox duration of precautions

Until LESIONS CRUST OVER

Pneumonia duration of precautions

Until culture is negative

Herpex simplex duration of precautions

Until lesions crust over

TB duration of precautions

Until three sputum smears are negative on consecutive days or TB is ruled out

Therapeutic Use for Macrolides

Upper respiratory infections Sinusitis Legionnaire's disease Whooping cough Acute diphtheria Chlamydia

Therapeutic Uses for Cephalosporins

Upper respiratory, skin, and urinary infections Used as prophylaxis for clients at risk

Indication dorsal recumbent

Urinary catheterization of female Abdominal assessment Abdominal wound evisceration

Therapeutic Uses for Anticholinergic medications for overactive bladder

Urinary incontinence Urinary urgency and frequency

Therapeutic Uses for Trimethoprim/Sulfamethoxazole

Urinary tract ifnection Bronchitis Otitis Media

Therapeutic Use for Nitrofurantoin

Urinary tract infections

Nursing Interventions for Intramuscular Iron Preparations

Use a large-bore needle (19-20 gauge, 3 inch) Change needle after drawing up from vial Use Z-track method Ventrogluteal site preferred Never administer in deltoid Do not massage injection site

Client Education for Medroxyprogesterone injection

Use backup form of birth control for 7 days after first injection Fertility returns approximately 1 year after stopping

Precautions/Interactions for Antiglaucoma Medications

Use caution in clients taking oral beta blocker or calcium channel blocker

Precautions/Interactions for Acetaminophen

Use caution in clients who consume three or more alcoholic beverages per day Concurrent use of rifampin, isonazid, carabamazepine, and barbiturates may increase hepatotoxic effects Slows the metabolism of warfarins

Precautions/Interactions for Antigout medications

Use caution in clients who have renal, cardiac, or gastrointestinal dysfunction. Should not be combined with theophylline.

Precautions/Interactions for Calcium Channel Blockers

Use cautiously in clients taking digoxin and beta blockers Do not consume grapefruit juice (toxic effects)

Precautions/Interactions for Diuretics

Use cautiously in clients who have diabetes mellitus Contraindicated in pregnancy NSAIDs reduced diuretic effect

Precautions/Interactions for Lithium

Use cautiously in clients who have renal dysfunction, heart disease, hyponatremia, and dehydration NSAIDs will increase lithium levels Monitor serum sodium levels

Precautions/Interactions of Sedative/Hypnotic Medications

Use cautiously in clients who have severe mental depression Avoid combined use with alcohol and medications that depress CN functions

Precautions/interactions for Decongestants and Antihistamines

Use cautiously in clients with hypertension, glaucoma, peptic ulcer disease and urinary retention Children may have symptoms of excitation, hallucinations, incoordination, and seizures Avoid alcohol intake Products containing pseudoephedrine should not be used for longer than 7 days

Nursing interventions rape

Use nonjudgmental and empathic approach Assess, treat, and document all injuries Provide a private environment and limit personnel who examine the client Assess client emotions and provide support

Prevention of infiltration with IV infusion

Use smallest catheter for prescribed therapy stabilize port-access assess blood return

Prevention of Pneumothorax with regard to Central Venous Catheters

Use ultrasound to locate veins avoid subclavian insertion whenever possible

Precautions/Interactions for angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs)

Use with caution if diuretic therapy is in place Monitor potassium levels

Nursing Considerations of Glucosamine

Use with caution in clients who have a shellfish allergy Monitor glucose frequently in clients who have diabetes mellitus Allow extended time to see the effects of Glucosamine Use it often in combination with chondroitin

Precautions/Interactions for Antipsychotic Medications

Use with caution in clients who have glaucoma, paralytic ileus, prostate enlargement, or seizure disorder

Precautions/Interactions for Mannitol

Use with caution in heart failure May increase digoxin levels due to hypokalemia

Precautions/Interactions of Methylergonovine

Use with extreme caution in clients with hypertension, preeclampsia, heart disease, venoatrial shunts, mitral valve stenosis, sepsis, or hepatic or renal impairment

Considerations for use of Condoms

Use with spermicide

Considerations for use of Cervical Cap

Use with spermicide Fit by prescriber Pap smear every 3 months Increased risk of vaginal infections

Considerations for use of Cervical diaphragm

Use with spermicide Fit by prescriber Refitted after childbirth or weight gain/loss

Precautions for Macrolides

Used for clients who have a penicillin allergy Administer with meals

Therapeutic Uses of Warfarin

Venous thrombosis Thrombus prevention for clients with atrial fibrillation or prosthetic heart valves Prevention of recurrent myocardial infarction Transient ischemic attacks

Therapeutic Use for Amiodarone (Cordarone)

Ventricular fibrillation Unstable ventricular tachycardia

Toddler 18 months+ IM site

Ventrogluteal

Side Effects to Varicella vaccine

Vesciles on skin Pruritus

Measles nursing considerations

Virus can live on infected surfaces for up to 2 hr

Type Admissions Mental Health

Voluntary Involuntary

Operant Conditioning

Voluntary behaviors are learned through consequences and behavioral response are elicited through reinforcement which causes a behavior to occur more frequently.

Side/Adverse Effects of Magnesium Sulfate

Warmth Flushing Respiratory depression Diminished deep tendon reflexes Decreased urine output Pulmonary edema

Manifestations FVD

Weight loss Dry mucus membranes Increased heart rate and respirations Thready pulse Capillary refill less than 3 seconds Weakness, fatigue Orthostatic hypotension Poor skin turgor LATE SIGNS: Oliguria, decreased CVP, flattened neck veins

Studies for Echinacea

Well-conducted studies have conflicted as to the effectiveness of Echinacea in the treatment of the common cold

Myasthenia gravis

decrease in receptor sites for acetylcholine. weakness observed in muscles, eyes mastication and pharyngeal musles. watch for aspiration.

Iron toxicity reversal

deferoxamine

IM site for children

deltoid and gluteus maximus

Hyper Mg

depresses the CNS. Hypotension, facial flushing, muscle weakness, absent deep tendon reflexes, shallow respirations. EMERGENCY

myasthenia gravis

descending musle weakness

Hirschprung's

diagnosed with rectal biopsy. S/S infant-failure to pass meconium and later the classic ribbon-like/foul smelling stools

caput succedaneum

diffuse edema of the fetal scalp that crosses the suture lines. reabsorbes within 1 to 3 days

short cord

discontinue pictocin

After total hip replacement

don't sleep on side of surgery, don't flex hip more than 45-60 degress, don't elevate Head Of Bed more than 45 degrees. Maintain hip abduction by separating thighs with pillows.

birth weight

doubles by 6 months triples by 1 year

Cullen's sign

ecchymosis in umbilical area, seen with pancreatitis

Head Injury

elevate HOB 30 degrees to decrease ICP

Buck's Traction (skin)

elevate foot of bed for counter traction

AKA (above knee amputation)

elevate for first 24 hours on pillow. position prone daily to maintain hip extension.

wilm's tumor

encapsulated above kidneys...causes flank pain

pt with leukemia may have

epistaxis due to low platelets

Transesophageal fistula

esophagus doesn't fully develop. This is a surgical emergency (3 signs in newborn: choking, coughing, cyanosis)

Diabetes insipidus (decreased ADH)

excessive urine output and thirst, dehydration, weakness, administer Pitressin

hyperthyroidism/ grave's disease

exophthalmos

Glasgow coma scale

eyes, verbal, motor Max- 15 pts, below 8= coma

Hyper-parathyroid

fatigue, muscle weakness, renal calculi, back and joint pain (increased calcium) give a low calcium high phosphorous diet

Rotavirus reservoir

feces

Shigellosis reservoir

feces

otitis media

feed upright to avoid otitis media!

russell traction

femur or lower leg

lumbar puncture

fetal position. post-neuro assess q15-30 until stable. flat 2-3 hour. encourage fluids, oral analgesics for headache.

pneumonia

fever and chills are usually present. For the elderly confusion is often present.

when a pt comes in and is in active labor

first action of nurse is to listen to fetal heart tones/rate

pancreatitis

first pain relief, second cough and deep breathe

laboring mom's water breaks?

first thing--worry about prolapsed cord!

Pt with heat stroke

flat with legs elevated

retinal detachment

floaters and flashes of light. curtain vision

BKA (below knee amputation)

foot of bed elevated for first 24 hours. position prone to provide hip extension.

up stairs with crutches? down stairs with crutches?

good leg first followed by crutches(good girls go to heaven) crutches with the injured leg followed by the good leg.

Toxic Drug Levels for Qunidine

greater than 10 mcg/mL

Toxic Drug Levels for Methotrexate

greater than 10 mcmol over 24 hours

Toxic Drug Levels for Gentamicin

greater than 12 mcg/mL

Toxic Drug Levels for Tobramycin

greater than 12 mcg/mL

TB drugs are

hepatotoxic!

heat/cold

hot for chronic pain; cold for accute pain (sprain etc)

Pheochromocytoma

hypersecretion of epi/norepi. persistent HTN, increased HR, hyperglycemia, diaphoresis, tremor, pounding HA; avoid stress, frequent bathing and rest breaks, avoid cold and stimulating foods (surgery to remove tumor)

increased ICP

hypertension, bradypnea,, bradycarday (cushing's triad)

Spinal shock occurs

immediately after injury

DKA is rare

in DM II (there is enough insulin to prevent fat breakdown)

Edema is located

in the interstitial space, not the cardiovascular space (outside of the circulatory system)

Chest tubes are placed

in the pleural space

Dumping syndrome

increase fat and protein, small frequent meals, lie down after meal to decrease peristalsis. Wait 1 hr after meals to drink

the first sign of ARDS

increased respirations! followed by dyspnea and tachypnea

Hypovolemia

increased temp, rapid/weak pulse, increase respiration, hypotension, anxiety. Urine specific gravity >1.030

Hypernatremia

increased temp, weakness, disorientation, dilusions, hypotension, tachycardia. give hypotonic solution.

Digitalis

increases ventricular irritability ----could convert a rhythm to v-fib following cardioversion

Toddlers need to express

independence!

thyroid med side effects

insomnia. body metabolism increases

Heroin withdrawal neonate

irritable, poor sucking

normal PCWC (pulmonary capillary wedge pressure)

is 8-13 readings 18-20 are considered high

Defamation

is a false communication or careless disregard for the truth that causes damage to someone's reputation. in writing(Libel) or Verbally(Slander)

orange tag in psych

is emergent psych

MMR

is given SQ not IM

When pt is in distress....medication administration

is rarely a good choice

buck's traction

knee immobility

measles

koplick's spots

positioning for pneumonia

lay on affected side, this will splint and reduce pain. However, if you are trying to reduce congestion, the sick lung goes up! (like when you have a stuffy nose and you lay with that side up, it clears!)

Older adults have....

less body water and decreased thirst sensation

Onset of Rapid-acting Insulin

less than 15 minutes

pain with diverticulitis

located in LLQ

appendicitis pain

located in RLQ

PTB

low grade afternoon fever

after Thyroidectomy

low or semi-fowler's position, support head, neck and shoulders.

Iatragenic

means it was caused by treatment, procedure or medication

early sign of cystic fibrosis

meconium in ileus at birth

alk ash diet

milk, veggies, rhubarb, salmon

hypokalemia

muscle weakness, dysrhythmias, increase K (rasins bananas apricots, oranges, beans, potatoes, carrots, celery)

Hypercalcemia

muscle weakness, lack of coordination, abdominal pain, confusion, absent tendon reflexes, shallow respirations, emergency!

multiple sclerosis

myelin sheath destruction. disruptions in nerve impulse conduction

Hyponatremia

nausea, muscle cramps, increased ICP, muscular twitching, convulsions. give osmotic diuretics (Mannitol) and fluids

for neutropenic pts

no fresh flowers, fresh fruits or veggies and no milk

Neutropenic pts

no fresh fruits or flowers

Head injury or skull fx

no nasotracheal suctioning

ECG

no sleep the night before, meals allowed, no stimulants/tranquilizers for 24-48 hours before. may be asked to hyperventilate 3-4 min and watch a bright flashing light. watch for seizures after the procedure.

with allopurinol

no vitamin C or warfarin!

Rubella nursing considerations

nonimmune pregnant women should not care for these clients

S3 sound

normal in CHF. Not normal in MI

Unstable Angina

not relieved by nitro

Before starting IV antibiotics

obtain cultures!

chest tube pulled out?

occlusive dressing

lead poisoning

test at 12 months of age

glomuloneprhitis

the most important assessment is blood pressure

placenta previa s/s placental abrution s/s

there is no pain, but there is bleeding there is pain, but no bleeding (board like abd)

Paget's disease

tinnitus, bone pain, elnargement of bone, thick bones

No phenylalanine

to a kid with PKU. No meat, dairy or aspartame

never give potassium

to a pt who has low urine output!

