Medications 1
Name at least 3 side effects of glucocorticoids?
Adrenal insufficiency
Infection
Osteoporosis
Glucose intolerance
PUD
Sodium retention
Hypokalemia
What is the most common side effect of phenytoin?
Gingival hyperplasia
(Other common side effects: Abdominal discomfort. It does not cause drowsiness like many other AED)
AEs: Teratogen, anemia, reduced WBC count, reduced platelets, rashes, bradycardia.
This is a complication of cast, splint being to tight, or from severe edema post fracture
Compartment syndrome
What is the disease the Guillan Barre?
(Peripheral nerves are infiltrated by lymphocytes which leads to edema and inflammation. Atrophy of axons resulting in slowed or blocked nerve conduction)
What are the two types of Hepatitis that are transmitted via fecal oral route?
A, E
Name at minimum two classes of drugs used to treat inflammatory bowel disease (IBD).
5 aminosalicylates (5-ASAs)
Glucocorticoids
Immunosuppressants
Immunomodulators
Antibiotics
Name at least two side effects of Allopurinol?
Slows metabolism of warfarin
Increase gout attacks first month
Kidney complications (Increase fluid intake 2-3L/day)
Rashes
Liver disease
Nausea
What precautions will you take on a patient who is s/p a total hip arthroplasty to prevent dislocation? (Name at least 3)
Needs pillow between legs when turning
Avoid hyperflexion (bending forward more than 90 degrees)
Straight back chair with arm rests when sitting
Two pillows when sleeping (one proximal, one distal)
What neuromuscular disorder is a Tensilon (Edrophonium) challenge test done for?
Myasthenia Gravis
(MG body produces antibodies aganist ACh receptors therefore ACH cannot stimulate muscle contraction. Autoimmune.
Edrophomium (anticholinesterase drug) injected IV if strength improves MG diagnosed
Name three symptoms of meningitis
Nuchal rigidity
Severe headache
Nausea/vomiting
Photophobia
Petechiae (skin, mucous membranes)
How does an opthalmic beta blocker work?
Decreases intraocular pressure by reducing aqueous humor production
(E.G. Timolol, Carteolol, Metipranolol)
Nursing Considerations: Can be absorbed systemically and cause bronchoconstriction, bradycardia, hypotension, hypoglycemia)
What are three side effects of oxybutynin (Ditropan)?
Dry mouth, dry eyes, headache, constipation
DO NOT use if patient has glaucoma
(MOA: Inhibits involuntary nerve induced contractions of the detrusor muscle in the bladder wall, allowing bladder to relax and hold more urine)
Name at minimum three nonmodifiable risk factors for osteoporosis
Female gender
Postmenopausal state
Family history
White or Asian ethnicity
Small boned/petite
Low testosterone in male
Age
What is the classic presentation of an epidural hematoma?
Lucid period followed by rapid loss of consciousness
Name three symptoms of bladder cancer. Please discuss what would be considered early versus late symptoms.
Painless hematuria (initially intermittent)
Frank hematuria (later on)
Urinary retention
Bladder irritability (from clots, fistula)
Pelvic pain, pain in lower back, painful urination
How do mydriatic eye drops work?
Dilate pupils for examination or surgical procedures
E.G. Atropine (Isopto Atropine)
Why would a patient with chronic pancreatitis be prescribed pancreatic enzymes?
Replaces the pancreatic enzymes they are deficient therefore helping absorb there food and stop steatorrhea
E.G. Pancrealipase, Creon, Ultrase
What is the difference between skin traction and skeletal traction?
Skin traction: 5-10 lbs, used for patients with hip fractures preop to reduce muscle spasms, stabilize fracture. Traction is applied to the skin. E.G. Buck's traction
Skeletal traction: Uses pins/wires/tongs in the bone for bone alignment while fracture heals. Can use 20-40lb weights. E.G. Halo
Name three measures to prevent increased intracranial pressure (ICP)
Keep head in neutral position
Limit noxious stimuli
Keep HOB 30 degrees
Administer stool softners/antiemetics/antitutissives
Avoid hip/neck flexion
What are the signs and symptoms of retinal detachment?
Sudden change in vision
Flashing lights, floaters
"Curtain being lowered."
"Looking through cobwebs."
NO PAIN
What blood test needs to be monitored with Carbamazepine and why?
CBC
Its affects the bone marrow leading to anemia, reduced WBC counts, and reduced platelets
Name three nursing interventions you must educate the patient on when taking Alendronate.
1. Take on an empty stomach 30 minutes prior to breakfast/other medication
2. Take with 6-8 oz of water
3. Sit up right for at least 30 minutes after taking
4. Notify your dentist that you are taking this medication
Name three therapeutic measures for osteoarthritis.
Low impact exercises
Weight control (BMI 18.5-24.9)
Heat/cold therapy
Medications (NSAIDs)
Surgery
Discuss what occurs in autonomic dysreflexia
This occurs in patients with a T6 and above spinal cord injury from a noxious stimuli. Causes imbalance between sympathetic and parasympathetic NS. SNS activated but PNS cannot respond.
The SBP goes up to 300 mg Hg
Bradycardia
Above injury: Facial flushing
Below injury: Cool, pale skin, gooseflesh
Nasal stuffiness/severe headache
Discuss client education postop cataract surgery (must get at least 3)
No heavy lifting, strenuous activity
Avoid swimming, getting eyes wet
Avoid activities that increase IOP (no bending at waist, sneezing, blowing nose, coughing, straining, sexual intercourse)
Report severe pain, decreased vision, bleeding, flashes of light, floaters, n/v