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Eye Medication Administration

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Client supine with head turned to affected side 2. Place drops in the conjunctival sac 3. Put gentle pressure on the inner canthus, take contact lenses out first, wash hands first, do not touch tip to anything, put eye drops in infected eye last.

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Albuterol PROVENTIL

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Bronchodilators

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Aluminum Hydroxide

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antacid. Constipation and hypophosphatemia; proximal muscle weakness, osteodystrophy, seizures

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Ampicillin

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Penicillin: wider?spectrum than pen G, susceptible to penicillinases unless used with sulbactam. Activity similar to pen G, plus E coli, H influenzae, P mirabilis, Shigella. Synergy with aminoglycosides versus enterococci and listeria. Tox: penicillin allergy; more adverse effects on GI tract than other penicillins; maculopapular skin rash

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Angiotensin Converting Enzyme (ACE) Inhibitors

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prevent conversion of angiotensin I to angiotensin II 2. Examples of drugs a. Captopril (Capoten) b. Enalapril, enalaprilat (Vasotec) c. Benazepril (Lotensin) d. Fosinopril (Monopril) e. Lisinopril (Prinivil, Zestril) f. Ramipril (Altace) Side effects / nursing care 1. Orthostatic hypotension and dizziness. a. Blood pressures should be taken both supine and upright b. Teach clients to change positions slowly. c. Teach patients to avoid very hot baths and showers. d. Avoid alcohol. 2. Drowsiness- beta blockers particularly 3. Rebound hypertension when discontinued abruptly

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Atenolol

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Beta1?selective blocker: low lipid solubility, less CNS effect; used for HTN. (Note mnemonic for beta1?selective blockers: their names start with A through M. [Exceptions: carteolol & labetalol are not selective])

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Atorvastatin

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Closely follow prescribed diet, Avoid overexposure to sun, Don't take when pregnant, Limit alcohol consumption, If dose missed take as soon as possible, report muscle pain. Liver function tests and eye exams.

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Baclofen

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muscle relaxant. Drowsiness. Avoid alcohol.

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Benztropine

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Centrally acting antimuscarinic prototype for parkinsonism 22 y/o female confused, disoriented, dry mouth, dilated unresponsive pupils. Likely ingested:

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Biphosphonates

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Biphosphonates should be taken with an empty stomach and full glass of water. Patient should stay upright for 30 minutes after taking pill

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Bupropion

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used for both depression and smoking cessation. side effects: headache, dry mouth, nausea, vomiting, decrease reuptake of dopamine in CNS. adverse: seizures, suicidal thoughts, tremor, agitation, change in appetite, photosensitivity, mania, SIADH. Nursing: frequent oral care, take at the same time each day, take early for insomnia, take with food, do not crush or chew, avoid activities requiring mental alertness until know effects, avoid alcohol, do not stop abruptly, no pregnancy, use sunscreen

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Captopril

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ACE inhibitor. Potent effect in first dose stay in bed for 3 hours. Gastric irritation, orthostatic hypotension, dizziness, tachycardia, myocardial infarction, cough, agranulocytosis. monitor complete blood cell count, educate client to change position slowly, eat small frequent meals and practice good mouth care

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Carbamazepine

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Anticonvulsant. Side effects: myelosuppression, dizziness, drowsiness, ataxia, diplopia, rash. Nursing: monitor I;O's, supervise ambulation, monitor CBC. client education: take with meals, wear protective clothing from sun, do not decrease dose or stop abruptly.

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Chemotherapy

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A treatment for cancer that uses drugs to destroy rapidly dividing cancer cells.

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Cimetidine

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H2 blocker prototype: inhibit gastric acid secretion and decreases total pepsin output. side effects: diarrhea, confusion, dizziness, headache, dysrhythmias, hepatic abnormalities. Nursing: single dose may be better for compliance, monitor for confusion, rapid infusion can cause bradycardia/cardiac arrest; large doses produces confusion in the elderly. Client education: avoid antacids within 1 hour of dose, bedtime dose suppresses nighttime acid production.

