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Nonpurging

Compensate for binge eating through other means, such as excessive exercise

Nursing interventions protective isolation

Follow STANDARD PRECAUTIONSInstitute MAXIMUM protection, which may include the use of STERILE LINENS, FOOD, and other SUPPLIESMINIMIZE EXPOSURE to microorganisms found on the outer layers of FRESH FLOWERS, FRUITS, and VEGETABLESWear sterile GLOVES and GOWN/MASK when in contact with clientMAXIMUM protection will require ventilated/positive pressure room

Side/Adverse Effects of Insulin

Hypo/HyperglycemiaLipodystrophy

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

HyponatremiaSeizuresComa

Side/Adverse Effects of Nifedipine

HypotensionFatigueNauseaFlushingUteroplacental 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 numbnessDisbeliefFearDenialFlashbacksEmotional 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

HallucinationsDelusions

CRE nursing considerations

Hand hygieneContact precautions

Clostridium difficile nursing considerations

Hand hygienePPE (enteric precautions) if in contact with potentially contaminated materialsOnly 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 libidoReduced ejaculate

List of Thiazide Diuretics

HydrochlorothiazideChlorothiazide

Two-point gait

Move left crutch and right foot forward togetherMove right crutch and left foot forward ahead together

Four-point alternating gait

Move right crutch forwardMove left foot forwardMove left crutch forwardmove 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

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 clientright drugright doseright routeright timeright documentation

typhoid

rose spots on the abdomen

pneumonia

rusty sputum

five interventions for psych patients

safetysetting limitsestablish trusting relationshipmedsleast 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)

PhenelzineTranylypromine

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 neutropeniaNeonatal sepsisNeutrophil dysfunction

VRE reservoir

Stoolbody 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 influenzaHepatitis A

What adverse effects do both typical and atypical antipsychotics share?ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• Agranulocytosis• Extrapyramidal effectsATI Comprehensive NCLEX-RN Review: Pharmacology Effects

What do NSAIDs do with lithium carbonate?ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

• ↑ lithium levelsATI Comprehensive NCLEX-RN Review: Pharmacology Effects

Side/Adverse Effects of Ginseng

InsomniaNervousness

Medications of Autistic Disorder

AntipsychoticsSelective 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 neomycinImmunocompromised

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 consentOften 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

BenztropineCarbidopa/LevodopaLevodopa

List of Sympatholytics

Beta Adrenergic BlockersAlpha Adrenergic Blockers

-olol

Beta blocker

Herb/Medication Interactions for Melatonin

Beta blockersWarfarinSteroids

Factors that influence choice of a contraceptive include:

Age and health status, including risk for STIReligion and culturePlans for future contraceptionFrequency of intercourseNumber of sexual partnersPersonal concerns about availability, spontaneity, ease of use

Contraindications for Haemophilius influenza type B vaccine

Age younger than 6 weeks

Symptoms of serotonin syndrome

AgitationConfusionHallucinations

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 weeks2. Continuation: focus on prevention of a relapse through pharmacotherapy, education and psychotherapy and lasts 4-9 months3. 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 yearinfancy

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 yearsEarly 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 yearsYoung 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 yearspreschooler

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 contraceptiveTaken no later than 72 hours after unprotected sexSecond dose is repeated 12 hours laterAntiemetics 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 relationshipMaintain client relationshipGather further dataPromote client's problem-solving skillsFacilitate behavioral changeOvercome resistance behaviorsEvaluate problems and goalsPromote 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 messagesClient: "I can't focus."Nurse: "You are having problems focusing?"

-zosin

Alpha Adrenergic Blockers

List of Antianxiety Medications

AlprazolamBuspironeChlordiazepoxideClonazepamDiazepamLorazepam

List of Thrombolytic Medications

AlteplaseTenecteplaseReteplase

List of Antacids

Aluminum hydroxideMagnesium hydroxideSodium Bicarbonate

Factor Dementia

Alzheimer's diseaseNeurological diseaseVascular diseaseAlcohol use disorderHead trauma

List of Aminoglycosides

AmikacinVancomycinGentamicinStreptomycin

-mycin

Aminoglycoside

List of Methylxanthines

AminophyllineTheophylline (Theo-Dur, Theolair, Theo-42)

List of Tricyclic Antidepressants

AmitriptylineClomipramineDoxepinImipramine

List of Penicillins

AmoxicillinAmpicillin

Maladaptive use of regression

An employee who is not promoted begins missing appointments and showing up late for meetings

Therapeutic Use of Acetaminophen

AnalgesicAntipyretic

Side Effects for Hepatitis A or Hepatitis B vaccine

Anaphylaxis

Side/Adverse Effects of Carbamazepine

AnemiaLeukopeniaStevens-Johnson Syndrome

-caine

Anesthetics

Therapeutic Use for Calcium Channel Blockers

AnginaHypertension

Adverse Reaction to ACE Inhibitiors

Angioedema

Side/Adverse Effects for angiotensin II receptor blockers (ARBs)

AngioedemaHypotensionShould not be used in second and third trimester of pregnancy

Side/Adverse Effects for Dabigatran (Pradaxa)

BleedingGI 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 fluidsFeces

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 visionPhotophobiaDry eyesMay have systemic effects of beta blockade

Side/Adverse Effects for Scopolamine

Blurred visionSedationAnticholinergic effects

MRSA reservoir

Body fluids and sites contaminated with MRSA

Side/Adverse Effects for Filgrastim injection and Pegfilgrastim IV

Bone painLeukocytosis

Cluster B

BorderlineAntisocialNarcissisticHistrionic

Side/Adverse Effects for Amiodarone (Cordarone)

BradycardiaCardiogenic shockPulmonary disorders

Therapeutic Use for Atropine

BradycardiaKnown exposure to chemical nerve agent (AtroPEN)

Side/Adverse Effects for Beta Adrenergic Blockers

BradycardiaNasal stuffinessAV blockRebound myocardium excitation if stopped abruptlyBronchospasm

Nursing Considerations for Ginkgo biloba

Discontinue 2 weeks prior to surgeryMay cause seizures with overdoseKeep out of the reach of children

Medication AD

DonepezilGalantamineMemantineCitalopramParaxetineLorazepamOxazepam

Dosage on hand (H)/mL

Dosage desired (D)/mL

Side/Adverse Effects for Promethazine

DrowsinessAnticholinergic effectsExtrapyramidal symptomsPotentiates effects when given with narcotics

Side/Adverse Effects for Metoclopramide

DrowsinessAnticholinergic effectsRestlessnessExtrapyramidal symptomsTardive dyskinesia

Side/Adverse Effects of Valerian Root

DrowsinessAnxietyHepatotoxicity from long-term use

S & S Bulimia Nervosa

Bradycardia, hypotensionElectrolyte imbalancesErosion of teethEsophageal tears from vomitingNormal to slightly low body weightMuscle weakening Calluses/scars on hand from self-induced vomiting

Adverse Effects for Oral contraceptives

Breast tendernessBleedingNausea/vomiting

Precautions for Nitrofurantoin

Broad-spectrumContraindicated in renal dysfunctionUrine will have brown discoloration

Therapeutic Use for Fluoroquinolones

BronchitisChlamydiaGonorheaPelvic Inflammatory DiseaseUrinary tract infectionsPneumoniaProstatitisSinusitis

-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 depressionInsomniaExcitationEuphoriaWithdrawal symptoms, except with BuspironeRisk of abuse and potential for overdose

Side/Adverse Effects for MAOIs

CNS stimulationOrthostatic hypotensionHypertensive crisis with intake of tyramine, SSRIs, and tricylics

Side/Adverse Effects of Tricyclic Antidepressants

Anticholinergic effectsSedationToxicityDecreased seizure threshold

Side/Adverse Effects for Anticholinergic medications for overactive bladder

Anticholinergic symptomsDrowsinessDyspepsia

-arin

Anticoagulant

-azine

Antiemetic

-zine

Antihistamine

-statin

Antilipidemic

Therapeutic Use of Oxytocin

Antepartum for contraction stress testIntrapartum for induction or augmentation of laborPostpartum 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 effectivenessAvoid smoking

Side/Adverse Effects for Antihistamines

Anticholinergic effectsDrowsiness

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 armPeriod will begin on week 4 (no patch)

Nursing Interventions for Vasodilators

Apply protective cover to containerDiscard unused fluid after 24 hoursProvide 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