What are the adverse effects of alpha adrenergic blockers? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Dizziness • Fainting ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of doxazosin mesylate? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Dizziness • Fainting ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are adverse effects of centrally acting alpha2 agonists? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Dry mouth • Drowsiness & sedation • Rebound hypertension • Black/sore tongue • Leukopenia ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of promethazine? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• EPS • Anticholinergic effects • Drowsiness • Narcotic effects potentiated • <2yr: Resp. Depression ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of metoclopramide? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• EPS • Anticholinergic effects • Drowsiness • Tardive dyskinesia • Restlessness ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of ondansetron? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• EPS • Headache ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What is a unique adverse effect of potassium-sparing diuretics? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Endocrine effects: . . . ○ impotence . . . ○ menstrual irregularities ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of oprelvekin? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Fluid retention • Blurred vision • Cardiac dysrhythmia ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are adverse effects of lithium carbonate? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• GI Distress • Fine hand tremors • Polyuria • Hypothyroidism • Renal toxicity ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What is the unique effect of ondansetron within antiemetics? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Headache ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of somatropin? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Hyperglycemia • Hypothyroidism ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of epoetin alfa? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Hypertension ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of methimazole? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Skin rash, pruritus • Abnormal hair loss • GI Upset • Paresthesias • Periorbital edema • Joint & muscle pain • Jaundice • Agranulocytosis • Thrombocytopenia

What are the unique effects of metoclopramide within antiemetics? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Tardive dyskinesia • Restlessness ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What unique effects do atypical antipsychotics have? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Weight gain • Diabetes • Dyslipidemia • Orthostatic hypotension ○ less severe ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Can you get leukopenia from centrally acting alpha2 agonists? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Yes ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Can you get leukopenia from clonidine? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Yes ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are the adverse effects of leukotriene modifiers? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Zileuton & Zafirlukast . . . ○ elevated liver enzymes . . . ○ warfarin & theophylline toxicity • Montelukast . . . ○ Phenobarbital will decrease levels. ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Which antibiotic causes urine to be brown? ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• nitrofurantoin ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What are effects of phenytoin? ATI Comprehensive NCLEX-RN Review: Pharmacology Effect

• ↑ excretion of: . . . ○ digoxin . . . ○ warfarin . . . ○ oral contraceptives ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Client Education for Inhaled Anticholinergics

Instruct client that maximum effects may take up to 2 weeks Shake inhaler well before administration when using two different inhaled medications, wait 5 minutes in between

Nursing Interventions for Antigout medications

Instruct client to avoid foods high in purines to reduce uric acid Monitor CBC and uric acid levels Instruct clients to avoid aspirin Administer with meals

Nursing Interventions for Sedative/Hypnotic Medications

Instruct client to take immediately before bedtime because medication has abrupt onset of sleep Instruct client to avoid alcohol Warm client and caregivers of potential for sleep activities without recall; notify prescriber immediately

Nursing Interventions for Antiglaucoma Medications

Instruct client to use sterile technique when handling applicator portion of the container Hold gentle pressure on the nasolacrimal duct for 30 - 60 seconds immediately after instilling drops Monitor pulse rate/rhythm for clients taking oral beta or calcium channel blocker

Nursing Interventions and Client Education for Histamine-2 Receptor Antagonists

Instruct clients to seek appropriate care, many take OTC preparations Instruct client to follow medication regimen Ranitidine can be taken with or without food. Instruct client to modify diet as prescribed

Use PPE to reduce risk of transmission

GOWN and GLOVES when TOUCHING BLOOD or BODY FLUID, NONINTACT SKIN, MUCOUS MEMBRANES, or CONTAMINATED MATERIALS MASK and face and GOOGLES when anticipating SPLASHING of BODY FLUIDS PPE is DISPOSED of in the CLIENT'S ROOM

Drugs associated with date rape

Gamma-hydroxybutyrate (GHB) produces relaxation, euphoria, and hisinhibition Flunitrazepam (Rohypnol) causes sedation, muscle relaxation, and amnesia

Therapeutic Uses for Antisecretory/Blocking Agents

Gastric and Peptic ulcers GERD Zolliner-Ellison syndrome

Therapeutic Uses for Sucralfate

Gastric and duodenal ulcers GERD

Indication semi-Fowler's

Gastric feeding Head injury Postoperative cranial surgery Respiratory illness with dyspnea Postoperative cataract removal Increased intracranial pressure

Therapeutic Use for Antianxiety Medications

Generalized anxiety disorder and panic disorder Insomnia Alcohol withdrawal Induction of anesthesia

Therapeutic Uses for Antiretrovirals

Genital herpes Shingles HIV

Signs and symptoms of severe anxiety

Gently reduced perceptual field Attention scattered Feelings of dread Confusion Hyperventilation Tachycardia Threats and demands

Side/Adverse Effects for Phenytoin

Gingival hypertrophy Diplopia Drowsiness Hirstuism

Nontherapeutic Communication Techniques

Giving premature advice Minimizing feelings False reassurance Disapproval Making value judgments

List of Sulfonylureas

Glipizide (Glucotrol) Glyburide (DiaBeta, Micronase)

-gliptin

Gliptins

Order of PPE removal

Gloves Goggles/face shield Gown Mask

PPE contact precautions

Gloves Gown Mask and goggles (as-needed)

What are standard precautions PPE

Gloves Mask Gown Googles

MRSA nursing considerations

Gloves PPE including a gown/mask if in contact with site of infection

Nursing Interventions for Anticholinergic medications for overactive bladder

Administer medication with a full glass of water Instruct client that full effects may take 1-2 months Instruct client to manage anticholinergic side effects Instruct client to report constipation lasting longer than 3 days

Nursing Interventions for Bethanechol

Administer on an empty stomach

Nursing Interventions and Client Education for Sucralfate

Administer on an empty stomach at least 1 hour before meals Do not administer within 30 minutes of antacids

Nursing Interventions for Glucocorticoids

Assess client activity and behavior Administer medication with meals

Staphylococcus aureus nursing considerations

Gloves PPE including gown/mask if in contact with site of infections

Therapeutic uses for Insulin

Glycemic control of diabetes mellitus patients to prevent complications.

Order of PPE application

Gown Mask Goggles/face shield Gloves

Crutches

Assess client for correct fit of crutches: 2-3 finger widths between the axilla and top of the crutch Position hands on crutch pads with elbows flexed. (Do not bear weight on axilla)

CABG

Great Saphenous vein in leg is taken and turned inside out (because of valves inside) . Used for bypass surgery of the heart.

Appearance in Mental Status Examination

Grooming Dress Hygiene Facial Expression

List of Expectorants

Guaifenesin (Mucinex)

Ventilatory alarms

HOLD High alarm--Obstruction due to secretions, kink, pt cough etc Low alarm--Disconnection, leak, etc

Crisis of Industry vs Inferiority Stage

"I'm dumb because I can't read as fast as everyone else."

Success of Industry vs Inferiority Stage

"I'm getting really good at piano since I started taking lessons."

Success of Intimacy vs Isolation Stage

"My partner has been my best friend for 10 years."

Crisis of Intimacy vs Isolation Stage

"No one is worthy of being in a relationship with me."

Extinguish properly

"PASS" P-Pull A-Aim S-Squeeze S-Sweep

Obsessive compulsive disorder

"Tell me more about how your partner responds to your returning home each day to check the coffee pot."

Minimizing feelings

"Things often get worse before they get better."

Crisis of Generativity vs Stagnation Stage

"This old scar on my face is worse then having cancer."

List of Inhaled Glucocorticoids

Beclomethasone dipropionate (QVAR) Budesonide (Pulmicort Flexhaler) Fluticasone propionate (Advair, Flovent) Triamcinolone acetonide (Azmacort)

Involuntary

Client deemed by lawful authority to be a danger to self or others At the end of a specified time, the client must have a hearing or be released

Nursing considerations AIDS/HIV

Hand hygiene PPE if in contact with potentially contaminated materials

VRE nursing considerations

Hand hygiene and gloves gowns if in contact with contaminated material Only soap and water

Three-point gait

Client must be able to bear entire body weight on unaffected leg Two crutches and unaffected leg bear alternately Move both crutches and the weak leg forward Move stronger leg forward

Hep A nursing considerations

Contact precautions used Clients wearing diapers or who are incontinent Minimum of 1 week Depending on client's age

Rotavirus nursing considerations

Contact precautions used, particularly for children who are wearing diapers or incontinent

Prevention of Air Embolism

Have client lie flat when changing administration set or needless connectors ask client to perform Valsalva maneuver if possible

Trendelenburg

Head and body lowered while feet are elevated

Reverse Trendelenbury

Head elevated while feet are lowered

Precautions/Interactions for Biophosphonates

Contraindicated during lactation Clients who have esophageal stricture or difficulty swallowing may only use zoledronate Absorption is decreased when taken with calcium supplements, antacids, orange juice and caffeine

Indication Fowler's

Head injury Postoperative cranial surgery Postoperative abdominal surgery Respiratory illness or cardiac problems with dyspnea Bleeding esophageal varices Postoperative throidectomy or cataract removal Increased intracranial pressure

Precautions/Interactions for Beta-2 Adrenergic Agonist Medications

Contraindicated for clients with tachydysrhythmias Caution in clients with diabetes mellitus, hyperthyroidism, heart disease, hypertension, and angina. Beta blockers will reduce effects MAOIs will increase effects

Nursing Interventions with Statin Medications

Do not administer with grapefruit juice

Therapeutic Uses for Digoxin

Heart failure Atrial fibrillation

Client Education for for Calcium Channel Blockers

Do not crush or chew sustained-release tablets

Nursing Interventions and Client Education for Proton Pump Inhibitors

Do not crush, chew, or break tablets Notify prescriber of any sign of GI bleeding Teach client to take medications as scheduled.

Client Education for Beta Adrenergic Blockers

Do not discontinue without consulting provider. Do not crush or chew extended-release tablets.

Client Education on the rhythm method

Do not have sexual intercourse during "fertile periods" Low reliability for preventing pregnancy

Precautions/Interactions for Glucagon

Do not mix with sodium chloride or dextrose solutions

Side/Adverse Effects for NSAIDs

GI discomforts GI ulceration Renal impairment Photosensitivity

Walker

"WANDER WILMA'S ALWAYS LATE" W-Walker W-With A-Affected L-Leg For correct size, have the client wear shoes. The client's wrists are even with the hand grips on the walker when arms are dangling downward. Advance the WALKER approximately 12 inches Advance the WITH the AFFECTED LEG Move UNAFFECTED LEG Assess appropriateness of a rolling walker if walker is being used for support due to overall weakness. A ROLLING WALKER is NOT appropriate for client with PARKINSON'S DISEASE due to SHUFFLING GAIT.

Nursing Interventions and Client Education for Warfarin

Administer once daily. Monitor INR or PT Teach client about bleeding risk remains up to 5 days after discontinued therapy. Teach client to avoid NSAIDs and medications with aspirin. Teach client to wear a medical alert bracelet. Client may self-monitor for PT/INR. Teach measures to prevent injury and bleeding Administer vitamin K for warfarin toxicity Garlic, ginger, gingko and ginseng may increase the risk of bleeding

Treatment of Pneumothorax with regard to Central Venous Catheters

Administer oxygen assist provider with chest tube insertion

Nursing Interventions for Nitrostat/Nitrolingual

Administer sublingual. Repeat in 5 min if no relief and call 911; may take up to 3 doses. Keep Nitrostat in original dark container Nitrolingual may be used prophylactically 5-10 minutes before exercise. Do not shake Nitrolingual container because it forms bubbles. Replace nitrostat tablets every 6 months Wear medical alert identification

Nursing Interventions for Ondansetron

Administer tablets 30 minutes prior to chemotherapy and 1 -2 hours before radiation

Nursing Interventions for Betamethasone

Administer two doses, usually IM, 24 hours apart, repeat doses not recommended Provide emotional support to family

Precautions/Interactions for Thyroid Hormone Antagonists

Administer with caution in clients who have bone marrow depression, hepatic disease, or bleeding disorders Discontinue prior to radioactive iodine uptake testing Contraindicated with breastfeeding

Nursing Interventions for NSAIDs

Administer with food and full glass of water Avoid lying down for 30 minutes after administration Instruct client to use only as needed for symptoms to reduce risk of GI ulceration Instruct client to use sunscreen

Nursing Interventions for Thyroid Hormone Antagonists

Administer with food at the same time each day. Increase fluids to 3 L/day Instruct client to avoid OTC products containing iodine Instruct client to take medications as prescribed If discontinuing dose must be tapered off Monitor client for therapeutic response Monitor client for signs of overdose

Nursing Interventions and Client Education for Thrombolytic Medications

Administration must take place within 4-6 hours of symptom onset Continuous monitoring is required Clients will being anticoagulant therapy to prevent repeated thrombotic event

Intravenous Therapy

Administration of fluids via an intravenous catheter OR peripheral or central vein access for the purpose of providing medication, fluid, electrolyte, or nutrient replacement

Voluntary

Admit self Consents to all treatment Can refuse treatment, including medications, unless a danger to self or others Can demand and receive discharge

Side/Adverse Effects for Medications for Adrenal Hormone Replacement

Adrenal suppression when administered for inflammation or allergic reactions Infection Hyperglycemia Osteoporosis GI bleeding Fluid retention

Nursing Considerations for Valerian Root

Advise client against driving or operating machinery Advise client against long-term use Discontinue valerian at least 1 week prior to surgery

The following guidelines should be followed when administering multiple respiratory drug therapies:

Advise the client to take the beta 2 agonist before the inhaled glucocorticoid to increase steroid absorption Instruct on procedures for inhalation Examine mouth for irritation Perform frequent oral care.

Lumbar Puncture

After the procedure, the pt should be supine for 4-12 hours as prescribed.

