1. PAIN
1.1. Hydrocodone with acetaminophen
1.1.1. Decreased respirations might occur
1.2. Ergotamine sublingual
1.2.1. to treat migraine headaches
1.2.2. Teaching
1.2.2.1. Take one tablet at onset of migraine
1.2.3. AE
1.2.3.1. muscle pain
1.2.3.2. paresthesia in fingers and toes
1.2.3.3. cold, pale extremities
1.3. Morphine
1.3.1. via patient-controlled analgesia
1.3.1.1. assessment is the nurse's priority?
1.3.1.1.1. Respiratory rate
1.3.2. morphine sulfate PRN
1.3.2.1. AE
1.3.2.1.1. Urinary retention
1.3.3. Report
1.3.3.1. Pupillary constriction
1.4. Indomethacin
1.4.1. Nonsteroidal anti-inflammatory drug
1.5. Hydromorphone
1.5.1. Withhold if:
1.5.1.1. Bowel sounds are absent in all four quadrants.
1.5.2. complications include:
1.5.2.1. Constipation
1.5.2.1.1. increases the client’s risk for constipation
1.5.2.2. respiratory depression
1.5.2.3. orthostatic hypotension
1.5.2.4. urinary retention
1.6. Phenazopyridine
1.6.1. Common brands:
1.6.1.1. Urinary Pain Relief, Pyridium, Azo Urinary Pain Relief
1.6.2. outcomes of the medication
1.6.2.1. relieved burning upon urination
1.6.2.1.1. Relieves manifestations of burning with urination, pain, frequency, and urgency
1.7. Nitroglycerin
1.7.1. Nitroglycerin transdermal patches
1.7.1.1. understanding of the teaching
1.7.1.1.1. I will take the patch off right after my evening meal
1.7.2. Sublingual nitroglycerin
1.7.2.1. Discard any tablets you do not use every 6 months
1.7.2.2. Sequence
1.7.2.2.1. Stop activity
1.7.2.2.2. Place tab under tongue
1.7.2.2.3. wait 5 min
1.7.2.2.4. call 911 if pain not relieved
1.8. Azathioprine
1.8.1. diagnostic tests prior to starting the medication?
1.8.1.1. Pregnancy test
1.9. Fentanyl lozenges
1.9.1. EDU
1.9.1.1. instruct the client to place the fentanyl stick between their cheek and lower gum and actively suck it for increased absorption of the medication.
1.9.1.2. periodically move the medication stick to a different location in the mouth for best absorption.
1.9.1.3. expect the medication's analgesia effects to begin within 10 to 15 min.
1.9.1.4. store unused, used, or partially used medication sticks in the safe storage container that comes in the kit when the medication is initially prescribed.
2. DIABETES
2.1. Administration
2.1.1. Factors that might cause the client to have difficulty safely self-administering insulin?
2.1.1.1. macular degeneration
2.1.2. New prescription for combination of lispro insulin and NPH Insulin.
2.1.2.1. I will mix these medications in one syringe
2.2. Insulin glargine
2.2.1. LONG-ACTING, manmade version of human insulin.
2.2.2. EDU
2.2.2.1. Observe for hypoglycemia when the insulin peaks
2.2.3. Insulin glulisine has a very short onset of action of 15 min.
2.3. DESMOPRESSIN
2.3.1. EDU
2.3.1.1. You can expect to have less urine output when you are taking this medication
2.4. Pioglitazone
2.4.1. AE
2.4.1.1. Fluid retention
2.4.1.1.1. also hepatoxicity, and increased LDLs
2.5. glipizide
2.5.1. adherence is effective when HbA1C is < 7%
2.6. Regular inuslin 10 units and NPH 30 units SQ 0730. Onset:
2.6.1. 0800
2.7. Metformin
2.7.1. manifestations of lactic acidosis, which rarely occur while taking metformin:
2.7.1.1. Myalgia
2.7.1.2. Malaise
2.7.1.3. Somnolence
2.7.1.4. hyperventilation
3. COLORS
3.1. Ranitidine
3.1.1. report yellowing of the skin
3.2. Isoniazid
3.2.1. Yellow skin tones
3.3. Digoxin
3.3.1. Yellow- tinged vision
3.4. Rifampin
3.4.1. urine and sweat can develop a red orange tinge
4. LUNGS/AIRWAY
4.1. fluticasone inhaler
4.1.1. spacer decreases the risk for:
4.1.1.1. Oral candidiasis
4.1.2. candidiasis
4.2. Albuterol
4.2.1. use during an acute asthma attack
4.2.2. The client should use the bronchodilator, albuterol, prior to taking beclomethasone, a glucocorticoid inhaler, to enhance its absorption.
4.2.3. albuterol D/C teaching with MDI for asthma. Recognize as priority assessment?
