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4th Semester > 1st exam > Flashcards

1st exam Flashcards

1
Q

Albuterol (indications, contraindications, side effects, nursing implications)

A

Bronchodilator

Indications: asthma, acute bronchospasm, bronchitis, emphysema, bronchiestasis, reversible airway obstruction

Contraindications: hypersensitivity

Side effects: tremors, anxiety, tachycardia, HTN, bronchospasm

Nursing implications:

  • Assess respiratory functions
  • Determine that pt hasn’t received theophylline therapy before dose
  • Monitor for evidence of allergic reactions; paradoxic bronchospasm**
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2
Q

Aldactone (indications, contraindications, side effects, nursing implications, teaching)

A

Spironolactone (POTASSIUM-SPARING DIURETIC)

Indications: Edema of CHF, HTN, diuretic induced hypokalemia, primary hyperaldosteronism

Contraindications: Pregnancy, anuria, severe renal disease, HYPERKALEMIA

Side effects: Hyperkalemia, bleeding, agranulocytosis, rash, pruritus

Nursing Implications:

  • Hypokalemia (assess for polyuria, polydipsia, dysrhythmias)
  • Hyperkalemia (assess for weakness, fatigue, dyspnea, dysrhythmias, confusion)
  • Assess fluid volume status (IO’s, crackles in lungs, specific gravity of urine)
  • Monitor electrolytes

Teaching

  • take early in day to prevent nocturia
  • take with food or milk
  • Avoid high potassium foods since this drug SPARES POTASSIUM
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3
Q

Amoxicillin (indications, contraindications, side effects, nursing implications, teaching)

A

Antiinfective, antiulcer

Indications: infections of respiratory tract, skin, GI, GU tract, otitis media, meningitis, septicemia, sinusitis

Contraindications: hypersensitivity to penicillins

Side effects: N/V, diarrhea, pseudomembranous colitis, granulocytopenia, Stevens-Johnson syndrome

Nursing implications:

  • Assess pt for signs and symptoms of infection; obtain C/S before therapy
  • Assess for allergic reactions during tx
  • Assess bowel patterns daily (if severe, could be pseudomembranous colitis)

Teaching:

  • report sore throat, bruising, bleeding
  • report vaginal itching, smelly and loose stools, furry tongue! (superinfection)
  • report diarrhea with blood or pus, abdominal pain (pseudomembranous colitis)
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4
Q

Aspirin (indications, contraindications, side effects, nursing implications, teaching)

A

Non-opioid analgesic

Indications: mild to moderate pain or fever including RA, osteoarthritis, post- MI, prophylaxis of MI, ischemic stroke, angina, acute MI

Contraindications: GI bleeding, bleeding disorders, peptic ulcer, IICP

Side effects:GI bleeding, hepatitis, GI ulcer, Reye’s syndrome (children)

Nursing implications:

  • assess pain
  • monitor liver function, renal function, blood studies, hepatotoxicity, allergic reactions
  • assess OTOTOXICITY: tinnitus, ringing in ears!!

Teaching:

  • report any symptoms of renal/hepatic toxicity, visual changes, take with 8oz of water and sit upright
  • do not exceed recommended dosage, acute poisoning may result
  • not to be taken in third trimester
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5
Q

Atenolol (indications, contraindications, side effects, nursing implications, teaching)

A

Tenormin/ Antihypertensive

Indications: mild to moderate HTN, prophylaxis of angina pectoris, suspected or known MI

Contraindications: Pregnancy D, cardiogenic shock, 2nd-3rd degree heart block, sinus bradycardia, cardiac failure

Side effects: Profound hypotension, bradycardia, CHF, cold extremities, postural hypotension

Nursing implications:

  • abrupt discontinuation may lead to angina, MI. Taper over 2 weeks.
  • monitor HTN
  • assess edema
  • Baselines in renal, liver function

Teaching:

