Meds Flashcards

Question

Tenormin

Answer 1

Atenolol (Tenormin) class: beta blocker, antianginal, antihypertensive Indication: hypertension, angina, prevention of MI Action: blocks the stimulation of beta1 receptors in the SNS with minimal effect on beta2 receptors Nursing Considerations: - Contraindicated in CHF, pulmonary edema, cardiogenic shock, bradycardia, heart block - monitor hemodynamic parameters (HR, BP) - May cause bradycardia, CHF, pulmonary edema - Masks symptoms associated with diabetes mellitus - advise to change positions slowly to prevent orthostatic hypotension - instruct patient on how to take blood pressure

Answer 2

Atropine class: antiarrhythmic, anticholinergic, antimuscarinic Indication: decreases oral and respiratory secretions, treats sinus bradycardia and heart block, treatment of bronchospasm Action: Atropine is an anticholinergic which means that it inhibits the effects of the parasympathetic nervous system, specifically acetylcholine. This inhibition causes increase in HR, bronchodilation, decreased GI and respiratory secretions. Nursing Considerations: - Avoid in acute hemorrhage, tachycardia, and angle closure glaucoma - monitor patient for tachycardia and palpitations - may cause urinary retention in elderly patients - patients may experience constipation due to slowed GI motility

Answer 3

Azithromycin (Zithromax) class: agents for atypical mycobacterium, anti-infectives Indication: URI, chronic bronchitis, lower respiratory infections, otitis media, skin infections, various STIs, prevention of bacterial endocarditis, treatment of cystic fibrosis Action: inhibits bacterial protein synthesis Nursing Considerations: -may lead to pseudomembranous colitis, pain, diarrhea, nausea, Stevens-Johnson syndrome, angioedema - may increase risks for warfarin toxicity - monitor patient for signs of anaphylaxis - instruct patient to notify physician for diarrhea, or blood or pus in stool - instruct patient to take medication exactly as prescribed

Answer 4

Azithromycin (Zithromax) class: agents for atypical mycobacterium, anti-infectives Indication: URI, chronic bronchitis, lower respiratory infections, otitis media, skin infections, various STIs, prevention of bacterial endocarditis, treatment of cystic fibrosis Action: inhibits bacterial protein synthesis Nursing Considerations: -may lead to pseudomembranous colitis, pain, diarrhea, nausea, Stevens-Johnson syndrome, angioedema - may increase risks for warfarin toxicity - monitor patient for signs of anaphylaxis - instruct patient to notify physician for diarrhea, or blood or pus in stool - instruct patient to take medication exactly as prescribed

Answer 5

Benzotropine (Cogentin) class: Anticholinergic, Antiparkinson agent Indication: anticholinergic properties in the CNS to reduce rigidity and tremors Action: treatment for Parkinson's disease, Nursing Considerations: - may lead to arrhythmias, hypotension, palpitations, and tachycardia - anticholinergic effects like constipation, dry mouth - assess for extrapyramidal symptoms - instruct patient to take as directed - instruct patient to maintain good oral hygiene

Answer 6

Benzotropine (Cogentin) class: Anticholinergic, Antiparkinson agent Indication: anticholinergic properties in the CNS to reduce rigidity and tremors Action: treatment for Parkinson's disease, Nursing Considerations: - may lead to arrhythmias, hypotension, palpitations, and tachycardia - anticholinergic effects like constipation, dry mouth - assess for extrapyramidal symptoms - instruct patient to take as directed - instruct patient to maintain good oral hygiene

Answer 7

Bismuth Subsalicylate (Kaopectate, Pepto-Bismol) class: antidiarrheal, antiulcer Indication: diarrhea, heartburn, indigestion, H. pylori associated ulcer Action: Stimulates the absorption of fluids and electrolytes in the intestinal wall, reduction in hypermotility of the stomach, and binds to toxins Nursing Considerations: -contraindicated in aspirin hypersensitivity - increase risk for impaction with geriatric and pediatric patients - monitor liver profile - bismuth may interfere with radiologic exams

Answer 8

Bismuth Subsalicylate (Kaopectate, Pepto-Bismol) class: antidiarrheal, antiulcer Indication: diarrhea, heartburn, indigestion, H. pylori associated ulcer Action: Stimulates the absorption of fluids and electrolytes in the intestinal wall, reduction in hypermotility of the stomach, and binds to toxins Nursing Considerations: -contraindicated in aspirin hypersensitivity - increase risk for impaction with geriatric and pediatric patients - monitor liver profile - bismuth may interfere with radiologic exams