4.2.3.1. Fine motor control
4.3. Salmeterol
4.3.1. Bronchodilator
4.3.2. It can prevent asthma attacks and exercise-induced bronchospasm. It can also treat COPD, including chronic bronchitis and emphysema
4.3.3. Effectiveness of the medication
4.3.3.1. Improved breathing
4.4. Theophylline
4.4.1. EDU
4.4.1.1. “I will need to have blood levels drawn”
4.5. Montelukast
4.5.1. Control Inflammation in the airways
4.6. beclomethasone
4.6.1. The client should rinse their mouth after using beclomethasone, a glucocorticoid inhaler, to prevent oropharyngeal candidiasis and hoarseness.
4.7. Theophylline (Theo-Dur)
4.7.1. For chronic relief bronchitis
4.7.2. what indicates toxicity
4.7.2.1. Tremors
4.7.2.1.1. earliest manifestation Tremors because CNS stimulation. Others: insomnia, confusion, irritability
4.8. EDU
4.8.1. Use prior to physical activity?
4.8.1.1. Cromolyn
4.8.1.1.1. "I will use my cromolyn nebulizer before using my albuterol inhaler."
4.8.2. Discharge teaching for long term oral glucocorticoid for asthma. Include in teaching plan:
4.8.2.1. schedule on alt days to decrease side effects
4.9. MDI's
4.9.1. Add a spacer to each MDI.
4.9.1.1. A spacer applied to an MDI can make up for lack of hand-lung coordination by increasing the amount of medication delivered to the lungs.
5. ANTIBIOTICS
5.1. cefazolin IV
5.1.1. client has anxiety, hypotension, and dyspnea
5.1.1.1. Administer Epinephrine
5.1.2. Gentamicin
5.1.2.1. can potentiate nephrotoxicity
5.2. ciprofloxacin
5.2.1. report any signs of tendon pain or swelling
5.3. Ceftazidime
5.3.1. can treat bacterial infections.
5.3.2. Priority lab finding for the nurse to report to the provider before administering the medication?
5.3.2.1. Creatinine 2.6 mg/dl
5.4. oral amoxicillin/clavulanate
5.4.1. If urticaria is reported
5.4.1.1. Request a change in the type of the antibiotic
5.5. Gentamicin
5.5.1. AE
5.5.1.1. Tinnitus
5.6. Trimethoprim / Sulfamethoxazole
5.6.1. AE
5.6.1.1. Vesicular, crusty rash
5.7. Tetracycline
5.7.1. Take the medication with food
5.7.2. EDU
5.7.2.1. I will avoid drinking milk when I take this medication
5.7.2.2. I won’t worry if I experience diarrhea while taking this medication
5.7.2.3. DON'T take antacids with digoxin or tetracycline
5.7.2.3.1. Calcium carbonate
5.8. Clindamycin
5.8.1. Report
5.8.1.1. Watery diarrhea
5.9. Metronidazole
5.9.1. Alcohol:
5.10. Doxycycline
5.10.1. avoided during pregnancy
5.10.1.1. Avoid. Very serious interactions can occur
5.11. Broad spectrum antibiotics
5.11.1. risk for developing
5.11.1.1. Suprainfection
5.12. Cefaclor
5.12.1. indication of an allergic reaction?
5.12.1.1. Pruritus
5.12.1.1.1. Allergic reaction includes
5.13. EDU
5.13.1. The nurse should identify that an antibiotic can be administered 30 min before or after the scheduled time to maintain therapeutic blood levels without requiring an incident report.
6. Cardiac
6.1. Metoprolol
6.1.1. interventions
6.1.1.1. Determine apical pulse prior to administering
6.1.2. EDU
6.1.2.1. Check your pulse rate daily
6.1.3. AE
6.1.3.1. HYPOglycemia
6.1.3.1.1. "I might have difficulty recognizing when my blood sugar is low."
6.1.3.2. Can cause weight gain due to fluid retention.
6.1.3.2.1. The client should be taught to report unexpected weight gain, edema, and cough while taking beta-adrenergic blockers.
6.2. Digoxin
6.2.1. Adverse effects
6.2.1.1. Yellow- tinged vision
6.2.2. Digoxin Toxicity
6.2.2.1. Anorexia
6.2.2.2. Nausea
6.2.2.2.1. Check apical pulse
6.2.2.3. Vomiting
6.2.2.4. visual disturbances
6.2.2.5. Dysrhythmias
6.2.2.6. Hypokalemia increases the risk for toxicity
6.2.3. early indication of medication toxicity?
6.2.3.1. Visual disturbances
6.2.4. EDU
6.2.4.1. Don't take antacids with digoxin or tetracycline
6.2.4.2. These medications can increase ventricular irritability and put the client at risk for ventricular fibrillation after the synchronized countershock of cardioversion.
