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Atypical anxiolytics

Buspirone (BuSpar) → Used for anxiety, panic disorder, OCD, PTSD S/E include dizziness, nausea (take w/ meals to decrease), headache NO SEDATION. Dependency not likely so long-term use is ok. Full effect not felt fr several wks

Cane Walking

COAL (Cane, Opposite, Affected, Leg)

Atypical antidepressants side effects

Common S/E - appetite suppression, wt loss, GI distress, agitation, seizure, headache Headache and dry mouth may be severe and pt should notify provider if this occurs

Agonists

Drugs that allow the body's neurotransmitters, hormones, and other regulators to perform the jobs they are supposed to perform

Hypokalemia

Dysrhythmias, muscle weakness/cramps, constipation/ileus, hypotension, weak pulse

Venous disorder

Elevate legs Make a v with your 2 fingers (the 2 fingers being the legs) to help remember care for pt with arterial vs venous disorder

Sodium bicarbonate

Given orally as an antacid or via IV Numerous incompatibilities with IV form

Calcium citrate (Citrical)

Implement seizure precautions during administration and have emergency equipment on hand

Order of Assessment

Inspection, palpation, percussion, auscultation Except with abdomen it is IAPP-inspect, auscultate, percuss and palpate.

Incentive Spirometer Use

Instruct pt to keep a tight mouth seal around mouthpiece and to inhale and hold breath for 3-5 secs

Contact Precautions

MRSA, VRSA, RSV, skin infection (herpes zoster, cutaneous diphtheria, impetigo, pediculosis, scabies, and staphylococcus), wound infections, enteric infection (C diff), eye infections (conjunctivitis) Management → gown, gloves, goggles, private room

Hemoglobin Lab Value

Male 14-18, Female 12-16

RBC Lab Value

Male 4.7-6.1, Female 4.2-5.4

Hematocrit Lab Value

Male 42-52%, Female 37-47%

HDL Lab Value

Male > 45 mg/dL, women > 55 mg/dL

Magnesium sulfate

Monitor BP, pulse and respirations with IV administration Decreased/absent deep tendon reflexes indicates toxicity Have injectable calcium gluconate on hand to counteract toxicity when giving magnesium sulfate via IV

Normal PT/Normal INR Lab Value

Normal PT = 11-12.5 sec, Normal INR = 0.7-1.8 (Therapeutic INR 2-3) PT on Coumadin should be 2-3x higher INR of 3.9 means it is 3.9x higher than normal person

Normal PTT Lab Value

Normal PTT = 30-40 sec (Therapeutic PTT 1.5 - 2 x normal or control values) PTT on heparin should be 1.5-2x higher

Latex Allergies

Note that clients allergic to bananas, apricots, cherries, grapes, kiwis, passion fruit, avocados, chestnuts, tomatoes, and/or peaches may experience latex allergies as well

Potassium Chloride (K-Dur)

Oral or IV administration NEVER give IV push to avoid fatal hyperkalemia Dilute potassium and give no more than 40 mEq/L per IV to prevent irritation of vein Administer no faster than 10 mEq/L per IV Concurrent use with potassium-sparing diuretics or ACE inhibitors can cause hyperkalemia

Arterial disorder

Place legs in a dependent position (dangling legs down)

Antagonists

Prevent the body from performing a function that it would normally perform (narcan)

Hypomagnesemia

c

Dysphasia

difficulty speaking

Dysphagia

difficulty swallowing Aspiration precautions; Avoid thin liquids and sticky food and provide oral care prior to eating (helps to enhance taste of food)

Hyperkalemia

dysrhythmias, muscle weakness, numbness/tingling, diarrhea

surgical asepsis

sterile technique

Hypernatremia

↑HR, muscle twitching/weakness, GI upset

Hyponatremia

↑HR, ↓BP, confusion, fatigue, N/V, headache

Hypercalcemia

↓ DTR, kidney stones, lethargy, constipation

Hypermagnesemia

↓BP, muscle weakness, lethargy, respiratory/cardiac arrest

Airborne Precautions

"My chicken hez TB" Measles, chicken pox, herpes zoster, TB Management → Neg pressure room, private room, mask, n95 for TB

Venturi Mask

(4-10L/min) is most precise O2 delivery. Best for pt w/ chronic lung disease (i.e. COPD)