Answer 9

Biscodyl (Ducolax) class: stimulant laxatives Indication: treatment of constipation, bowel regimen Action: stimulates peristalsis leads to fluid accumulation in the colon Nursing Considerations: -may lead to hypokalemia - may cause abdominal pain and cramps - use caution with milk - assess for abdominal distention and bowel function - instruct patient to drink 1500-2000 mL/day during therapy - monitor fluid and electrolyte levels - instruct patient to take as ordered

Answer 10

Biscodyl (Ducolax) class: stimulant laxatives Indication: treatment of constipation, bowel regimen Action: stimulates peristalsis leads to fluid accumulation in the colon Nursing Considerations: -may lead to hypokalemia - may cause abdominal pain and cramps - use caution with milk - assess for abdominal distention and bowel function - instruct patient to drink 1500-2000 mL/day during therapy - monitor fluid and electrolyte levels - instruct patient to take as ordered

Answer 11

Bismuth Subsalicylate (Kaopectate, Pepto-Bismol) class: antidiarrheal, antiulcer Indication: diarrhea, heartburn, indigestion, H. pylori associated ulcer Action: Stimulates the absorption of fluids and electrolytes in the intestinal wall, reduction in hypermotility of the stomach, and binds to toxins Nursing Considerations: -contraindicated in aspirin hypersensitivity - increase risk for impaction with geriatric and pediatric patients - monitor liver profile - bismuth may interfere with radiologic exams

Answer 12

Buspirone (BuSpar) class: Antidepressants, smoking deterrents Indication:management of anxiety Action: relieves anxiety by binding to dopamine and serotonin receptors Nursing Considerations: - do not administer concurrently with MOAI or grapefruit juice - may lead to dizziness, drowsiness, fatigue, and weakness - patient may experience chest pain, palpitations, tachycardia - instruct patient to take as directed - instruct patient to avoid alcohol and other CNS depressants

Answer 13

Bupropion (Wellbutrin) class: Antidepressants, smoking deterrents Indication: depression, smoking cessation, treat ADHD in adults Action: Nursing Considerations: - may lead to seizures, suicidal thoughts - do not administer if patient is taking MAOI - use caution with renal and liver impairment - assess mental status - instruct patient to avoid alcohol while taking bupropion

Answer 14

Bupropion (Wellbutrin) class: Antidepressants, smoking deterrents Indication: depression, smoking cessation, treat ADHD in adults Action: Nursing Considerations: - may lead to seizures, suicidal thoughts - do not administer if patient is taking MAOI - use caution with renal and liver impairment - assess mental status - instruct patient to avoid alcohol while taking bupropion

Answer 15

Buspirone (BuSpar) class: Antidepressants, smoking deterrents Indication:management of anxiety Action: relieves anxiety by binding to dopamine and serotonin receptors Nursing Considerations: - do not administer concurrently with MOAI or grapefruit juice - may lead to dizziness, drowsiness, fatigue, and weakness - patient may experience chest pain, palpitations, tachycardia - instruct patient to take as directed - instruct patient to avoid alcohol and other CNS depressants

Answer 16

Butorphanol (Stadol) class: Opioid Analgesic Indication: moderate to severe pain, labor pain, sedation Action: alters perception and response to pain by biding to opiate receptors in CNS Nursing Considerations: -use caution with concurrent use of MAOIs - may cause confusion, hallucinations, sedation - monitor for CNS depression - assess blood pressure pulse and respirations during administration - administer slowly through IV line

Answer 17

Butorphanol (Stadol) class: Opioid Analgesic Indication: moderate to severe pain, labor pain, sedation Action: alters perception and response to pain by biding to opiate receptors in CNS Nursing Considerations: -use caution with concurrent use of MAOIs - may cause confusion, hallucinations, sedation - monitor for CNS depression - assess blood pressure pulse and respirations during administration - administer slowly through IV line