List of Beta-2 Adrenergic Agonists

Albuterol (Proventil, Ventolin) Formoterol (Foradil) Salmeterol (Serevent) Terbutaline (Brethine)

List of Biophosphonates

Alendronate Risedronate Ibandronate Zoledronic acid

Side Effects for Polio Vaccine (IPV)

Allergic reaction

Therapeutic Use for Decongestants

Allergic rhinitis Sinusitis Common cold

Contraindication for Rotavirus vaccine

Allergic to mycin drugs

Contraindication for Hepatitis B vaccine

Allergy to yeast

List of Antigout medications

Allopurinol Colchicine

Nursing Considerations for Saw Palmetto

Allow 4-6 weeks to see effects Discontinue use prior to surgery

Prevention of Venous spasm with IV infusion

Allow time for vein diameter to return after tourniquet removed infuse fluids at room temperature

Adaptive use of defense mechanisms

Allows anxiety to be lowered and goals to be acheived

Working phase of group development

Allows for a focus on problem-solving

-sartan

Angiotensin II receptor blockers (ARBS)

Antihypertensive Medications

Angiotensin-Converting Enzyme (ACE) Inhibitors Angiotensin II Receptor Blockers (ARBs) Calcium Channel Blockers Alpha Adrenergic Blockers Centrally Acting Alpha2 Agonists Beta Adrenergic Blockers Vasodilators

Nursing intervention Addictive disorders

Assess Vital signs Assess dehydration Assess low self-worth Provide client safety Assess toxicology screen/blood alcohol level Assess severe withdrawal syndrome Assess overdose with warrants immediate medical attention Assess suicidal thoughts and behaviors Assess family members for codependency Explore the client's interests in participating in a 12-step program such as Alcoholics Anonymous or Narcotics Anonymous Explore the family's interest participating in self-help groups such as Al-Anon or Alateen

Nursing Interventions for Digoxin

Assess apical pulse for 1 minute prior to administration Notify provider if heart rate is less than 60 in adults, less than 70 in a child or less than 90 in an infant. Monitor for signs of digoxin toxicity, hypokalemia, or hypomagnesemia. Notify provider of any sudden increase in pulse rate that previously had been normal or low Maintain therapeutic digoxin level

Nursing Interventions for Antidepressants

Assess client for suicide risk Instruct client to take on daily basis and never to miss a dose Instruct client about therapeutic effects and time of onset Instruct client to avoid discontinuing drug abruptly Instruct client to take SSRIs in the morning to minimize sleep disturbances Provide clients taking MAOIs a list of foods containing tyramine Advise clients to avoid taking other medications without consulting provider

Nursing Interventions for Rett's syndrome

Assess for developmental delays Assess caregiver-child relationship Assess for family coping skills, risk for child abuse

Nursing intervention suicide

Assess for suicidal ideation with intent Assess for lethal suicide plan Assess for coexisting psychiatric or medical illness Assess family history of suicide Assess recent lack of support Assess for feelings of hopelessness and helplessness Assess for covert statements such as "Things will never work out." Assess for overt statements such as "I can't take it anymore."

Nursing interventions on lifting and transfer of clients

Assess mobility and strength Instruct client to assist when possible Use mechanical lift and assistive devices Avoid twisting the thoracic spine or bending at the waist Use major muscle groups, and tighten abdominal muscles

Nursing Interventions for Attention deficit disorder and attention deficit hyperactivity disorder

Assess relationship between the child and caregivers. Assess the caregiver's parenting practices for rules and responsibilities within the family. Assess the child's cognitive and psychosocial development including social skills. Assess school history for strengths and disciplinary problems

Nursing intervention Seizure precaution

Assess seizure history, noting frequency, presence of auras, and sequence of events Identify precipitating factors that may exacerbate or lead to seizure Review medication history. If routine lab work is required (Dilantin), when was last level drawn Place rescue equipment at the bedside, including oxygen, oral airway, and suction equipment Establish IV or saline lock access for high risk clients Inspects the client's environment for items that may cause injury in the event of a seizure. Remove any unnecessary items from the immediate environment At the onset seizure, position the client for safety, and remain with client If sitting or standing, ease client to floor. Protect the client's head. If client is in bed, raise the side rails and pad for safety Roll the client to the side with the head flexed slightly forward Do not put anything in the client's mouth Loosen restrictive clothing Accurately document the event, including timing precipitating behaviors or events, and a description of the event (movements, loss of consciousness, loss of continence, injuries, mention of aura, postictal state). Report seizure to the provider

Nursing Interventions of Conduct Disorder

Assess the seriousness, types, and initiation of disruptive behavior and how it has been managed. Assess anxiety, aggression and anger levels, motivation and the ability to control impulses. Assess moral development to understand the impact of hurtful behavior on others. Assess the ability to form a therapeutic relationship and engage in honest and committed therapeutic work. Assess for substance use

Nursing interventions for all clients taking antihypertensives

Assess weight, vital signs and hydration status. Assess blood pressure in supine, sitting, and standing positions. Assess laboratory profile. Teach clients to take medication at same time each day. Clients should avoid hot tubs or saunas. Do not discontinue medication abruptly. Prevent orthostatic hypotension.

Nursing interventions Bipolar disorder

Assess whether client is a danger to self or other Assess the need to protect client from uninhibited behaviors Assess for coexisting medical conditions such as substance use disorder Use firm calm approach Provide frequent high-calorie fluids Maintain low-level stimuli

Signs and Symptoms of Disorganized Schizophrenia

Associative looseness, inappropriate affect, bizarre mannerisms, incoherence of speech, and extreme social withdrawal. Poorly organized hallucinations and delusions. Often live in the homeless population.

Bipolar I

At least one episode of mania alternating with major depression. Psychosis may accompany mania

List of Nonstimulant Attention Deficit Hyperactive Disorder Medications

Atomoxetine Guanfacine (Intuniv)

Codependent Behaviors

Attempting to control someone else's drug use, finding excuses for the person's substance abuse, or destroying the person's drug or alcohol supply

Defense Mechanisms

Automatic coping styles that protect individuals from anxiety and maintain self-image

Considerations for use of Spermicides

Available as cream, foam, gel, suppository, or film

Precautions/Interactions for Selective Serotonin Reuptake Inhibitors

Avoid alcohol Do not discontinue abruptly Monitor for serotonin syndrome within the first 72 hours

Nursing intervention Paranoid

Avoid being too nice or too friendly Give clear explanation Warn about any changes and reasons for delays

Nursing intervention Schizoid

Avoid being too nice or too friendly Try not to increase socialization

Client Education for Methylxanthines

Avoid caffeine intake Smoking will decrease effects Alcohol abuse will increase effects

Precautions/Interactions for MAOIs

Avoid foods containing tyramine Antihypertensives have additive hypotensive effect Contraindicated with SSRIs, tricyclics, heart failure, CVA, and renal insufficiency

Prevention of Hematoma with IV infusion

Avoid veins not easily seen or palpated obtain hemostasis after insertion

List of Macrolides

Azithromycin Clarithromycin Erythromycin

Hepatitis b

B= blood and body fluids (hep c is the same)

Nursing intervention Dependent

Be aware of countertransference that can occur due to client's clinging behaviors Identify current stresses Satisfy client's needs with limits

Side/Adverse Effects for Antigout medications

GI distress Hepatitis

Crutches: Non-weight bearing

Begin in the tripod position, maintain weight on the "unaffected" (weight-bearing) extremity Advance both crutches and the affected extremity Move the unaffected weight-bearing foot/leg forward (beyond the crutches). Advance both crutches, and then the affected extremity Continue sequence making steps of equal length

Document Restraints

Behaviors making restraint necessary Alternatives attempted and the client's response Type and location of restraint and time applied Frequency and type of assessment

If extrapyramidal effects occur, what should be administered?

Benzatropine

Central Nervous System Depressants

Benzodiaxepines Barbiturates Alcohol "Ben go to Bar to have Alcohol"

Therapeutic Uses for Lithium

Bipolar disorder Alcohol use disorder Bulimia Schizophrenia

laparoscopy

CO2 used to enhance visual. general anesthesia. foley. post--ambulate to decrease CO2 buildup

Myxedema coma

COLD (hypothermia)

-dipine

Calcium channel blocker

Antidote/Reversal Agent for Magnesium sulfate

Calcium gluconate 10% (Kalcinate)

Orientation Phase of Nurse-Client Relationship

Can last for a few meetings or longer Rapport and trust is established The nurse's role is clarified and all roles are defined Confidentiality is established The terms of termination are introduced The nurse becomes aware of transference and countertransference issues Client problems are articulated, and mutually agreed-upon goals are established

Rule about Anticholinergics

Can't see, can't pee, can't spit, can't shit

Therapeutic Use for Fluconazole

Candidiasis infections

List of Angiotensin-Converting Enzyme (ACE) Inhibitiors

Captopril (Capoten) Enalapril (Vasotec) Enalaprilat (Vasotec IV) Fosinopril (Monopril) Lisinopril (Prinivil)

Client Education for for angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs)

Captopril should be taken 1 hour before meals

List of Antiseizure medications

Carbamazepine Gabapentin Phenobarbital Phenytoin Valproic Acid

Cholinergic Crisis

Caused by excessive medication ---stop giving Tensilon...will make it worse.

Precautions/Interactions for Phenytoin

Causes increased excretion of digoxin, warfarin, and oral contraceptives

Nursing Interventions for Salmeterol (Serevent)

Caution against using more frequently than every 12 hours

Precautions/Interactions for Oral Hypoglycemics

Caution in clients with renal, hepatic or cardiac disorders Generally avoided during pregnancy and lactation. Instruct client to discus with prescriber.

Precautions/Interactions for Dabigatran (Pradaxa)

Caution when client is making a change in medication if currently receiving warfarin. Must discontinue warfarin and start dabigatran when INR is below 2.0. When possible, discontinue 1-2 days prior to surgical procedures

Precautions for Fluoroquinolones

Caution with hepatic, renal, or seizure disorders

Precautions/Interactions for Sitagliptin

Caution with impaired renal function - dose will be reduced

List of Cephalosporins

Cephalexin Cefaclor Cefotaxime

Indication reverse trendelenbury

Cervical traction To feed client restricted to supine position, such as post cardiac catheterization

Treatment of Bloodstream Infection with Central Venous Catheters

Change entire infusion system notify provider obtain cultures administer antibiotics

Generalized anxiety disorder

Characterized by excessive anxiety or worry about numerous situations, and the anxiety is way out of proportion to the true impact of the event

Medications children

Child's age, size, and maturity of the targeted organ To reduce the risk of toxicity, safe calculation of the child's dosage (mg/kg/day), medication that is age-appropriate, monitoring of IV medications to prevent fluid overload (smaller solution containers should be used to avoid infusing too much fluid), and the administration of inhalants using a metered-space device

Attention deficit disorder and attention deficit hyperactivity disorder

Children show an inappropriate degree of inattention and impulsiveness. These symptoms are present for children with ADHD with the addition of hyperactivity.

List of Conventional Antipsychotic Medications

Chlorpromazine Fluphenazine Haloperidol Thiothixene

Therapeutic Use for Allopurinol

Chronic gouty arthritis

Therapeutic Use of Antitussives

Chronic nonproductive cough

List of Fluoroquinolones

Ciprofloxacin Levofloxacin

Selective Serotonin Reuptake Inhibitors (SSRIs)

Citalopram Escitalopram

Client: "I am so worried." Nurse: "What specifically are you worried about?"

Clarifying with reflection

Type fire extinguisher

Class A Class B Class C

Nursing Interventions of Excited Catatonic Schiozphrenia

Clear, direct communication Stimulation reduction Monitor for adequate caloric intake and rest

Nursing Interventions for Blood Administration

Client ID, name, and blood type must be verified by 2 nurses. Prior to administration, assess baseline vital signs, including temperature. Establish IV access, 18-gauge or larger catheter Must have 0.9% sodium chloride primed tubing. For the first 15 minutes, stay with the client and infuse slowly, monitoring for any reaction. Complete infusion of product within 4 hours

Cohort

Client must have SAME ORGANISM AVOID placing client on CONTACT PRECAUTIONS in SAME ROOM with clients who are IMMUNUNOCOMPROMISE, have OPEN WOUNDS, or have anticipated PROLONGED LENGTHS OF STAY Ensure client are located MORE THAN 3 FEET FROM EACH OTHER ( uses PRIVACY CURTAIN between beds to MINIMIZE OPPORTUNITIES for DIRECT CONTACT) CHANGE PROTECTIVE ATTIRE and perform HAND HYGIENE regardless of disease status

Adaptive use of denial

Client states, "I don't believe you when hearing news that a loved one died."

Indication Prone

Client who is immobilized or unconscious Post lumbar puncture 6 to 12 hr Post myelogram 12 to 24 hr (oil-based dye) Postoperative tonsillectomy and adenoidectomy

Indication Sims'

Client who is unconscious Enemas

Signs and symptoms of paranoid schiozphrenia

Clients are usually frightened, guarded, and untrusting, and may behave defensively. A delusion may include someone trying to kill them. Most common defense mechanism used is projection. If the client feels angry, she may state, "I'm not angry you are." Ideas of reference may be used. If a client sees a nurse speaking with a psychiatrist, the client may believe the discussion is about him/her.

Nursing Interventions for Heparin and Enoxaparin

Clients receiving heparin: monitor aPTT every 4-6 hour for IV administration Monitor for signs of bleeding Safety precautions to prevent bleeding Administer subcutaneous heparin to abdomen, 2 inches from umbilicus, do not aspirate or massage area Rotate injection sites and observe for bleeding or hematoma Administer protamine sulfate for heparin toxicity

Precautions/Interactions for Glucocorticoids

Clients who have diabetes mellitus may require higher doses. Never stop medication abruptly.

Contraindications for Calcium Channel Blockers

Clients who have heart failure, heart block, or bradycardia

Precautions/Interactions for Vasodilators

Clients who have hepatic or renal disease Older adults Electrolyte imbalances

List of Centrally Acting Alpha-2 Agonists

Clonidine (Catapres) Guanfacine HCL (Tenex) Methyldopa (Aldomet)

Client: "I have't taken my medicine in 4 days. Nurse: "Can you tell me reasons for not taking your medication?"