AripiprazoleClozapineOlanzapinePaliperidoneQuetiapineZiprasidone

List of Antiplatelet medications

AspirinAbciximab ClopidogrelTiclopidinePentoxyfillineDipyridamole

Nursing intervention major depressive

Assess symptoms. Depressed mood, anhedonia, and anergia are most commonEvaluate client's risk of harm to self or othersEvaluate client's use of drugs and alcoholAssess client's history of depressionAssess client's support systemEncourage activities that raise self-esteemEncourage exerciseEncourage problem-solvingWork 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, IVPitressin (Vasopressin): intranasal, subcutaneous, IV

Stage 2 (AD)

Deterioration become evident, and cannot remember a home address or dateMemory gap occur, hygiene suffers, and clothing may be put incorrectlyMood swings occur, moments of paranoia, anger, jealously and apathyCare and supervision become a full-time job

Nursing interventions on chemical and Radiation

Determine type and amount of radiation usedPlace a sign on door. "Caution Radioactive Material."Wear monitoring badge to record amount of exposureDispose of items removed from the room in appropriate containersNever 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

HeadacheEpigastric painConstipation

Side/Adverse Effects for Ondansetron

HeadacheExtrapyramidal symptoms

Side/Adverse Effects for Sexual Dysfunction Medications

HeadacheHeartburnDiarrheaFlushingNosebleedsDifficulty falling asleep or staying asleepParesthesiasMuscle achesChanges in color visionSensitivity to light

Side/Adverse Effects of Chondroitin sulfate

HeadacheHivesPhotosensitivityHypertensionConstipation

Side/Adverse Effects of Organic Nitrates

HeadacheOrthostatic HypotensionReflex TachycardiaTolerance

Side/Adverse Effects for St. John's Wort

HeadacheSleep disturbancesHepatotoxicity from long-term useConstipation

Precautions/Interactions for Alpha Adrenergic Blockers

Increased risk of hypotension and syncope if given with other antihypertensives, beta blockers, or diureticsNSAIDs may decrease the effect of prazosin.

Side/Adverse Effects for Methotrexate

Increased risk of infectionBone marrow suppressionGI ulceration

Precautions/Interactions for Antidiarrheals

Increased risk of megacolon for clients who have IBSMay cause drowsiness or dizziness

Precautions for Antimalarials

Increased risk of psoriasisMonitor 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 behaviorsUnderstanding 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 thoughtsCompulsions 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 ORGANISMGLOVES and GOWN worn by caregivers and visitorsDISPOSAL of INFECTIOUS dressing material into NONPOROUS BAGDEDICATED EQUIPMENT for the patient or disinfect after each useClient 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

PsylliumDocusate sodiumBisacodylMagnesium 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 edemaFluid and electrolyte imbalancesThirst, dry mouth

Therapeutic Uses for Diuretics

Pulmonary edema caused by heart failureEdema unresponsive to other diuretics

Type Bulimia Nervosa

PurgingNonpurging

-floxacin

Quinolone antibiotic

Fire response

R-Rescue: protect and evacuate clients in immediate dangerA-Alarm: Activate the alarm and report the fireC-Contain: Close doors or windowsE-Extinguish: use correct fire extinguisher to exliminate the fire"RACE"

Sprain or Strain

RICERestIceCompressElevate

Speech Delirium

RapidInappropriateIncoherent

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 infectionOsteoporosisAdrenal suppressionFluid retentionGI DiscomfortHyperglycemiaHypokalemia

Indication modifies Trendelenbury

Shock

Therapeutic Use of Sedative/Hypnotic Medications

Short-term insomniaDifficulty falling or staying asleep

Precautions/Interactions for Antilipemic Medications

Should be discontinued during pregnancyUse with caution in renal dysfunction

Client Education for Emergency contraception

Should discuss options with providerShould 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

TachycardiaDilated pupilsElevated Blood PressureGrandiosityImpaired judgementParanoia with delusion

Termination Phase of Nurse-Client Relationship

The final phase of nurse-client relationshipSummarize the goals achievedDiscuss new coping strategiesRenew situations that occurred during the relationshipExchange 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 administrationDo not massage or rub areaApply 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 placeGradually reduce the dose and frequency of application over 4-6 weeks

Signs of therapeutic response for Thyroid Hormone Antagonists

Weight gainDecreased pulseBlood pressureT4 Levels

Side/Adverse Effects of Selective Serotonin Reuptake Inhibitors

Weight gainSexual dysfunctionFatigueDrowsiness

Manifestations of isotonic dehydration

Weight lossDry mucous membranesIncreased heart rate and respirationsThready pulseCapillary refill less than 3 secondsWeaknessFatigueOrthostatic hypotensionPoor 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• SedationATI Comprehensive NCLEX-RN Review: Pharmacology Effects

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• Bone pain• LeukocytosisATI Comprehensive NCLEX-RN Review: Pharmacology Effects

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• Bone pain• LeukocytosisATI Comprehensive NCLEX-RN Review: Pharmacology Effects

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• Bradycardia• Nasal stuffiness• AV Block• Rebound myocardium excitation if stopped abruptly• BronchospasmATI Comprehensive NCLEX-RN Review: Pharmacology Effects

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• Narcotic effects potentiatied• <2yr: Resp. DepressionATI Comprehensive NCLEX-RN Review: Pharmacology Effects

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• No, ACE inhibitors do.ATI Comprehensive NCLEX-RN Review: Pharmacology

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• No, ACE inhibitors do.ATI Comprehensive NCLEX-RN Review: Pharmacology Effects

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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

Standardairbornecontact

VRE precautions

Standardcontact

Rubella precautions

Standarddroplet

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 chemotherapySubcutaneous

Nursing Interventions and Client Education for Mannitol

Monitor daily weight, I&O, and electrolytesMonitor for signs of hypovolemiaMonitor 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?

Glaucoma

No atropine

List of Glucocorticoids

PrednisonePrednisolone

Client Education for Glucocorticoids

Teach symptoms to reportDo not take with NSAIDsTeach 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 rateapply warm compress

Adverse Reaction to Ciprofloxacin (Cipro)

Tendon rupture

Cycle of Violence

Tension-building stageBattering stageHoneymoon stage

List of Tocolytics

Terbutaline sulfateRitodrine HClNifedipineMagnesium Sulfate

Nursing Interventions for Methylergonovine

Continuously monitor blood pressureAssess uterine bleeding and uterine tone

Tetrology of Fallot

DROP (Defect, septal, Right ventricular hypertrophy, Overriding aortas, Pulmonary stenosis)

List of Childhood Immunizations

DTap, TdapHaemophilius influenza BRotavirusIPVMMRVaricellaSeasonal influenzaHepatitis A, BMeningococcal vaccineHPV - 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/impotenceLethargyDepressionConfusion

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

DependentAvoidantObsessive-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

VCHIPSVaricella zosterCutaneous diptheriaHerpes simplezImpetigoPeduculosisScabies

Rape Trauma Syndrome

Variant of PTSD that can lasts for weeks following rape

Symptoms of Major depressive disorder

Depressed mood most of the dayAnhedoniaGreater than 5% of weight loss or gain in 1 monthInsomnia or hypersomniaAnergiaFeelings of worthlessnessDecreased concentration

Uses of St. John's Wort

DepressionSeasonal affective disorderAnxiety

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 breastfeedingOften used in combination with glucosamineAllow 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 IMContraindicated 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 enzymesWarfarin 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 wayProblem 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

FeverIrritabilitySeizures

Onset for Albuterol (Proventil, Ventolin)

Few minutes

Class B

Flammable liquidsGases

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 retentionElevated blood pressure

Side/Adverse Effects for Oprelvekin

Fluid retentionPapilledemaCardiac 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)

FlushingNauseaBronchospasmProlonged 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.