Answer 18

Calcium acetate (PhosLo) class: antacids Indication: treatment of hypocalcemia, prevention of post menopausal osteoporosis, treatment of hypokalemia and hypomagnesaemia, adjunct in cardiac arrest, control of hyperphosphatemia with ESRD Action: calcium is essential for nervous muscular and skeletal systems, helps maintain cell membranes, aids in transmission of nerve impulses and muscle contraction, aids in blood formation and coagulation Nursing Considerations: - may cause cardiac arrest and arrhythmias - phlebitis at site of insertion - monitor hemodynamics - may causes hypotension, bradycardia, and arrhythmias - hypercalcemia can increase risk for digoxin toxicity - administer slowly - instruct pt on foods that contain Vitamin D and encourage adequate intake. - monitor parathyroid hormone

Answer 19

Calcium acetate (PhosLo) class: antacids Indication: treatment of hypocalcemia, prevention of post menopausal osteoporosis, treatment of hypokalemia and hypomagnesaemia, adjunct in cardiac arrest, control of hyperphosphatemia with ESRD Action: calcium is essential for nervous muscular and skeletal systems, helps maintain cell membranes, aids in transmission of nerve impulses and muscle contraction, aids in blood formation and coagulation Nursing Considerations: - may cause cardiac arrest and arrhythmias - phlebitis at site of insertion - monitor hemodynamics - may causes hypotension, bradycardia, and arrhythmias - hypercalcemia can increase risk for digoxin toxicity - administer slowly - instruct pt on foods that contain Vitamin D and encourage adequate intake. - monitor parathyroid hormone

Answer 20

Calcium carbonate (Tums / Rolaids) class: antacids Indication: treatment of hypocalcemia, prevention of post menopausal osteoporosis, treatment of hypokalemia and hypomagnesaemia, adjunct in cardiac arrest, used as antacid Action: calcium is essential for nervous muscular and skeletal systems, helps maintain cell membranes, aids in transmission of nerve impulses and muscle contraction, aids in blood formation and coagulation Nursing Considerations: - may cause cardiac arrest and arrhythmias - monitor hemodynamics - may causes hypotension, bradycardia, and arrhythmias - hypercalcemia can increase risk for digoxin toxicity - instruct pt on foods that contain Vitamin D and encourage adequate intake. - monitor parathyroid hormone

Answer 21

Calcium carbonate (Tums / Rolaids) class: antacids Indication: treatment of hypocalcemia, prevention of post menopausal osteoporosis, treatment of hypokalemia and hypomagnesaemia, adjunct in cardiac arrest, used as antacid Action: calcium is essential for nervous muscular and skeletal systems, helps maintain cell membranes, aids in transmission of nerve impulses and muscle contraction, aids in blood formation and coagulation Nursing Considerations: - may cause cardiac arrest and arrhythmias - monitor hemodynamics - may causes hypotension, bradycardia, and arrhythmias - hypercalcemia can increase risk for digoxin toxicity - instruct pt on foods that contain Vitamin D and encourage adequate intake. - monitor parathyroid hormone

Answer 22

Captopril (Capoten) class: ACE Inhibitor, antihypertensives Indication: hypertension, management of CHF, decrease progression of DM neuropathy Action: block conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation Nursing Considerations: - can cause neutropenia - check WBCs regularly - use cautiously with potassium supplements and potassium sparing diuretics. - use cautiously with diuretic therapy - administer 1 hour before meals - monitor blood pressure often - monitor weight and fluid status - monitor renal profile - monitor CBC frequently - May lead to Rhabdomyolysis - Dry cough

Answer 23

Captopril (Capoten) class: ACE Inhibitor, antihypertensives Indication: hypertension, management of CHF, decrease progression of DM neuropathy Action: block conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation Nursing Considerations: - can cause neutropenia - check WBCs regularly - use cautiously with potassium supplements and potassium sparing diuretics. - use cautiously with diuretic therapy - administer 1 hour before meals - monitor blood pressure often - monitor weight and fluid status - monitor renal profile - monitor CBC frequently - May lead to Rhabdomyolysis - Dry cough

Answer 24

Carbamazepine (Tegretol) class: Anticonvulsant Indication: seizures, DM neuropathy, pain associated with trigeminal neuralgia Action: affects Na channels in neurons leading to decreased synaptic transmission Nursing Considerations: - interferes with oral contraceptives - do not use with MAOIs - may cause suicidal thoughts - may cause Stevens-Johnson syndrome, agranulocytosis, aplastic anemia, thrombocytopenia - do not consume grapefruit juice while taking this medication - monitor CBC and platelet count - monitor serum blood levels of medication often