Closed-ended questions

Central Nervous system stimulants

Cocaine Amphetamines "CAmp"

Intussusception

Common in kids with CF. Obstruction may cause fecal emesis, current jelly stools. enema---resolution=bowel movements

Example secondary prevention

Communicable disease screening and case finding Early detection and treatment of hypertension Exercise programs for older adults who are frail

Factors that promote client growth

Communicating genuineness Expressing empathy Having positive regard for client

Nursing Interventions of Disorganized Schizophrenia

Communication should be concise, clear, and concrete Takes should be taken one at a time. Repeated focusing may be required to keep the client on topic

Nursing interventions Falls

Complete a fall risk assessment Communicate identified risks with the health care team Assign clients at risk falls to a room close to nurses' stations and assess frequently Provide clients with nonskid footwear Keep the floor free of clutter and maintain an unobstructed path to the bathroom Orient the client setting (grab bars, call light), including how to use and locate all necessary items Maintain bed in low position Instruct the client who is unsteady to use the call light for assistance before ambulating Answer call lights promptly to prevent clients who are at risk from trying to ambulate independently Provide adequate lighting (nightlight for necessary trips to the bathroom) Determine the client's ability to use assistive devices (walkers, canes, etc.). Keep all items within reach Use chair or bed sensors for client who are at risk Lock wheels on beds, wheelchairs, and gurneys to prevent rolling during transfers or stops Report and document all incidents per the facility policy

Nursing interventions disease prevention

Conduct a risk factor assessment Educate clients to follow standards for recommended screenings Identify lifestyle risk behaviors requiring modification Encourage client to continue health-promoting behaviors Instruct client about preventive immunizations

Do's

Conduct the interview in private Be direct, honest, and professional Be understanding and attentive Assess for client safety

Precautions for RhoD Immune Globulin (RhoGAM)

Confirm that the mother is Rh-negative Never administer the IGIM full-dose or microdose products intravenously Never administer to a neonate

Studies of Ginseng

Conflict as to the effectiveness of ginseng in all uses

Side/Adverse Effects for Aluminum Hydroxide

Constipation Hypophosphatemia

Side/Adverse Effects for Calcium Channel Blockers

Constipation Reflex Tachycardia Peripheral Edema Toxicity

Intoxication Opiates

Constricted pupils Decreased respirations Decreased Blood Pressure Initial euphoria followed by dysphoria

Nursing Interventions for Immunizations

Consult CDC guidelines for schedule of administration Educate clients about the purpose of immunizations and keeping records. Instruct parents to avoid administration of aspirin for management of adverse effects in children. Instruct clients regarding side/adverse effects and management

Precautions for Trimethoprim/Sulfamethoxazole

Consume at least 3 L/day of fluid Use backup contraception Avoid sun exposure

Precautions for Tetracyclines

Consume at least 3 L/day of fluid Use backup contraceptives Avoid sun exposure Permanent tooth discoloration if given to children younger than 8 years

Hep B nursing considerations

Contact precautions for blood and body fluids Hand hygiene

Hep C nursing consideration

Contact precautions for blood and body fluids Hand hygiene

Precautions/Interactions for Thrombolytic Medications

Contraindicated for intracranial hemorrhage, active internal bleeding, aortic dissection, brain tumors Use caution when using in clients who have severe hypertension Concurrent use of anticoagulants or antiplatelet medications increases risk for bleeding

Nursing Considerations of Ginseng

Contraindicated for women who are pregnant and/or lactating

Considerations for use of Intrauterine device

Contraindicated for women with diabetes or history of PID High risk of infection May have cramping and heavier periods

Precautions/Interactions for Sexual Dysfunction Medications

Contraindicated in clients taking nitrate drugs, anticoagulants, alpha blockers for benign prostatic hyperplasia, or antihypertensives Contraindicated in clients who have history of stroke, uncontrolled diabetes mellitus, hypo/hypertension, or heart failure

Precautions/Interactions of Anterior Pituitary/Growth Hormone

Contraindicated in clients who are severely obese. Therapy must be discontinued prior to epiphyseal closure. Avoid concurrent use of glucocorticoids

Precautions/Interactions for Beta Adrenergic Blockers

Contraindicated in clients who have AV block and sinus bradycardia. Do not administer nonselective beta blockers to clients who have asthma, bronchospasm, or heart failure

Precautions/Interactions for Carbamazepine

Contraindicated in clients who have bone marrow suppression or bleeding disorders Warfarin therapy decreases effectiveness

Precautions/Interactions for Dinoprostone cervical gel

Contraindicated in clients who have genital herpes, ruptured membranes, or placenta previa

Precautions/Interactions for Medications for Adrenal Hormone Replacement

Contraindicated in clients who have systemic fungal infection Caution in clients who have hypertension, gastric ulcers, diabetes, osteoporosis Requires higher doses in acute illness or extreme stress

Precautions/Interactions for Methylxanthines

Contraindicated in clients with active peptic ulcer disease. Caution in clients with diabetes mellitus, hyperthyroidism, heart disease, hypertension, and angina. Do not mix parenteral form with other medications. Phenobarbital and phenytoin decrease theophylline levels. Caffeine, furosemide, cimetidine, fluoroquinolones, acetaminophen, and phenylbutazone falsely elevate therapeutic levvels

Precautions/Interactions for Posterior Pituitary Hormones/Antidiuretic Hormones

Contraindicated in clients with chronic nephritis or high risk for myocardial infarction

Precautions/Interactions for Organic Nitrates

Contraindicated in clients with head injury Hypotensive risk with antihypertensive medications Erectile dysfunction medications - life threatening hypotension

Precautions/Interactions for Alpha-Glucosidase Inhibitors

Contraindicated in clients with intestinal disease due to increased gas formation

Precautions/Interactions for Inhaled Anticholinergics

Contraindicated in clients with peanut allergy because it contains soy lecithin Use extreme caution with narrow-angle glaucoma and benign prostatic hyperplasia. Do not use for treatment of acute bronchospasms

Precautions/Interactions for Phenobarbital

Contraindicated in history of substance use disorder

Precautions/Interactions for Valproic Acid

Contraindicated in liver disease and pregnancy

Precautions/Interactions for Methotrexate

Contraindicated in pregnancy, kidney or liver failure, psoriasis, alcohol use disorder or hematologic dyscrasias

Precuations/Interactions for Glucocorticoids for Antirheumatic purposes

Contraindicated in systemic fungal infection Do not administer live virus vaccines during therapy Should only be used for a short duration

Precautions/Interactions for Antiplatelet medications

Contraindicated in thrombocytopenia Caution with peptic ulcer disease

Precautions/Interactions for Centrally Acting Alpha-2 Agonists

Contraindicated with anticoagulant therapy and hepatic failure. Do not administer to clients taking MAOIs. Do not administer methyldopa through IV line with barbiturates or sulfonamides. Use cautiously in cerebrovascular attack, myocardial infarction, diabetes mellitus, major depression, or chronic renal failure. Do not use during lactation.

Nursing Interventions and Client Education for Stool Softeners/Laxatives

Contraindicated with fecal impaction, bowel obstruction, and acute surgical abdomen Encourage regular exercise and promote regular bowel elimination Monitor for chronic laxative use/abuse Provide adequate fluid intake to avoid obstruction

Precautions/Interactions for Oxytocin

Contraindicated with placental insufficiency Bishop score of 6 or greater when planning induction

Therapeutic use for Adenosine (Adenocard)

Convert supraventricular tachycardia to sinus rhythm

-asone, -solone

Corticosteroid

Precautions for Cephalosporins

Cross-sensitivity to penicillins Monitor for signs of Clostridium difficile

Culture and Sensitivity

Cultures are obtained to detect the presence of pathogens within the specimen collected. If a culture produces organisms, testing is performed in the laboratory to identify the appropriate antibiotic therapy. Begin antibiotic therapy after obtaining lab sample.

Prednisone toxicity

Cushings (buffalo hump, moon face, high blood sugar, HTN)

Nursing intervention Anorexia Nervosa

Develop a supportive relationship with client Monitor electrolytes and vital signs Monitor food and fluid intake Set achievable weight goals Limit exercise regimen to promote weight gain Explore client's feeling of self-worth Assist in the development of effective coping strategies Encourage client attendance in behavior modification therapy Encourage family support group Administer antidepressants as prescribed Provide positive reinforcement for weight gain Monitor ECG for Arrhythmia

Nursing Intervention Bulimia Nervosa

Develop supportive relationship with client Monitor electrolytes and vital signs Monitor food and fluid intake Monitor the client 30-60 minute after a meal Monitor exercise regimen Explore client's feeling of self-worth Observe teeth for erosion and caries Observe room for food hoarding Encourage client attendance in behavior modification therapy Encourage family support groups Administer antidepressants as prescribed

Asperger's Disorder

Developmental disorder that impacts the ability to effectively socialize and communicate with others. Social awkwardness and intense obsession in specific topics are noted in childhood.

List of Medications for Adrenal Hormone Replacement

Dexamethasone Hydrocortisone Fludrocortisone acetate Prednisone

List of Stimulant Attention Deficit Hyperactive Disorder Medications

Dextroamphetamine and amphetamine Methylphenidate transdermal Methylphenidate ER Methylphenidate

If a TPN solution is temporarily unavailable, what should the nurse administer to the patient?

Dextrose 10% in water

Therapeutic Uses for Posterior Pituitary Hormones/Antidiuretic Hormones

Diabetes insipidus Cardiac arrest Nocturnal enuresis

Side/Adverse Effects for Magnesium hydroxide

Diarrhea Renal impairment Hypermagnesemia

Precautions/Interactions for Antianxiety Medications

Diazepam and Buspirone are used with caution in clients who have substance use disorder and liver disease. Buspirone is contraindicated for clients taking MAOIs

List of Cardiac Glycosides

Digoxin (Lanoxin, Lanoxicaps, Digitek)

Antidote/Reversal Agent for Digitalis

Digoxin Immune FAB (Digibind)

Side/Adverse Effects of Digoxin

Digoxin Toxicity: Anorexia, nausea/vomiting, abdominal pain, fatigue, weakness, diplopia, blurred vision, yellow-green or white halos around objects

Nursing Interventions for Oral Iron Preparations

Dilute liquid preparations with juice or water and administer with a plastic straw or medication dosing syringe to avoid contact with teeth. Encourage orange juice fortified with vitamin C Avoid antacids, coffee, tea, dairy products, or whole gain breads concurrently and for 1 hour after administration due to decreased absorption Monitor the client for constipation and GI upset

Cervical Ripening Agent

Dinoprostone cervical gel

List of Antihistamines

Diphenhydramine (Benadryl) Loratadine (Claritin) Cetirizine (Zyrtec) Fexofendine (Allegra) Desloratadine (Clarinex)

List of Antidiarrheals

Diphenoxylate plus atropine Loperamide

Immunizations for children at 4-6 years

Diphtheria, tetanus, and pertussis. (DTap) Polio vaccine (IPV) Yearly influenza Measles, mumps, rubella (MMR) Varicella

Immunizations for children at 4 months

Diphtheria, tetanus, and pertussis. (DTap) Rotavirus (RV) Haemophilius influenza B (Hib) Pneumococcal conjugate vaccine (PCV) Polio vaccine (IPV)

Action of Vasodilators

Direct vasodilation of arteries and veins resulting in rapid reduction of blood pressure (Decreased preload and afterload)

Management of Digoxin Toxicity

Discontinue digoxin and potassium-wasting medications Treat dysrhythmias with phenytoin (Dilantin) or lidocaine Treat bradycardia with atropine For excess overdose, administer digoxin immune FAB to prevent absorption

Feelings that can precipitate anger

Discounted Embarrassed Guilty Humiliated Hurt Ignored Unheard Rejected Threatened Tired Vulnerable

Nursing Interventions for Contraception

Discuss conception and contraceptive plans with client to include reliability, benefits, and risks Instruct client to maintain regular health screening visits Instruct client about measures to prevent PID, STIs Explain that contraceptive decisions may change over the life span Teach clients unreliable forms of birth control including coitus interruptus, douching, and breastfeeding

Airborne Precautions

Disease known to be transmitted by air for infectious agents SMALLER THAN 5 mcg "My CHICKEN Hez TB" M-Measles C-Chicken pox H-Herpes zoster TB

Thoughts in Mental Status Examination

Disorganized Flight of ideas

Disseminated herpes zoster localized herpes zoster

Disseminated herpes=airborne precautions Localized herpes= contact precautions. A nurse with localized may take care of patients as long as pts are not immunosuppressed and the lesions must be covered!

Action of Thrombolytic Medictions

Dissolve clots that have already formed by converting plasminogen to plasmin, which destroys fibrinogen and other clotting factors

LLQ

Diverticulitis

Side/Adverse Effects of Gabapentin

Dizziness Ataxia Somnolence Hypertension Bruising

Side/Adverse Effects of Alpha Adrenergic Blockers

Dizziness Fainting

Side/Adverse Effects for Vasodilators

Dizziness Headache Profound hypotension Cyanide toxicity Thiocyanate poisoning

Side/Adverse Effects of Ginkgo biloba

Dizziness Palpitations

Precautions/Interactions for Gabapentin

Do not abruptly discontinue

Nursing Interventions and Client Education for Antacids

Do not administer to clients who have GI perforation or obstruction Clients who have renal impairment should only use aluminum-based preparations Other medications should be taken 1 hour before or after antacids Require repeated doses up to 7 times per day: 1 hour and 3 hour after meals and at bedtime

Precautions/Interactions for Tricyclic Antidepressants

Do not administer with MAOIs or St. John's wort Must avoid alcohol Contraindicated in clients with seizure disorder

Nursing Interventions for Glucocorticoids for Antirheumatic purposes

Do not skip doses Monitor blood pressure Monitor fluid and electrolyte balance and weight Monitor for signs of bleeding, GI discomforts Teach client to take calcium supplements and maintain vitamin D levels Give with food Never stop abruptly Provide immunoprotection

Nursing Interventions for Medications for Adrenal Hormone Replacement

Do not skip doses Monitor blood pressure Monitor fluid and electrolyte balance, weight, and output Monitor for signs of bleeding and GI discomfort Teach client to take calcium supplements and maintain vitamin D levels Give with food Taper off dose regimen when discontinuing medication Provide immunoprotection

Precautions/Interactions for Leukotriene Modifiers

Do not use for acute asthma attack. Chewable tablets contain phenylalanine

Precautions/Interactions for Anticholinergic medications for overactive bladder

Do not use for clients who have intestinal obstruction Use with other anticholinergics can increase anticholinergic effects

Precautions/Interactions for Methadone

Do not use in clients who have severe asthma, chronic respiratory disease, or history of head injury

Precautions/Interactions of Anti-Parkinson's Drugs

Do not use levodopa within 2 weeks of MAOI use Pyridoxine (vitamin B6) decreases effects of levodopa. Benztropine is contraindicated in clients who have narrow-angle glaucoma Must discontinue 6-8 hours before anesthesia

Nursing Interventions for Scopolamine

Do not use with angle-closure glaucoma Apply transdermal patches behind ear Use lubricating eye drops

Nursing Interventions for Cholinesterase inhibitors

Dose must be individualized Instruct clients to keep individual diary to record side effects Advise client to wear medical alert bracelet Monitor for cholinergic crisis

List of Tetracyclines

Doxycycline Tetracycline

Side/Adverse Effects for Antitussives, Expectorants, and Mucloytics

Drowsiness Dizziness Aspiration and bronchospasm risk with mucolytics Constipation

Side/Adverse Effects for Disulfiram

Drowsiness Headache Metallic taste

Side/Adverse Effects of Phenobarbital

Drowsiness Hypotension Respiratory Depression

Side/Adverse Effects of Sedative/Hypnotic Medications

Dry mouth Decreased libido Respiratory depression

Side/Adverse Effects for Centrally Acting Alpha-2 Agonists

Dry mouth Drowsiness and sedation that resolves over time Rebound hypertension Black or sore tongue Leukopenia

Side/Adverse Effects for Inhaled Anticholinergics

Dry mouth and eyes Urinary retention

List of Selective Serotonin Reuptake Inhibitors

Duloxetine Fluoxetine Escitalopram Fluvoxamine Paroxetine Sertraline

AIDS/HIV duration of precautions

Duration of illness

Clostridium difficile duration of precautions

Duration of illness

Hep B duration of precautions

Duration of illness

Hep C duration of precautions

Duration of illness

Measles duration of precautions

Duration of illness

RSV duration of precautions

Duration of illness

Rotavirus durations of precautions

Duration of illness

Herpes zoster duration of precautions

Duration of illness or with visible lesions

Informed consent required for Mental Health

ECT Medications Seclusion Restraints

Onset of Disorganized Schizophrenia

Early to middle teens

Anorexia Nervosa

Eating disorder characterized by an extreme fear of obesity and altered perception of one's own body weight

Antidote/Reversal Agent for Curare

Edrophonium (Tensilon)

Better peripheral perfusion?