Understand seductive behavior as a response to distressModel 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 infectionsSinusitisLegionnaire's diseaseWhooping coughAcute diphtheriaChlamydia

Therapeutic Uses for Cephalosporins

Upper respiratory, skin, and urinary infectionsUsed as prophylaxis for clients at risk

Indication dorsal recumbent

Urinary catheterization of femaleAbdominal assessmentAbdominal wound evisceration

Therapeutic Uses for Anticholinergic medications for overactive bladder

Urinary incontinenceUrinary urgency and frequency

Therapeutic Uses for Trimethoprim/Sulfamethoxazole

Urinary tract ifnectionBronchitisOtitis 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 vialUse Z-track methodVentrogluteal site preferredNever administer in deltoidDo not massage injection site

Client Education for Medroxyprogesterone injection

Use backup form of birth control for 7 days after first injectionFertility 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 dayConcurrent use of rifampin, isonazid, carabamazepine, and barbiturates may increase hepatotoxic effectsSlows 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 blockersDo not consume grapefruit juice (toxic effects)

Precautions/Interactions for Diuretics

Use cautiously in clients who have diabetes mellitusContraindicated in pregnancyNSAIDs reduced diuretic effect

Precautions/Interactions for Lithium

Use cautiously in clients who have renal dysfunction, heart disease, hyponatremia, and dehydrationNSAIDs will increase lithium levelsMonitor serum sodium levels

Precautions/Interactions of Sedative/Hypnotic Medications

Use cautiously in clients who have severe mental depressionAvoid 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 retentionChildren may have symptoms of excitation, hallucinations, incoordination, and seizuresAvoid alcohol intakeProducts containing pseudoephedrine should not be used for longer than 7 days

Nursing interventions rape

Use nonjudgmental and empathic approachAssess, treat, and document all injuriesProvide a private environment and limit personnel who examine the clientAssess client emotions and provide support

Prevention of infiltration with IV infusion

Use smallest catheter for prescribed therapystabilize port-accessassess blood return

Prevention of Pneumothorax with regard to Central Venous Catheters

Use ultrasound to locate veinsavoid 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 placeMonitor potassium levels

Nursing Considerations of Glucosamine

Use with caution in clients who have a shellfish allergyMonitor glucose frequently in clients who have diabetes mellitusAllow extended time to see the effects of GlucosamineUse 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 failureMay 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 spermicideFit by prescriberPap smear every 3 monthsIncreased risk of vaginal infections

Considerations for use of Cervical diaphragm

Use with spermicideFit by prescriberRefitted after childbirth or weight gain/loss

Precautions for Macrolides

Used for clients who have a penicillin allergyAdminister with meals

Therapeutic Uses of Warfarin

Venous thrombosisThrombus prevention for clients with atrial fibrillation or prosthetic heart valvesPrevention of recurrent myocardial infarctionTransient ischemic attacks

Therapeutic Use for Amiodarone (Cordarone)

Ventricular fibrillationUnstable ventricular tachycardia

Toddler 18 months+ IM site

Ventrogluteal

Side Effects to Varicella vaccine

Vesciles on skinPruritus

Measles nursing considerations

Virus can live on infected surfaces for up to 2 hr

Type Admissions Mental Health

VoluntaryInvoluntary

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

WarmthFlushingRespiratory depressionDiminished deep tendon reflexesDecreased urine outputPulmonary edema

Manifestations FVD

Weight lossDry mucus membranesIncreased heart rate and respirationsThready pulseCapillary refill less than 3 secondsWeakness, fatigueOrthostatic hypotensionPoor skin turgorLATE 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, motorMax- 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/splacental abrution s/s

there is no pain, but there is bleedingthere 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!

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Client Education for Inhaled Anticholinergics

Instruct client that maximum effects may take up to 2 weeksShake inhaler well before administrationwhen 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 acidMonitor CBC and uric acid levelsInstruct clients to avoid aspirinAdminister with meals

Nursing Interventions for Sedative/Hypnotic Medications

Instruct client to take immediately before bedtime because medication has abrupt onset of sleepInstruct client to avoid alcoholWarm 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 containerHold gentle pressure on the nasolacrimal duct for 30 - 60 seconds immediately after instilling dropsMonitor 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 preparationsInstruct client to follow medication regimenRanitidine 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 MATERIALSMASK and face and GOOGLES when anticipating SPLASHING of BODY FLUIDSPPE is DISPOSED of in the CLIENT'S ROOM

Drugs associated with date rape

Gamma-hydroxybutyrate (GHB) produces relaxation, euphoria, and hisinhibitionFlunitrazepam (Rohypnol) causes sedation, muscle relaxation, and amnesia

Therapeutic Uses for Antisecretory/Blocking Agents

Gastric and Peptic ulcersGERDZolliner-Ellison syndrome

Therapeutic Uses for Sucralfate

Gastric and duodenal ulcersGERD

Indication semi-Fowler's

Gastric feedingHead injuryPostoperative cranial surgeryRespiratory illness with dyspneaPostoperative cataract removalIncreased intracranial pressure

Therapeutic Use for Antianxiety Medications

Generalized anxiety disorder and panic disorderInsomniaAlcohol withdrawalInduction of anesthesia

Therapeutic Uses for Antiretrovirals

Genital herpesShinglesHIV

Signs and symptoms of severe anxiety

Gently reduced perceptual fieldAttention scatteredFeelings of dreadConfusionHyperventilationTachycardiaThreats and demands

Side/Adverse Effects for Phenytoin

Gingival hypertrophyDiplopiaDrowsinessHirstuism

Nontherapeutic Communication Techniques

Giving premature adviceMinimizing feelingsFalse reassuranceDisapprovalMaking value judgments

List of Sulfonylureas

Glipizide (Glucotrol)Glyburide (DiaBeta, Micronase)

-gliptin

Gliptins

Order of PPE removal

GlovesGoggles/face shieldGownMask

PPE contact precautions

GlovesGownMask and goggles (as-needed)

What are standard precautions PPE

GlovesMaskGownGoogles

MRSA nursing considerations

GlovesPPE 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 waterInstruct client that full effects may take 1-2 monthsInstruct client to manage anticholinergic side effectsInstruct 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 mealsDo not administer within 30 minutes of antacids

Nursing Interventions for Glucocorticoids

Assess client activity and behaviorAdminister medication with meals

Staphylococcus aureus nursing considerations

GlovesPPE 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

GownMaskGoggles/face shieldGloves

Crutches

Assess client for correct fit of crutches: 2-3 finger widths between the axilla and top of the crutchPosition 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

GroomingDressHygieneFacial Expression

List of Expectorants

Guaifenesin (Mucinex)

Ventilatory alarms

HOLD High alarm--Obstruction due to secretions, kink, pt cough etcLow 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-PullA-AimS-SqueezeS-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 othersAt the end of a specified time, the client must have a hearing or be released

Nursing considerations AIDS/HIV

Hand hygienePPE if in contact with potentially contaminated materials

VRE nursing considerations

Hand hygiene and glovesgowns if in contact with contaminated materialOnly soap and water

Three-point gait

Client must be able to bear entire body weight on unaffected legTwo crutches and unaffected leg bear alternatelyMove both crutches and the weak leg forwardMove stronger leg forward

Hep A nursing considerations

Contact precautions usedClients wearing diapers or who are incontinentMinimum of 1 weekDepending 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 connectorsask 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 lactationClients who have esophageal stricture or difficulty swallowing may only use zoledronateAbsorption is decreased when taken with calcium supplements, antacids, orange juice and caffeine

Indication Fowler's

Head injuryPostoperative cranial surgeryPostoperative abdominal surgeryRespiratory illness or cardiac problems with dyspnea Bleeding esophageal varicesPostoperative throidectomy or cataract removalIncreased intracranial pressure

Precautions/Interactions for Beta-2 Adrenergic Agonist Medications

Contraindicated for clients with tachydysrhythmiasCaution in clients with diabetes mellitus, hyperthyroidism, heart disease, hypertension, and angina.Beta blockers will reduce effectsMAOIs will increase effects

Nursing Interventions with Statin Medications

Do not administer with grapefruit juice

Therapeutic Uses for Digoxin

Heart failureAtrial 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 tabletsNotify prescriber of any sign of GI bleedingTeach 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 discomfortsGI ulcerationRenal impairmentPhotosensitivity

Walker

"WANDER WILMA'S ALWAYS LATE"W-WalkerW-WithA-AffectedL-LegFor 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 inchesAdvance the WITH the AFFECTED LEGMove UNAFFECTED LEGAssess 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 PTTeach 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 bleedingAdminister vitamin K for warfarin toxicityGarlic, ginger, gingko and ginseng may increase the risk of bleeding

Treatment of Pneumothorax with regard to Central Venous Catheters

Administer oxygenassist 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 containerNitrolingual may be used prophylactically 5-10 minutes before exercise. Do not shake Nitrolingual container because it forms bubbles.Replace nitrostat tablets every 6 monthsWear 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 recommendedProvide emotional support to family

Precautions/Interactions for Thyroid Hormone Antagonists

Administer with caution in clients who have bone marrow depression, hepatic disease, or bleeding disordersDiscontinue prior to radioactive iodine uptake testingContraindicated with breastfeeding

Nursing Interventions for NSAIDs

Administer with food and full glass of waterAvoid lying down for 30 minutes after administrationInstruct client to use only as needed for symptoms to reduce risk of GI ulcerationInstruct client to use sunscreen