Answer 25

Carbamazepine (Tegretol) class: Anticonvulsant Indication: seizures, DM neuropathy, pain associated with trigeminal neuralgia Action: affects Na channels in neurons leading to decreased synaptic transmission Nursing Considerations: - interferes with oral contraceptives - do not use with MAOIs - may cause suicidal thoughts - may cause Stevens-Johnson syndrome, agranulocytosis, aplastic anemia, thrombocytopenia - do not consume grapefruit juice while taking this medication - monitor CBC and platelet count - monitor serum blood levels of medication often

Answer 26

Carbidopa / Levodopa (Sinemet) class: Antiparkinson agent, Dopamine Agonist Indication: Parkinson's disease Action: levodopa is converted to dopamine and works as a neurotransmitter and carbidopa prevents the destruction of levodopa Nursing Considerations: - may cause orthostatic hypotension - may cause dark urine - weeks to months to take effect - do not use with MAOIs - don't use with glaucoma, melanoma - assess for parkinsonian symptoms - instruct patient to take as directed

Answer 27

Carbidopa / Levodopa (Sinemet) class: Antiparkinson agent, Dopamine Agonist Indication: Parkinson's disease Action: levodopa is converted to dopamine and works as a neurotransmitter and carbidopa prevents the destruction of levodopa Nursing Considerations: - may cause orthostatic hypotension - may cause dark urine - weeks to months to take effect - do not use with MAOIs - don't use with glaucoma, melanoma - assess for parkinsonian symptoms - instruct patient to take as directed

Answer 28

Carbidopa / Levodopa (Sinemet) class: Antiparkinson agent, Dopamine Agonist Indication: Parkinson's disease Action: levodopa is converted to dopamine and works as a neurotransmitter and carbidopa prevents the destruction of levodopa Nursing Considerations: - may cause orthostatic hypotension - may cause dark urine - weeks to months to take effect - do not use with MAOIs - don't use with glaucoma, melanoma - assess for parkinsonian symptoms - instruct patient to take as directed

Answer 29

Cefaclor (Ceclor) class: Cephalosporin 2nd generations Indication: treatment of respiratory tract infections, skin infections, otitis media Action: bacteriacidal, binds to bacterial cell wall causing cell death Nursing Considerations: contraindicated in cephalosporin and possibly penicillin allergies - may need lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at IV site, anaphylaxis - Assess infection and allergies - obtain cultures prior to therapy - monitor bowel function - may lead to super infection

Answer 30

Cefaclor (Ceclor) class: Cephalosporin 2nd generations Indication: treatment of respiratory tract infections, skin infections, otitis media Action: bacteriacidal, binds to bacterial cell wall causing cell death Nursing Considerations: contraindicated in cephalosporin and possibly penicillin allergies - may need lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at IV site, anaphylaxis - Assess infection and allergies - obtain cultures prior to therapy - monitor bowel function - may lead to super infection

Answer 31

Cefdinir (Omnicef) class: Cephalosporin 2nd generations Indication: treatment of skin infections, otitis media Action: bactericidal, binds to bacterial cell wall causing cell death Nursing Considerations: - contraindicated in cephalosporin and possibly penicillin allergies - may need lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at IV site, anaphylaxis - Assess infection and allergies - obtain cultures prior to therapy - monitor bowel function - monitor for bleeding - may lead to super infection

Answer 32

Cefdinir (Omnicef) class: Cephalosporin 2nd generations Indication: treatment of skin infections, otitis media Action: bactericidal, binds to bacterial cell wall causing cell death Nursing Considerations: - contraindicated in cephalosporin and possibly penicillin allergies - may need lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at IV site, anaphylaxis - Assess infection and allergies - obtain cultures prior to therapy - monitor bowel function - monitor for bleeding - may lead to super infection

Answer 33

Celecoxib (Celebrex) class: antirrheumatics/NSAID Indication: osteoarthritis, rheumatoid arthritis, acute pain Action: decreases pain and inflammation by inhibiting synthesis of prostaglandins Nursing Considerations: - use caution with cardiovascular disease - increases risk for MI, CVA, thrombosis - may cause GI bleeding, Stevens-Johnson syndrome, dermatitis - notify provider for new-onset abdominal pain or black stool