EleVate Veins, DAngle Arteries

Nursing interventions on Equipment

Electrial equipment must be grounded Do not overcrowd outlets Do not extension cords on client care areas Only used equipment for intended purpose Regularly inspect equipment for frayed cords Disconnect all equipment prior to cleaning

Precautions/Interactions for Heparin and Enoxaparin

Enoxaparin must be given subcutaneously Heparing can be given subcutaneously or IV Incompatible with many medications, anything with a bicarbonate base Avoid NSAIDs, aspirin, or medications containing salicylates

List of Hematopoietic Growth Factors

Epoetin alfa (Procrit) Filgrastim (Neuopogen) Pegfilgrastim (Neulasta) Oprelvekin (Neumega)

Therapeutic Uses Sexual Dysfunction Medications

Erectile dysfunction Sexual dysfunction in women

-afil

Erectile dysfunction medication

Nursing intervention Delirium

Establish the client's baseline level of consciousness by interviewing family members Assess vital signs and perform neurological checks Assess acute onset and fluctuating levels of consciousness Assess client's ability to function in the immediate environment Determine the physiologic reason delirium is occurring Maintain comfort measures

List of Sedative/Hypnotic Medications

Eszopiclone Temazepam Zolpidem tartrate

Side/Adverse Effects of Glucocorticoids

Euphoria Insomnia Psychotic behavior Hyperglycemia Peptic Ulcer Fluid retention Increased appetite Withdrawal symptoms

Side Effects of Nonstimulant Attention Deficit Hyperactive Disorder Medications

GI upset Constipation Fatigue

IM injections children

Eutectic mix of lidocaine and prilocaine (EMLA) or liposomal lidocaine cream (LMX) may be applied topically if time permits and is congruent with facility practice guidelines. child who are 6 months and older VASTUS LATERALIS (ANTEROLATERAL THIGH) is the site for IM injections in childredn who are LESS THAN 2 YEARS OF AGE use 0.5- to 2-inche needle, depending upon the child's body size MAXIMUM DOSE is NOT to EXCEED 0.5 mL for small infants or 1 mL for small children

Nursing Intervention Dementia

Evaluate client's level of cognitive and daily functioning Identify any threats to client's safety Review all medications the client is taking Interview family members to obtain a full history Use short, simple words and phrases Speak slowly Have Clocks, calendars, and personal items in clear view Explore how well the family understands the disease progression Review resources available to the family

How often should a tetanus booster be gotten?

Every 10 years

How often should the IV tubing be changed for a patient on TPN?

Every 24 hours

How often should the nurse take blood glucose levels for a patient on TPN?

Every 4-6 hours

How often should the dressing be changed for a patient on TPN?

Every 48 to 72 hours or per facility protocol

Therapeutic Uses for Heparin and Enoxaparin

Evolving stroke Pulmonary embolism Massive deep-vein thrombosis Cardiac catheterization Myocardial infarction DIC

Contributing factors to isotonic dehydration

Excess GI loss Diaphoresis Fever Excess renal loss Hemorrhage Insufficient intake Burns Diuretic Aging

Contributing Factors FVD

Excess GI loss Diaphoresis Fever Excess renal loss Hemorrhage Insufficient intake Burns Diuretic therapy Aging: Older adults have less body water and decreased thirst sensation

Symptoms of Generalized anxiety disorder

Excessive anxiety/worry more days than not over 6 months associated with restlessness, fatigue, difficulty concentrating, sleep disturbances and irritability

Dependent

Excessive need to be taken care of that lead to submissive behavior

Behavior in Mental Status Examination

Excessive or reduced body movements Level of eye contact

Side/Adverse Effects of Bethanechol

Excessive salivation, tearing

Action/Therapeutic Uses for Albumin

Expand volume via oncotic changes Hypovolemia Hypoalbuminemia Burns Severe nephrosis Hemolytic disease of the newborn

Medication Older adult

Experience TWICE as many ADVERSE EFFECTS CONFUSION, LETHARGY, FALLS, AND WEAKNESS RISK for TOXICITY INCREASES-POLYPHARMACY TOXICITY: taking DIURETICS, ANTIHYPERTENSIVES, DIGOXIN, STEROIDS, ANTICOAGULANTS, HYPNOTICS, and OVER-THE-COUNTER MEDICATIONS

S/S of hip fx

External rotation, shortening adduction

Precautions/Indications for Sulfonylureas

Extreme high risk of hypoglycemia in clients with renal, hepatic, or adrenal disorders

List of Cholesterol Absorption Inhibitiors

Ezetimibe (Zetia)

centigrade to Fahrenheit conversion

F= C+40 multiply 5/9 and subtract 40 C=F+40 multiply 9/5 and subtract 40

Client: "I wish everyone would leave me alone." Nurse: "You are going to do fine, you'll see."

False reassurance

Withdrawal Stimulants

Fatigue Depression Agitation Apathy Anxiety Craving

Hematophobia

Fear of blood

Claustrophobia

Fear of closed spaces

Acrophobia

Fear of heights

Monitor for reactions with plaetlets

Febrile Sepsis

Clostridium difficile reservoir

Feces

Hep A reservoir

Feces

Salmonella reservoir

Feces

Primary Risk Factors for Major Depressive Disorder

Female gender Unmarried status Low socioeconomic class Early childhood trauma Family history of depression Postpartum period Medical illness

List of Opioid Analgesics

Fentanyl Hydromorphone Morphine sulfate Meperidine Codeine Oxycodone

Side Effects for yearly influenza vaccine

Fever

Factor Delirium

Fever Hypotension Infection Hypoglycemia Adverse drug reaction Head injury Emotional stress Seizure

Cane

For correct size, have client wear shoes. The correct length is measured from the wrist to the floor Cane is used on the unaffected side to provide support to the opposite lower limb In initial gait assistance, having the client move the affected leg forward (after balance is achieved) is optimal. This should only be done with personnel present to assist if a fall occurs, and a gait belt should be worn As the client gains strength, PT should instruct the client to move the affected extremity and cane at the same time, as this reduces contact pressure by at least 50% and continues to aid in balance Long-term cane use should involve the client moving the affected extremity and cane at the same time to improve muscle function "COAL" C-Cane O-Opposite A-Affected L-Leg

Nursing Considerations for Omega-3 fatty acids

Found in fish oils, nuts, and vegetable oils Some fish contain methylmercury and polychlorinated biphenyls that can be harmful in large amounts especially in women who are pregnant or nursing

Therapeutic Use for Tetracyclines

Fungal, bacterial, protozoal, rickettsial infections

List of Loop Diuretic Medications

Furosemide Bumetanide

Side/Adverse Effects for Lithium

GI Distress Fine hand tremors Polyuria Weight gain Renal toxicity

Walking up stairs

Hold onto rail with one hand and crutches with the other hand Push down on the stair rail and the crutches and step up with the unaffected leg If not allowed to place weight on the affected leg, hop up with the unaffected leg Bring the affected leg and the crutches up beside the unaffected leg Remember, the unaffected leg goes up first and the crutches move with the affected leg "GOOD GO TO HEAVEN"

Behavior of Trust vs Mistrust stage

Hopefulness Trusting vs withdrawn Alienated

Herpex simplex nursing considerations

Horizontal transmission from contact with skin and secretions Vertical transmission from mother to child in utero or childbirth

Client Education for use of Intrauterine device

Hormonal IUD effective for up to 7 years Copper IUD effective for up to 12 years Must monitor for signs of infection Verify string is present

List of Antitussives

Hydrocodone Codeine

List of Intravenous Glucocorticoids

Hydrocortisone sodium succinate (Solu-Cortef) Methylprednisolone sodium succinate (Solu-Medrol) Betamethasone sodium phosphate (Betnesol, Celestone Phosphate)

List of Antimalarials

Hydroxychloroquine Qunine sulfate

Cushings

Hyper Na, Hypo K, hyperglycemia, prone to infection, muscle wasting, weakness, edema, HTN, hirsutism, moonface/buffalo hump

Side/Adverse Effects of Anterior Pituitary/Growth Hormone

Hyperglycemia Hypothyroidism

Side/Adverse Effects for Potassium-sparing diuretics

Hyperkalemia Endocrine effects such as impotence and menstrual irregularities

Precautions/Interactions for NSAIDs

Hypersensitivity to aspirin or other NSAIDs May increase the risk of myocardial infarction and stroke

Precautions with Penicillins

Hypersensitivity with possible anaphylaxis

Side/Averse Effects for Epoetin alfa

Hypertension

Therapeutic use for angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs)

Hypertension Heart failure Myocardial infarction Diabetic neuropathy

Therapeutic Use of Vasodilators

Hypertensive emergencies

Therapeutic Uses for Thyroid Hormone Antagonists

Hyperthyroidism Preoperative thyroidectomy Thyrotoxic crisis Thyroid storm

Total Parenteral Nutrition (TPN)

Hypertonic solution containing dextrose, proteins, electrolytes, minerals, trace elements, and insulin prescribed according to the client's needs and administered via central venous device such as a PICC line, subclavian or internal jugular vein

Addison's

Hypo Na, Hyper K, Hypoglycemia, dark pigmentation, decreased resistance to stress fx, alopecia, weight loss. GI stress.

Therapeutic uses for Levothyroxine (Synthroid)

Hypothyroidism Emergency treatment of myxedema coma

Side/Adverse Effects for Loop and Thiazide Diuretics

Hypovolemia Ototoxicity Hypokalemia Hyponatremia Hyperglycemia Digoxin toxicity Lithium toxicity

ICP and Shock

ICP- Increased BP, decreased pulse, decreased resp Shock--Decreased BP, increased pulse, increased resp

Nursing interventions standard precautions

IMPLEMENT STANDARD PRECAUTIONS for ALL CLIENTS Determine need for client-specific, disease-specific precautions Provide education to health care team, clients, and visitors Report communicable disease per CDC policy Handle all blood and body fluids as if contaminated Use PPE to REDUCE risk of transmission Considered ROOM PLACEMENT for client safety Clean equipment according to facility policy DISCARD a NEEDLES and SHARPS in the appropriate CONTAINERS; DO NOT RECAP Place contaminated linens in appropriate receptacle per facility's policy CLEAN SPILLS with a solution of BLEACH and WATER (1:10 DILUTION)

Zoledronic acid is administered:

IV annually

never give K+ in

IV push

List of NSAIDs

Ibuprofen Diclofenac Indomethacin Naproxen Celecoxib

Interactive systems of the personality

Id, ego and superego

Nursing Interventions of Oppositional Defiant Disorder

Identify issues that result in power struggles and triggers for outbursts. Assess the child's view of her behavior and its impact on others. Explore how the child can exercise control and take responsibility and problem solve for future situations.

Nursing Interventions for Inhaled Anticholinergics

If administered via nebulizer, use within 1 hour of reconstitution

Tricyclic Antidepressants (TCAs)

Imipramine

Example primary prevention

Immunization programs Child car seat education Nutrition and fitness activities Health education programs

Presenting symptoms of Autistic Disorder

Impaired language development Impaired behavior development Impaired social interaction development

Cognition Dementia

Impaired memory Judgment Attention span Abstract thinking

Cognition Delirium

Impaired memory Judgment Attention span that can fluctuate

Presenting symptoms of Rett's syndrome

Impairment in communication Seizure disorder Abnormal gait Impaired head growth Severe or profound mental retardation

Nursing Interventions for Anti-Parkinson's Drugs

Instruct family members to assist with medication regimen Instruct client to notify prescriber if sudden loss of the medication effects occurs Instruct client that maximum therapeutic effects may take 4-6 weeks Monitor closely for signs of adverse reactions Instruct client to avoid high-protein meals and snacks Keep medication away from heat, light, and moisture. If pills become darkened, they may have lost potency and must be discarded

Nursing intervention Restraints

Implement nonpharmacologic measures such as distraction, frequent observation, or diversion activities Prior to application, review manufacturer's instructions for correct application Notify the provider immediately when restraints are implemented Remove the restraints and assess client every 2 hr Assess neurovascular and neurosensory status every 2 hr Leave the restraint loose enough to prevent injury Always tie the restraint to the bed frame (using loose knots that are easily removed) Reassess the need for continue use Document

Uses of Ginkgo biloba

Improves cerebral circulation to treat dementia and memory loss "Good for your Brain"

Uses of Omega-3 fatty acids

Improves hypertriglyceridemia Helps maintain cardiac health

Uses of Ginseng

Improves strength and stamina Prevents and treats cancer and diabetes mellitus

Angiotenson II

In the lungs...potent vasodialator, aldosterone attracts sodium.