  • do not use OTC products such as nasal decongestants, OTC cold preps, limit alcohol, limit sodium intake
  • teach pt how to take pulse and BP at home
  • use contraception
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6
Q

Atrovent (indications, contraindications, side effects, nursing implications, teaching)

A

Ipratropium/ Anticholinergic, bronchodilator

Indications: Bronchospasm, COPD, rhinorrhea

Contraindications: atropine, bromide, soybean, peanut products

Side effects: anxiety, dizziness, headache, N/V, cough, bronchospasm

Nursing implications:

  • Monitor respiratory function: vital capacity, ABG’s, lung sounds, HR
  • Evidence of allergic reactions, paradoxical bronchospasm

Teaching:

  • Avoid OTC meds
  • geriatric pt to use spacer device
  • if paradoxical bronchospasm occurs, notify MD ASAP
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7
Q

Cefazolin (indications, contraindications, side effects, nursing implications, teaching)

A

Cephalosporin/Keflex

Indications: Upper, lower respiratory tract, urinary tract, skin infections

Contraindications: hypersensitivity, infants younger than 1 month

Side effects: pseudomembranous colitis, nephrotoxicity, stevens johnson’s syndrome

Nursing implications:

  • assess pt for previous sensitivity reaction to penicillins
  • assess signs and symptoms of infection; obtain C/S before
  • assess for anaphylaxis
  • ID urine output (if decreasing, could be nephrotoxicity)
  • assess bowel pattern daily
  • assess for superinfection (perineal itching, fever, malaise)

Teaching:

  • report sore throat, bruising, bleeding
  • advise pt to contact prescriber if vaginal itching
  • notify MD of diarrhea with blood, pus, mucus
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8
Q

Ceftriaxone (indications, contraindications, side effects, nursing implications, teaching)

A

Rocephin/Broad spectrum antibiotic

Indications: serious lower respiratory tract, urinary tract skin, infections, septicemia, meningitis, bone/joint infections

Contraindications: hypersensitivity, younger than 1 month

Side effects: pseudomembranous colitis, bleeding, nephrotoxicity, anaphylaxis, Stevens-Johnson syndrome

Nursing implications:
- Assess for signs of infection, anaphylaxis, ID urine output, assess bowel pattern daily

Teaching: advise pt to report diarrhea with blood or pus ASAP

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9
Q

Coumadin (indications, contraindications, side effects, nursing implications, teaching)

A

Warfarin/ Anticoagulant

Indications: arterial thromboembolism prophylaxis, DVT, MI prophylaxis, post MI, stroke prophylaxis, thrombosis

Contraindications: bleeding tendencies of GI/GU/respiratory, stroke, Pregnancy X, breastfeeding, bleeding is black box warning*

Side effects: hematuria, hemorrhage, anaphylaxis, nose bleeds, purple toe syndrome

Nursing implications:

  • monitor blood studies
  • assess for bleeding gums, petechiae, ecchymosis, black tarry stools, hematuria

Teaching:

  • Avoid foods high in vitamin K (green leafy vegetables)
  • soft bristle toothbrush, no contact sports, use electric razor
  • avoid ST JOHN’S WORT!!
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10
Q

Demerol (indications, contraindications, side effects, nursing implications, teaching)

A

Meperidine/Opioid analgesic

Indications: moderate to severe pain, preop, post op, general anesthesia maintenance, sedation induction

Contraindications: severe respiratory insufficiency

Side effects: increased ICP, serotonin syndrome, respiratory depression, bradycardia, hypotension

Nursing implications:
- assess pain, renal function, CNS changes, constipation

Teaching:

  • avoid CNS depressants (alcohol, sedatives, hypnotics)
  • change positions slowly
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11
Q

Digoxin (indications, contraindications, side effects, nursing implications, teaching)

A

Inotropic antidysrhythmic

Indications: atrial fibrillation

Contraindications: ventricular fibrillation, ventricular tachycardia, carotid sinus syndrome, 2nd or 2rd degree heart block