Answer 34

Celecoxib (Celebrex) class: antirrheumatics/NSAID Indication: osteoarthritis, rheumatoid arthritis, acute pain Action: decreases pain and inflammation by inhibiting synthesis of prostaglandins Nursing Considerations: - use caution with cardiovascular disease - increases risk for MI, CVA, thrombosis - may cause GI bleeding, Stevens-Johnson syndrome, dermatitis - notify provider for new-onset abdominal pain or black stool

Answer 35

Cephalexin (Keflex) class: Cephalosporin 1st generations Indication: skin infections, pneumonia, UTI, otitis media Action: bactericidal: binds to bacterial cell wall leading to cell death Nursing Considerations: - contraindicated with cephalosporin and serious penicillin allergies. - may need lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at IV site, anaphylaxis - Assess infection and allergies - obtain cultures prior to therapy - monitor bowel function - may lead to super infection - may cause elevated liver enzymes

Answer 36

Cephalexin (Keflex) class: Cephalosporin 1st generations Indication: skin infections, pneumonia, UTI, otitis media Action: bactericidal: binds to bacterial cell wall leading to cell death Nursing Considerations: - contraindicated with cephalosporin and serious penicillin allergies. - may need lead to seizures, pseudomembranous colitis, diarrhea, phlebitis at IV site, anaphylaxis - Assess infection and allergies - obtain cultures prior to therapy - monitor bowel function - may lead to super infection - may cause elevated liver enzymes

Answer 37

Chlorpromazine (Thorazine) class: Antipsychotic, antiemetic Indication:second line treatment of schizophrenia and psychosis, nausea/vomiting, pre-op sedation, acute intermittent porphyria, headache, bipolar Action: exhibits anticholinergic activity, alters effects of dopamine in CNS Nursing Considerations: - may cause neuroliptic malignant syndrome, sedation, tardive dyskineisa, hypotenstion, agranulocytosis - assess mental status prior to and during treatment - monitor blood pressure - ensure patient is taking medication - monitor CBC and liver function tests - instruct patient not to skip doses or double dose

Answer 38

Chlorpromazine (Thorazine) class: Antipsychotic, antiemetic Indication:second line treatment of schizophrenia and psychosis, nausea/vomiting, pre-op sedation, acute intermittent porphyria, headache, bipolar Action: exhibits anticholinergic activity, alters effects of dopamine in CNS Nursing Considerations: - may cause neuroliptic malignant syndrome, sedation, tardive dyskineisa, hypotenstion, agranulocytosis - assess mental status prior to and during treatment - monitor blood pressure - ensure patient is taking medication - monitor CBC and liver function tests - instruct patient not to skip doses or double dose

Answer 39

Cimetidine (Tagamet) class: Histamine H2 antagonist, antiulcer agent Indication: treatment of duodenal ulcers, GERD, heartburn, Zollinger Ellison syndrome, prevention of GI bleeding in critical patients. Action: inhibits action of histamine leading to inhibition of gastric acid secretion Nursing Considerations: - increases serum level of warfarin - can lead to respiratory infection (green sputum) - monitor for arryhtmias - may cause agranulocytosis, aplastic anemia - monitor CBC during therapy - take medication as directed - instruct patient to increase fluid and fiber intake to decrease constipation

Answer 40

Cimetidine (Tagamet) class: Histamine H2 antagonist, antiulcer agent Indication: treatment of duodenal ulcers, GERD, heartburn, Zollinger Ellison syndrome, prevention of GI bleeding in critical patients. Action: inhibits action of histamine leading to inhibition of gastric acid secretion Nursing Considerations: - increases serum level of warfarin - can lead to respiratory infection (green sputum) - monitor for arryhtmias - may cause agranulocytosis, aplastic anemia - monitor CBC during therapy - take medication as directed - instruct patient to increase fluid and fiber intake to decrease constipation