Speech Dementia

Incoherent Slow Inappropriate

Nursing Interventions for Amiodarone (Cordarone)

Incompatible with heparin May be given in oral maintenance dose Monitor for respiratory complications

Action of Attention Deficit Hyperactive Disorder Medications

Increase attention span; reduce impulsive behavior and hyperactivity

Action/Therapeutic Use for Packed RBCs

Increase available RBC Severe anemia Hemoglobinopathies Hemolytic anemia Erythroblastosis fetalis

Action of Anti-Parkinson's Drugs

Increase dopamine to minimize tremors and rigidity

Action of Nonstimulant Attention Deficit Hyperactive Disorder Medications

Increase levels of norepinephrine into the CNS

Action of Stimulant Attention Deficit Hyperactive Disorder Medications

Increase levels of norepinephrine, serotonin, and dopamine into the CNS

Action/Therapeutic Uses for platelets

Increase platelet count Active bleeding Thrombocytopenia Aplastic anemia Bone marrow suppression

Action of Anterior Pituitary/Growth Hormone

Increase production of insulin-like growth factor throughout the body

Action of Antianxiety medications

Increase the efficacy of GABA to reduce anxiety

Action of Cardiac Glycosides

Increase the force and velocity of myocardial contractions to improve stroke volume and cardiac output. Slow the conduction rate, allowing for increased ventricular filling.

Action of Diuretics

Increases the amount of fluid excretion via the renal system

Electroconvulsive Therapy (ECT)

Induce seizure activity found to be helpful in treating clients who have MDD. Clients may experience temporary short-term memory loss after several ECT treatment.

Crisis of Trust vs Mistrust stage

Infant is withdrawn and unresponsive

Side Effects for Rotavirus vaccine

Infant with diarrhea and vomiting Immunocompromised

Complications associated with IV infusion

Infiltration extravastation phelbitis/thrombophlebitis hematoma venous spasm

Symptoms Bipolar disorder

Inflated self-esteem or grandiosity Decreased need for sleep More talkative than usual Fight of ideas Increase in goal directed activity Excessive involvement in unrestrained buying sprees, poor business investments, or sexual indiscretions due to loss of impulse control

Emotional abuse

Infliction of mental anguish such as threatening or intimidating

Physical abuse

Infliction of physical pain or bodily harm such as hitting or choking

Action for Beta Adrenergic Blockers

Inhibit stimulation of receptor sites, resulting in decreased cardiac excitability, cardiac output, myocardial oxygen demand. They lower blood pressure by decreasing release of renin in the kidney.

Action of Colchicine

Inhibits processes to prevent leukocytes from invading joints

Action of Tamsulosin

Inhibits smooth muscle contraction in the prostate, which improves the rate of urine flow for clients with benign prostatic hyperplasia.

Action of Thyroid Hormone Antagonists

Inhibits synthesis of thyroid hormone

Action of Cholesterol Absorption Inhibitior

Inhibits the absorption of cholesterol secreted in the bile and from food. Often used in combination with other antilipemic medications.

Action of Allopurinol

Inhibits uric acid production

Action of Glucagon

Initiates regulatory processes to promote breakdown of glycogen to glucose in the liver, resulting in increased serum glucose levels

Considerations for the use of Medroxyprogesterone injection

Injection is administered every 3 months during menstrual cycle

Paradoxical response effects

Insomnia Excitation Euphoria

Uses of Valerian Root

Insomnia Migraines Menstrual cramps

Nursing Interventions for Disease-modifying antirheumatic drugs (DMARDs)

Instruct client about measures to prevent infection Monitor liver function tests Instruct client to use reliable contraception Instruct client that initial effects may take 3-6 weeks and full therapeutic effects may take several months Administer with food Instruct clients taking hydroxychloroquine about the critical importance of retinal examination every 6 months

Nursing Interventions for Metoclopramide

Instruct client about rapid GI emptying Discontinue with signs of extrapyramidal symptoms

Nursing intervention on transferring clients from bed to chair or chair to bed

Instruct the client how to assist when possible Lower the bed to the lowest setting Position the bed or chair so that the client is moving toward the strong side Assist the client to stand, then pivot

Long-acting insulin

Insulin glargine (Lantus)

Side/Adverse Effects of Oxytocin

Intense uterine contractions Uterine hyperstimulation or contractions lasting longer than 90 seconds Uterine rupture

Herbal medications may:

Interact with other medicines and produce serious side effects

Action of Statin Medications

Interfere with hepatic enzyme HMG COA to reduce formation of cholesterol precursors.

Restraints should NEVER

Interfere with treatment Be used because of short-staffing or staff convenience Not written as PRN orders

Action of Disulfiram

Interferes with hepatic oxidation of alcohol, resulting in elevation of blood acetaldehyde levels

Action of Disease-modifying antirheumatic drugs (DMARDs)

Interrupt complex immune response, preventing disease progression

Seclusion

Involuntary confinement of a client alone in a room The goal is always centered around the safety of client and others, and is never punitive

List of Inhaled Anticholinergics

Ipratropium (Atrovent) Tiotropium (Spiriva)

Side/Adverse Effects for Methylxanthines

Irritability Restlessness Toxic effects: tachycardia, tachypnea, seizures

List of MAOIs

Isocarboxazid Tranylcypromine Phenelzine

List of Antitubercular Medications

Isoniazid Rifampin

Precautions/Interactions for Disulfiram

Isoniazid will increase the risk of adverse CNS effects for clients taking Disulfiram. Ingestion of large amounts of alcohol may cause respiratory depression, arrhythmias, and cardiac arrest Adjust medication doses of warfarin and phenytoin

Side/Adverse Effects of Glucosamine

Itching Edema Headache

Peritoneal dialysis

Its ok to have abd cramps, blood tinged outflow and leaking around site if the cath (tenkoff) was placed in the last 1-2 weeks. Cloudy outflow is never ok

Side Effects for Measles, Mumps, and Rubella (MMR) vaccine

Joint pain Anaphylaxis Thrombocytopenia

Meningitis--check for

Kernig's/ brudinski's signs

Honeymoon stage

Kindness and loving behaviors such as flowers Victim wants to believe the abuser will change

Prolapsed cord

Knee to chest or Trendelenburg oxygen 8 to 10 L

Prevention of extravastation with IV infusion

Know vesicant potential before giving medication

Age of onset for paranoid schizophrenia

Late 20-30's

Client Education for Cervical Cap

Leave in place 6 hours after intercourse for not longer than 48 hours

Client Education for Cervical diaphragm

Leave in place for 6 hours after intercourse Refit size with 10 pound or more weight change

Herpes zoster reservior

Lesions

Chickenpox reservoir

Lesions Respiratory secretions

-lukast

Leukotriene Modifiers

List of Antiglaucoma Medications

Levobunolol Pilocarpine Timolol maleate

List of Thyroid Hormone Medications

Levothyroxine (Synthroid)

Rapid-acting Insulin

Lispro (Humalog)

Medication Bipolar disorder

Lithium Valproic acid Aripipraxole Risperidone Clonazepam

List of Bipolar Medications

Lithium carbonate

Therapeutic Use for Terbutaline (Brethine)

Long-term control of asthma

Therapeutic Use of Formoterol (Foradil) and Salmeterol (Serevent)

Long-term control of asthma

Therapeutic Uses for Leukotriene Modifiers

Long-term management of asthma in adults and children older than 15 yeas. Prevention of exercise-induced bronchospsm

Nursing Considerations for Echinacea

Long-term use may cause immunosuppression

Medications

Lorazepam Alprazolam Diazepam Haloperidol Chlorpromazaine

List of Angiotensin II Receptor Blockkers (ARBs)

Losartan (Cozaar) Valsartan (Diovan) Irbesartan (Avapro)

Stage 1 (AD)

Loss of intellectual ability is insidious Loses energy, drive, and initiative Difficulty learning

Side/Adverse Effects for Proton Pump Inhibitors

Low incidence of diarrhea, nausea, and vomiting Can increase the risk of fractures, pneumonia, and acid rebound

Side Effects for Haemophilius influenza type B vaccine

Low-grade fever

Prone

Lying on abdomen, legs extended, and head turned to the side

Supine

Lying on back, head, and shoulders Slightly elevated with small pillow

Sims' (semi-prone)

Lying on left side with most of the body weight borne by the anterior aspect of the ilium, humerus, and clavicle

Lateral (side-lying)

Lying on side with most of the body weight borne by the lateral aspect of the lower ilium

Nursing Interventions and Client Education for Diuretics

Monitor I&O Monitor vital signs Monitor fluid and electrolyte imbalances Administer early morning to prevent nocturia Instruct clients taking loop/thiazide diuretics to increase intake of foods high in potassium Instruct clients taking potassium-sparing diuretics to avoid salt substitutes

Nursing Interventions for for angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs)

Monitor blood pressure Monitor for angioedema and promptly administer epinephrine 0.5 mL of 1:1,000 solution subcutaneously

Nursing Interventions for Levothyroxine (Synthroid)

Monitor cardiac system Therapy initiated with low doses; advance to higher doses while monitoring laboratory values Monitor T4 and TSH levels Take in early morning

Nursing Interventions for Methadone

Monitor clients for signs of drug tolerance and psychological dependence Monitor pancreatic enzymes because medication may cause biliary spasms Instruct client that methadone must be slowly reduced to produce detoxification Client must be monitored through treatment center

Nursing Interventions for Terbutaline sulfate and Ritodrine HCl

Monitor contractions and fetal heart tones Monitor vital signs Do not administer if pulse rate is greater than 130/min or if client has chest pain Administer beta blocking agent as antidote

Nursing Interventions with Antitussives, Expectorants, and Mucloytics

Monitor cough frequency, effort, and ability to expectorate Monitor character, tenacity of secretions Auscultate for adventitious lung sounds Teach client why multiple therapies are needed Promote fluid intake

Nursing Interventions and Client Education for Antidiarrheals

Monitor fluid and electrolytes Avoid caffeine intake because it increases GI motility

Nursing interventions for Centrally Acting Alpha-2 Agonists

Monitor for adverse CNS effects. Monitor CBC, heart rate, and blood pressure. Assess for weight gain or edema. Monitor closely for rebound hypertension when medication is discontinued, usually 48 hours

Nursing Interventions for Atropine

Monitor for dry mouth, blurred vision, photophobia, urinary retention and constipation

Nursing Interventions for Antihistamines and Decongestants

Monitor for hypokalemia Monitor blood pressure Teach client to manage anticholinergic effects Advise to take at night

Nursing Interventions for Antipsychotic Medications

Monitor for side effects within 5 hours to 5 days of administration Advise client of potential side effects Monitor CBC Encourage fluids Stop medication for signs of neuroleptic malignant syndrome

Nursing Interventions for Antiplatelet medications

Monitor for signs of prolonged bleeding Teach client to report tarry stool, ecchymosis

Nursing Interventions for Antiseizure Medications

Monitor for therapeutic effects Monitor clients taking phenytoin for toxic effects, including serum levels for toxicity Instruct clients regarding the importance of compliance; medication is treatment, not a cure Individualize treatment regimen Instruct client regarding side/adverse effects Medication therapy for status epilepticus: IV phenytoin and diazepam

Nursing Interventions for Anterior Pituitary/Growth Hormone

Monitor growth patterns Reconstitute medication, do not shake Administer subcutaneously per protocol Dose is individualized

Nursing Interventions for Alpha Adrenergic Blockers

Monitor heart rate and blood pressure

Precautions for Fluconazole

Monitor hepatic and renal function Refrigerate suspensions Increased risk of bleeding for clients taking anticoagulants

Nursing Interventions and Client Education for Acetaminophen

Monitor liver function Monitor kidney function Instruct client not to exceed single dose of 325 mg or 4,000 mg in 24 hours Instruct client about the risk of hepatotoxicity Administration to children should be based on age, not to exceed 5 doses per day Treat acetaminophen overdose with acetylcysteine

Nursing Interventions for Antilipemic Medications

Monitor renal and liver function laboratory profiles Note dietary precautions with specific classes

Nursing Interventions for Insulin

Monitor serum glucose levels before meals and at bedtime or patterned schedule-specific to client Roll vial of insulin, except regular to mix; do not shake Instruct client to rotate injection sites to prevent lipodystrophy Teach signs and management for hypo/hyperglycemia Encourage diet and exercise to follow ADA recommendations Monitor glycosylated hemoglobin (HbA1C) Refer to diabetic nurse educator

Nursing Interventions for Lithium

Monitor therapeutic levels Monitor serum sodium levels Instruct client that therapeutic effects begin in 7-14 days Doses must be administered 2-3 times daily per prescriber Provide nutritional counseling to include food sources for sodium Administer with food to decrease GI distress

Nursing Interventions for Methylxanthines

Monitor therapeutic levels for Aminophylline and Theophylline Monitor for signs of toxicity

Nursing Interventions for Posterior Pituitary Hormones/Antidiuretic Hormones

Monitor urine specific gravity Monitor blood pressure Monitor urinary output Prevent hyponatremia due to water intoxication Instruct for use of nasal spray

Nursing Interventions for Antianxiety Medications

Monitor vital signs Instruct clients to never abruptly discontinue medications Monitor clients for side/adverse effects Instruct clients to avoid alcohol Treat overdose of benzodiazepines with flumazenil

Nursing Interventions for Opioid Analgesics

Monitor vital signs Monitor for respiratory depression Instruct client regarding administration with PCA pump Administer naloxone for clients who have respiratory depression

Nursing interventions for isotonic dehydration

Monitor vital signs Monitor skin turgor Maintain strict I&O

Nursing Interventions for Promethazine

Monitor vital signs Safety precautions Intramuscular injection in a large muscle

Nursing Interventions for Magnesium Sulfate

Monitor vital signs and deep tendon reflexes Monitor magnesium levels, therapeutic levels 4-8 mg/dL Administer via infusion pump in diluted form Use indwelling catheter to monitor urinary elimination Administer calcium gluconate 10% if available for signs of toxicity

