Fluids
give 3 examples of hypertonic fluids
3% NaCl, 5% dextrose in normal saline, 5% dextrose in LA, 5% dextrose in plasma-lyte 56
How long of a treatment period may be required for a gastric ulcer to heal when using a omeprazole?
Although this drug can take 2 hours to reach therapeutic levels, its effects last up to 72 hours. It is used for the short-term, 4- to 8-week therapy of active peptic
2 priority labs before administering any kinds of IV fluids
Kidney function: Creatinine, BUN, GFR
What is the black box warning for terbutaline?
Terbutaline carries a BBW: use of this drug for more than 48-72 hours during pregnancy can result is serious adverse health conditions, including death of fetus
What is the pharm class AND the MOA of Finasteride?
Finasteride is a 5-alpha reductase inhibitor, MOA: promotes shrinkage of enlarged prostates and subsequently helps restore urinary function
Double Jeopardy!
1. What kind (category) of fluids should a pt who is hyponatremic receive?
2. Give an example of an above fluid?
1. hypertonic
2. 3% NaCl
what is the MOA of Bismuth subsalicylate?
its is an antidiarrheal (Pepto- Bismol) and it works by binding to and absorbing toxins
2 parts
1. A pt who is receiving fluids develops a cough, SOB, dyspnea, and tachycardia. What priority condition is this likely to reflect?
2. What is the priority RN assesment in this senerio?
1. Fluid overload; hypervolemia
2. Auscultate lungs
Why would oxytocin be needed post partum?
Oxytocin may also be administered postpartum to reduce hemorrhage after expulsion of the placenta and to aid in returning normal muscular tone to the uterus
For what DX is testosterone approved for in women?
The drug is approved for the palliative treatment of inoperable breast cancer in women.
Hypotonic: fluid shifts from plasma (intravascular space) to interstitial space. Vessel -> cells and tissues
Hypertonic: Plasma gains more solutes than the interstitial fluid= fluids moves from interstitial space (low) to plasma (high). Cells -> intravascular
What is the MOA of sucralfate?
Sucralfate consists of sucrose and aluminum hydroxide. This drug produces a gel-like substance that coats the ulcers, protecting it against further erosion and promotes healing. It does not decrease gastric acid formation/secretion
List 3 priority assessments that require monitoring when a pt is receiving TPN
renal status (BUN/ Creatinine), Intake and output ratio, daily weight, glucose levels, s/s of fluid overload
List at least 4 adverse effects associated with Medroxyprogesterone
Breast tenderness, breakthrough bleeding, wt gain, depression, htn, N/V, dysmenorrhea, vaginal candidiasis, increased risk of thromboembolic events
How often should a testosterone patch be changed?
daily
list at least 3 administration alerts for potassium chloride
•Always give oral medication while the patient is upright to prevent esophagitis.
•Do not crush tablets or allow the patient to chew tablets.
•Dilute liquid forms before giving P O or through a nasogastric tube.
•Never administer I V push or in concentrated amounts (can cause cardiac arrest), and do not exceed an I V rate of 10m E q/h.
•Use caution to avoid extravasation and infiltration. This is why you give slowly and ALWAYS give/dilute it w/ normal saline
Double Jeopardy!
1. What pharmacological class does omeprazole belong to?
2. list 3 risks associated with prolonged use of omeprazole
1. Pharmacologic Class: Proton pump inhibitor
2. Atrophic gastritis, increase risk for bone fractures, and hypomagnesemia have been reported rarely with prolonged treatment with PPI s. Therapy is generally limited to 2 months.
What is the priority administration alert of vitamin A
Very high doses taken during pregnancy can cause birth defects. Patients should consult with their healthcare provider regarding which dietary supplements should be taken during pregnancy and their recommended doses.
Give 3 examples of tocolytic drugs
Terbutaline, Nifedipine, Magnesium Sulfate, Hydroxyprogesterone
List at least 4 adverse effects of finasteride
Sexual dysfunction (impotence, impaired fertility, decreased libido, ED), headaches, dizziness, rash, asthenia (lack of energy/ strength)
Can increase risk for prostate CA
3 parts:
1. What are the advantages of colloid solutions?
2. list 3 indications for receiving colloids?
3. What is the most frequently used colloid?
1. they stay in the intravascular space and rapidly expand plasma volume.
2. Important in treating hypovolemic shock d/t burns, hemorrhage, sx
3. normal serum albumin
2 parts:
1. What is the MOA of Psyllium
2. list the priority teaching point to pts who are interested in taking Psyllium
1. Psyllium is derived from a natural product, the seeds of the plantain plant. it is an insoluble fiber that is indigestible and not absorbed from the G I tract. When taken with a sufficient quantity of water, psyllium swells and increases the size of the fecal mass, which promotes the passage of stool
2. Mix with at least 8 o z of water, fruit juice, or milk, and administer immediately. Follow each dose with an additional 8 o z of liquid. If taken with insufficient water, psyllium may swell in the esophagus and cause an obstruction.
list 3 A/Es of sodium bicarbonate
have to include: metabolic alkalosis
Symptoms may include confusion, irritability, slow respiration rate, and vomiting
Give at least 3 risks that are associated with estrogen-progestin hormone replacement therapy
Increased risk of M I, stroke, breast cancer, dementia, and venous thromboembolism
Decreased risk of hip fracture and colorectal cancer
Give 3 priority administration alerts associated with finasteride
Pregnant woman should not handle this drug, need to double glove if you are not the person taking drug, patients cannot donate blood while taking this drug, not approved for use in women