Side effects: dysrhythmias, AV block, yellow green halos, photophobia

Nursing implications:

  • Assess apical pulse for 1 minute before giving. If less than 60, hold and take again
  • monitor electrolytes
  • monitor resolution of atrial dysrhythmias
  • Monitor ECG continuously

Teaching:

  • Do not stop abruptly
  • Notify if loss of appetite, lower stomach pain, yellow-green vision
  • instruct pt to report shortness of breath, difficulty breathing, weight gain, edema, persistent cough
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12
Q

Dilantin (indications, contraindications, side effects, nursing implications, teaching)

A

Phenytoin/ Anticonvulsant/Antidysrhythmic

Indications: tonic clonic seizures, status epilepticus, absence of dysrhythmias

Contraindications: bradycardia, SA/AV block

Side effects: suicidal tendencies, v fib, bradycardia, stevens johnson syndrome

Nursing implications:

  • assess mental status, mood, sensorium affect, memory,
  • phenytoin hypersensitivity syndrome
  • serious skin disorders
  • seizures
  • toxicity (bone marrow depression, NV, ataxia)

Teaching:

  • do not discontinue abruptly, taper off over several weeks
  • use condoms! avoid hormonal contraception, teach pt to notify prescriber of unusual bleeding, bruising, petechiae
  • report suicidal thoughts ASAP
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13
Q

Dilaudid (indications, contraindications, side effects, nursing implications, teaching)

A

Hydromorphone/Opioid analgesic/Antitussive

Indications: antitussive to suppress cough, moderate to severe pain

contraindications: COPD, emphysema, GI obstruction, ileus, IICP, status asthmaticus

Side effects: respiratory depression, hypotension, bradycardia

Nursing implications:

  • Assess pain control
  • Monitor respiratory dysfunction
  • Monitor CNS changes

Teaching:

  • report CNS changes
  • Advise dizziness, drowsiness can occur
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14
Q

Doxycycline (indications, contraindications, side effects, nursing implications, teaching)

A

Antiinfective

Indications: syphilis, gonorrhea

Contraindications: children under 8, esophageal ulceration

Side effects: hepatotoxicity, neutropenia, rash, urticaria, stevens-johnson syndrome, angioedema

Nursing implications:

  • Assess for signs and symptoms of infection, obtain C/S
  • assess for allergic reactions (rash, urticaria, pruritus, chills)
  • assess bowel pattern daily
  • assess for overgrowth of infection (perineal itching, fever)

Teaching:

  • report sore throat, bruising, bleeding, joint pain
  • contact prescriber if experiencing loose foul smelling stools, furry tongue,
  • avoid antacid, iron products, H2 blockers,
  • notify if diarrhea with blood/pus is present
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15
Q

Gentamicin (indications, contraindications, side effects, nursing implications, teaching)

A

Cidomycin, Antiinfective

Indications: systemic infections of CNS, respiratory, GI and urinary tracts, bone, skin

Contraindications: hypersensitivity, pregnancy D, renal disease, hearing deficits, parkinson’s disease

Side effects: neurotoxicity, seizures, ototoxicity, oliguria, anaphylaxis

Nursing implications:

  • neuromuscular disease (myasthenia gravis, Parkinson’s disease, infant botulism)- assess for paresthesias, tetany, muscle weakness
  • assess for signs and symptoms of infection, complete C/S
  • Assess for RENAL DISEASE
  • Assess for DEAFNESS
  • Assess for overgrowth of infection

Teaching:
- advise pt to report sore throat, bruising, bleeding, RINGING OF EARS!!

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16
Q

Heparin (indications, contraindications, side effects, nursing implications, teaching)

A

Anticoagulant, antithrombotic

Indications: prevention/tx of MI, open heart surgery, a fib with embolization, maintain patency of indwelling IVs, tx of DIC

Contraindications: bleeding, pork product

Side effects: hematuria, hemorrhage, thrombocytopenia, anemia, anaphylaxis

Nursing implications:
- assess blood studies, PTT, Hct, bleeding hemorrhage, nose bleeds, ecchymosis, black tarry stools. WATCH FOR BLEEEEEDING!!!!