6.2.5. Cardiac glycosides, such as digoxin, are withheld prior to cardioversion.
6.2.5.1. These medications can increase ventricular irritability and put the client at risk for ventricular fibrillation after the synchronized countershock of cardioversion.
6.3. ACE inhibitors
6.3.1. lisinopril
6.3.1.1. Adverse effects
6.3.1.1.1. Persistent cough
6.3.1.2. works by relaxing blood vessels so blood can flow more easily
6.3.1.3. It can treat high blood pressure and heart failure. It can also reduce the risk of death after a heart attack.
6.3.2. captopril
6.3.2.1. Teaching
6.3.2.1.1. I should tell my provider if I develop a sore throat
6.3.2.1.2. How should captopril be taken?
6.3.2.2. contraindicated
6.3.2.2.1. When taking naproxen and other NSAIDS
6.3.2.3. AE
6.3.2.3.1. Neutropenia evidenced by a sore throat.
6.3.2.4. SE
6.3.2.4.1. Dysuria
6.3.2.4.2. urinary frequency
6.3.2.4.3. changes in the normal amount of urine.
6.3.3. Enalapril
6.3.3.1. AE
6.3.3.1.1. Hyperkalemia
6.4. Calcium-channel blockers
6.4.1. Diltiazem
6.4.1.1. EDU
6.4.1.1.1. This medication will lower blood pressure and is contraindicated for a client who is hypotensive.
6.4.1.2. Contraindication
6.4.1.2.1. Diltiazem and other calcium channel blockers are contraindicated for use in certain conditions where bradycardia is present, such as second- or third-degree heart block.
6.4.1.3. Use
6.4.1.3.1. It is used to treat tachydysrhythmia, such as:
6.4.1.3.2. Diltiazem can be a treatment option for essential hypertension.
6.5. Atropine
6.5.1. used to treat the symptoms of low heart rate (bradycardia), reduce salivation and bronchial secretions before surgery or as an antidote for overdose of cholinergic drugs
6.5.1.1. myasthenia gravis and is in a cholinergic crisis
6.6. Atorvastatin
6.6.1. For hyperlipidemia
6.6.2. Which of the following lab values should the nurse monitor?
6.6.2.1. Creatinine kinase
6.6.3. indicates the treatment has been effective?
6.6.3.1. LDL 120 mg/dL
6.6.3.1.1. LDL < 130 is the norm
6.7. Beta blockers
6.7.1. Atenolol
6.7.1.1. Use
6.7.1.1.1. It can treat high blood pressure and chest pain (angina). It can also reduce the risk of death after a heart attack.
6.7.1.2. AE
6.7.1.2.1. hypotension
6.8. Niacin
6.8.1. Use
6.8.1.1. It can treat high cholesterol and triglyceride levels as well as niacin deficiency.
6.8.1.2. AE
6.8.1.2.1. Flushing of the skin
6.9. The nurse should advise the client that decongestants
6.9.1. can constrict blood vessels
6.10. Taking aspirin daily for the past year
6.10.1. report
6.10.1.1. Hyperventilation
6.10.1.2. tinnitus
6.11. Epoetin alfa
6.11.1. monitor BP
6.12. Nitroprusside
6.12.1. Titrate according to
6.12.1.1. Blood pressure
6.12.2. Used in hypertensive crisis
6.13. Amiodarone
6.13.1. For life-threatening ventricular dysrhythmia
6.14. Clonidine (catapres)
6.14.1. EDU
6.14.1.1. Clonidine can cause drowsiness, weakness, sedation, and other CNS effects.
6.14.1.1.1. Until the client’s response to the medication is known, the nurse should instruct the client to avoid driving or handling other potentially hazardous equipment
6.14.1.1.2. Change position slowly
6.15. Procainamide
6.15.1. Brand name: Pronestyl
6.15.2. AE
6.15.2.1. Hypotension
6.15.2.1.1. If BP drops more than 15mmHg.
6.16. Verapamil
6.16.1. verapamil has more than one action
6.17. Adenosine
6.17.1. Monitor
6.17.1.1. Dyspnea
6.17.1.1.1. can occur during administration of adenosine due to bronchoconstriction
6.17.1.2. Flushing of the face and a feeling of warmth
6.17.1.2.1. transient findings that occur during administration of adenosine
7. SUBSTANCE ABUSE
7.1. Bupropion
7.1.1. aid to quit smoking
7.1.2. adverse effects
7.1.2.1. Insomnia
7.2. Diazepam
7.2.1. acute cocaine toxicity
7.3. Heroin Overdose
7.3.1. A greatly decreased respiratory rate (8/min)
7.3.2. Pinpoint pupils
7.4. Chlordiazepoxide
7.4.1. First-line medication to use for a client who is experiencing manifestations of acute alcohol withdrawal
7.4.1.1. Prevent delirium tremens
8. Laxatives & Stool Softeners
8.1. Docusate sodium
8.1.1. Mechanism of action
8.1.1.1. reduces the surface tension of the stools to change their consistency
9. DIURETICS
9.1. Furosemide
9.1.1. Teaching
9.1.1.1. increase intake
9.1.1.2. Monitor for muscle
9.1.1.3. Dangle your legs
9.1.2. AE
9.1.2.1. dizziness
9.1.2.2. hypokalemia
9.1.2.2.1. The nurse should identify the presence of U-waves as a manifestation of hypokalemia, an adverse effect of furosemide.