List of Leukotriene Modifiers

Montelukast (Singulair) Zileuton (Zyflo) Zafirlukast (Accolate)

Side Effects for Stimulant Attention Deficit Hyperactive Disorder Medications

Mood changes Insomnia Anxiety

Side/Adverse Effects of Melatonin

Morning grogginess Lower body temperature Vivid dreams

Precautions/Interactions of Opioid Analgesics

Morphine is contraindicated after biliary tract surgery Meperidine is contraindicated in clients who have kidney failure Monitor for potentiate effects when given with barbiturates, benzodiazepines, phenothiazines, hypnotics, and sedatives

Alzheimer's disease

Most common cause dementia in older adults It is marked by impaired memory and thinking skills

Panic attacks

Most commonly seen feature of panic disorder. Characterized as a sudden onset of extreme apprehension of fear usually associated with impending doom

Medications Breastfeeding

Most medications taken by a mother who is breastfeeding appear in BREAST MILK Medication LEVELS tend to be the HIGHEST in the NEWBORN immediately AFTER the medication is administered to the mother Mothers who are breastfeeding are advised to BREASTFEEDING BEFORE taking the medication

Crutches: Weight bearing

Move crutches forward about one step's length Move "affected" leg forward; level with the crutch tips Move the "unaffected" leg forward Continue sequence making steps of equal length

Munchausen syndrome vs munchausen by proxy

Munchausen will self inflict injury or illness to fabricate symptoms of physical or mental illness to receive medical care or hospitalization. by proxy mother or other care taker fabricates illness in child

Action of Inhaled Anticholinergics

Muscarinic receptor blocker resulting in bronchodilation

Side/Adverse Effects for Antilipemic Medications

Muscle aches Hepatotoxicity Myopathy Rhabdomyolysis Peripheral neuropathy

Side/Adverse Effects of Anti-Parkinson's Drugs

Muscle twitching, especially eyelid spasms Headache Dizziness Dark urine Agitation

Side/Adverse Effects for Biophosphonates

Musculoskeletal pain Esophagitis and GI discomfort Jaw pain with zoledronate

Weighted NI (naso intestinal tubes)

Must float from stomach to intestine. Don't tape right away after placement. May leave coiled next to pt on HOB. Position pt on RIGHT to facilitate movement through pyloris

Precautions/Interactions for Tamsulosin

Must rule out bladder cancer prior to administering Combined used with cimetidine may facilitate toxicity

Nursing Interventions for Disulfiram

Must wait 12 hours between time of last alcohol intake and starting medication. Instruct client that consumption of alcohol while taking Disulfiram will result in flushing, throbbing in head and neck, respiratory difficulty, nausea, copious vomiting, sweating, thirst, chest pain, palpitation, dyspnea, hyperventilation, tachycardia, hypotension, syncope, marked uneasiness, weakness, vertigo, blurred vision, and confusion. Instruct client that undesirable effects lasts 30 minutes to several hours when alcohol is consumed. Instruct client that effects of Disulfiram may stay in the body for weeks after therapy is discontinued Instruct client that therapy may last months to years

Addesonian crisis

N/V confusion, abdominal pain, extreme weakness, hypoglycemia, dehydration, decreased BP

TB nursing considerations

N95 mask client wears SURGICAL MASK when transported outside of negative-airflow room

3-4 cups of milk a day for a child?

NO too much milk can reduce the intake of other nutrients especially iron. Watch for ANEMIA

Intermediate-Acting Insulin

NPH (Humulin N)

Cardiac cath

NPO 8-12 hours. empty bladder, pulses, tell pt may feel heat, palpitations or desire to cough with injection of dye. Post: V.S.--keep leg straight. bedrest for 6-8 hr

Myelogram

NPO for 4-6 hours. allergy hx phenothiazines, cns depressants and stimulants withheld 48 hours prior. Table moved to various positions during test. Post--neuro assessment q2-4 hours, water soluble HOB UP. oil soluble HOB down. oralanalgesics for HA. No po fluids. assess for distended bladder. Inspect site

Antidote/Reversal Agent for Narcotics

Naloxone (Narcan)

Signs and symptoms of moderate anxiety

Narrow perceptual field Voice tremors Difficulty concentrating Increased respiratory and heart rate Pacing Banging hands on table

Moderate Anxiety

Narrows the perceptual field, and some details become excluded

Contraindication for seasonal influenza vaccine

Nasal spray contraindicated for child younger than 2 years and adults older than 50 years History of Gullian-Barre syndrome

Side/Adverse Effects of Omega-3 fatty acids

Nausea Diarrhea Hypotension

Side/Adverse Effects of Dinoprostone cervical gel

Nausea Stomach pain Back pain Feeling of warmth in the vaginal area

Side/Adverse Effects of Acetaminophen

Nausea and vomiting Long-term therapy: hemolytic anemia, leukopenia, neutropenia, and thrombocytopenia

Side/Adverse Effects of Glucagon

Nausea and vomiting Rebound hypoglycemia

Withdrawal depressants

Nausea/Vomiting Tachycardia Diaphoresis Tremors Grand mal seizures Visual hallucation Paranoid delusion

PE

Needs O2!

Precautions/Interactions with Statin Medications

Prolonged bleeding in clients taking warfarin Drug interactions with digoxin, warfarin, thyroid hormones, thiazide diuretics, phenobarbital, NSAIDs, tetracycline, beta-blocking agents, gemfibrozil, glipizide, glyburide, oral contraceptives, and phenytoin

Side/Adverse Effects of Saw Palmetto

Prolonged bleeding time Altered platelet function

Action of Amiodarone (Cordarone)

Prolongs repolarization, relaxes smooth muscles, decreases vascular resistance

List of Antiemetics

Promethazine Metoclopramide Ondansetron Scopolamine

Action of Beta-2 Adrenergic Agonists

Promote bronchodilation by activating beta-2 receptors in bronchial smooth muscle

Therapeutic Use of Betamethasone

Promote fetal lung maturity in preterm labor when delivery is likely

Action of Expectorants

Promote increased mucous secretion to increase cough production

Action of Posterior Pituitary Hormones/Antidiuretic Hormones

Promotes reabsoprtion of water with the kidneys; vasoconstriction of vascular smooth muscle

Termination phase of group development

Promotes reflection on the progress that has been made

Action of Sulfonylureas

Promotes release of insulin from the pancreas

Action for Sitagliptin

Promotes release of insulin, lowers glucagon secretion and slows gastric emptying

Infant with Spina Bifida

Prone so that sac does not rupture

Long-Term Therapeutic Uses for Inhaled Glucocorticoids

Prophylaxis of asthma

List of Nonselective, Beta 1 and Beta 2, Medications

Propranolol (Inderal) Nadolol (Corgard) Labetalol (Normodyne)

Action of Cervical Ripening

Prostaglandins cause cervical softening in preparation for cervical dilation and effacement

Antidote/Reversal Agent for Heparin and Enoxaparin (Lovenox)

Protamine sulfate

Client Education for Condoms

Protects against STDs Apply and remove correctly Use only water-soluble lubricants

Nursing interventions airborne precautions

Provide PRIVATE ROOM with monitored NEGATIVE AIRFLOW (air exchanged and air discharge through HEPA filter) KEEP DOOR CLOSED RESPIRATORY PROTECTION: NURSE must FIT tested for N95 respiratory. Apply a small, particulate MASK to that client if LEAVING ROOM for medical necessary.

Nursing Interventions for Paranoid schizophrenia

Provide a safe, secure environment Maintain a therapeutic, objective, communicative approach If delusions exist with food being poisoned, provide commercially sealed packages when possible

Nursing intervention Borderline

Provide clear and consistent boundaries Use clear communication Be aware of manipulative behaviors Assess for self-mutilating behaviors

Nursing interventions repositioning clients in bed

Raise the bed to waist level Lower side rails Use slide boards or draw sheets Have the client fold his arms across his chest while lifting the head Proceed in one smooth movement Collaborate with other staff members for assistance

List of Histamine-2 Receptor Antagonists

Ranitidine Hydrochloride Cimetidine Nizatidine Famotidine

Nursing Interventions for Adenosine (Adenocard)

Rapid IV (1-2 seconds) push Flush immediately with normal saline

Types of Insulin

Rapid-acting Short-acting Intermediate-acting Long-acting

Symptoms of Panic Disorder

Recurrent episodes of panic attacks that can include palpitations, chest pain, breathing difficulties, nausea, feelings of chocking

Oppositional Defiant Disorder

Recurrent pattern of negative, disobedient, hostile, defiant behavior toward authority figures without violating the basic rights of others.

codes for pt care

Red- unstable, ie.. occluded airway, actively bleeding...see first Yellow--stable, can wait up to an hour for treatment Green--stable can wait even longer to be seen---walking wounded Black--unstable, probably will not make it, need comfort care DOA--dead on arrival

Action of Metformin

Reduces gluconeogenesis Increases uptake of glucose by muscles

Action of Meglitinides

Reduces production of glucose within the liver through suppression of gluconeogenesis. Increases muscle uptake and use of glucose.

Therapeutic Uses for Dabigatran (Pradaxa)

Reduces the risk of stroke and embolism for clients with nonvalvular atrial fibrillation

Action of Antiglaucoma Medications

Reduction of aqueous humor

Trough levels

Reflect the LOWEST CONCENTRATION or RESIDUAL LEVEL and are usually OBTAINED WITHIN 15 MINUTES prior to administration of the next scheduled dose. The scheduled dose of medication should NOT be ADMINISTERED until the LEVEL is CONFIRMED.

Action of Organic Nitrates

Relax peripheral vascular smooth muscles, resulting in dilation of arteries and veins, thus reducing venous blood return (reduced preload) to the heart, which leads to decreased oxygen demands on the heart. Increase myocardial oxygen supply by dilating large coronary arteries and redistributing blood flow.

Therapeutic Uses of Methylxanthines

Relief of bronchospasm Long-term control of asthma

Therapeutic Use of Opioid Analgesics

Relief of moderate to severe pain Sedation

Therapeutic Uses for Antihistamines

Relieve/prevent hypersensitivity reactions

Therapeutic Uses for Docusate sodium

Relieves constipation because it is a surfactant

Precautions for Antitubercular Medications

Risk of neuropathies and hepatotoxicity Consume foods high in vitamin B6 Avoid foods with tyramine with Isoniazid Increased risk of phenytoin toxicity with Isoniazid Avoid alcohol Discoloration of urine, saliva, sweat, and tears with Rifampin

Medications for Conduct Disorder

Risperidone Methylphenidate Buproprion Carbamazepine

Compulsion

Ritualistic behaviors an individual feels driven to perform to attempt a reduction in anxiety

List of Thiazolidinediones

Rosiglitazone (Avandia) Pioglitazone (Actos)

Prevention of Phlebitis/Thrombophlebitis with IV infusion

Rotate sites every 72-96 hours secure catheter use aseptic technique for PICC lines avoid excessive activity with the extremity

Hypernatremia

S (Skin flushed) A (agitation) L (low grade fever ) T (thirst)

Air or Pulmonary Embolism

S/S chest pain, dyspnea, tachycardia, pale/cyanotic, sense of impending doom. (turn pt to LEFT side and LOWER the head of bed.)

Autonomic Dysreflexia/Hyperreflexia

S/S pounding headache, profuse sweating, nasal congestion, chills, bradycardia, hypertension. Place client in sitting position (elevate HOB) FIRST!

Cranial nerves

S=sensory M=motor B=both Oh (Olfactory I) Some Oh (Optic II ) Say Oh (Oculomotor III) Marry To (trochlear IV) Money Touch (trigeminal V) But And (Abducens VI ) My Feel (facial VII) Brother A (auditory VIII) Says Girl's (glossopharyngeal IX) Big Vagina (vagus X) Bras And (accessory XI) Matter Hymen (Hypoglossal XII) More

Mood in Mental Status Examination

Sad Labile Euphoric Flat affect Bland affect

Side/Adverse Effects for Antipsychotic Medications

Sedation Extrapyramidal effects Anticholinergic effects Tardive dyskinesia Agranulocytosis Neuroleptic malignant syrome Seizures

Side/Adverse Effects of Methadone

Sedation Respiratory depression Paradoxical CNS excitation

-pram, -ine

Selective Serotonin Reuptake Inhibitiors

Medication Depressive disorder

Selective Serotonin Reuptake Inhibitors (SSRIs) Serotonin Norepinephrine Reuptake Inhibitors (SNRIs) Norepinephrine Dopamine Reuptake Inhibitors (NDRI) Tricyclic Antidepressants (TCAs) Monoamine Oxidase Inhibitors (MAOIs)

Action of Alpha Adrenergic Blockers

Selectively inhibit alpha-1 adrenergic receptors, resulting in peripheral arterial and venous dilation that lowers blood pressure

Behavior of Autonomy vs Shame and Doubt Stage

Self-control and using willpower vs uncertainty of doing anything at all

Suicide

Self-imposed death manifested through inner pain, hopelessness, and helplessness, often accompanied by psychiatric disorder

Therapeutic use for Aminoglycosides

Septicemia Meningitis Pneumonia

Side/Adverse Effects for Thrombolytic Medications

Serious bleeding risks from recent wounds, puncture sites, weakened vessels Hypotension Possible anaphylactic reaction

What diagnostic procedures can be done for isotonic dehydration?

