Drip or Die
A client is hypotensive and experiencing fluid loss from vomiting. What type of IV solution should the nurse expect to administer, and why?
What is an isotonic solution like 0.9% normal saline or lactated Ringer’s, because it expands intravascular volume without shifting fluid into or out of cells?
A client is taking acetaminophen for mild pain. What is the maximum daily dose, and why is it important not to exceed it?
What is 3 to 4 grams per day, because higher doses can lead to liver toxicity?
Clients receiving gentamicin or tobramycin must be monitored for two major toxicities.
Name these toxicities and the signs and labs associated with them.
What are nephrotoxicity (↑ BUN/creatinine, ↓ urine output) and ototoxicity (tinnitus, dizziness)?
What are two long-term complications associated with proton pump inhibitors?
What are osteoporosis and vitamin B12 deficency?
Which type of antidepressant must clients avoid foods high in tyramine and why?
What is MAOI because it can cause a hypertensive crisis?
A client with a peripheral IV site reports burning and tightness, and the nurse notes the site is cool, pale, and swollen. What complication is most likely occurring, and what is the nurse’s priority action?
What is infiltration, and the nurse should stop the infusion immediately, remove the VAD and elevate the extremity?
A nurse is reviewing discharge instructions for a client prescribed ibuprofen. What two organ systems should the nurse monitor, and why?
What are the kidneys and the gastrointestinal system, because NSAIDs can cause GI bleeding and kidney injury?
What is the difference between Red Man Syndrome and an anaphylactic reaction during vancomycin infusion, and what are the appropriate actions for each?
What is: Red Man Syndrome is a histamine reaction (not an allergy) caused by rapid infusion; slow the rate. Anaphylaxis involves airway symptoms (wheezing, hives); stop the infusion and give epinephrine.
Why should antacids be used cautiously in clients with heart failure or hypertension?
What is because they may contain high amounts of sodium?
Which two types of clients should not receive live vaccines?
What are immunocomprised clinets and pregnant women?
A nurse begins a blood transfusion. Ten minutes later, the client reports feeling unwell and says, “My lower back hurts and I feel nauseous.”
What should the nurse do first, and what additional actions are required?
What is to stop the transfusion immediately, maintain IV access with new tubing and normal saline, and notify the provider and blood bank while sending the blood bag and tubing for analysis?
After administering an analgesic, when should the nurse reassess pain for oral and IV medications?
What is 1 hour after oral administration and 30 minutes after IV administration?
Which antibiotic class should be avoided in children under 8 and pregnant clients, and why?
What are tetracyclines, because they can stain developing teeth and affect bone growth?
How should sucralfate be timed in relation to meals and other medications?
What is 1 hour before meals and at bedtime, and at least 2 hours apartment from other medications?
What are two serious complications that may occur with Tamoxifen?
What is endometrial cancer and thromboembolism?
True or False: Rh-negative clients can receive either Rh-negative or Rh-positive blood.
What is false? Rh-negative clients can only receive Rh-negative blood. Rh-positive clients can receive either negative or positive blood.
A UAP tells the nurse they plan to remind the client’s family to press the PCA button when the client looks uncomfortable. Should the nurse intervene or not? Why?
What is educate that only the client should press the PCA button, because allowing others to press it increases the risk of oversedation and respiratory depression?
What is a serious adverse effect associated with macrolide antibiotics?
What is QT prolongation?
Which H2 receptor blocker inhibits liver enzymes and increases the risk of toxicitiy from drugs like warfarin or phenytoin?
What is cimetidine?
Explain Tumor lysis syndrome and which demographic is at risk for this complication?
What is a rapid release of intracellular contents from cancel cell death that causes hyperkalemia, hyperuricemia, hyperphosphatemia, and hypocalcemia. Clients recieving chemotherapy are at risk for this.
Explain the difference between infiltration and extravasation, including the key assessment findings and nursing actions for each.
What is:
Infiltration is the leakage of non-vesicant fluid into surrounding tissue. Signs include swelling, coolness, pallor, and discomfort. The nurse should stop the infusion, remove the VAD, and elevate the limb.
Extravasation is the leakage of a vesicant medication into tissue, which can cause tissue damage or necrosis. Signs include pain, burning, swelling, and possible blistering. The nurse should stop the infusion, aspirate remaining drug from the line, administer an antidote if indicated, and remove the VAD.
A client reports taking several over-the-counter cold medications throughout the day and now has nausea, RUQ pain, and dark urine.
What medication toxicity should the nurse suspect, and what antidote should be retrieved?
What is acetaminophen toxicity, and the nurse should retrieve acetylcysteine?
Which antibiotic drug class causes tendon rupture?
What is Fluoroquinolones?
What are two gastric protectants used to prevent and heal gastric ulcers by protecting the stomach lining?
What is Sucralfate (covers ulcers with a protective barrier) and Misoprostol (reduces gastric acid and increases mucus production)?
What is Pyridoxine and what is it typically used for?
What is antiemetic (saying Vitamin B6 is acceptable), and is typically used for hyperemeisis gravidarium.