123

each liter of fluid weighs

2.2 pounds or 1 kilogram

safe acetaminophen dose

4000 in 24 hr 2000 g 24 hr for geriatrics and liver disease/impairment

nursing considerations of aspirin

GI bleed risk w/ patient 60 yr older have stomach ulcers or bleeding problems

magnesium sulfate supplement

PO and IV

non opioid analgesic

acetaminophen

what is a safe alternative to NSAID to reduce risk of GI bleed

acetaminophen

which medication is safe to take for pain in the week before a surgical procedure

acetaminophen, it does not affect platelet function

MOA furosemide

acts on loop of henle

MOA spironolactone

aldosterone antagonist causes increased amounts of sodium and water to be excreted in distal convoluted tubules while K is retained

the nurse is taking care of a client who has chronic back pain. which nursing considerations would be made when determining the clients plan of care

ask client about acceptable level of pain administer pain meds regularly around the clock

which medication increases the risk for upper GI bleeding

aspirin ibuprofen methylprednisolone

nursing considerations tramadol

assess LOC BP HR RR bowel function safety! fall risk change positions slowly avoid alcohol

nursing considerations for kayexalate

assess bowel sounds and movement patient ability to form BM monitor I&O labs: CMP (k and na)

nursing considerations of calcitonin

assess for fish/salmon allergy patency of nares alternate nares monitor for s/s hypo/hypercalcemia

nursing considerations of magnesium sulfate supplements

assess neuro, DTR, and vitals assess mg levels and I&O s/s hypomagnesia foods: nuts, fish, chocolate

nursing considerations for morphine sulfate

assess pain 1 hr (PO) and 20 min (IV) assess loc, BP, HR, RR prior to admin assess bowel function assess I&O monitor respiratory status safety! fall risk

nursing considerations of ibuprofen

assess renal function GI bleed give with food or milk do not combine with other nsaids do not take with alcohol

when is ibuprofen contraindicated

asthma cardiac disease peptic ulcer disease

which food would nurse instruct client to include in the diet when being prescribed furosemide

bananas

morphine sulfate MOA

binds to opioid receptors in the CNS to prevent neurons to signal to eachother, decreasing and eliminating pain leads to CNS depression

MOA hydrocodone w/apap

binds to opioid receptors to prevent neurons from signaling to eachother

tramadol MOA

binds to selective opioid receptor inhibits reuptake of serotonin and norepinephrine in the CNS

child with juvenile idiopathic arthritis (JIA) is started on a nonsteroidal antiinflammatory drug (NSAID). what nursing consideration should be included

blood in urine -hematuria may result from use of NSAID b/c they may cause nephrotoxicity

calcium carbonate is essential for

bone formation and blood coagulation -reduces stomach acid

which sensation reported by the client would the nurse consider when determining that furosemide is being administered too quickly

buzzing ears -rapid administration of furosemide can cause tinnitus, loss of hearing and ear pain

antidote for magnesium sulfate

calcium gluconate

kayexalate is a

cationic exchange resin removes K via stool, exchanges potassium ions for sodium ions in the GI tract (intestine)

tramadol is a

centrally acting non opioid

potassium sparing diuretics act on

collecting duct in the kidney

side effects of naproxen

confusion GI ulcer/bleeding

side effects of hydrocodone w/ apap

constipation N/V drowsiness/dizziness respiratory depression

methylprednisolone

corticosteroid that is known to cause medication induced GI bleeding by causing irritation and erosion of the gastric mucosal barrier

which action would the nurse take before administering each dose in a client who takes oxycodone every 3 hours for pain after surgery

count respiratory rate ask client to rate level of pain assess client LOC -oxy depresses the CNS, resulting in depressed respirations and decreased LOC

NSAIDs inhibit

cox-1 and cox-2 which inhibit the production of prostaglandins thereby contributing to analgesia

MOA of calcitonin

decreases osteoclast activity allows osteoblasts to outwork osteoclasts and build bones

side effects of furosemide

dehydration hypokalemia ototoxicity (tinnitus)

thiazides act on

distal convoluted tubule

fluid volume overload signs

edema bounding pulse distended neck veins HR, BP, RR, WT go up fine crackles in lungs heart failure

hyponatremia causes

fatigue headache confusion seizures

indications for spironolactone

fluid management HF needs diuretic but also needs to spare potassium

indications for magensium sulfate

hypomagnesia constipation bronchspasm

which meds are contraindicated for clients undergoing surgery

naproxen aspirin ketorolac NSAIDs

side effects of aspirin

nephrototoxic GI bleed/ulcer epistaxis (bleeding gums) stomach pain tinnitus cramping

