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