Serum electrolytes Blood urea nitrogen Hematocrit Urine specific gravity Urine osmolarity

Nursing intervention Antisocial

Set clear limits on specific behavior Be aware of guilt and manipulation the client will attempt when not getting what he wants

Studies for Valerian Root

Several studies support the use of valerian for mild to moderate sleep disorders and mild anxiety

Studies for St. John's Wort

Several well conducted studies support the use of St John's wort for mild to moderate depression

Studies for Saw Palmetto

Several well-conducted studies support the use of saw palmetto for reducing symptoms of benign prostatic hypertrophy

Antipsychotic Medications are Contraindicated in Clients who have:

Severe depression Parkinson's disease Prolactin-dependent cancer Severe hypotension

Severe anxiety

Severely narrows the perceptual field, and right amount of focus on detail is lost

Precautions/Interactions for Meglitinides

Should not be used with NPH insulin due to risk of angina

Client Education for Spermicides

Should use with barrier method Can insert up to 1 hour before intercourse

List of Sexual Dysfunction Medications

Sildenafil Tadalfil Vardenafil

List of Statin Medications

Simvastatin (Zocor) Lovastatin (Mevacor) Pravastatin sodium (Pravachol) Rosuvastatin (Crestor) Fluvastatin (Lescol, Lescol XL)

List of Gliptins

Sitagliptin (Januvia)

Nursing Interventions for Nitro-Dur (Transderm patch)

Skin irritation may alter medication absorption Optimal locations for patch are upper chest or side; pelvis; and inner, upper arm Rotate skin sites daily

Side/Adverse Effects of Thyroid Hormone Antagonists

Skin rash, pruritus Abnormal hair loss GI upset Paresthesias Periorbital edema Joint and muscle pain Jaundice Agranulocytosis Thrombocytopenia

Speech in Mental Status Examination

Slow Rapid Normal Loud Soft Disorganized

Side/Adverse Effects of Cholinesterase inhibitors

Slow heart rate Chest pain Weak pulse Increased sweating Dizziness Client feeling like he/she might pass out Weak or shallow breathing Urinating more than usual Seizures Trouble swallowing

Therapeutic Use for Disease-modifying antirheumatic drugs (DMARDs)

Slow joint degeneration and progression of rheumatoid arthritis

Action of Sedative/Hypnotic Medications

Slow neuronal activity in the brain to induce sedation/sleep

If a reaction occurs during blood administration:

Stop blood immediately and take vital signs Infuse 0.9% sodium chloride Notify the provider Follow facility protocol such as send urine sample, CBC, and bag and tubing to laboratory for analysis

Treatment of extravastation with IV infusion

Stop infusion discontinue administration set aspirate drug if possible apply cold compress document condition of site, may photograph

Treatment of Phlebitis/Thrombophlebitis with IV infusion

Stop infusion remove peripheral IV catheters apply heat compress insert new catheter in opposite extremity

Treatment of infiltrtion with IV infusion

Stop infusion remove peripheral catheters apply cold compress elevate extremity insert new catheter in opposite extremity

Treatment of Toxicity of Methylxanthines

Stop parenteral infusion Activated charcoal to decrease absorption in oral overdose Lidocaine for dsyrhythmias Diazepam to control seizures

Therapeutic Use of Tocolytics

Stop preterm labor

Paranoid Schizophrenia

Strong irrational suspicion with dominant symptoms of hallucnations and delusions

Meningococcal vaccination for adults

Students entering college Adults older than 56 years Repeat every 5 years for high-risk clients

Studies of Ginkgo biloba

Studies conflict as to the effectiveness of gingko in all uses

Withdrawan Symptoms of Catatonic Schizophrenia

Stuporous or comatose appearance Mute for hours, days, or weeks Acutely aware of environment, though appear detached Unable or refuse to participate in activities

Nursing Interventions for Filgrastim injection and Pegfilgrastim IV

Subcutaneous or IV Do not agitate vial Monitor CBC

Nursing Interventions for Epoetin alfa

Subcutaneous or IV Do not agitate vial Monitor hematocrit

Antidote/Reversal Agent for Lead

Succimer (Chemet)

Onset Delirium

Sudden Over hours to days

Side/Adverse Effects for Beta-2 Adrenergic Agonist Medications

Tachycardia Palpitations Tremors

Side/Adverse Effects for Levothyroxine (Synthroid)

Tachycardia Restlessness Diarrhea Weight loss Decreased bone density Heat intolerance Insomnia

Client Education for Ezetimibe

Take 1 hour before or 4 hours after other antilipemics.

Nursing Interventions for Tamsulosin

Take 30 minutes after meal at same time each day Teach client to contact prescriber if greater than 4 doses are missed

Client Education for Alpha Adrenergic Blockers

Take medication at bedtime to minimize effects of hypotension. Advise to notify prescriber immediately about adverse reactions. Consult prescriber before taking any OTC medications.

Nursing Interventions of Nonstimulant Attention Deficit Hyperactive Disorder Medications

Take medication daily Do not crush or chew Instruct client to immediately report worsening of anxiety, agitation Do no take with MAOIs

Client Education for Antilipemic Medications

Take medication in the evening because this is when cholesterol synthesis increases. Eat a low-fat/high-fiber diet.

INH can cause peripheral neuritis

Take vitamin B6 to prevent. Hepatotoxic

Precautions for Metronidazole

Take with food Do not consume alcohol during therapy for 48 hours after completion of regimen

Excited Symptoms of Catatonic Schizophrenia

Talk or shout continually and incoherently Hyperactive behavior

Client Education for Leukotriene Modifiers

Teach client to take daily Do not decrease or stop taking other prescribed asthma drugs until instructed

Nursing Interventions and Client Education for Dabigatran (Pradaxa)

Teach client to take medication daily and avoid skipping doses If a dose is missed, it should not be taken within 6 hours of the next scheduled dose. Tablets should not be crushed, broken or chewed Teach client to avoid NSAIDs and medications with aspirin Teach client to monitor for signs of GI bleeding

S & S Anorexia Nervosa

Terror of gaining weight Preoccupation with thoughts of food Judges self-worth by body weight Low body weight Amenorrhea Cold extremities Constipation Hypotension, bradycarida Impaired renal function Hypokalemia Hyperactivity

shilling test

Test for pernicious anemia

Guthrie test

Tests for PKU. Baby should have eaten protein first

Maintenance Phase of Schizophrenia

The client is at or near baseline functioning

Catatonic Schizophrenia

The essential feature is abnormal levels of motor behavior, either extreme motor agitation or retardation

Panic anxiety

The extreme level of anxiety and leaves a person unable to process the environment

Medication Education group

These groups are designed to teach clients about their medications allow for questions and concerns to be discussed

Dual Diagnosis group

These groups engage clients in treatment, and their use of substances following a systematic process

Stress Management group

These groups focus on teaching relaxation techniques

Precautions/Interactions for Digoxin

Thiazide or loop diuretics increase risk of hypokalemia and precipitate digoxin toxicity. Angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs) increase risk of hyperkalemia Verapamil (Calan) increases risk of toxicity

Precautions/Interactions for Insulin

When mixing regular with NPH insulin, draw up regular insulin first Do not mix other insulins with lispro, glargine, or combination 70/30 Only regular insulin is given IV in normal saline Administer glargine at bedtime

Side/Adverse Effects for Atropine

When used for life-threatening emergency, has no contraindications

Coitus interruptus

Withdrawal

Precautions/Interactions with Metformin

Withhold 48 hours prior to and 48 hours after a test with contrast media. Contraindicated in clients with severe infection, shock, and hypoxic conditions

Economic abuse

Withholding of financial support or illegal use of funds for one's personal gain

Varicella Vacccine

Women who are not immune to varicella should be immunized in the postpartum period. Instruct client to use reliable form of contraception and avoid pregnancy for 3 months.

Withdrawal Opiates

Yawning Insomnia Panic Diaphoresis Cramps Nausea/Vomiting Chills Fever Diarrhea

Seasonal influenza vaccination for adults

Yearly

Immunizations for children at 2-3 years

Yearly influenza

Adverse Reaction to Digoxin (Lanoxin)

Yellow tinge to vision

Labels on herbal medications must include:

a disclaimer, stating that the FDA has not approved the product for safety and effectiveness

Myesthenia Gravis

a positive reaction to Tensilon---will improve symptoms

eclampsia is

a seizure

Grave's Disease/ hyperthyroidism

accelerated physical and mental function. Sensitivity to heat. Fine/soft hair.

DKA

acetone and keytones increase! once treated expect postassium to drop! have K+ ready

TB reservoir

airborne respiratory droplet nuclei

Before medication administration, the RN must assess the client's:

allergies and adverse effects current medication regimen for potential interactions physiologic status compared to baseline assessment data.

what to ask before flu shot

allergy to eggs

what to ask before MMR

allergy to eggs or neomycin

Contraindication for Hep B vaccine

anaphylactic reaction to baker's yeast

Glucagon increases the effects of?

anticoagulants

clozapine, Clozaril

antipsychotic anticholinergic

RLQ

appendicitis watch for peritonitis

ARDS and DIC

are always secondary to another disease or trauma

detached retina

area of detachment should be in the dependent position

gullian-barre syndrome

ascending muscle weakness

Gullian -Barre syndrome

ascending paralysis. watch for respiratory problems.

Latex allergies

assess for allergies to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes and peaches

emphysema

barrel chest

Shock

bedrest with extremities elevated 20 degrees. knees straight, head slightly elevated (modified Trendelenberg)

perform amniocentesis

before 20 weeks to check for cardiac and pulmonary abnormalities

pathological jaundice occurs: physiological jaundice occurs:

before 24 hours (lasts 7 days) after 24 hours

flumazenil, Romazicon

benzo overdose

Cold stress and the newborn

biggest concern resp. distress

Hep C reservoir

blood and body fluids

Fat embolism

blood tinged sputum r/t inflammations. Increase ESR, respiratory alkalosis. Hypocalcemia, increased serum lipids.

NCLEX answer tips

choose assessment first! (assess, collect, auscultate, monitor, palpate) only choose intervention in an emergency or stress situation. If the answer has an absolute, discard it. Give priority to the answers that deal with the patient's body, not machines, or equipment.

Pneumonia nursing considerations

consider organism-specific precautions as indicated

Salmonella nursing considerations

contact precautions used, particularly for children who are wearing diapers or incontinent

RSV nursing considerations

contact/ droplet precautions follow established guidelines for administration of ribavirin

cognitive therapy

counseling

Sucking stab wound

cover wound and tape on 3 sides to allow air to escape. If you cover and occlude it--it could turn into a closed pneumo or tension pneumo!

MI

crushing stabbing chest pain unrelieved by nitro

angina

crushing, stabbing chest pain relieved by nitro

when on nitroprusside monitor:

cyanide. normal value should be 1.

Alendronate is administered:

daily or weekly

Risedronate is administered:

daily, weekly, and monthly

intraosseous infusion

often used in peds when venous access can't be obtained. hand drilled through tibia where cryatalloids, colloids, blood products and meds are administered into the marrow. one med that CANNOT be administered IO is isoproterenol, a beta agonist.

pyloric stenosis

olive like mass

During internal radiation

on bed rest while implant in place

glaucoma

painful vision loss. tunnel vision. halo

Bladder CA

painless hematuria

hemophilia is x linked

passed from mother to son

In an emergency

patients with a greater chance to live are treated first

Autonomic dysreflexia

patients with spinal cord injuries are at risk for developing autonomic dyreflexia (T-7 or above)

Battery

performing procedure without consent

Glaucoma patients lose

peripheral vision.

complications of mechanical ventilation

pneumothorax, ulcers

After Myringotomy

position on the side of AFFECTED ear, allows drainage.

Thoracentesis:

position pt on side or over bed table. no more than 1000 cc removed at a time. Listen for bilateral breath sounds, V.S, check leakage, sterile dressing

Airborne precautions protective equip

private room, neg pressure with 6-12 air exchanges/hr mask & respirator N95 for TB

Koplick's spots

prodomal stage of measles. Red spots with blue center, in the mouth--think kopLICK in the mouth

Dementia

progressive deterioration of cognitive functioning and global impairment of intellect with no change in consciousness

diptheria

pseudo membrane formation

After lumbar puncture and oil based myelogram

pt is flat SUPINE (prevent headache and leaking of CSF)

administration of enema

pt should be left side lying (Sim's) with knee flexed.

After Cateract surgery

pt sleep on UNAFFECTED side with a night shield for 1-4 weeks

WBC left shift

pt with pyelo. neutrophils kick in to fight infections

brachial pulse

pulse area on an infant

when drawing an ABG

put in heparinized tube. Ice immediately, be sure there are no bubbles and label if pt was on O2

pancreatitis pts

put them in fetal position, NPO, gut rest, Prepare anticubital site for PICC, they are probably going to get TPN/Lipids

Cushing's triad

r/t ICP (HTN, bradycardia, irritability, sleep, widening pulse pressure)

pernicious anemia

red beefy tongue

patients with hallucinations patients with delusions

redirect them distract them

BPH

reduced size and force of urine

umbilical cord compression

reposition side to side or knee-chest

Meningococcal reservoir

respiratory secretions

William's position

semi Fowler's with knees flexed to reduce low back pain

Paracentesis

semi fowler's or upright on edge of bed. Empty bladder. post VS--report elevated temp. watch for hypovolemia

Post-Thyroidectomy

semi-fowler's. Prevent neck flexion/hyperextension. Trach at bedside

Mania

severe enough to cause marked impairment in activities or relationships and may necessitate hospitalization to prevent harm to self or others

children 5 and up

should have an explanation of what will happen a week before surgery

Droplet precautions

spiderman! sepsis, scarlet fever, streptococcal pharyngitis, parvovirus, pneumonia, pertussis, influenza, diptheria, epiglottitis, rubella (German measles), mumps, meningitis, mycoplasma or meningeal pneumonia, adeNovirus (Private room and mask)

Measles (Rubeola virus) precautions

standard airborne

Tuberculosis (TB) (pulmonary) precautions

standard airborne

Rotavirus precautions

standard contact

Shigellosis (dysentery) precautions

standard contact

Staphylococcus aureus (infection or colonization) precaution

standard contact

RSV precautions

standard contact droplet

Pneumonia precautions

standard droplet

Meningococcal disease precautions

standard droplet

malaria

stepladder like fever--with chills

kawasaki syndrome

strawberry tongue

first sign of PE

sudden chest pain followed by dyspnea and tachypnea

bethamethasone (celestone)

surfactant. premature babies

SSRI's

take about 3 weeks to work

a nurse makes a mistake?

take it to him/her first then take up the chain

milieu therapy

taking care of pt and environmental therapy