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Clonidine

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antihypertensive, analgesic. use: hypertension and adjunct therapy for severe pain. side effects: drowsiness, hypotension, tachycardia, bradycardia, rash, insomnia, depression, severe rebound hypertension. Nursing: monitor depression, client eduction: apply patch to dry non hairy area. change position slowly, lie down if dizzy, don't stop abruptly.

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Digoxin and Furosemide

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cardiac glycoside administered once per day and can be administered within 12 hours of the scheduled time. Take pulse for 1 full minute before administering. hold if pulse less than 60. and loop diuretic; **monitor potassium levels and HR. Digoxin should be 0.125 to 0.5 mg

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Digoxin: Infant

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rarely above 0.05mcg/1ml

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Diphenhydramine

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antihistamine. side effects: drowsiness, dizziness, disturbed coordination, dry mouth, blurred vision, nasal stuffiness, photosensitivity. may be given IM, oral, IV. Be cautious when operating equipment, ambulate with care, sunscreen, consume fluids. take with food, avoid alcohol.

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Fentanyl side effects

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1. Life threatening respiratory depression can occur if taken in patients that are not opioid tolerant - should only be used in patients with breakthrough pain with opioid tolerance; patients should never take more than 2 doses to treat an episode of breakthrough pain, must wait a minimum of 4 hrs after second dose before additional dose; cannot substitute for Actiq without lowering dose

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Furosemide

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Loop diuretic. diuresis in 30 minutes. side effects: hypotension, hypokalemia, GI upset, weakness. Nursing: monitor BP, pulse, I;O's, potassium, weigh client daily do not give at hour of sleep. Educate client on potassium rich foods.

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Gentamicin

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Aminoglycoside prototype: bactericidal inhibitor of protein synthesis (30S); active against many aerobic gram?negative bacteria. Narrow therapeutic window; dose reduction required in renal impairment. Tox: renal dysfunction, ototoxicity; once?daily dosing is effective (post?antibiotic effect) and less toxic

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Ginkgo Biloba

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Increased bleeding risk

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Haloperidol

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Antipsychotic. side effects: EPS, muscle rigidity, tremors, tongue protrusion, slowing of voluntary movement, abnormal posturing, tardive dyskinesia, blurred vision, dry mouth. nursing: dystonic reactions treated with IV bendadryl. Can also treat tourettes.

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Heparin

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anticoagulant. used for short term. given IV or sub Q. dosage adjusted according to PTT. therapeutic range is 1.5 to 2 times normal value. nursing: leave needle in place 10 seconds after injection, don't massage. side effects: hemorrhage, thrombocytopenia, hypersensitivity. antidote: protamine sulfate

question

Insulin: Administration

answer

Upper arm, thigh, abdomen. Rotate spots to avoid skin irritation. (Vial and syringe, insulin pen, insulin pump)

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Insulin: Rapid-Acting

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onset 5-15 minutes, peak 1 hour, duration 3 hours. rarely given IV. side effects: hypoglycemia, allergic reaction, lipidodystrophy, administer sub Q 0-15 minutes before meals. monitor for hypoglycemia for 30 to 90 minutes after. draw up rapid acting insulin first before intermediate. use same injection site rotating in the area approximately an inch from last site.

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Iron Supplements

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ferrous sulfate. stay upright 15 to 30 minutes after administering. nausea, constipation, black stools. monitor hemoglobin and hematocrit and give with Vitamin C to increase absorption.

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Isoniazid

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Hepatotoxicity ; peripheral neuritis, rash, fever, don't give with phenytoin, blood dyscrasias, GI upset, local injection site redness. Take on empty stomach take B6 for neuritis. monitor liver function tests. Antimycobacterial: primary drug in combination regimens for tuberculosis; used as sole agent in prophylaxis.

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IV Flow Rate

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to determine drops per minute, multiple total volume by the drop factor and divide that result by the time in minute

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IV Infiltration

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the leaking of IV fluid into the tissue surrounding the vein. This occurs when IV fluids continue to be delivered even though the tip of the catheter is no longer in the vessel or is blocked.