Trendelenburg position

(legs in the air) → Used to promote venous circulation

SSRIS definition and names

(selective serotonin reuptake inhibitors) - inhibits serotonin reuptake (↑ serotonin) Citalopram (Celexa), Sertraline (Zoloft), Fluoxetine (Prozac), Paroxetine (Paxil) End in "ine" so think of how its stressful to have a teen in the house - these meds are used for anxiety and depression Full effects not felt for up to a month

Hypocalcemia

+Chvostek's & Trousseau's signs, muscle spasms, numbness/tingling in lips/fingers, GI upset, ↓BP, ↓HR

AST Lab Value

0-35 units/L

Digoxin Lab Value

0.5 to 2.0ng/mL

Creatinine Lab Value

0.6 - 1.2mg/dL M, 0.5 - 1.1 F

Lithium Lab Value

0.8 to 1.4 mEq/L

Total Magnesium Lab Value

1.3-2.1 mg/dL

Theophylline Lab Value

10 to 20 mcg/mL

Dilantin Lab Value

10-20 mcg/mL

BUN Lab Value

10-20 mg/dL

Sodium Lab Value

136-145 mEq/L

Platelet Lab Value

150,000-400,000/mm3

HCO3 Lab Value

21-28 mmol/L

Phosphorous Lab Value

3.0 -4.5 mg/dL

Albumin Lab Value

3.5-5.0 g/dL

Potassium Lab Value

3.5-5.0 mEq/L

pC02 Lab Value

35 to 45 mm Hg

ALT Lab Value

4-36 units/L

WBC Lab Value

5,000-10,000/mm3

Home oxygen education

Avoid synthetic or wool fabrics (encourage wearing cotton) Educate to apply a water-soluble lubricant to soothe irritation of the mucous membranes

Atypical antidepressants

Bupropion (Wellbutrin), Trazodone Used for depression and as an aid to quit smoking (be APPROPRIATE and don't smoke) Avoid use in pt w/ seizure disorders

pH Lab Value

7.35-7.45

Glucose Lab Value

70 -105 mg/dL

p02 Lab Value

80-100 mmHg

Total Calcium Lab Value

9.0-10.5 mg/dL

LDL Lab Value

< 130 mg/dL

Total Cholesterol Lab Value

< 200 mg/dL

HbA1c Lab Value

<6.5%

Sodium Supplementation

Administer isotonic IV therapy of 0.9% normal saline or Ringer's lactate

Renewal of restraint prescription

Adults - q4h, 9-17 y/o - q2h, under 9 y/o - q1h Staff member must remain continuously w/ pt or view the pt via camera

3 point gait

Allows pt to be mobile without bearing weight on affected extremity Used when pt is non-weight bearing on a leg

Benzodiazepines

Alprazolam (xanax) → antidote is flumazenil

restraints

Assess and document pt physical needs, safety and comfort q 15-30 mins

SSRI Patient education

Avoid st. john's wort. Ensure a healthy diet

Delegation

RNs DO NOT delegate what they can EAT (Evaluate, Assess, Teach) A nursing assistant can perform tasks such as taking vital signs, range of motion exercises, bathing, bed making, obtaining urine specimens, enemas and blood glucose monitoring. Nursing assistants cannot interpret results or perform any task beyond the skill level of the certification they received. (Performing gastrostomy feeding thru an established gastrostomy tube) The PN is managed under the supervision of the RN. Certain higher level skills can be delegated after competency has been established by the RN (e.g., dressing changes or suctioning).

Crutch Walking

Remember the phase "step up" when picturing a person going up stairs with crutches. The good leg goes up first followed by the crutches and the bad leg. The opposite happens going down the stairs....OR "up to heaven...down to hell"

SSRI side effects

S/E include insomnia (paroxetine), nausea, fatigue, sexual dysfunction, wt gain Watch for serotonin syndrome!! S/S → agitation, hallucinations, fever, diaphoresis, tremors

Droplet Precautions

SPIDERMAn Sepsis, scarlet fever, strep, pertussis, pneumonia, parvovirus, influenza, diphtheria, epiglottitis, rubella, mumps, adenovirus Management → private room, mask

antidotes

chemical that counteracts the effects of another drug or poison Muscarinic agonists, cholinesterase inhibitors → Bethanechol, Neostigine Atropine Anticholinergic drugs (Atropine) → Phyosostigmine Digoxin, digitoxin → Digibind Warfarin (Coumadin) → Vitamin K Heparin → Protamine sulfate Insulin-induced hypoglycemia → Glucagon Acetaminophen (Tylenol) → Acetylcysteine

Medical Asepsis

clean technique

aerosol mask/face tent

good for pt w/ facial trauma or burns


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