Nursing Interventions for Thyroid Hormone Antagonists

Administer with food at the same time each day.Increase fluids to 3 L/dayInstruct client to avoid OTC products containing iodineInstruct client to take medications as prescribedIf discontinuing dose must be tapered offMonitor client for therapeutic responseMonitor client for signs of overdose

Nursing Interventions and Client Education for Thrombolytic Medications

Administration must take place within 4-6 hours of symptom onsetContinuous monitoring is requiredClients 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 selfConsents to all treatmentCan refuse treatment, including medications, unless a danger to self or othersCan demand and receive discharge

Side/Adverse Effects for Medications for Adrenal Hormone Replacement

Adrenal suppression when administered for inflammation or allergic reactionsInfectionHyperglycemiaOsteoporosisGI bleedingFluid retention

Nursing Considerations for Valerian Root

Advise client against driving or operating machineryAdvise client against long-term useDiscontinue 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 absorptionInstruct on procedures for inhalationExamine mouth for irritationPerform 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

AlendronateRisedronateIbandronateZoledronic acid

Side Effects for Polio Vaccine (IPV)

Allergic reaction

Therapeutic Use for Decongestants

Allergic rhinitisSinusitis Common cold

Contraindication for Rotavirus vaccine

Allergic to mycin drugs

Contraindication for Hepatitis B vaccine

Allergy to yeast

List of Antigout medications

AllopurinolColchicine

Nursing Considerations for Saw Palmetto

Allow 4-6 weeks to see effectsDiscontinue use prior to surgery

Prevention of Venous spasm with IV infusion

Allow time for vein diameter to return after tourniquet removedinfuse 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) InhibitorsAngiotensin II Receptor Blockers (ARBs)Calcium Channel BlockersAlpha Adrenergic BlockersCentrally Acting Alpha2 AgonistsBeta Adrenergic BlockersVasodilators

Nursing intervention Addictive disorders

Assess Vital signsAssess dehydrationAssess low self-worthProvide client safetyAssess toxicology screen/blood alcohol levelAssess severe withdrawal syndromeAssess overdose with warrants immediate medical attentionAssess suicidal thoughts and behaviorsAssess family members for codependencyExplore the client's interests in participating in a 12-step program such as Alcoholics Anonymous or Narcotics AnonymousExplore 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 administrationNotify 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 lowMaintain therapeutic digoxin level

Nursing Interventions for Antidepressants

Assess client for suicide riskInstruct client to take on daily basis and never to miss a doseInstruct client about therapeutic effects and time of onsetInstruct client to avoid discontinuing drug abruptlyInstruct client to take SSRIs in the morning to minimize sleep disturbancesProvide clients taking MAOIs a list of foods containing tyramineAdvise clients to avoid taking other medications without consulting provider

Nursing Interventions for Rett's syndrome

Assess for developmental delaysAssess caregiver-child relationshipAssess for family coping skills, risk for child abuse

Nursing intervention suicide

Assess for suicidal ideation with intentAssess for lethal suicide planAssess for coexisting psychiatric or medical illnessAssess family history of suicideAssess recent lack of supportAssess for feelings of hopelessness and helplessnessAssess 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 strengthInstruct client to assist when possibleUse mechanical lift and assistive devicesAvoid twisting the thoracic spine or bending at the waistUse 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 eventsIdentify precipitating factors that may exacerbate or lead to seizureReview medication history. If routine lab work is required (Dilantin), when was last level drawnPlace rescue equipment at the bedside, including oxygen, oral airway, and suction equipmentEstablish IV or saline lock access for high risk clientsInspects the client's environment for items that may cause injury in the event of a seizure.Remove any unnecessary items from the immediate environmentAt the onset seizure, position the client for safety, and remain with clientIf sitting or standing, ease client to floor. Protect the client's head. If client is in bed, raise the side rails and pad for safetyRoll the client to the side with the head flexed slightly forwardDo not put anything in the client's mouthLoosen restrictive clothingAccurately 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 otherAssess the need to protect client from uninhibited behaviorsAssess for coexisting medical conditions such as substance use disorderUse firm calm approachProvide frequent high-calorie fluidsMaintain 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

AtomoxetineGuanfacine (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 alcoholDo not discontinue abruptlyMonitor for serotonin syndrome within the first 72 hours

Nursing intervention Paranoid

Avoid being too nice or too friendlyGive clear explanationWarn about any changes and reasons for delays

Nursing intervention Schizoid

Avoid being too nice or too friendlyTry not to increase socialization

Client Education for Methylxanthines

Avoid caffeine intakeSmoking will decrease effectsAlcohol abuse will increase effects

Precautions/Interactions for MAOIs

Avoid foods containing tyramineAntihypertensives have additive hypotensive effectContraindicated with SSRIs, tricyclics, heart failure, CVA, and renal insufficiency

Prevention of Hematoma with IV infusion

Avoid veins not easily seen or palpatedobtain hemostasis after insertion

List of Macrolides

AzithromycinClarithromycinErythromycin

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 behaviorsIdentify current stressesSatisfy client's needs with limits

Side/Adverse Effects for Antigout medications

GI distressHepatitis

Crutches: Non-weight bearing

Begin in the tripod position, maintain weight on the "unaffected" (weight-bearing) extremityAdvance both crutches and the affected extremityMove the unaffected weight-bearing foot/leg forward (beyond the crutches).Advance both crutches, and then the affected extremityContinue sequence making steps of equal length

Document Restraints

Behaviors making restraint necessaryAlternatives attempted and the client's responseType and location of restraint and time appliedFrequency and type of assessment

If extrapyramidal effects occur, what should be administered?

Benzatropine

Central Nervous System Depressants

BenzodiaxepinesBarbituratesAlcohol"Ben go to Bar to have Alcohol"

Therapeutic Uses for Lithium

Bipolar disorderAlcohol use disorderBulimiaSchizophrenia

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 longerRapport and trust is establishedThe nurse's role is clarified and all roles are definedConfidentiality is establishedThe terms of termination are introducedThe nurse becomes aware of transference and countertransference issuesClient 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

CarbamazepineGabapentinPhenobarbitalPhenytoinValproic 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 disordersGenerally 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

CephalexinCefaclorCefotaxime

Indication reverse trendelenbury

Cervical tractionTo feed client restricted to supine position, such as post cardiac catheterization

Treatment of Bloodstream Infection with Central Venous Catheters

Change entire infusion systemnotify providerobtain culturesadminister 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 organTo 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

ChlorpromazineFluphenazineHaloperidolThiothixene

Therapeutic Use for Allopurinol

Chronic gouty arthritis

Therapeutic Use of Antitussives

Chronic nonproductive cough

List of Fluoroquinolones

CiprofloxacinLevofloxacin

Selective Serotonin Reuptake Inhibitors (SSRIs)

CitalopramEscitalopram

Client: "I am so worried."Nurse: "What specifically are you worried about?"

Clarifying with reflection

Type fire extinguisher

Class AClass BClass C

Nursing Interventions of Excited Catatonic Schiozphrenia

Clear, direct communicationStimulation reductionMonitor 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 catheterMust 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 ORGANISMAVOID placing client on CONTACT PRECAUTIONS in SAME ROOM with clients who are IMMUNUNOCOMPROMISE, have OPEN WOUNDS, or have anticipated PROLONGED LENGTHS OF STAYEnsure 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 unconsciousPost lumbar puncture 6 to 12 hrPost myelogram 12 to 24 hr (oil-based dye)Postoperative tonsillectomy and adenoidectomy

Indication Sims'

Client who is unconsciousEnemas

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 administrationMonitor for signs of bleedingSafety precautions to prevent bleedingAdminister subcutaneous heparin to abdomen, 2 inches from umbilicus, do not aspirate or massage areaRotate injection sites and observe for bleeding or hematomaAdminister 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 diseaseOlder adultsElectrolyte 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

CocaineAmphetamines"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 findingEarly detection and treatment of hypertensionExercise programs for older adults who are frail

Factors that promote client growth

Communicating genuinenessExpressing empathyHaving positive regard for client

Nursing Interventions of Disorganized Schizophrenia

Communication should be concise, clear, and concreteTakes 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 assessmentCommunicate identified risks with the health care teamAssign clients at risk falls to a room close to nurses' stations and assess frequentlyProvide clients with nonskid footwearKeep the floor free of clutter and maintain an unobstructed path to the bathroomOrient the client setting (grab bars, call light), including how to use and locate all necessary itemsMaintain bed in low positionInstruct the client who is unsteady to use the call light for assistance before ambulatingAnswer call lights promptly to prevent clients who are at risk from trying to ambulate independentlyProvide 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 reachUse chair or bed sensors for client who are at riskLock wheels on beds, wheelchairs, and gurneys to prevent rolling during transfers or stopsReport and document all incidents per the facility policy