9.1.2.2.2. EDU
9.1.2.3. urinary frequency
9.1.2.4. hypoglycemia
9.1.2.5. Dehydration
9.1.2.5.1. Oliguria, increased urine concentration, and an increase in urine specific gravity greater than 1.030 are expected findings in clients who are dehydrated.
9.1.3. desired therapeutic effect
9.1.3.1. A decrease in pulmonary or peripheral edema
9.1.3.2. weight loss
9.1.3.3. decrease BP
9.1.3.4. increase output
9.1.4. EDU
9.1.4.1. Loop diuretics, such as furosemide, can cause ototoxicity.
9.1.4.1.1. The client should be taught to notify the provider if tinnitus, a full feeling in the ears, or hearing loss occurs.
9.2. Mannitol
9.2.1. Use
9.2.1.1. used to force urine production in people with acute (sudden) kidney failure.
9.2.1.2. ICP
9.2.2. AE
9.2.2.1. Bibasilar crackles
9.2.2.2. Increased thirst
9.3. Acetazolamide
9.3.1. It can treat glaucoma, epilepsy, mountain sickness, and fluid retention (edema).
9.3.2. AE
9.3.2.1. Hypoglycemia
9.4. Bumetanide
9.4.1. same as FUROSEMIDE
9.4.2. EDU
9.4.2.1. You should monitor for hearing difficulties
9.4.2.1.1. complications include
9.5. Hydrochlorothiazide
9.5.1. AE
9.5.1.1. hypokalemia
9.5.1.1.1. Thiazide diuretics adverse effects
9.5.1.1.2. Eat foods rich in K
9.6. Triamterene
9.6.1. (potassium sparring diuretic)
9.6.1.1. lab values should the nurse withhold the medication
9.6.1.1.1. Potassium 5.3
9.7. Client with dehydration secondary to diuretics.
9.7.1. Expect to find:
9.7.1.1. dry mucous membranes
9.8. Spironolactone
9.8.1. Potassium-sparing diuretic
9.8.1.1. Clients taking potassium-sparing diuretics should limit their intake of foods high in potassium due to the risk of hyperkalemia.
9.8.2. AE
9.8.2.1. Hyperkalemia
9.8.2.1.1. should NOT use salt substitutes because they contain potassium and place the client at risk for hyperkalemia.
9.8.2.2. Electrolyte imbalances, including hyponatremia, are common.
9.8.2.2.1. Drinking large amounts of water can cause dilutional hyponatremia, which is dangerous when taking spirolactone
9.8.3. EDU
9.8.3.1. Watch for increased breast tissue growth while taking this medication
9.8.3.2. Spironolactone, which is derived from steroids, can cause adverse endocrine effects, such as:
9.8.3.2.1. Gynecomastia
9.8.3.2.2. impotence in men
9.8.3.2.3. irregular menses, and hirsutism in women.
10. Anticoagulants ('blood thinners')
10.1. Warfarin
10.1.1. MOA
10.1.1.1. Used to treat or prevent venous thrombosis (swelling and blood clot in a vein) and pulmonary embolism (a blood clot in the lung).
10.1.1.2. Works by decreasing the clotting ability of the blood.
10.1.2. Administer if the client experiences bleeding
10.1.2.1. Vitamin K
10.1.3. Outside the expected range
10.1.3.1. INR 4.5
10.1.3.1.1. normal is 2-3 seconds
10.1.3.1.2. Warfarin check INR and PT (18-24 seconds)
10.1.4. EDU
10.1.4.1. Aspirin will increase the risk of bleeding
10.1.4.2. Interferes with the effectiveness of the oral contraceptives
10.1.4.3. Carry med alert bracelet at all times
10.1.5. Labs
10.1.5.1. Warfarin therapy is evaluated by PT and the INR, which is drawn daily for the first 5 days, then twice weekly for the next 1 to 2 weeks.
10.2. Heparin
10.2.1. heparin via continuous IV
10.2.1.1. discontinue when?
10.2.1.1.1. Platelet 96,000/mm3
10.2.1.2. fastest anticoagulation
10.2.2. Where to inject subcutaneous heparin?
10.2.2.1. abdomen in an area that is above the iliac crest and at least 5 cm (2 in) away from the umbilicus.
10.2.2.1.1. after injecting heparin subcutaneously?