weakest diuretic

potassium sparing often combined with loop or thiazide

aldosterone receptor diuretic

spironolactone

which mechanism of action explains how diuretics reduce BP

they reduce circulating blood volume by blocking reabsorption of sodium in the renal tubules thus promoting fluid loss and reducing arterial pressure

sodium chloride tabs patient education

they taste bad, make sure you eat balance diet

MOA hydrochlorothiazide

works in early part of distal convoluted tubule to inhibit sodium chloride transporter

vitamin D supplement side effects

hypercalcemia

nursing considerations for furosemide

s/s of dehydration and hypokalemia measure BP and HR monitor foods high in K weigh self change position slowly

indications for vitamin d supplement

vitamin d deficiency osteoporosis hypocalcemia hypoparathyroidism

which instructions would the nurse include when providing teaching to the parent of a child prescribed diuretics

fluid intake should be adequate diuretics should be taken same time each day diuretics may interfere with normal lab test values

indications for furosemide

fluid volume overload heart failure hypertension pulmonary edema ascites

a child with pulmonary edema is treated with opioids and furosemide. Which nursing interventions would the nurse perform to promote safe medication administration

follow principal of atraumatic care administer oral drugs with food or snacks document child age weight and height

which drugs generally cause hypokalemia

furosemide and hydrochlorthiazide

most powerful diuretic

furosemide, loop diuretic

which symptom in a client receiving hydrochlorothiazide would cause a nurse to notify the provider

generalized weakness -symptom of significant hypokalemia

nursing considerations for naproxen

give with food or milk may increase risk for stroke or MI

kayexalate must be

given with no other med for up to 6 hours

side effects of acetaminophen

hepatotoxic jaundice GI bleed N/V fatigue

side effects of calcium carbonate

hypercalcemia -muscle weakness -arrhythmias -high BP -chronic bone pain -N/V/D -hypoactive bowels -constipation -positive chvostek and trousseau sign

side effects of potassium chloride

hyperkalemia -arrhythmias -tetany -N/V/D -abdominal cramps -muscle weakness/cramps

which adverse medication effect will a nurse monitor for in a client with cirrhosis of the liver who develops ascites and is prescribed spironolactone

hyperkalemia b/c it is a potassium sparing diuretic that is used to treat patients with ascites

side effects of spironolactone

hyperkalemia gynecomastia dehydration (BP decreases, HR and temp increase)

side effects of magnesium sulfate

hypermagnesia -decreased DTR -flushed skin -decrease in BP, HR and RR

side effects of sodium chloride tablets

hypernatremia -confusion -low BP -high HR and RR -orthostatic hypotension -FVO

indications for hydrochlorothiazide

hypertension heart failure edema renal calculi

indications for calcium carbonate

hypocalcemia GERD heartburn/indigestion

side effects of calcitonin

hypocalcemia hypercalcemia rhinitis

side effects of hydrochlorothiazide

hypokalemia -muscle cramps -muscle weakness/spasms -arrhythmias -fatigue

which adverse effect would a nurse monitor for when caring for a client receiving furosemide to relieve edema

hypokalemia b/c it causes depletion of electrolytes like potassium and sodium

side effects of kayexalate

hypokalemia hypernatremia low serum electrolye levels except for sodium

sodium chloride tablets indication

hyponatremia

which client statement indicates teaching about furosemide is understood

i need to change position slowly i should eat more foods high in potassium

which statement by a client receiving diuretic therapy indicates that the teaching about potassium supplements is understood

i will report any abdominal distress -potassium supplements may cause GI ulceration and bleeding

best NSAID for children

ibuprofen

first generation nsaids

ibuprofen naproxen aspirin

nursing considerations for celecoxib

increases risk of VTE monitor BP renal and liver function s/s GI bleed increases risk of MI, CVA, and thrombosis

antidote for potassium chloride

kayexalate

indications for potassium chloride supplements

low k-hypokalemia on loop diuretic

furosemide may do what to BP

may cause hypovolemia which can result in orthostatic hypotension with sudden changes in position

indication of aspirin

may lower risk of heart attack and stroke reduce fever mild to moderate pain relief muscle ache headache tooth ache

which conclusion would the nurse make regarding a clients response to pain medication when a client using a pain scale of 1-10 rates the pain as a 8 before receiving a analgesic and a 7 after being medicated

medication is not adequately effective -expected effect should be more than one point decrease in the pain level

indication of acetaminophen

mild-moderate pain fever, but no affect on inflammation

indications for tramadol

moderate to severe pain

indications for morphine sulfate

moderate to severe pain respiratory issues (tachypnea)

indications for hydrocodone w/apap

moderate to severe pain in post op patient, cancer patient or patient with trauma