Answer 41

Ciprofloxacin (Cipro) class: Fluoroquinolone, anti-infectives Indication: urinary tract infections, gonorrhea, respiratory tract infections, bronchitis, pneumonia, skin and bone infections, infectious diarrhea, abdominal infections Action: inhibits bacterial DNA synthesis Nursing Considerations: - contraindicated in allergies - may cause QT prolongation, avoid use with other drugs that can cause QT prolongation - can cause seizures, arrythmias, pseudomembranous colitis, anaphalaxis, Stevens Johnson syndrome - may decreased of phenytoin - monitor renal panel - assess for infection, obtain cultures prior to therapy - monitor liver function tests

Answer 42

Ciprofloxacin (Cipro) class: Fluoroquinolone, anti-infectives Indication: urinary tract infections, gonorrhea, respiratory tract infections, bronchitis, pneumonia, skin and bone infections, infectious diarrhea, abdominal infections Action: inhibits bacterial DNA synthesis Nursing Considerations: - contraindicated in allergies - may cause QT prolongation, avoid use with other drugs that can cause QT prolongation - can cause seizures, arrythmias, pseudomembranous colitis, anaphalaxis, Stevens Johnson syndrome - may decreased of phenytoin - monitor renal panel - assess for infection, obtain cultures prior to therapy - monitor liver function tests

Answer 43

Clindamycin (Cleocin) class: Anti-infectives Indication: skin infections, respiratory tract infections, septicemia, intra-abdominal infections, osteomyelitis Action: inhibits protein synthesis Nursing Considerations: - arrythmias, pseudomembranous colitis, diarrhea, phlebitis - monitor bowel function - assess for infection, obtain cultures prior to therapy - monitor liver function tests. - monitor CBC

Answer 44

Clindamycin (Cleocin) class: Anti-infectives Indication: skin infections, respiratory tract infections, septicemia, intra-abdominal infections, osteomyelitis Action: inhibits protein synthesis Nursing Considerations: - arrythmias, pseudomembranous colitis, diarrhea, phlebitis - monitor bowel function - assess for infection, obtain cultures prior to therapy - monitor liver function tests. - monitor CBC

Answer 45

Clopidogrel (Plavix) class: Antiplatelet agent Indication: atherosclerotic events, MI, CVA, PVD, acute coronary syndrome Action: Nursing Considerations: - may cause GI bleeding, neutropenia, hypercholesterolemia - may increase risk for bleeding in warfarin, aspirin, heparin - can increase risk for bleeding with garlic, ginkgo, ginger - monitor for signs of bleeding - monitor bleeding times - monitor CBS and platelet count - discontinue use 5-7 days before surgery

Answer 46

Clopidogrel (Plavix) class: Antiplatelet agent Indication: atherosclerotic events, MI, CVA, PVD, acute coronary syndrome Action: Nursing Considerations: - may cause GI bleeding, neutropenia, hypercholesterolemia - may increase risk for bleeding in warfarin, aspirin, heparin - can increase risk for bleeding with garlic, ginkgo, ginger - monitor for signs of bleeding - monitor bleeding times - monitor CBS and platelet count - discontinue use 5-7 days before surgery

Answer 47

Codeine (Paveral) class: opioid agonist Indication: management of pain, diarrhea, cough suppressant Action: Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. This depression also causes a decrease in the cough reflex and GI motility. Nursing Considerations: - may cause alterations in mentation, hypotension, constipation, nausea, vomiting - assess BP, pulse, and respiratory rate prior to administration and frequently during administration - use caution if patient is receiving MAO Inhibitors - Narcan (naloxone) is the antidote for opioid agonists

Answer 48

Codeine (Paveral) class: opioid agonist Indication: management of pain, diarrhea, cough suppressant Action: Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. This depression also causes a decrease in the cough reflex and GI motility. Nursing Considerations: - may cause alterations in mentation, hypotension, constipation, nausea, vomiting - assess BP, pulse, and respiratory rate prior to administration and frequently during administration - use caution if patient is receiving MAO Inhibitors - Narcan (naloxone) is the antidote for opioid agonists

Answer 49

Cortisone (Cortone) class: antiasthmatics, corticosteroids Indication: management of adrenocortical insufficiency (Addison's Disease). Action: Replace cortisol in states of deficiency, suppress inflammation and normal immune response. Nursing Considerations: - Excreted by the liver - monitor liver profile - Avoid in active untreated infections - may cause CNS alterations - may cause peptic ulcers - may cause Cushingoid appearance (buffalo hump, moon face) - Weight gain - Osteoporosis - Decrease wound healing - May elevate blood sugars - May increase cholesterol and lipid values