10.2.3. manifestations of heparin toxicity?
10.2.3.1. Blood in urine
10.2.3.2. bruising
10.2.3.3. hematomas
10.2.3.4. hypotension
10.2.3.5. tachycardia
10.3. Enoxaparin (Lovenox)
10.3.1. EDU
10.3.1.1. Self Admin
10.3.1.1.1. Grasp the skin between the thumb and forefinger, while injecting the medication (SQ)
10.3.1.1.2. Alternate the injection sites between the side of the abdomen
10.3.1.1.3. Insert the entire length of the needle into the skin during injection
11. Bladder Relaxant
11.1. Oxybutynin
11.1.1. Used to treat symptoms of overactive bladder, such as frequent or urgent urination, incontinence (urine leakage), and increased night-time urination.
11.1.2. adverse effect
11.1.2.1. dry mouth
11.1.2.2. blurred vision
11.1.2.3. dry eyes
12. MENTAL HEALTH
12.1. Selective Serotonin Reuptake Inhibitor (SSRI)
12.1.1. Fluoxetine
12.1.1.1. AE
12.1.1.1.1. Muscle twitching
12.1.1.1.2. Sexual dysfunction
12.1.1.1.3. CNS
12.1.1.1.4. Agitation
12.1.1.1.5. euphoria
12.1.1.2. Teaching
12.1.1.2.1. I should take acetaminophen instead of ibuprofen for my headaches while taking this medication
12.1.2. Citalopram
12.1.2.1. Common brands: Celexa
12.1.2.2. AE
12.1.2.2.1. Confusion
12.1.3. Paroxetine
12.1.3.1. AE
12.1.3.1.1. Drowsiness
12.2. Lithium
12.2.1. Used for mental illnesses, including bipolar disorder, depression, and schizophrenia.
12.2.2. discontinue
12.2.2.1. Ibuprofen
12.2.2.1.1. NSAIDs, such as naproxen and ibuprofen, increase renal reabsorption of sodium and lithium, which causes an increase in lithium levels and possible toxicity.
12.2.3. EDU
12.2.3.1. Vomiting or diarrhea can cause electrolyte imbalances.
12.2.3.1.1. Sodium
12.2.3.2. Diuretics
12.2.3.2.1. Diuretics decrease kidney excretion of lithium, which causes lithium levels to rise and increases the potential for toxicity.
12.3. Amitriptyline
12.3.1. AE
12.3.1.1. Dry mouth
12.3.2. EDU
12.3.2.1. Amitriptyline is Tricyclic and should be avoided especially during 1st trimester because associated with fetal abnormalities
12.4. Donepezil
12.4.1. Alzheimer's disease
12.4.2. AE
12.4.2.1. Dyspnea
12.5. Haloperidol
12.5.1. AE
12.5.1.1. Akathisia
12.6. Neuroleptic malignant syndrome (NMS)
12.6.1. A rare reaction to antipsychotic drugs
12.6.2. S/S
12.6.2.1. Fever
12.6.2.2. respiratory distress
12.6.2.3. diaphoresis
12.6.2.4. hyper and hypotension
12.6.2.5. incontinence
12.6.2.6. tachycardia
12.6.2.7. severe muscle rigidity
12.7. Clozapine
12.7.1. report to the provider immediately?
12.7.1.1. LDL 220 mg/dL
12.7.1.1.1. LDL should be < 130
12.7.1.1.2. Monitor cholesterol triglycerides and blood glucose if weight gain is more than 14 kg (30 lbs.)
12.8. Lorazepam
12.8.1. Brand name: Ativan
12.8.2. Nurse Monitor
12.8.2.1. Sedation
12.8.2.1.1. Lorazepam is a benzodiazepine with anti-anxiety and sedative effects.
12.9. Buspirone
12.9.1. Delayed onset of action
12.10. Diazepam
12.10.1. Avoid alcohol
12.11. Phenelzine
12.11.1. Phenelzine, an MAOI, is an antidepressant.
12.11.2. This medication interacts with a variety of foods to produce a hypertensive crisis.
12.11.2.1. Beef steak and other meats that are fresh do not interact with phenelzine and are safe to consume.
13. TB
13.1. Isoniazid
13.1.1. adverse effect
13.1.1.1. Yellow skin tones
13.1.2. will need frequent monitoring of?
13.1.2.1. Aspartate aminotransferase (AST)
13.2. EDU
13.2.1. Client is prescribed a four-medications
13.2.1.1. “This regimen will eliminate various combinations of resistant strains of TB”
13.2.2. “You will need to take two or more medications to treat your disease”
13.3. Rifampin
13.3.1. urine and sweat can develop a red orange tinge
13.3.1.1. Document this as an expected finding
13.4. Mantoux skin test, for TB.
13.4.1. Appropriate nursing action:
13.4.1.1. insert with bevel up
13.4.1.2. 5-15 degree angle
13.4.1.3. 0.1mg or mL of stuff to form wheal
14. Cancer
14.1. Oprelvekin
14.1.1. Used to stimulate the bone marrow to produce platelets in order to prevent low platelets that may be caused by chemotherapy.
