PEE all the time
what is the effect on NA & K for loop diuretics
lowers both
MOA of nitrates
dilates coronary arteries
A 53-yr old pt. received abx therapy and 20 minutes into administration, patient's face, scalp, chest, and trunk areas turned flushed and red.
What is this condition called and what antibiotic is most likely culprit and anticipated intervention
red man syndrome
vancomycin
reduce rate
Paul is complaining of white coating on his tongue. he has been on abx for his UTI.
what does he have.
what is anticipated will be ordered and nursing implications for this medication
thrush
nystatin
swish & swallow.
patient was admitted lethargic. vitals were 90/50, 110, rr-6, sats 92.
he is on metoprolol, lorazepam, finasteride, and sildenafil
what medication would you be concerned about.
what would you anticipate the tx
lorazepam: benzodiazepine
antidote: flumazenil
what is your therapeutic response for
1. furosemide
2. hydrochlorothiazide
3. spironolactone
4. mannitol
5. acetazolamide
1. decrease in fluid overload
2. decrease in bp
3. decrease in potassium loss/ improved K
4. improved MS, decrease in ICP
5. improved metabolic alkalosis in loop diuretics
what is the effect on NA & K for spironolactone
lowers NA
increase K
what is the administration for NTG SL
take 1 at first symptom of CP, if no response call 911 and then take the other two q5 min apart
what are two known antibiotics that have cross sensitivity
penicillin & cephalsporin
nancy was diagnosed with TB and noticed her urine is orange and now she is having some neuropathy.
what medications is she on.
what are some anticipated management for these symptoms.
urine: rifampin. normal. no change.
neuropathy: isoniazid. vit b6
patient is intubated and is having increase agitation and having high peak pressures. you need to start him on something but not overly sedate. what IV medication would you think is appropriate.
what hemodynamics would you monitor.
dexmedetomidine
bp/hr
kasey was started on furosemide for heart failure and now she is complaining of some muscle weakness and lethargy and hasnt had a bowel movement for 5 days.
what would you be concerned about
hypokalemia.
what are some dehydration s/s
a male patient diagnosed with BPH and HTN and was started on tamsulosin. what patient teaching is important with this patient
first syncope
what inotrope gtt is commonly used in heart failure patients
dobutamine
Mr C was started on ibuprofen, oxycontin for his arthritis.
his labs showed a wbc 10, hgb 9, plts 200.
he also was complaining of dark stools.
which medication are you concerned with and why
what other labs would you want to monitor
ibuprofen
NSAIDS. risk for GIB
bun / cr
patient was started on gout medicine but is concerned why he is on colchicine now and instructed he will be on allopurinol later once he is improved.
why.
colchicine: pain relief by reducing inflammation
allopurinol: prevent uric acid production. drink 2L fluid
patient has been diagnosed with alzheimer and was started on donepezil. she is having a hard time remembering if she took her medications. she is admitted with n/v, abd pain, hypotension (90/40).
1. what does she have and tx.
2. 2 hours later, her hypotension is worsening (70/30) and is having vtach episodes and had an episode of GIB. what is happening & tx
1. early cholinergic crisis: atropine
2. severe Cholinergic crisis: epinephrine
patient was started on ciprofloxacin for a UTI. she developed new onset diarrhea.
1. what would your concern be and what would be some tx
2. what are some effects to monitor for
1. cdiff. check cx. vanco/flagyl PO.
what if cdiff was negative.
2. QTC / tendonitis / rupture
what is the potential effect on BP / HR & why
decrease BP. increase HR due to dehydration
what pressor is used for hypotensive patients and also for allergic reaction
epinephrine
Mr C 12 yo daughter acne has worsened and needs to be started on ABX. what category is contraindicated for this age group?
why?
what other groups do you want to avoid
tetracycline
discolored teeth
pregnant women due to fetal retardation in fetus.
robert is in septic shock due to + fungal blood cultures. he was started on amphotericin B.
he developed fever/chills/hypotension with infusion. what should you do at this point.
what are some other nursing implications with amphotericin B
may give antipyretics, antihistamine, steroids to alleviate s/s.
vitals q15 during infusion due to risk for hypotension.
monitor cbc, lft, rfp, ekg
patient had a total knee surgery 1 week ago and came in with resp distress and hypotension. he is lethargic and not responding to pain.
what do you anticipate
what are your treatment
1. OD of narcotics
2. naloxone (narcan)
patient had CABG and was started on Ketorolac.
her recent vitals 80/50, 120
what would you be concerned about.
what labs would you check.
1. GIB, bleeding due to NSAIDS
2. cbc / bun/cr.
what labs do you monitor for diuretics
BUN / CR
LYTES
what effect does metoprolol have on a patient that is positive for AMI
protection from further ischemia by decreasing catecholamines which is high after MI causing imbalance O2 supply / demand.
MR C was started on an abx for pseudomonas infection. a week into the treatment, he starts complaining of hearing loss. labs were drawn and revealed wbc-12, hgb-14, plt-190. na-135, k-3.6, cl-100, co2- 26, bun-25, cr 2.1.
what is concerning about this case.
what abx do you anticipate was ordered.
hearing loss & bun/cr. monitor hearing / u/o
gentamycin or another aminoglycoside.
patient was started on erythromycin for his strep infection. he started complaining of generalized itching and angioedema.
what is your concern
what would be some potential treatment
allergic reaction. possible anaphylactic
stop abx
give antihistamine or epi if c/o throat / swallowing / wheezing concerns.
patient is admitted with septic shock and continues to have bp 80/50 and HR 30. which pressor would be appropiate for this patient.
dopamine. increase HR / BP
luna was started on selegline (MAOI) for her bi polar 3 weeks ago and is feeling better. she is going out to dinner with her friends but is confused with what to eat.
1. salmon / vegetables
2. salad with blue cheese, smoked sardines
3. glass of reisling
4. chicken salad sandwich
1. salad with blue cheese / smoked sardines.
should avoid tyramine foods.