#gonnathrowup
Used for chemotherapy-induced nausea and vomiting, Dronabinol (Marinol) is a synthetic cannabinoid. What is important to consider with this medication?
Withdrawl symptoms: insomnia, restlessness, hot flashes, and sweating
A patient calls the clinic on-call line regarding severe diarrhea that has had a sudden onset. The patient wants recommendations for anti-diarrheal agents to start taking. What would be appropriate to inform the patient of?
Stopping diarrhea is not always recommended, we need to assess fluid and electrolyte status first, contact us if diarrhea persists more than 3 days and if there are signs of fever, severe abdominal pain, or bloody/black stools!
An older male patient arrived at the Emergency Room earlier this evening. What chief complaint would indicate the presence of Benign Prostatic Hypertrophy (BPH)?
"I really have to bear down to start my stream" or others....
As Jack’s Chronic Kidney Disease progresses into End Stage Renal Disease, we are preparing to administer Phosphate binder to combat the inability of the kidneys to excrete it. What is a nursing consideration for Calcium Carbonate (Os-Cal)?
taken with meals! may cause hypercalcemia!
On your unit, you have a Cystic Fibrosis patient whose laboratory data reflects worsening pancreatic enzyme production. The physician orders Pancrelipase (Creon) for the patient. What is important to educate the patient on regarding this medication?
Take with every meal/snack
Metoclopramide (Reglan) is prescribed to a patient that has nausea and GERD. Knowing that this medication is a Dopamine Receptor Antagonist, what is important to consider as a side effect of this medication?
Irreversible tardive dyskinesia
A patient with Irritable Bowel Syndrome and is prescribed Dicyclomine (Bentyl) to reduce painful muscle spasms. Knowing that this medication works as a smooth muscle relaxant by blocking acetylcholine at muscarinic cholinergic receptors, what adverse effects do we anticipate with this medication?
blurry vision, dry mouth, urinary retention, constipation!
An older male patient arrived at the Emergency Room earlier this evening. What chief complaint would indicate the presence of Benign Prostatic Hypertrophy (BPH)?
Besides SPS (Kayexalate) and Potassium Binders, list a few medication categories or treatments that may be used to treat hyperkalemia (>5 mEq/L)?
diuretics, hemodialysis, insulin, sodium bicarbonate, calcium gluconate
Sara, a 25 year old female, is suspected to have a gallstone. She is prescribed Chenodiol (Chenodal) to gradually dissolve the gallstone. What is an important nursing consideration for this medication?
Monitor LFTs and signs of liver failure!
Sara, a 56-year-old patient with breast cancer, has nausea from chemotherapy treatments. Her physician prescribed Promethazine (Phenergan) for treatment of the nausea. Since this medication antagonizes dopamine receptors in the brain and CTZ, what is important to consider with this medication?
Use lowest dose possible to prevent EPS symptoms, anticholinergic side effects, BBW: increased risk of death for older adults with dementia, contraindicated with glaucoma
A patient asks you, the nurse, how Diphenoxylate with Atropine (Lomotil) and Loperamide (Imodium) are different. What is a correct statement?
"Loperamide (Immodium) does not cause CNS Depression"
In order to improve therapy, Tamsulosin (Flomax) is added to the medication regimen. How does this medication work to treat Benign Prostatic Hypertrophy (BPH)?
Relax muscles in prostate and bladder neck to enhance urination
When prescribing medications for Hyperkalemia that function to increase fecal potassium excretion, what are contraindications to prescribing the medication?
Bowel Obstruction & Severe Constipation
A patient with End-Stage Liver Disease presents to the emergency room with sleep disturbances, mood changes, confusion, and asterixis. What medication do you anticipate administering?
Lacutolose (Constulose)
Following a surgical procedure, a patient has postoperative nausea and is given Ondansetron (Zofran) which blocks serotonin receptors to prevent activation by emetogenic drugs/toxins. What is important to consider with this medication?
QT interval prolongation, avoid in class 1 or class III antiarrythmics are taken, monitor for LFT elevation
Janet, a 56 year old patient, is suffering from chronic constipation. She has been taking Bisacodyl (Dulcolax) continuously for the past few months. What are the important nursing considerations for this scenario?
High risk of abuse, monitor for electrolyte imbalances
Beatrice, an 83-year-old woman, arrives at the clinic with the chief complaint of urinary frequency, urgency, and leakage. After ruling out possible infections or other causes, a diagnosis of Overactive Bladder (OAB) is made and Oxybutynin (Ditropan XL) is started. Since we know this medication is an Anticholinergic, what adverse effects should we monitor for?
Blurry vision, constipation, dry mouth, urinary hesitancy
For the patient with Hyperkalemia, what are some of the correct patient teachings for potassium-binders and SPS in regards to medication administration?
Potassium Binders (Veltassa/Lokelma): decreases absorption of other meds, take 6 hours before or after!
SPS (Kayexalate): decreases absorption of other meds, take 3 hours before or after
Tom, a patient with end-stage-liver disease, is taken to the hospital due to hypersomnia, mood changes, and confusion. Laboratory tests confirm a diagnosis of Hepatic Encephalopathy and the physician prescribed Lactulose (Constulose). What is a priority safety concern prior to administering this medication?
Assess gag reflex and swallowing ability
Sara, who is receiving chemotherapy for breast cancer, is still having nausea from chemotherapy. In addition to Promethazine (Phenergan), the physicians prescribed Aprepitant (Emend) as well. Which of the following are associated with this medication?
inform to avoid grapefruit juice, combination used to prevent chemotherapy-induced N&V
On the unit, a patient you have is fearful of taking Docusate Sodium (Colace) due to the stories their friend told them of becoming dependent on these medications to have a bowel movement. What would you inform the patient on regarding this medication, specifically?
“Since this medication does not actually produce a stool, it just makes it easier to go, there is very minimal to no dependence involved with this type of medication.”
For which of the following medical conditions would the prescription of Oxybutynin (Ditropan XL) be contraindicated for Beatrice?
Hypertension!!
A patient with Chronic Kidney Disease is preparing for surgery. They question why they are receiving medication through an IV site. When looking at the IV bag, you see it is Mannitol (Osmitrol). Knowing the patient's history and their reason for being hospitalized, what would you educate them on regarding this medication?
1. Used to protect kidneys in surgery
2. Rapidly pulls water into the blood and decreases water reabsorption in the kidneys which can reduce ICP in as fast as 15-30 minutes
3. May cause edema, dehydration, and headache (caution with CHF, pulmonary edema)
Please categorize the following as either a bulk-forming, stool softener, or stimulant/saline lubricant laxative:
Docusate Sodium (Colace)
Psyllium (Metamucil)
Bisacodyl (Dulcolax)
Polyethelene Glycol (Miralax)
Stimulatnt Lubricant: Bisacodyl (Dulcolax)
Saline Lubricant: Polyethelene Glycol (Miralax)
Stool Softener: Docusate Sodium (Colace)
Bulk-forming: Psyllium (Metamucil)