14.1.2. May be given to decrease the need for platelet transfusions
14.1.3. Indicate the effectiveness of the therapy?
14.1.3.1. Increased platelet count
14.2. Tamoxifen
14.2.1. AE
14.2.1.1. Hot flashes
14.2.2. for the treatment of breast cancer
14.3. Methotrexate
14.3.1. Chemotherapy and Immunosuppressive drug
14.3.2. It can treat cancer of the blood, bone, lung, breast, head, and neck. It can also treat rheumatoid arthritis and psoriasis.
14.3.3. Monitor and report:
14.3.3.1. Fever
14.3.4. Labs
14.3.4.1. BUN
14.3.4.1.1. Can cause kidney injury.
14.3.4.2. Platelets
14.3.4.2.1. Can cause thrombocytopenia.
14.3.4.3. HgB
14.3.4.3.1. Can cause bone marrow suppression.
14.3.4.4. AST
14.3.4.4.1. Can cause liver damage.
14.4. Filgrastim
14.4.1. nurse should monitor for an increase in which of the following types of cells to determine the effectiveness of the medication?
14.4.1.1. Granulocytes
14.4.1.1.1. neutrophils, eosinophils, basophils, aka white blood cells.
14.4.1.1.2. Filgrastim stimulates the bone marrow to produce neutrophils. For clients receiving chemotherapy, the risk of infection is minimized.
14.4.2. Decreases the risk of infection in clients who have neutropenia from cancer.
14.4.2.1. Monitor CBC twice per week.
14.5. Fluorouracil
14.5.1. Antimetabolite antineoplastic agent
14.6. WHO analgesic ladder for cancer pain management
14.6.1. Oxycodone
14.6.1.1. An oral opioid that relieves moderate to moderately severe pain
15. ANTIDOTES
15.1. diazepam overdose
15.1.1. fluazenil
15.1.1.1. antidote used to reverse benzodiazepines
15.2. opioid overdose
15.2.1. heroin toxicity
15.2.1.1. naloxone
15.2.1.1.1. nurse should not administer naloxone too quickly
15.3. acute acetaminophen toxicity
15.3.1. Acetylcysteine
16. WOMEN'S HEALTH
16.1. Folic Acid
16.1.1. start taking before becoming pregnant
16.1.1.1. prevents neural tube defects
16.2. Betamethasone
16.2.1. The nurse understands the medication was effective when she observes which of the following?
16.2.1.1. The newborn has normal respiratory patterns
16.2.2. EDU
16.2.2.1. Patients taking beclomethasone should up their intake of what to minimize bone loss?
16.2.2.1.1. Vitamin D and calcium
16.2.3. Premature ROM in labor
16.3. Magnesium sulfate
16.3.1. Use
16.3.1.1. for preterm labor
16.3.2. Magnesium toxicity
16.3.2.1. Decreased level of consciousness
16.4. Tamoxifen
16.4.1. Estrogen modulator
16.4.2. It can treat breast cancer. It may also prevent breast cancer in women at high risk of developing it.
16.4.3. AE
16.4.3.1. Hot flashes
16.5. Ferrous sulfate
16.5.1. EDU
16.5.1.1. “Call your provider if you begin to bruise easily”
16.5.2. Used to treat and prevent iron deficiency anemia
16.6. Oxytocin (Pitocin)
16.6.1. nonreassuring FHR
16.6.1.1. Turn the client on the left side
16.6.2. Administration
16.6.2.1. administered via IV infusion when used for labor induction.
16.6.2.1.1. Effective uterine contractions should occur every 2 to 3 min.
16.6.2.1.2. The goal during oxytocin therapy is for the client to experience contractions that last from 45 to 60 seconds.
16.6.2.2. Can be administered IM to decrease postpartum bleeding.
16.7. Contraceptives
16.7.1. Carbamazepine
16.7.1.1. causes an accelerated inactivation of oral contraceptives because of its action on hepatic medication-metabolizing enzymes.
16.8. Nifedipine (adalat)
16.8.1. suppresses uterine contractions by doing what?
16.8.1.1. blocking calcium channels
17. GUT
17.1. Metoclopramide
17.1.1. Antiemetic and Gut motility stimulator
17.1.2. It can treat gastroesophageal reflux disease (GERD)
17.1.3. AE
17.1.3.1. Tardive dyskinesia
17.1.3.2. CNS effects
17.1.3.2.1. dizziness, fatigue, and sedation
17.1.4. Common brands
17.1.4.1. Reglan
17.2. Sucralfate
17.2.1. For PUD
17.2.2. Teaching
17.2.2.1. Forms a protective barrier over ulcers
17.3. Ranitidine
17.3.1. Use
17.3.1.1. Antihistamine and Antacid
17.3.1.1.1. It can treat and prevent heartburn
17.3.1.1.2. It can also treat stomach ulcers, GERD, and conditions that cause too much stomach acid.
17.3.2. EDU
17.3.2.1. It can be taken with or without food.
17.3.2.2. full course therapy is recommended.