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IV Therapy

answer

is an advanced life support procedure. In this procedure, an intravenous (IV) catheter is inserted into a vein so that blood, fluids, or medications can be administered directly into the patient's circulation.

question

Levothyroxine

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used for hypothyroidism. taken lifelong. hormone levels monitored periodically. side effects: nervousness, tremors, insomnia, tachycardia, dysrhythmias. monitor pulse and BP. instruct patient to report chest pain, palpitations, shortness of breath, sweating to physician.

question

Lithium

answer

Mood stabilizer. use: control manic episodes of bipolar. side effects: dizzy, hand tremor, impaired vision. nursing: monitor blood levels 2 to 3 times per week at start, then monthly while on maintenance. Client education: fluid intake 2,500 to 3,000 mL per day and adequate salt intake.

question

Lorazepam

answer

May causes drowsiness. Avoid alcohol. Medication may be habit-forming.

question

Magnesium Sulfate

answer

CNS depressant administered to a preeclamptic client to prevent seizures, may be used as a tocolytic to stop preterm labor contractions; adverse reactions: CNS depression: depressed RR, depressed DTRs, decreased urine output, pulmonary edema; hold if RR ;12 or urine output ;100ml/4hr; DTRs absent; monitor levels; therapeutic range 5-8mg/dl; remind client of warm, flushed feeling with IV administration; keep calcium gluconate antidote

question

Medication Administration

answer

assess MD orders against MAR; prepare meds (5 rights); assess abdomen; allergies; check placement; elevate HOB 30 degrees or more; check residual and replace; pour meds into syringe and allow to flow by gravity; flush with 10cc H2O after each med; when complete flush with 30-60cc H2O

question

Metered Dose Inhaler (MDI) and Dry Powder Inhaler (DPI)

answer

aerosolized pressurized inhaler allows bronchodilators, mast cell stabilizers, and corticosteroids to go right to lungs and airways through the mouth. rapid onset of action. Give bronchodilators first, remove the cap, shake 5 or 6 times, breath out all the way, then put the inhaler in mouth or 1 to 2 inches in front of mouth, depress while inhaling deeply and slowly for 3-5 secs. hold breath, exhale slowly through pursed lips. wait 2 to 5 minutes to repeat if necessary. good oral care to prevent candida. hold breath for at least 10 seconds

question

Metformin

answer

What oral hypoglycemic agent should be used with caution in patients with CHF because it causes lactic acidosis?

question

Methotrexate

answer

Antineoplastic, DMARD. use:psoriasis, cancer, RA. side effects: pulmonary fibrosis, aplastic anemia, N;V, arachnoiditis, osteonecrosis, nephropathy, fever, chills, soft tissue necrosis, stomatitis, anorexia, hepatotoxicity, infertility, alopecia, photosensitivity. nursing: CBC, renal and liver function, daily weights, s/s of gout, nuchal rigidity,frequent oral care, hair loss strategies, teach client bleeding infection precautions and change position slowly, drink 1/2 gallon per day, use sunscreen, avoid alcohol and NSAIDs

question

Morphine

answer

Opioid analgesic prototype: strong mu receptor agonist. Poor oral bioavailability. Effects include analgesia, constipation, emesis, sedation, respiratory depression, miosis, and urinary retention. Tolerance may be marked; high potential for psychologic and physical dependence. Additive effects with other CNS depressants

question

Naproxen side effects

answer

NSAID gastritis, GI bleeding, renal failure

question

Nifedipine

answer

Calcium channel blocker prototype: vasoselective (less cardiac depression); used in angina, HTN. Tox: constipation, headache

question

Nitroglycerin

answer

Headache, postural hypotension, facial flushing; circulatory collapse Sit down when taking sub-lingual tablet to avoid lightheartedness and fainting. Keep tablets in original container. Close tightly after use. Tablets should taste bitter, if not replace with new ones. If angina is not relieved 5 minutes after 1st tablet, may take a 2nd one and then a third. If not relieved by 3rd tablet call physician.

question

Oxytocin

answer

Use: Stimulates labor, uterin contractions, milk let-down, controls uterine hemorrhage

question

Pancreatic Enzyme Replacement

answer

Anorexia, nausea, vomiting, diarrhea, hypersensitivity, sneezing, lacrimation, skin rashes.