Answer 50

Cortisone (Cortone) class: antiasthmatics, corticosteroids Indication: management of adrenocortical insufficiency (Addison's Disease). Action: Replace cortisol in states of deficiency, suppress inflammation and normal immune response. Nursing Considerations: - Excreted by the liver - monitor liver profile - Avoid in active untreated infections - may cause CNS alterations - may cause peptic ulcers - may cause Cushingoid appearance (buffalo hump, moon face) - Weight gain - Osteoporosis - Decrease wound healing - May elevate blood sugars - May increase cholesterol and lipid values

Answer 51

Cyclosporine (Sandimmune) class: immunosuppresants, antirheumatics (DMARD) Indication: prevention of rejection in transplantation, treatment of severe RA, management of ulcerative colitis Action: inhibits normal immune response Nursing Considerations: -may cause seizures, tremors, hypertension, hepatotoxicity, diarrhea, N/V, gingival hyperplasia - increases immune suppression with corticosteroids - avoid grapefruit juice while taking this medications - assess for signs of organ rejection - monitor renal panel, liver enzymes - take medication as directed - lifelong therapy required for transplant patients - instruct pt on how to take blood pressure

Answer 52

Cyclosporine (Sandimmune) class: immunosuppresants, antirheumatics (DMARD) Indication: prevention of rejection in transplantation, treatment of severe RA, management of ulcerative colitis Action: inhibits normal immune response Nursing Considerations: -may cause seizures, tremors, hypertension, hepatotoxicity, diarrhea, N/V, gingival hyperplasia - increases immune suppression with corticosteroids - avoid grapefruit juice while taking this medications - assess for signs of organ rejection - monitor renal panel, liver enzymes - take medication as directed - lifelong therapy required for transplant patients - instruct pt on how to take blood pressure

Answer 53

Dexamethasone (Decadron) class: antiasthmatics, corticosteroids Indication:Manage cerebral edema, assess for Cushing's Disease Action: Suppress inflammation and normal immune response. Used in inflammatory states to decrease inflammation. Nursing Considerations: -Excreted by the liver - monitor liver profile - Avoid in active untreated infections - may cause CNS alterations - may cause peptic ulcers - may cause Cushingoid appearance (buffalo hump, moon face) - Weight gain - Osteoporosis - Decrease wound healing - May elevate blood sugars - May increase cholesterol and lipid values

Answer 54

Dexamethasone (Decadron) class: antiasthmatics, corticosteroids Indication:Manage cerebral edema, assess for Cushing's Disease Action: Suppress inflammation and normal immune response. Used in inflammatory states to decrease inflammation. Nursing Considerations: -Excreted by the liver - monitor liver profile - Avoid in active untreated infections - may cause CNS alterations - may cause peptic ulcers - may cause Cushingoid appearance (buffalo hump, moon face) - Weight gain - Osteoporosis - Decrease wound healing - May elevate blood sugars - May increase cholesterol and lipid values

Answer 55

Diazepam (Valium) class: Benzodiazepine Indication: anxiety, pre-op sedation, conscious sedation, treatment of seizures, insomnia, management of alcohol withdrawal Action: depresses the CNS Nursing Considerations: - contraindicated in hepatic dysfunction - use caution with renal impairment - can cause dizziness, drowsiness, lethargy, hypotension, physical dependence, tolerance - instruct patient to take as directed - caution to avoid alcohol use - Romazicon is the reversal agent

Answer 56

Diazepam (Valium) class: Benzodiazepine Indication: anxiety, pre-op sedation, conscious sedation, treatment of seizures, insomnia, management of alcohol withdrawal Action: depresses the CNS Nursing Considerations: - contraindicated in hepatic dysfunction - use caution with renal impairment - can cause dizziness, drowsiness, lethargy, hypotension, physical dependence, tolerance - instruct patient to take as directed - caution to avoid alcohol use - Romazicon is the reversal agent