Teaching:
- soft bristle tooth brush, electric razor, report signs of bleeding: gums, under skin, urine, stools or unsual bruising

17
Q

Lasix (indications, contraindications, side effects, nursing implications, teaching)

A

Furosemide/Loop diuretic

Indications: pulmonary edema, edema in CHF, nephrotic syndrome, HTN

Contraindications: anuria, hypovolemia

Side effects: Hypokalemia/magnesemia/natremia/calcemia, hyperglycemia, stevens johnson syndrome

nursing implications:

  • Assess pt for tinnitus, hearing loss, ear pain,
  • assess for hypokalemia: acidic urine, reduced urine osmolality
  • Assess fluid volume status: I/O’s, crackles, distended red veins, thirst
  • monitor electrolytes
  • assess for HTN

Teaching:

  • take med early in day
  • take with food or milk
  • med causes loss of potassium! so foods high in potassium should be included in diet!!
18
Q

Lorazepam (indications, contraindications, side effects, nursing implications, teaching)

A

Ativan/ Sedative-hypnotic/antianxiety/benzodiazepine (short acting)

Indications: anxiety, irritability in psych, preoperative, status epliepticus

Contraindications: alcohol, closed-angle glaucoma, psychosis, hx of drug abuse, COPD

Side effects: orthostatic hypotension, ECG CHANGES, tachycardia, apnea, cardiac arrest, blurred vision

Nursing implications:

  • assess degree of anxiety
  • assess for alcohol withdrawal symptoms including hallucinations, delirium, irritability
  • monitor bp

Patient teaching:

  • notify md is pregnancy is planned or suspected, do NOT breastfeed
  • report suicidal ideation!!
  • product not used for everyday stress- can be HABIT FORMING, DO NOT GIVE TO PT W/ HX OF DRUG ABUSE
19
Q

Lovenox (indications, contraindications, side effects, nursing implications, teaching)

A

Enoxaparin/Anticoagulant/antithrombotic

Indications: prevention of DVT

Contraindications: hypersensitivity to heparin or pork, any active major bleeding

Side effects: hemorrhage from any site, thrombocytopenia, bleeding

Nursing implications:

  • monitor antifactor Xa activity in chronic therapy (renal disease)
  • monitor blood studies
  • assess pt for bleeding gums, petechiae, ecchymosis, black tarry stools
  • BB warning: assess for neuro symptoms in patients who have received spinal anesthesia

Teaching:

  • avoid OTC
  • soft bristle tooth brush, avoid contact sports, use electric razor
  • report any signs of bleeding from anywhere!
20
Q

Metoprolol (indications, contraindications, side effects, nursing implications, teaching)

A

Lopressor/Antihypertensive/antianginal (beta blocker)

Indications: mild to moderate HTN, acute MI to reduce CV mortality, angina pectoris

Contraindications: cardiogenic shock, 2/3rd degree heart block, sinus bradycardia

Side effects: CHF, palpitations, cardiac arrest, AV block, chest pain, bronchospasm

Nursing implications:

  • ABRUPT WITHDRAWAL CAN CAUSE MI, ventricular dysrhythmias, myocardial ischemia, TAPER DOSE OVER 1-2 WEEKS
  • HTN/angina- monitor ECG directly
  • baselines in renal, liver function
  • assess for edema in feet, legs daily!

Teaching:

  • do not abruptly withdrawal!!!
  • comply with weight control, teach how to take pulse and bp
  • avoid hazardous activities
  • do not double dose or skip doses, take any misses doses as soon as remembered if at least 4 hr until next dose!
21
Q

Midazolam (indications, contraindications, side effects, nursing implications, teaching)

A

Sedative/hypnotic/Antianxiety/BENZO

Indication: preop sedation, general anesthesia induction, sedation for diagnostic endoscopic procedure, intubation, anxiety

Contraindications: hypersensitivity to benzos, acute closed-angle glaucoma, epidural use

Side effects: cardiac arrest, N/V, blurred vision, apnea, respiratory depression

Nursing implications:

  • Monitor BP, pulse, RR
  • assess degree of amnesia in geriatric
  • Assess respiratory depression/insufficiency: assess for apnea, respiratory depression, which may be increased in geriatric!

