Flashcards in ATI CH 1 Deck (37)
What is the hallmark sign of hypoglycemia?
Cold, clammy,sweaty skin (diaphoresis)
Other signs include confusion, unsteadiness, & loss of consciousness.
What vital sign should be monitored when using morphine?
Respirations are important to watch. Morphine is notorious for causing respiratory depression.
What should you be cautious of when administering gentamicin?
Be cautious of the pt. c/o hearing loss.
Gentamicin is a antibiotic of the amino-glycoside family. Amino glycosides are known for being ototoxic & nephrotoxic.
Any drug with the suffix "cet" contains what?
Any drug with the suffix CET contains tylenol
( Percocet, darvocet)
How can you tell if a drug is a ace inhibitor?
Ace inhibitors end in PRIL
Angiotensin receptor blockers end in what suffix?
Beta blockers prefix is what?
Furosemide is known as what?
Lasix, a potent loop diuretic that lasts up to 6 hours.
Gabapentin is also known as what?
An anticonvulsant indicated for diabetic neuropathy.
An opiod analgesic indicated for severe pain.
What is the only form of insulin that can be given via IV?
When administering eye drops, what are appropriate nursing interventions?
Ask client to look at ceiling
Drop med into center of pt. conjunctival sac
Instruct client to close eye gently
Medication doses need to be DECREASED for what reasons?
Concurrent use of meds metabolized by the same pathway.
Is a pt. trough level needs to be checked, what is an appropriate nursing intervention?
Have a blood specimen obtained immediately prior to the next dose.
Has a half life of 4 days. Most likely prescribed once per day because of 4 day half life.
A catheter is advanced through a needle that is inserted into the epidural space at the level of 4th or 5th vertebrae.
Type of IM injection that prevents meds from leaking back into subcutaneous tissue.
Appropriate for irritating medications, solutions in oil, & aqueous suspensions.
What needle sizes are used for intramuscular injections?
18-27 gauge typically 22-25 guage.
1 to 1.5 inches long. Inject at 90 degree angle
Volume injected is usually 1-3ml. If greater amts is required, uses to syringes at two different sites.
What are common sites for IM injections?
Ventrogluteal, deltoid & vastus lateralis (pediatric)
Dorsogluteal is not recommended due to close proximity to sciatic nerve.
Subcutaneous injections are appropriate
Appropriate for small doses of non irritating, water soluble medications and is commonly used for insulin and heparin.
If giving a subcutaneous injection what needle would you use?
3/8 to 5/8 inch
25 to 27 guage needle or
Insulin syringe of 28- 31 guage. Inject no more than 1.5ml of solution.
For average sized ppl pinch skin and inject 45-90 degree angle. Fat ppl use 90 degree angle
Usually used for tuberculin testing or checking for medication/ allergy sensitivities.
May be used for some cancer immunotherapy
What is important to remember
When giving intradermal injections?
Use small amounts of solution (0.01- 0.1 ml) in tuberculin syringe with fine guage needle (26-27) in lightly pigmented, thin skinned hairless sites( inner surface of mid forearm or scapular area of back) at a 5- 15 degree angle bevel up.
Vastus lateralis is recommended for infants & children younger than 2. After 2 yrs old the ventral gluteal site can be used.
Both sites can hold up to ml of fluid.
Deltoid muscle has smaller muscle mass and can only hold 1ml of fluid.
For parenteral medications what would you do with a volume to be injected that is less than 1ml.
Use a tuberculin syringe for volumes less than 0.5ml.
What is true of a MDI?
(Metered dose inhaler)
Shake inhaler 5-6 times
Hold approx 2-4cm (1-2in) from front of
Hold med in for 10sec.
For a dry powder inhaler
(DPI) what should the nurse intruct the client not to do?
Avoid shaking the device
What is true of rectal suppositories?
Position client in left lateral position
Insert just beyond internal sphincter
Instruct client to retain meds for 20-30 min for stimulation of defacation & 60 min for systemic absorption.
What is true when instilling eye drops?
Use surgical technique
Apply gentle pressure with finger and a clean tissue on nasolacrimal duct for 30-60 sec to prevent systemic absorption of medication.
What would a nurse educate a client to do after instilling a medication through the nose?
Use aseptic technique
Instruct client to breath through mouth, stay in a supine position and avoid blowing nose for 5 min after drop insertion.
When giving ear drops, what must a nurse keep in mind?
Straighten ear canal by pulling auricle upward and outward for adults, or down and back for kids. Hold dropper 1cm above ear, instill med the. Gently apply pressure with finger to Tragus of ear.
What is a agonist?
Is a medication that binds to a receptor to produce a biological response.
Morphine is considered a agonist because it activates the receptors to produce analgesia, sedation, constipation, and other effects.
What is an antagonist?
A med that interferes with , or inhibits the action of another med.
Angiotensin II receptor blocker that is classified as a antagonist because it blocks the angiotensin II receptors on blood vessels , which prevents vasoconstriction.
What is true of medications with a high therapeutic index?
They have a wide safety margin, therefore no need for routine serum med level monitoring.
Meds with a low TI should have med levels monitored closely
Monitor peak levels based on route of administration