17.3.2.3. Store at Room temperature
17.3.3. AE
17.3.3.1. Can be hepatotoxic and cause jaundice
17.4. Client who has peptic ulcer disease and is to start antacid therapy.
17.4.1. Take antacids 1 hour after meals, 3 hours after meals, and at bedtime
17.5. Bismuth Subsalicylate (Pepto)
17.5.1. Useful against H Pylori, and also coats stomach providing protection from gastric juices
17.6. alosetron
17.6.1. The client must sign an agreement with the provider before beginning alosetron.
17.6.2. EDU
17.6.2.1. notify the provider and stop the medication if diarrhea is not controlled after 1 month of starting alosetron.
17.6.2.2. notify the provider about tachydysrhythmia
17.7. omeprazole
17.7.1. EDU
17.7.1.1. should take omeprazole once daily before a meal (usually breakfast) because the medication is less effective when taken with food.
17.7.1.2. Should be used for no more than 1 to 2 months due to long-term adverse effects
17.7.2. Clients who have active duodenal ulcer or gastric reflux disease
18. NERVOUS SYSTEM
18.1. Methylprednisolone
18.1.1. Common brands:
18.1.1.1. Depo-Medrol, Medrol, Solu-Medrol
18.1.2. Teaching
18.1.2.1. Blood glucose
18.1.2.2. Avoid contact
18.1.2.3. Grapefruit juice
18.1.3. Steroid
18.1.3.1. It can treat inflammation, severe allergies, flares of chronic illnesses, and many other medical problems.
18.2. Phenytoin
18.2.1. EDU
18.2.1.1. “I should take my medication with milk to minimize gastric upset”
18.2.2. Anticonvulsant
18.2.2.1. It can treat and prevent seizures
18.2.3. Report
18.2.3.1. Cognitive impairment
18.3. Neostigmine
18.3.1. Muscle strengthener
18.3.2. It can treat myasthenia gravis
18.3.3. AE
18.3.3.1. Tachycardia
18.4. Valproic acid
18.4.1. Anticonvulsant
18.4.2. It can treat seizures and bipolar disorder. It can also help prevent migraine headaches
18.4.3. Monitor and report:
18.4.3.1. Muscle pain
18.5. Benzatropine
18.5.1. Anti-Tremor
18.5.2. It can treat Parkinson's disease and side effects of other drugs.
18.5.3. Monitor for
18.5.3.1. Tachycardia
18.6. Atarax Brand name: Vistaril
18.6.1. dry mouth
19. Gout
19.1. Allopurinol
19.1.1. Teaching
19.1.1.1. Drink 2 L of water a day
19.1.1.2. Take after meals
19.1.1.2.1. to minimize GI distress, insomnia, headache
19.1.1.2.2. Advise clients to take oral gout medication with food or after meals
20. MUSCLE RELAXERS
20.1. Dantrolene
20.1.1. Reconstitute the initial dose with 60 ml of sterile water without a bacteriostatic agent
20.2. Cyclobenzaprine
20.2.1. EDU
20.2.1.1. Taper off the medication before discontinuing it
20.3. Baclofen
20.3.1. therapeutic outcome
20.3.1.1. Decrease in paralysis of the extremities
20.4. Succinylcholine
20.4.1. AE
20.4.1.1. hyperthermia
20.4.1.1.1. Stop succinylcholine
20.4.1.1.2. Give oxygen
20.4.1.1.3. Give cooling measure
20.4.1.1.4. Ice to groin
20.4.1.1.5. Give dantrolene
21. OSTEOPOROSIS
21.1. risedronate
21.1.1. Teaching
21.1.1.1. I should sit up for 30 minutes after taking the risedronate
21.1.1.2. With a full glass of what in the mornings
21.1.1.3. When should the immediate release and delayed-release form of risedronate be taken related to food intake?
21.1.1.3.1. Immediate release: At least 30 min prior to eating
21.1.1.3.2. Delayed-release: Can be taken after eating.
21.1.1.4. When on risedronate, when should a patient take an antacid?
21.1.1.4.1. Absorption of risedronate is reduced in antacids containing calcium, aluminum, or magnesium.
21.1.1.4.2. The nurse should instruct the client to take the antacid 2 hours after taking risedronate.
21.1.2. contraindicated
21.1.2.1. When client cannot sit or stand upright for 30 minutes
21.1.3. AE
21.1.3.1. GI effects such as esophagitis and dyspepsia.
21.1.3.1.1. The client should sit up for 30 min after taking med
21.2. Calcitonin salmon
21.2.1. used to treat osteoporosis in women who are at least 5 years past menopause and cannot or do not want to take estrogen products.
