Pharmacology
What electrolyte must be closely monitored in a client taking ACE inhibitors, and why?
Potassium
Risk of hyperkalemia due to decreased aldosterone.
What condition is indicated by sudden unilateral absent breath sounds + tracheal deviation?
Tension pneumothorax
What condition is indicated by abdominal pain + dark red vaginal bleeding + rigid uterus?
Placental abruption
A child presents to the ED with a barking cough and inspiratory stridor. The nurse suspects what condition?
Croup (laryngotracheobronchitis)
What condition is indicated by stridor + drooling + tripod positioning?
Epiglottitis (airway emergency)
Which medication class is contraindicated with lithium, and why?
Thiazide diuretics
Increase lithium reabsorption in kidneys → toxicity risk.
What condition is indicated by ascites + confusion + elevated ammonia in a cirrhosis patient?
Hepatic encephalopathy
What is the priority intervention for late decelerations?
Reposition to left lateral + oxygen + notify provider
A child has projectile vomiting and olive-shaped mass in abdomen. What condition?
Bonus: This disease process causes what ABG finding?
Pyloric stenosis
Metabolic alkalosis (loss of gastric acid) is expected in pyloric stenosis. Pyloric stenosis causes metabolic alkalosis primarily through the persistent, forceful vomiting of gastric contents!
List disease processes that require airborne precautions
TB
Airborne
Varicella
Measles
Disseminated herpes zoster
Smallpox
Beta blockers should be used sparingly in clients with what common disease process? Why?
Beta blockers should be used cautiously in diabetic patients. They mask hypoglycemia symptoms (tachycardia, tremors).
What condition is suggested by rigid abdomen + rebound tenderness?
Peritonitis or perforation
A client has BP 168/112 at 32 weeks with proteinuria. What medication class is expected?
Antihypertensives + magnesium sulfate (seizure prophylaxis)
What is the most common cause of croup?
Parainfluenza virus
What is the FIRST sign of magnesium sulfate toxicity?
Decreased deep tendon reflexes
Grapefruit juice contraindicated with what medication class?
Bonus: what does this medication class end in?
Grapefruit juice contraindicated with many calcium channel blockers.
Inhibits CYP3A4 metabolism → increased drug levels → toxicity.
The primary suffix for calcium channel blockers (CCBs) is -dipine. Medications with this ending, such as amlodipine and nifedipine, belong to the dihydropyridine class and primarily work to dilate blood vessels.
Calcium channel blockers (CCBs) are medications that prevent calcium from entering the muscle cells of your heart and blood vessels. By limiting calcium—which causes muscles to contract—CCBs allow blood vessels to relax and widen and can slow your heart rate.
What condition is indicated by sudden severe chest pain that radiates to the back + unequal blood pressures in each arm?
Aortic dissection
What condition is indicated by postpartum hemorrhage with a boggy uterus?
Uterine atony
What is the normal respiratory rate range for a toddler?
25–30 breaths/min
What does continuous bubbling in the water-seal chamber of a chest tube drainage system indicate?
Air leak in the system (not normal; requires assessment)
Continuous gentle bubbling in the SUCTION CHAMBER is expected. Bubbling in the SEAL CHAMBER = air leak.
What is the relationship between lithium and sodium?
Low sodium = lithium toxicity risk.
"Sodium goes down, lithium goes up."
What condition is indicated by oliguria + elevated creatinine + recent contrast dye exposure?
Acute kidney injury (contrast-induced nephropathy)
What condition is indicated by late decelerations on fetal monitor?
Uteroplacental insufficiency (fetal hypoxia)
Why is aspirin contraindicated in children with viral illness?
Risk of Reye syndrome (liver + brain injury)
What does “uterine atony” mean?
Failure of uterus to contract after delivery → postpartum hemorrhage