Nursing interventions disease prevention

Conduct a risk factor assessmentEducate clients to follow standards for recommended screeningsIdentify lifestyle risk behaviors requiring modificationEncourage client to continue health-promoting behaviorsInstruct client about preventive immunizations

Do's

Conduct the interview in privateBe direct, honest, and professionalBe understanding and attentiveAssess for client safety

Precautions for RhoD Immune Globulin (RhoGAM)

Confirm that the mother is Rh-negativeNever administer the IGIM full-dose or microdose products intravenouslyNever administer to a neonate

Studies of Ginseng

Conflict as to the effectiveness of ginseng in all uses

Side/Adverse Effects for Aluminum Hydroxide

ConstipationHypophosphatemia

Side/Adverse Effects for Calcium Channel Blockers

ConstipationReflex TachycardiaPeripheral EdemaToxicity

Intoxication Opiates

Constricted pupilsDecreased respirationsDecreased Blood PressureInitial euphoria followed by dysphoria

Nursing Interventions for Immunizations

Consult CDC guidelines for schedule of administrationEducate 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 fluidUse backup contraceptionAvoid sun exposure

Precautions for Tetracyclines

Consume at least 3 L/day of fluidUse backup contraceptivesAvoid sun exposurePermanent tooth discoloration if given to children younger than 8 years

Hep B nursing considerations

Contact precautions for blood and body fluidsHand hygiene

Hep C nursing consideration

Contact precautions for blood and body fluidsHand hygiene

Precautions/Interactions for Thrombolytic Medications

Contraindicated for intracranial hemorrhage, active internal bleeding, aortic dissection, brain tumorsUse caution when using in clients who have severe hypertensionConcurrent 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 PIDHigh risk of infectionMay 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 antihypertensivesContraindicated 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 disordersWarfarin 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 infectionCaution in clients who have hypertension, gastric ulcers, diabetes, osteoporosisRequires 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 injuryHypotensive risk with antihypertensive medicationsErectile 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 lecithinUse 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 infectionDo not administer live virus vaccines during therapyShould only be used for a short duration

Precautions/Interactions for Antiplatelet medications

Contraindicated in thrombocytopeniaCaution 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 abdomenEncourage regular exercise and promote regular bowel eliminationMonitor for chronic laxative use/abuseProvide adequate fluid intake to avoid obstruction

Precautions/Interactions for Oxytocin

Contraindicated with placental insufficiencyBishop 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 penicillinsMonitor 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 clientMonitor electrolytes and vital signsMonitor food and fluid intakeSet achievable weight goalsLimit exercise regimen to promote weight gainExplore client's feeling of self-worthAssist in the development of effective coping strategiesEncourage client attendance in behavior modification therapyEncourage family support groupAdminister antidepressants as prescribedProvide positive reinforcement for weight gainMonitor ECG for Arrhythmia

Nursing Intervention Bulimia Nervosa

Develop supportive relationship with clientMonitor electrolytes and vital signsMonitor food and fluid intakeMonitor the client 30-60 minute after a mealMonitor exercise regimenExplore client's feeling of self-worthObserve teeth for erosion and cariesObserve room for food hoardingEncourage client attendance in behavior modification therapyEncourage family support groupsAdminister 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

DexamethasoneHydrocortisoneFludrocortisone acetatePrednisone

List of Stimulant Attention Deficit Hyperactive Disorder Medications

Dextroamphetamine and amphetamineMethylphenidate transdermalMethylphenidate ERMethylphenidate

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 insipidusCardiac arrestNocturnal enuresis

Side/Adverse Effects for Magnesium hydroxide

DiarrheaRenal impairmentHypermagnesemia

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 CAvoid antacids, coffee, tea, dairy products, or whole gain breads concurrently and for 1 hour after administration due to decreased absorptionMonitor 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 atropineLoperamide

Immunizations for children at 4-6 years

Diphtheria, tetanus, and pertussis. (DTap)Polio vaccine (IPV)Yearly influenzaMeasles, 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 medicationsTreat dysrhythmias with phenytoin (Dilantin) or lidocaineTreat bradycardia with atropineFor excess overdose, administer digoxin immune FAB to prevent absorption

Feelings that can precipitate anger

DiscountedEmbarrassedGuiltyHumiliatedHurtIgnoredUnheardRejectedThreatenedTiredVulnerable

Nursing Interventions for Contraception

Discuss conception and contraceptive plans with client to include reliability, benefits, and risksInstruct client to maintain regular health screening visitsInstruct client about measures to prevent PID, STIsExplain that contraceptive decisions may change over the life spanTeach 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-MeaslesC-Chicken poxH-Herpes zosterTB

Thoughts in Mental Status Examination

DisorganizedFlight of ideas

Disseminated herpes zosterlocalized herpes zoster

Disseminated herpes=airborne precautionsLocalized 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

DizzinessAtaxiaSomnolenceHypertensionBruising

Side/Adverse Effects of Alpha Adrenergic Blockers

DizzinessFainting

Side/Adverse Effects for Vasodilators

DizzinessHeadacheProfound hypotensionCyanide toxicityThiocyanate poisoning

Side/Adverse Effects of Ginkgo biloba

DizzinessPalpitations

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 obstructionClients who have renal impairment should only use aluminum-based preparationsOther medications should be taken 1 hour before or after antacidsRequire 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 wortMust avoid alcoholContraindicated in clients with seizure disorder

Nursing Interventions for Glucocorticoids for Antirheumatic purposes

Do not skip dosesMonitor blood pressureMonitor fluid and electrolyte balance and weightMonitor for signs of bleeding, GI discomfortsTeach client to take calcium supplements and maintain vitamin D levelsGive with foodNever stop abruptlyProvide immunoprotection

Nursing Interventions for Medications for Adrenal Hormone Replacement

Do not skip dosesMonitor blood pressureMonitor fluid and electrolyte balance, weight, and outputMonitor for signs of bleeding and GI discomfortTeach client to take calcium supplements and maintain vitamin D levelsGive with foodTaper off dose regimen when discontinuing medicationProvide 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 obstructionUse 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 usePyridoxine (vitamin B6) decreases effects of levodopa.Benztropine is contraindicated in clients who have narrow-angle glaucomaMust discontinue 6-8 hours before anesthesia

Nursing Interventions for Scopolamine

Do not use with angle-closure glaucomaApply transdermal patches behind earUse lubricating eye drops

Nursing Interventions for Cholinesterase inhibitors

Dose must be individualizedInstruct clients to keep individual diary to record side effectsAdvise client to wear medical alert braceletMonitor for cholinergic crisis

List of Tetracyclines

DoxycyclineTetracycline

Side/Adverse Effects for Antitussives, Expectorants, and Mucloytics

DrowsinessDizzinessAspiration and bronchospasm risk with mucolyticsConstipation

Side/Adverse Effects for Disulfiram

DrowsinessHeadacheMetallic taste

Side/Adverse Effects of Phenobarbital

DrowsinessHypotensionRespiratory Depression

Side/Adverse Effects of Sedative/Hypnotic Medications

Dry mouthDecreased libidoRespiratory depression

Side/Adverse Effects for Centrally Acting Alpha-2 Agonists

Dry mouthDrowsiness and sedation that resolves over timeRebound hypertensionBlack or sore tongueLeukopenia

Side/Adverse Effects for Inhaled Anticholinergics

Dry mouth and eyesUrinary retention

List of Selective Serotonin Reuptake Inhibitors

DuloxetineFluoxetineEscitalopramFluvoxamineParoxetineSertraline

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

ECTMedicationsSeclusionRestraints

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 groundedDo not overcrowd outletsDo not extension cords on client care areasOnly used equipment for intended purposeRegularly inspect equipment for frayed cordsDisconnect all equipment prior to cleaning

Precautions/Interactions for Heparin and Enoxaparin

Enoxaparin must be given subcutaneouslyHeparing can be given subcutaneously or IVIncompatible with many medications, anything with a bicarbonate baseAvoid 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 dysfunctionSexual dysfunction in women

-afil

Erectile dysfunction medication

Nursing intervention Delirium

Establish the client's baseline level of consciousness by interviewing family membersAssess vital signs and perform neurological checksAssess acute onset and fluctuating levels of consciousnessAssess client's ability to function in the immediate environmentDetermine the physiologic reason delirium is occurringMaintain comfort measures