21.2.2. long-term treatment therapy for postmenopausal osteoporosis
21.2.3. Intranasal spray
21.2.3.1. depress the side arms to activate the pump
21.2.3.1.1. Instruct the client to activate the pump on the initial use by holding the bottle upright and depressing the two white side arms toward the bottle six times.
21.2.3.2. administer calcitonin-salmon to one nostril daily, alternating nostrils.
21.2.3.3. nasal bleeding, or ulcerations, are indications to discontinue the medication and to notify the provider if nasal bleeding occurs.
22. Antithyroid agent
22.1. Propylthiouracil
22.1.1. A thyroid hormone antagonist that decreases the circulating T4 hormone
22.1.1.1. reducing the manifestations of hyperthyroidism.
22.1.1.2. medication has been effective?
22.1.1.2.1. Increase in ability to focus
22.1.1.2.2. More sleep
22.1.1.2.3. Decrease or normal appetite
22.1.2. AE
22.1.2.1. decreased WBC count
22.2. Levothyroxine
22.2.1. After 6 weeks of treatment, the nurse determines that the medication was effective if the
22.2.1.1. thyroid-stimulating hormone (TSH) level is 2 microunits/mL
22.2.2. What indicates the need for an increase in dosage?
22.2.2.1. Cold intolerance
22.2.3. AE
22.2.3.1. Acute levothyroxine overdose
22.2.3.1.1. Tachycardia
22.2.3.1.2. Heat intolerance
22.2.3.1.3. Hyperthermia
22.2.3.1.4. Tremor and anxiety
22.2.4. EDU
22.2.4.1. The nurse should instruct the client to avoid taking calcium within 4 hr of levothyroxine administration.
22.3. Methimazole
22.3.1. Increased sleeping
23. CONTRACEPTIVES
23.1. Interferes with the effectiveness of the oral contraceptives
23.1.1. Warfarin
24. STEROIDS
24.1. Prednisone
24.1.1. Expect to undergo which of the following diagnostic test to monitor long-term complications?
24.1.1.1. Electrocardiograms
24.2. Dexamethasone
24.2.1. Brand name: Decadron
24.2.1.1. More susceptible to developing infection
25. ANTIFUNGAL
25.1. Amphotericin B
25.1.1. AE
25.1.1.1. Bradycardia
25.1.2. Infusion reaction includes:
25.1.2.1. Fever
25.1.2.2. Chills
25.1.2.3. Rigors
25.1.2.4. headache 1-3 hrs. after initiation
26. ANEMIA
26.1. cyanocobalamin
26.1.1. vitamin B12
26.1.1.1. helps convert folic acid to active form)
26.1.2. EDU
26.1.2.1. Use a nasal decongestant 15 minutes before the medication if you have a stuffy nose
26.2. Ferrous gluconate (IRON)
26.2.1. Used to treat or prevent iron deficiency anemia
26.2.2. EDU
26.2.2.1. I should stay upright for at least 15 minutes after medication
26.3. INFeD (Iron Dextran Injection USP)
26.3.1. IM
26.3.1.1. What is an appropriate site?
26.3.1.1.1. Vastus Lateralis
27. HIV
27.1. efavirenz
27.1.1. Notify the provider for the appearance of a skin rash
27.2. Contraindication for varicella vaccination
28. RENAL
28.1. Cyclosporine (Sandimmune)
28.1.1. EDU
28.1.1.1. I will need to take it:
28.1.1.1.1. For the rest of my life
28.1.2. AE
28.1.2.1. HTN
28.1.2.1.1. Half the clients who take cyclosporine develop a 10% to 15% increase in blood pressure and might need to start antihypertensive therapy.
28.2. Epoetin alfa
28.2.1. AE
28.2.1.1. HTN
28.2.1.1.1. Causes HTN, which can lead to stroke or other cardiovascular complications.
29. LABS
29.1. Calcium
29.1.1. A calcium level of 9.2 mg/dL is within the expected reference range of 9.0 to 10.5 mg/dL
29.2. magnesium
29.2.1. A magnesium level of 1.6 mEq/L is within the expected reference range of 1.3 to 2.1 mEq/L
29.3. digoxin
29.3.1. A digoxin level of 1.1 ng/mL is within the expected reference range of 0.8 to 2 ng/mL
29.4. potassium
29.4.1. A potassium level of 2.8 mEq/L is below the expected reference range of 3.5 to 5 mEq/L
30. Herbal Supplements
30.1. saw palmetto
30.1.1. Promote urinary health.
30.1.2. r/t prostatic conditions like BPH