Teaching:

  • inform pt that amnesia occurs
  • avoid CNS depressants including alcohol after taking this product
22
Q

Morphine (indications, contraindications, side effects, nursing implications, teaching)

A

Opioid analgesic

Indications: moderate to severe pain

Contraindications: addiction (opioid/alcohol), hemorrhage, increased ICP, paralytic ileus, hypovolemic shock, MAOI therapy
Black box warning: RESPIRATORY DEPRESSION

Side effects: drowsiness, confusion, sedation, bradycardia, respiratory DEPRESSION/ARREST

Nursing implications:

  • Assess pain, monitor I/O’s
  • Gradually taper!!
  • Monitor CNS changes
  • ASSESS RESPIRATORY DYSFUNCTION!

Teaching:

  • avoid CNS depressants (alcohol, sedative/hypnotics)
  • dizziness, drowsiness, confusion are common, don’t get up without assistance
23
Q

Motrin (indications, contraindications, side effects, nursing implications, teaching)

A

Ibuprofen/NSAID

Indications: RA, osteoarthritis, dental pain, fever, migraine

Contraindications: avoid pregnancy (3rd trimester), NSAIDS, salicylates, asthma, severe renal/hepatic disease. Perioperative pain in CABG*** GI bleeding, MI, stroke

Side effects: CV thrombotic events, MI, stroke, tinnitus, hearing loss, GI bleeding, ulceration, nephrotoxicity, stevens johnson syndrome

Nursing implications:

  • Assess for infection: may mask symptoms
  • assess for pain
  • monitor liver function tests
  • perioperative pain in CABG: MI and stroke can be FATAL in those taking NSAIDS
  • nephrotoxicity,
  • WATCH FOR GI BLEEDING

Teaching:

  • use sunscreen, sun glasses (photophobia)
  • avoid alcohol
  • can be NEPHROTOXIC so advise to report changes in urinary pattern, weight increase, edema, increased pain in joints
24
Q

Nitroglycerin (indications, contraindications, side effects, nursing implications, teaching)

A

Coronary Vasodilator/Antianginal

Indications: chronic stable angina, prophylaxis of angina pain, CHF associated with acute MI

Contraindications: increased ICP, cerebral hemorrhage, closed angle glaucoma, cardiac tamponade, cardiomyopathy

Side effects: headache, flushing, dizziness, postural hypotension, syncope

Nursing implications:

  • Monitor BP, pulse
  • assess pain
  • monitor for light headedness, decreased BP

Teaching:

  • avoid alcohol
  • may cause headache
  • slowly change positions
  • Advise pt to NEVER USE ED pills (sildenafil, tadalafil, vardenafil) may cause SEVERE HYPOTENSION, DEATH
25
Q

Prednisone (indications, contraindications, side effects, nursing implications, teaching)

A

Corticosteroid

Indications: severe inflammation, MS, collagen disorders, dermatologic disorders

Contraindications: hypersensitivity

Side effects: fluid retention, increased appetite, GI hemorrhage, hyperglycemia, acne

Nursing implications:

  • Adrenal insufficiency: assess for nausea, vomiting, anorexia, confusion, hypotension, weight loss before and during treatment
  • monitor potassium, blood sugar (long term) hypokalemia and hyperglycemia can occur
  • daily weights
  • assess adrenal function periodically
  • assess potassium depletion

Teaching:

  • do not discontinue abruptly, ADRENAL CRISIS CAN RESULT
  • NOTIFY MD IF PREGNANCY IS SUSPECTED OR PLANNED- cleft palate, stillbirth, abortion has been reported!
26
Q