List of Sedative/Hypnotic Medications

EszopicloneTemazepamZolpidem tartrate

Side/Adverse Effects of Glucocorticoids

EuphoriaInsomniaPsychotic behaviorHyperglycemiaPeptic UlcerFluid retentionIncreased appetiteWithdrawal symptoms

Side Effects of Nonstimulant Attention Deficit Hyperactive Disorder Medications

GI upsetConstipationFatigue

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 olderVASTUS LATERALIS (ANTEROLATERAL THIGH) is the site for IM injections in childredn who are LESS THAN 2 YEARS OF AGEuse 0.5- to 2-inche needle, depending upon the child's body sizeMAXIMUM 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 functioningIdentify any threats to client's safetyReview all medications the client is takingInterview family members to obtain a full historyUse short, simple words and phrasesSpeak slowlyHave Clocks, calendars, and personal items in clear viewExplore how well the family understands the disease progressionReview 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 strokePulmonary embolismMassive deep-vein thrombosisCardiac catheterizationMyocardial infarctionDIC

Contributing factors to isotonic dehydration

Excess GI lossDiaphoresisFeverExcess renal lossHemorrhageInsufficient intakeBurnsDiureticAging

Contributing Factors FVD

Excess GI lossDiaphoresisFeverExcess renal lossHemorrhageInsufficient intakeBurnsDiuretic therapyAging: 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 movementsLevel of eye contact

Side/Adverse Effects of Bethanechol

Excessive salivation, tearing

Action/Therapeutic Uses for Albumin

Expand volume via oncotic changesHypovolemiaHypoalbuminemiaBurnsSevere nephrosisHemolytic disease of the newborn

Medication Older adult

Experience TWICE as many ADVERSE EFFECTSCONFUSION, LETHARGY, FALLS, AND WEAKNESS RISK for TOXICITY INCREASES-POLYPHARMACYTOXICITY: 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 40C=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

FatigueDepressionAgitationApathyAnxietyCraving

Hematophobia

Fear of blood

Claustrophobia

Fear of closed spaces

Acrophobia

Fear of heights

Monitor for reactions with plaetlets

FebrileSepsis

Clostridium difficile reservoir

Feces

Hep A reservoir

Feces

Salmonella reservoir

Feces

Primary Risk Factors for Major Depressive Disorder

Female genderUnmarried statusLow socioeconomic classEarly childhood traumaFamily history of depressionPostpartum periodMedical illness

List of Opioid Analgesics

Fentanyl HydromorphoneMorphine sulfateMeperidineCodeineOxycodone

Side Effects for yearly influenza vaccine

Fever

Factor Delirium

FeverHypotensionInfectionHypoglycemiaAdverse drug reactionHead injuryEmotional stressSeizure

Cane

For correct size, have client wear shoes. The correct length is measured from the wrist to the floorCane is used on the unaffected side to provide support to the opposite lower limbIn 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 wornAs 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 balanceLong-term cane use should involve the client moving the affected extremity and cane at the same time to improve muscle function"COAL"C-CaneO-OppositeA-AffectedL-Leg

Nursing Considerations for Omega-3 fatty acids

Found in fish oils, nuts, and vegetable oilsSome 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

FurosemideBumetanide

Side/Adverse Effects for Lithium

GI DistressFine hand tremorsPolyuriaWeight gainRenal toxicity

Walking up stairs

Hold onto rail with one hand and crutches with the other handPush down on the stair rail and the crutches and step up with the unaffected legIf not allowed to place weight on the affected leg, hop up with the unaffected legBring the affected leg and the crutches up beside the unaffected legRemember, the unaffected leg goes up first and the crutches move with the affected leg"GOOD GO TO HEAVEN"

Behavior of Trust vs Mistrust stage

HopefulnessTrusting vs withdrawnAlienated

Herpex simplex nursing considerations

Horizontal transmission from contact with skin and secretionsVertical transmission from mother to child in utero or childbirth

Client Education for use of Intrauterine device

Hormonal IUD effective for up to 7 yearsCopper IUD effective for up to 12 yearsMust monitor for signs of infectionVerify string is present

List of Antitussives

HydrocodoneCodeine

List of Intravenous Glucocorticoids

Hydrocortisone sodium succinate (Solu-Cortef)Methylprednisolone sodium succinate (Solu-Medrol)Betamethasone sodium phosphate (Betnesol, Celestone Phosphate)

List of Antimalarials

HydroxychloroquineQunine 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

HyperglycemiaHypothyroidism

Side/Adverse Effects for Potassium-sparing diuretics

HyperkalemiaEndocrine effects such as impotence and menstrual irregularities

Precautions/Interactions for NSAIDs

Hypersensitivity to aspirin or other NSAIDsMay 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)

HypertensionHeart failureMyocardial infarctionDiabetic neuropathy

Therapeutic Use of Vasodilators

Hypertensive emergencies

Therapeutic Uses for Thyroid Hormone Antagonists

HyperthyroidismPreoperative thyroidectomyThyrotoxic crisisThyroid 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)

HypothyroidismEmergency treatment of myxedema coma

Side/Adverse Effects for Loop and Thiazide Diuretics

HypovolemiaOtotoxicityHypokalemiaHyponatremiaHyperglycemiaDigoxin toxicityLithium toxicity

ICP and Shock

ICP- Increased BP, decreased pulse, decreased respShock--Decreased BP, increased pulse, increased resp

Nursing interventions standard precautions

IMPLEMENT STANDARD PRECAUTIONS for ALL CLIENTSDetermine need for client-specific, disease-specific precautionsProvide education to health care team, clients, and visitorsReport communicable disease per CDC policyHandle all blood and body fluids as if contaminatedUse PPE to REDUCE risk of transmissionConsidered ROOM PLACEMENT for client safetyClean equipment according to facility policyDISCARD a NEEDLES and SHARPS in the appropriate CONTAINERS; DO NOT RECAPPlace contaminated linens in appropriate receptacle per facility's policyCLEAN 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

IbuprofenDiclofenacIndomethacinNaproxenCelecoxib

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 programsChild car seat educationNutrition and fitness activitiesHealth education programs

Presenting symptoms of Autistic Disorder

Impaired language developmentImpaired behavior developmentImpaired social interaction development

Cognition Dementia

Impaired memoryJudgmentAttention spanAbstract thinking

Cognition Delirium

Impaired memoryJudgmentAttention span that can fluctuate

Presenting symptoms of Rett's syndrome

Impairment in communicationSeizure disorderAbnormal gaitImpaired head growthSevere or profound mental retardation

Nursing Interventions for Anti-Parkinson's Drugs

Instruct family members to assist with medication regimenInstruct client to notify prescriber if sudden loss of the medication effects occursInstruct client that maximum therapeutic effects may take 4-6 weeksMonitor closely for signs of adverse reactionsInstruct client to avoid high-protein meals and snacksKeep 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 activitiesPrior to application, review manufacturer's instructions for correct applicationNotify the provider immediately when restraints are implementedRemove the restraints and assess client every 2 hrAssess neurovascular and neurosensory status every 2 hrLeave the restraint loose enough to prevent injuryAlways tie the restraint to the bed frame (using loose knots that are easily removed)Reassess the need for continue useDocument

Uses of Ginkgo biloba

Improves cerebral circulation to treat dementia and memory loss"Good for your Brain"

Uses of Omega-3 fatty acids

Improves hypertriglyceridemiaHelps maintain cardiac health

Uses of Ginseng

Improves strength and staminaPrevents and treats cancer and diabetes mellitus

Angiotenson II

In the lungs...potent vasodialator, aldosterone attracts sodium.

