IVs, blood transfusion, chemotherapy, osteoporosis
D5 0.9 NS
D5 0.45 NS
D5 LR
3% NS
TPN
What are hypertonic IV fluids
Name 4 side/adverse effects of testosterone usage
Acne
Gynecomastia
Testicular atrophy
BPH
Fluid retention
HTN
What are the 2 reasons why women experience perimenopausal symptoms? (low/high)
Low estrogen
High FSH
Inflammation of vein due to chemical or mechanical irritation evidenced by redness along and around vein, pain, swelling, warmth
How would you treat?
Phlebitis
Remove IV, warm compresses, NSAIDs, restart IV proximally
Name 2 contraindications for testosterone usage
Prostate cancer
Liver disease
Antiparkinsonian medication's therapeutic effects help alleviate the 4 cardinal signs of Parkinson's disease
Intentional tremors, rigidity, akinesia, postural instability
Blood transfusion: 0.9, 2, 15, 4
What is 0.9 NSS, 2 RNs to verify correct product, stay with patient for first 15 minutes, infuse within 4 hours
Explain the order of initiation and discontinuation of NMBAs related to sedation
Sedation must be given before administration of NMBA and maintained while patient is paralyzed
Always stop NMBA first and once fully recovered, then stop sedation
Catechol-O-methyl transferase (COMT) inhibitors and Monoamine Oxidase Type B inhibitors vs Anticholinergic Agents in the treatment of Parkinson's disease
Prevent breakdown of dopamine
Block cholinergic receptors to restore balance of dopamine
Steps of blood transfusion reaction
Stop transfusion
Assess patient w/ vitals
Disconnect IV tubing from patient; do not discard
Initiate infusion of new bag/tubing of 0.9 NSS
Notify blood bank and provider
Return entire blood set up including tubing to blood bank
Collect 1st voided urine specimen
Complete reports
Medication that should be given right before sleep; should only be used short-term as needed, and may cause dizziness, daytime drowsiness, an somnambulism
Zolpidem
Benztropine side effects
Anticholinergic: can't spit, can't see, can't poor, can't pee
Administration instructions for alendronate (4)
30 minutes before food
Remain upright 30 minutes
Drink full glass water
2 hours before or after Ca supplements or calcium-containing foods/drinks
How is phenytoin administered IV?
Slowly over 2 minutes; diluted in NSS
Hypotension, bradycardia w/ rapid IV administration
What to remind the patient taking oral contraceptives (4)
No protection against HIV and other sexually transmitted diseases
Takes a full cycle to become effective
Same time everyday that if dose is missed, take as soon as possible, even if taking 2 at the same time
If more than one dose is missed within a cycle, the woman should use another method of contraception for the rest of the cycle to prevent pregnancy
PPE must be worn to administer and dispose of chemotherapy in any form. How long must a nurse wear PPE to handle the body excretions after administering chemotherapy?
What is 48 hrs
Name 3 signs/symptoms that the patient would exhibit if the phenytoin level was above 20 mcg/mL
Decreased coordination; ataxia
Dizziness
Confusion
Insomnia
Slurred speech
Blurry vision; diplopia
Nystagmus
Contraindications for using oral contraceptives (4)
Breast, cervical, ovarian, uterine cancer
Hypercoagulable states, history of VTE
Heart failure
Smoking
Steps of chemotherapy extravasation
Immediately STOP infusion
Aspirate any residual drug
Heat or cold applications
Antidotes
Name 3 adverse effects of carbamazepine
Bone marrow depression
Stevens-Johnson syndrome
SIADH
Adverse effect of haloperidol: smacking lips, sticking out tongue, blinking, puffing cheeks
What is tardive dyskinesia
Name 5 adverse effects of chemotherapy
Bone marrow - pancytopenia
Hair -alopecia
Pulmonary - fibrosis, edema
Cardiovascular- CMP, HF, pericardial effusion
GI- N/V, mucositis, stomatitis
Nerves - neuropathy, orthostatic hypotension, gastroparesis, constipation, urinary retention
Name 2 drugs used to treat status epilepticus
Diazepam (Valium)
Lorazepam (Ativan)
After starting or increasing the dose of haloperidol, painful muscle rigidity and hyperthermia develop
Tell me about administering IV potassium. What must you do? What must you not do?
IV potassium is always diluted (irritating to vein --> phlebitis). Monitor IV site frequently while infusing
Dysrhythmias and cardiac arrest, result from rapid intravenous high concentration of potassium
Never given IM or SQ (tissue necrosis)
Do not add to IV bag because if not properly mixed can be delivered as a bolus
Side effects of cholinesterase inhibitors used to treat patients with Alzheimer’s disease and Myasthenia Gravis (bladder, GI, BP, HR, lungs, eye)
Increased urinary frequency
Diarrhea
Low blood pressure
Bradycardia
Bronchospasms
Constrict pupils
Antipsychotics are known to have anticholinergic properties. These should be avoided in patients with .... (2)