Promethazine (indications, contraindications, side effects, nursing implications, teaching)

A

Antihistamine, antiemetic, sedative/hypnotic

Indications: motion sickness, rhinitis, allergy symptoms, sedation, nausea, pre/post op sedation

Contraindications: bone marrow suppression, breast feeding, coma, jaundice, reye’s syndrome
= BB warning: infants, intraarterial/SUBCUT use, neonates, children, WATCH FOR IV USE- HIGHLY CONCENTRATED

Side effects: NMS, hyper/hypotension, thrombocytopenia

Nursing implications:

  • not to be used children under 2!
  • NMS can occur!! assess for fever, confusion, diaphoresis, rigid muscles, elevated CPK
  • assess respiratory status
  • I/O’s
  • monitor CBC

Teaching:

  • take 30 minutes before departing to avoid motion sickness
  • take 1 hour before or 2 hours after meals to facilitate absorption
27
Q

Tylenol (indications, contraindications, side effects, nursing implications, teaching)

A

Nonopioid analgesic

indications: mild to moderate pain or fever, dental pain, headache, osteoarthritis, dysmenorrhea

Contraindications: hypersensitivity

Side effects: hepatotoxicity, GI bleeding, renal failure, stevens-johnson syndrome

Nursing implications:

  • monitor liver, renal, blood function studies
  • assess I/O to assess renal failure
  • assess for chronic poisoning: rapid, weak pulse, dyspnea, cold, clammy extremities
  • assess HEPATOTOXICITY: dark urine, clay colored stools, yellowing of skin and sclera, itching, abdominal pain
  • Stevens-johnson syndrome can occur

Teaching:
- DO NOT EXCEED RECOMMENDED DOSAGE

28
Q

Vancomycin (indications, contraindications, side effects, nursing implications, teaching)

A

Antiinfective

indications: infections
contraindications: hypersensitivity, hearing loss

side effects: ototoxicity, deafness, nephrotoxicity, pseudomembranous colitis, anaphylaxis, superinfection

Nursing implications:

  • assess for infection
  • monitor I/O’s, blood tests, C/S
  • monitor auditory functioning
  • WATCH FOR RED MAN SYNDROME: flushing of neck, face, upper body, arms, back–> may lead to anaphylaxis
  • METFORMIN: increased lactic acidosis!

Teaching:

  • need to finish course of medication
  • report sore throat, fever
  • must be taken at equal intervals around the clock to maintain blood levels
29
Q

Vicodin (indications, contraindications, side effects, nursing implications, teaching)

A

Hydrocodone/Antitussive opioid analgesic/non opioid analgesic

Indications: mild to moderate pain

contraindications: cushing’s, measles, varicella, abrupt discontinuation, acne rosacea

Side effects: drowsiness, dizziness, light-headedness, dependence, respiratory depression***

Nursing implications:

  • assess pain
  • monitor CNS changes (dizziness, drowsiness)
  • assess bowel status: constipation, provide fluids, fiber

Teaching

  • report CNS changes
  • avoid CNS depressants (alcohol, sedative/hypnotics)
  • teach pt that dizziness, drowsiness, confusion is common
30
Q

Zofran (indications, contraindications, side effects, nursing implications, teaching)

A

Ondansetron/Antiemetic

indications: prevention of nausea, vomiting with cancer chemotherapy, radiotherapy, prevention of post op N/V

Contraindications: phenylketonuric, torsades de pointes

side effects: headache, diarrhea, bronchospasm, drowsiness, fatigue

nursing implications:

  • assess for absence of N/V
  • assess for hypersensitivity reaction
  • assess for EPS : shuffling gait, tremors, grimacing, rigidity
  • assess for QT PROLONGATION: MONITOR ECG IN THOSE WITH CARDIAC DISEASE

Teaching:
- report diarrhea, constipation, rash, changes in respirations

4th Semester (1 decks)

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