Speech Dementia

IncoherentSlowInappropriate

Nursing Interventions for Amiodarone (Cordarone)

Incompatible with heparinMay be given in oral maintenance doseMonitor 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 RBCSevere anemiaHemoglobinopathiesHemolytic anemiaErythroblastosis 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 countActive bleedingThrombocytopeniaAplastic anemiaBone 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 vomitingImmunocompromised

Complications associated with IV infusion

Infiltrationextravastationphelbitis/thrombophlebitishematomavenous spasm

Symptoms Bipolar disorder

Inflated self-esteem or grandiosityDecreased need for sleepMore talkative than usual Fight of ideasIncrease in goal directed activityExcessive 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

InsomniaExcitationEuphoria

Uses of Valerian Root

InsomniaMigrainesMenstrual cramps

Nursing Interventions for Disease-modifying antirheumatic drugs (DMARDs)

Instruct client about measures to prevent infectionMonitor liver function testsInstruct client to use reliable contraceptionInstruct client that initial effects may take 3-6 weeks and full therapeutic effects may take several monthsAdminister with foodInstruct clients taking hydroxychloroquine about the critical importance of retinal examination every 6 months

Nursing Interventions for Metoclopramide

Instruct client about rapid GI emptyingDiscontinue 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 settingPosition the bed or chair so that the client is moving toward the strong sideAssist the client to stand, then pivot

Long-acting insulin

Insulin glargine (Lantus)

Side/Adverse Effects of Oxytocin

Intense uterine contractionsUterine hyperstimulation or contractions lasting longer than 90 secondsUterine 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 treatmentBe used because of short-staffing or staff convenienceNot 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 roomThe 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

IrritabilityRestlessnessToxic effects: tachycardia, tachypnea, seizures

List of MAOIs

IsocarboxazidTranylcyprominePhenelzine

List of Antitubercular Medications

IsoniazidRifampin

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 arrestAdjust medication doses of warfarin and phenytoin

Side/Adverse Effects of Glucosamine

ItchingEdemaHeadache

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 painAnaphylaxisThrombocytopenia

Meningitis--check for

Kernig's/ brudinski's signs

Honeymoon stage

Kindness and loving behaviors such as flowersVictim wants to believe the abuser will change

Prolapsed cord

Knee to chest or Trendelenburgoxygen 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 intercourseRefit size with 10 pound or more weight change

Herpes zoster reservior

Lesions

Chickenpox reservoir

LesionsRespiratory secretions

-lukast

Leukotriene Modifiers

List of Antiglaucoma Medications

LevobunololPilocarpineTimolol maleate

List of Thyroid Hormone Medications

Levothyroxine (Synthroid)

Rapid-acting Insulin

Lispro (Humalog)

Medication Bipolar disorder

LithiumValproic acidAripipraxoleRisperidoneClonazepam

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

LorazepamAlprazolamDiazepamHaloperidolChlorpromazaine

List of Angiotensin II Receptor Blockkers (ARBs)

Losartan (Cozaar)Valsartan (Diovan)Irbesartan (Avapro)

Stage 1 (AD)

Loss of intellectual ability is insidiousLoses energy, drive, and initiativeDifficulty learning

Side/Adverse Effects for Proton Pump Inhibitors

Low incidence of diarrhea, nausea, and vomitingCan 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 shouldersSlightly 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&OMonitor vital signsMonitor fluid and electrolyte imbalancesAdminister early morning to prevent nocturiaInstruct clients taking loop/thiazide diuretics to increase intake of foods high in potassiumInstruct 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 pressureMonitor for angioedema and promptly administer epinephrine 0.5 mL of 1:1,000 solution subcutaneously

Nursing Interventions for Levothyroxine (Synthroid)

Monitor cardiac systemTherapy initiated with low doses; advance to higher doses while monitoring laboratory valuesMonitor T4 and TSH levelsTake in early morning

Nursing Interventions for Methadone

Monitor clients for signs of drug tolerance and psychological dependenceMonitor pancreatic enzymes because medication may cause biliary spasmsInstruct client that methadone must be slowly reduced to produce detoxificationClient must be monitored through treatment center

Nursing Interventions for Terbutaline sulfate and Ritodrine HCl

Monitor contractions and fetal heart tonesMonitor vital signsDo not administer if pulse rate is greater than 130/min or if client has chest painAdminister beta blocking agent as antidote

Nursing Interventions with Antitussives, Expectorants, and Mucloytics

Monitor cough frequency, effort, and ability to expectorateMonitor character, tenacity of secretionsAuscultate for adventitious lung soundsTeach client why multiple therapies are neededPromote fluid intake

Nursing Interventions and Client Education for Antidiarrheals

Monitor fluid and electrolytesAvoid 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 hypokalemiaMonitor blood pressureTeach client to manage anticholinergic effectsAdvise to take at night

Nursing Interventions for Antipsychotic Medications

Monitor for side effects within 5 hours to 5 days of administrationAdvise client of potential side effectsMonitor CBCEncourage fluidsStop medication for signs of neuroleptic malignant syndrome

Nursing Interventions for Antiplatelet medications

Monitor for signs of prolonged bleedingTeach client to report tarry stool, ecchymosis

Nursing Interventions for Antiseizure Medications

Monitor for therapeutic effectsMonitor clients taking phenytoin for toxic effects, including serum levels for toxicityInstruct clients regarding the importance of compliance; medication is treatment, not a cureIndividualize treatment regimenInstruct client regarding side/adverse effectsMedication therapy for status epilepticus: IV phenytoin and diazepam

Nursing Interventions for Anterior Pituitary/Growth Hormone

Monitor growth patternsReconstitute medication, do not shakeAdminister subcutaneously per protocolDose is individualized

Nursing Interventions for Alpha Adrenergic Blockers

Monitor heart rate and blood pressure

Precautions for Fluconazole

Monitor hepatic and renal functionRefrigerate suspensionsIncreased risk of bleeding for clients taking anticoagulants

Nursing Interventions and Client Education for Acetaminophen

Monitor liver functionMonitor kidney functionInstruct client not to exceed single dose of 325 mg or 4,000 mg in 24 hoursInstruct client about the risk of hepatotoxicityAdministration to children should be based on age, not to exceed 5 doses per dayTreat acetaminophen overdose with acetylcysteine

Nursing Interventions for Antilipemic Medications

Monitor renal and liver function laboratory profilesNote dietary precautions with specific classes

Nursing Interventions for Insulin

Monitor serum glucose levels before meals and at bedtime or patterned schedule-specific to clientRoll vial of insulin, except regular to mix; do not shakeInstruct client to rotate injection sites to prevent lipodystrophyTeach signs and management for hypo/hyperglycemiaEncourage diet and exercise to follow ADA recommendationsMonitor glycosylated hemoglobin (HbA1C)Refer to diabetic nurse educator

Nursing Interventions for Lithium

Monitor therapeutic levelsMonitor serum sodium levelsInstruct client that therapeutic effects begin in 7-14 daysDoses must be administered 2-3 times daily per prescriberProvide nutritional counseling to include food sources for sodiumAdminister with food to decrease GI distress

Nursing Interventions for Methylxanthines

Monitor therapeutic levels for Aminophylline and TheophyllineMonitor for signs of toxicity

Nursing Interventions for Posterior Pituitary Hormones/Antidiuretic Hormones

Monitor urine specific gravityMonitor blood pressureMonitor urinary outputPrevent hyponatremia due to water intoxicationInstruct for use of nasal spray

Nursing Interventions for Antianxiety Medications

Monitor vital signsInstruct clients to never abruptly discontinue medicationsMonitor clients for side/adverse effectsInstruct clients to avoid alcoholTreat overdose of benzodiazepines with flumazenil

Nursing Interventions for Opioid Analgesics

Monitor vital signsMonitor for respiratory depressionInstruct client regarding administration with PCA pumpAdminister naloxone for clients who have respiratory depression

Nursing interventions for isotonic dehydration

Monitor vital signsMonitor skin turgorMaintain strict I&O

Nursing Interventions for Promethazine

Monitor vital signsSafety precautionsIntramuscular injection in a large muscle

Nursing Interventions for Magnesium Sulfate

Monitor vital signs and deep tendon reflexesMonitor magnesium levels, therapeutic levels 4-8 mg/dLAdminister via infusion pump in diluted formUse indwelling catheter to monitor urinary eliminationAdminister 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 changesInsomniaAnxiety

Side/Adverse Effects of Melatonin

Morning grogginessLower body temperatureVivid dreams

Precautions/Interactions of Opioid Analgesics

Morphine is contraindicated after biliary tract surgeryMeperidine is contraindicated in clients who have kidney failureMonitor for potentiate effects when given with barbiturates, benzodiazepines, phenothiazines, hypnotics, and sedatives

Alzheimer's disease

Most common cause dementia in older adultsIt 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 MILKMedication LEVELS tend to be the HIGHEST in the NEWBORN immediately AFTER the medication is administered to the motherMothers who are breastfeeding are advised to BREASTFEEDING BEFORE taking the medication

Crutches: Weight bearing

Move crutches forward about one step's lengthMove "affected" leg forward; level with the crutch tipsMove the "unaffected" leg forwardContinue 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 achesHepatotoxicityMyopathyRhabdomyolysisPeripheral neuropathy

Side/Adverse Effects of Anti-Parkinson's Drugs

Muscle twitching, especially eyelid spasmsHeadacheDizzinessDark urineAgitation

Side/Adverse Effects for Biophosphonates

Musculoskeletal painEsophagitis and GI discomfortJaw 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 administeringCombined 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 discontinuedInstruct 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 maskclient 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 fieldVoice tremorsDifficulty concentratingIncreased respiratory and heart ratePacingBanging 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 yearsHistory of Gullian-Barre syndrome

Side/Adverse Effects of Omega-3 fatty acids

NauseaDiarrheaHypotension

Side/Adverse Effects of Dinoprostone cervical gel

NauseaStomach painBack painFeeling of warmth in the vaginal area

Side/Adverse Effects of Acetaminophen

Nausea and vomitingLong-term therapy: hemolytic anemia, leukopenia, neutropenia, and thrombocytopenia

Side/Adverse Effects of Glucagon

Nausea and vomitingRebound hypoglycemia

Withdrawal depressants

Nausea/VomitingTachycardiaDiaphoresisTremorsGrand mal seizuresVisual hallucationParanoid delusion

Needs O2!