question

Phenytoin

answer

anticonvulsant. side effects: drowsiness, ataxia, nystagmus, blurred vision, GI upset, lethargy, gingival hypertrophy, Never mix with any other IV med or dextrose, educate client take with at least 1/2 glass of water or food, don't drink alcohol, may make sweat/urine red/brown or pink. good oral hygiene.

question

Phytonadione

answer

fat-soluble vitamin: essential for liver synthesis of clotting factors used to prevent hemorrhagic disease of the newborn, vitamin K deficiency from warfarin

question

Pilocarpine

answer

Muscarinic agonist prototype: tertiary amine alkaloid. May cause paradoxical hypertension by activating excitatory muscarinic EPSP receptors in postganglionic sympathetic neurons. Used in glaucoma. Tox: muscarinic excess

question

Potassium (K+)

answer

3.5-5.0 essential for allowing muscles to contract (heart) and conduction of nervous impulses

question

Prednisone

answer

short acting steroid. side effects: hyperglycemia, peptic ulcers, muscle wasting, fluid retention, moon face, hypokalemia, osteoporosis, depression, increased ICP, psychoses, cataracts, petechiae, oral candida. monitor intake and output, LOC, daily weight, BP, with food, do not break or chew. don't drink grapefruit juice. don't stop abruptly needs to be tapered up or down.

question

Rifampin

answer

What antitubercular agent causes a red-orange tinge to tears and urine?

question

Risperidone

answer

atypical antipsychotic. improves negative symptoms of schizo. Side effects: EPS, insomnia, agitation, headache, anxiety, orthostatic hypotension, dry mouth, rhinitis, photosensitivity, sexual dysfunction, dysrhythmias, NMS. Nursing: monitor for NMS: sweating, rigidity, confusion, autonomic dysfunction. Education: lie down when dizzy, gum or lozenges for dry mouth, change position slowly, protect from sun. A client is diagnosed with schizophrenia is slow to respond and appears to be listening to unseen others. Which medication administered addresses this positive symptom?

question

Salicylate Poisoning

answer

indication of poisoning may be sense of **fullness or ringing in the ears, acute or chronic tinnitus, hyperventilation, hypoglycemia, respiratory alkalosis, hypovolemia, bleeding, convulsions, respiratory failure in kids

question

Schedule Drugs

answer

substance that has the potential for physical addiction, psychological addiction, and/or abuse. Schedule 1 is so high it is unacceptable just used for research. schedule 5 has less potential for abuse. but all these have potential for abuse.

question

Sodium Polystyrene Sulfonate

answer

What treatment is used to remove potassium from the body? At 0900 a nurse is preparing the clients medications based on the chart findings which of the following medications should the nurse administer first

question

Stomatitis

answer

inflammation of the mucosa of the mouth

question

Systemic Lupus Erythematosus (SLE)

answer

an autoimmune disorder characterized by a red, scaly rash on the face and upper trunk. also attacks the connective tissue in other body systems, especially in the joints. Prednisone can cause alterations in mental status.

question

Transfusion Reaction

answer

a serious, and potentially fatal, complication of a blood transfusion in which a severe immune response occurs because the patient's blood and the donated blood do not match

question

Vitamin B1 (Thiamin)

answer

the morale vitamin; deficiency leads to depression, irritability, fatigue, Beriberi (cannot move easily), and Wernicke-Korsakoff (associated with alcoholism);

question

Warfarin

answer

anticoagulant. interferes with synthesis of vitamin K dependent clotting factor. side effects: hemorrhage, alopecia. nursing: monitor prothrombin test, therapeutic level is 1.5 to 2 times control, observe for bleeding gums, dark stool, petechiae. antidote is vitamin K

question

Zidovudine

answer

antiviral. use: HIV, prevention of maternal transmission to fetus. side effects: anemia, GI upset, paresthesias, dizziness, insomnia, headache, agranulocytosis. Client eduction: comply strictly with dosing schedule. insomnia only at start of therapy.

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