nursing considerations for vitamin d supplement

monitor BMP: calcium take with calcium s/s hypercalcemia

nursing considerations for potassium chloride supplement

monitor K level do not crush or dilute IV dosage: peripheral 5-10 CVAD: up to 20

nursing considerations of calcium carbonate

monitor calcium levels s/s of hyper/hypo calcemia no medications ` hour before and 2 hours after

nursing considerations of acetaminophen

monitor liver function avoid alcohol do not use on patients with liver issues

nursing considerations for spironolactone

monitor weight monitor I&O s/s dehydration and hyperkalemia avoid salt substitutes

side effects of ibuprofen

nephrotoxic GI bleed/ulcer tinnitus bronchospasm

side effects of celecoxib

nephrotoxic GI ulcers/bleeds increase stroke and heart attack risk BP increase

magnesium is important for

neurotransmission and muscle excitability

indications of kayexalate

non life threatening hypokalemia (5.0-6.5) constipation

aspirin MOA

nonselective inhibition cox-1 and cox-2

ibuprofen MOA

nonselective inhibition of cox-1 and cox-2

naproxen MOA

nonselective inhibition of cox-1 and cox-2

potassium supplements should be taken

not on an empty stomach because they are irritating

which action will the nurse take in a client hospitalized for uncontrolled hypertension and chest pain on a daily diuretic for 2 days whose potassium level this morning was 2.7

notify HCP potassium level is below normal

which principle explains how loop diuretics promote diuresis

osmosis

indications for calcitonin

osteoporosis hypercalcemia hyperparathyroidism pagets disease

indications for ibuprofen

pain fever inflammation disorders

which therapeutic outcome is expected after administering ibuprofen

pain relief temperature reduction reduced inflammation

aspirin is contraindicated in

patients with asthma rhinitis can cause renal and liver impairment

which action will the nurse take when a client who had a MI complains of feeling dizzy 15 min after receiving 15 mg of morphine sulfate for chest pain

place client in supine position and take vitals -dizziness is a symptom of hypotension, a side effect of morphine -supine position increases venous return, cardiac output and blood flow to the brain

KCL

potassium chloride supplement PO & IV

hydrochlorothiaze is a

potassium wasting diuretic thiazide

vitamin D

promotes absorption of calcium

what accumulates at the site of injury causing pain

prostaglandins

loop diuretics inhibit

reabsorption of sodium and water in the ascending loop of Henle

after orthopedic surgery patient reports pain 5/10, nurse administers 5 mg of oxycodone every 3 hours as needed. two hours after med was given, patient reports pain 10/10, what action would the nurse take

request the provider to evaluate the need for additional medication

which adverse effect of morphine indicates need for narcan

respiratory depression

side effects of tramadol

respiratory depression euphoria bradypnea hypotension constipation drowsiness/dizziness

indications of naproxen

rheumatoid arthritis acute gout osteoarthritis

nursing considerations for sodium chloride tablets

s/s hyper/hypo natremia fvo precaution=seizures, falls

side effects of morphine sulfate

sedation drowsiness bradypnea hypotension bradycardia constipation urinary retention euphoria respiratory depression N/V

acetaminophen MOA

selective inhibition of cox-2 in CNS

MOA celecoxib

selective inhibitor of cox-2

after surgery a patient has a PCA that is set to allow morphine delivery every 6 min, which statement indicates to the nurse that the family understands instructions about the pump

she needs to push the pca button whenever she needs pain medication

diuretics may interfere with which labs

sodium potassium magnesium chloride

calcitonin is used

to treat osteoporosis

indications for celecoxib

treat pain redness swelling osteoarthritis

calcium carbonate

tums antacid

which clinical finding in a client receiving morphine warrant immediate follow up by the nurse

unconsciousness bradycardia bradypnea

the primary nurse, leaving for lunch, provides a verbal report for covering nurse. the report included one clients prescription for morphine: 2 mg IV every 3 hours for abdominal pain secondary to major abdominal surgery that morning. during the primary nurses lunch, the client complains of pain at 8/10 level on pain scale. which action would the covering nurse perform first

verify the written prescription matches the administration record

hydrocodone w/apap

vicodin norco

nursing considerations of hydrochlorothiazide

vitals I&O weight monitor labs: potassium, GFR, creatinine, BUN

hydrochlorothiazide increases excretion of

water sodium, potassium chloride

which response would a nurse monitor for when a client is receiving furosemide to relieve edema

weight loss excessive loss of potassium ions

how should diuretics be taken

with food or milk, same time every day in the AM

which action will the nurse take when a client is prescribed morphine sulfate via IV route every 3 hours as needed for pain requests medication for pain given that preoperative BP was 128/76 and postoperative assessment reveal BP ranges between 90/60 and 100/70

withhold morphine until BP stabilizes -morphine may decrease BP further so it should be withheld