Precautions/Interactions with Statin Medications

Prolonged bleeding in clients taking warfarinDrug 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 timeAltered platelet function

Action of Amiodarone (Cordarone)

Prolongs repolarization, relaxes smooth muscles, decreases vascular resistance

List of Antiemetics

PromethazineMetoclopramideOndansetronScopolamine

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 STDsApply and remove correctlyUse 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 CLOSEDRESPIRATORY 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 environmentMaintain a therapeutic, objective, communicative approachIf delusions exist with food being poisoned, provide commercially sealed packages when possible

Nursing intervention Borderline

Provide clear and consistent boundariesUse clear communicationBe aware of manipulative behaviorsAssess for self-mutilating behaviors

Nursing interventions repositioning clients in bed

Raise the bed to waist levelLower side railsUse slide boards or draw sheetsHave the client fold his arms across his chest while lifting the headProceed in one smooth movementCollaborate with other staff members for assistance

List of Histamine-2 Receptor Antagonists

Ranitidine HydrochlorideCimetidineNizatidineFamotidine

Nursing Interventions for Adenosine (Adenocard)

Rapid IV (1-2 seconds) pushFlush immediately with normal saline

Types of Insulin

Rapid-actingShort-actingIntermediate-actingLong-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 firstYellow--stable, can wait up to an hour for treatmentGreen--stable can wait even longer to be seen---walking woundedBlack--unstable, probably will not make it, need comfort careDOA--dead on arrival

Action of Metformin

Reduces gluconeogenesisIncreases 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 bronchospasmLong-term control of asthma

Therapeutic Use of Opioid Analgesics

Relief of moderate to severe painSedation

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 hepatotoxicityConsume foods high in vitamin B6Avoid foods with tyramine with IsoniazidIncreased risk of phenytoin toxicity with IsoniazidAvoid alcoholDiscoloration of urine, saliva, sweat, and tears with Rifampin

Medications for Conduct Disorder

RisperidoneMethylphenidateBuproprionCarbamazepine

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 hourssecure catheteruse aseptic technique for PICC linesavoid 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=bothOh (Olfactory I) SomeOh (Optic II ) SayOh (Oculomotor III) Marry To (trochlear IV) MoneyTouch (trigeminal V) ButAnd (Abducens VI ) MyFeel (facial VII) BrotherA (auditory VIII) Says Girl's (glossopharyngeal IX) Big Vagina (vagus X) BrasAnd (accessory XI) MatterHymen (Hypoglossal XII) More

Mood in Mental Status Examination

SadLabileEuphoricFlat affectBland affect

Side/Adverse Effects for Antipsychotic Medications

SedationExtrapyramidal effectsAnticholinergic effectsTardive dyskinesiaAgranulocytosisNeuroleptic malignant syromeSeizures

Side/Adverse Effects of Methadone

SedationRespiratory depressionParadoxical 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

SepticemiaMeningitisPneumonia

Side/Adverse Effects for Thrombolytic Medications

Serious bleeding risks from recent wounds, puncture sites, weakened vesselsHypotensionPossible anaphylactic reaction

What diagnostic procedures can be done for isotonic dehydration?

Serum electrolytesBlood urea nitrogenHematocritUrine specific gravityUrine osmolarity

Nursing intervention Antisocial

Set clear limits on specific behaviorBe 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 depressionParkinson's diseaseProlactin-dependent cancerSevere 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 methodCan insert up to 1 hour before intercourse

List of Sexual Dysfunction Medications

SildenafilTadalfilVardenafil

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 absorptionOptimal locations for patch are upper chest or side; pelvis; and inner, upper armRotate skin sites daily

Side/Adverse Effects of Thyroid Hormone Antagonists

Skin rash, pruritusAbnormal hair lossGI upsetParesthesiasPeriorbital edemaJoint and muscle painJaundiceAgranulocytosisThrombocytopenia

Speech in Mental Status Examination

SlowRapidNormalLoudSoftDisorganized

Side/Adverse Effects of Cholinesterase inhibitors

Slow heart rateChest painWeak pulseIncreased sweatingDizzinessClient feeling like he/she might pass outWeak or shallow breathingUrinating more than usualSeizuresTrouble 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 signsInfuse 0.9% sodium chlorideNotify the providerFollow facility protocol such as send urine sample, CBC, and bag and tubing to laboratory for analysis

Treatment of extravastation with IV infusion

Stop infusiondiscontinue administration setaspirate drug if possibleapply cold compressdocument condition of site, may photograph

Treatment of Phlebitis/Thrombophlebitis with IV infusion

Stop infusionremove peripheral IV cathetersapply heat compressinsert new catheter in opposite extremity

Treatment of infiltrtion with IV infusion

Stop infusionremove peripheral cathetersapply cold compresselevate extremityinsert new catheter in opposite extremity

Treatment of Toxicity of Methylxanthines

Stop parenteral infusionActivated charcoal to decrease absorption in oral overdoseLidocaine for dsyrhythmiasDiazepam 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 collegeAdults older than 56 yearsRepeat 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 appearanceMute for hours, days, or weeksAcutely aware of environment, though appear detachedUnable or refuse to participate in activities

Nursing Interventions for Filgrastim injection and Pegfilgrastim IV

Subcutaneous or IVDo not agitate vialMonitor CBC

Nursing Interventions for Epoetin alfa

Subcutaneous or IVDo not agitate vialMonitor hematocrit

Antidote/Reversal Agent for Lead

Succimer (Chemet)

Onset Delirium

SuddenOver hours to days

Side/Adverse Effects for Beta-2 Adrenergic Agonist Medications

TachycardiaPalpitationsTremors

Side/Adverse Effects for Levothyroxine (Synthroid)

TachycardiaRestlessnessDiarrheaWeight lossDecreased bone densityHeat intoleranceInsomnia

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 dayTeach 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 dailyDo not crush or chewInstruct client to immediately report worsening of anxiety, agitationDo 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 foodDo not consume alcohol during therapy for 48 hours after completion of regimen

Excited Symptoms of Catatonic Schizophrenia

Talk or shout continually and incoherentlyHyperactive behavior

Client Education for Leukotriene Modifiers

Teach client to take dailyDo 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 dosesIf a dose is missed, it should not be taken within 6 hours of the next scheduled dose.Tablets should not be crushed, broken or chewedTeach client to avoid NSAIDs and medications with aspirinTeach client to monitor for signs of GI bleeding

S & S Anorexia Nervosa

Terror of gaining weightPreoccupation with thoughts of foodJudges self-worth by body weightLow body weightAmenorrheaCold extremitiesConstipationHypotension, bradycaridaImpaired renal functionHypokalemiaHyperactivity

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 hyperkalemiaVerapamil (Calan) increases risk of toxicity

Precautions/Interactions for Insulin

When mixing regular with NPH insulin, draw up regular insulin firstDo not mix other insulins with lispro, glargine, or combination 70/30Only regular insulin is given IV in normal salineAdminister 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

YawningInsomniaPanicDiaphoresisCrampsNausea/VomitingChillsFeverDiarrhea

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 effectscurrent medication regimen for potential interactionsphysiologic 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

antipsychoticanticholinergic

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 precautionsfollow 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!

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 hallucinationspatients with delusions

redirect themdistract 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

standardairborne

Tuberculosis (TB) (pulmonary) precautions

standardairborne

Rotavirus precautions

standardcontact

Shigellosis (dysentery) precautions

standardcontact

Staphylococcus aureus (infection or colonization) precaution

standardcontact

RSV precautions

standardcontactdroplet

Pneumonia precautions

standarddroplet

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

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References