Answer 57

Digoxin (Lanoxin) class: antiarrhythmic, inotropics Indication: CHF, A-fib, A-flutter Action: Positive inotropic effect (increases force of myocardial contraction), prolongs refractory period, ↓ conduction through SA and AV nodes. Essentially digoxin is given to increase cardiac output and slow the rate. Nursing Considerations: - Excreted by kidneys - Assess patient for hypersensitivity - Contraindicated with uncontrolled ventricular arryhtmias - Hypokalemia increase risk for toxcicity - Hypercalcemia ↑ risk for toxicity - Use caution with diuretic use as they may cause electrolyte abnormalities that can lead to toxicity - Assess patient for cardiac arrythmias including bradycardia - Signs of toxicity include vision changes (blurred vision, yellow, green vision disturbances) - Monitor pulse rate for 1 full minute prior to dosing patient (hold for pulse <60)

Answer 58

Digoxin (Lanoxin) class: antiarrhythmic, inotropics Indication: CHF, A-fib, A-flutter Action: Positive inotropic effect (increases force of myocardial contraction), prolongs refractory period, ↓ conduction through SA and AV nodes. Essentially digoxin is given to increase cardiac output and slow the rate. Nursing Considerations: - Excreted by kidneys - Assess patient for hypersensitivity - Contraindicated with uncontrolled ventricular arryhtmias - Hypokalemia increase risk for toxcicity - Hypercalcemia ↑ risk for toxicity - Use caution with diuretic use as they may cause electrolyte abnormalities that can lead to toxicity - Assess patient for cardiac arrythmias including bradycardia - Signs of toxicity include vision changes (blurred vision, yellow, green vision disturbances) - Monitor pulse rate for 1 full minute prior to dosing patient (hold for pulse <60)

Answer 59

Diltiazem (Cardizem) class: Ca Channel Blocker (Bezothiazepine), antianginals, antiarrhythmics, antihypertensive Indication: hypertension, angina, SVT, a-fib, aflutter Action: inhibits calcium transport resulting in inhibition of excitation and contraction, leads to depression of AV and SA node leading to decreased HR, leads to vasodilatation and decreased blood pressure. Nursing Considerations: - contraindicated in 2nd and 3rd AV block - may cause arrhythmias, CHF, bradycardia, peripheral edema, gingival hyperplasia - increases digoxin levels - don't drink grapefruit juice - assess for signs of CHF - monitor EKG continuously - tell patient to change positions slowly - monitor serum potassium - instruct pt on how to take blood pressure

Answer 60

Diltiazem (Cardizem) class: Ca Channel Blocker (Bezothiazepine), antianginals, antiarrhythmics, antihypertensive Indication: hypertension, angina, SVT, a-fib, aflutter Action: inhibits calcium transport resulting in inhibition of excitation and contraction, leads to depression of AV and SA node leading to decreased HR, leads to vasodilatation and decreased blood pressure. Nursing Considerations: - contraindicated in 2nd and 3rd AV block - may cause arrhythmias, CHF, bradycardia, peripheral edema, gingival hyperplasia - increases digoxin levels - don't drink grapefruit juice - assess for signs of CHF - monitor EKG continuously - tell patient to change positions slowly - monitor serum potassium - instruct pt on how to take blood pressure

Answer 61

Diphenhydramine (Benadryl) class: antihistamine, antitussive Indication: allergy, anaphylaxis, sedation, motion sickness, antitussive Action: antagonizes effects of histamine, CNS depression Nursing Considerations: -may cause drowsiness, anorexia, dry mouth, nausea, chest tightness, thick secretions, hypotension, blurred vision, headache - anticholinergic effects - assess purpose of medication prior to giving it - assess allergies, sleep patterns, cough and lung sounds - patient should avoid other over-the-counter cough and cold remedies

Answer 62

Diphenhydramine (Benadryl) class: antihistamine, antitussive Indication: allergy, anaphylaxis, sedation, motion sickness, antitussive Action: antagonizes effects of histamine, CNS depression Nursing Considerations: -may cause drowsiness, anorexia, dry mouth, nausea, chest tightness, thick secretions, hypotension, blurred vision, headache - anticholinergic effects - assess purpose of medication prior to giving it - assess allergies, sleep patterns, cough and lung sounds - patient should avoid other over-the-counter cough and cold remedies

Answer 63

Diphenoxylate / Atropine (Lomotil) class: anticholinergic, antidiarrheal Indication: Treatment for diarrhea Action: Inhibits GI motility via anticholinergic effects Nursing Considerations: - Contraindicated with angle-closure glaucoma, dehydration - Structurally related to opioids so use caution with patients that have allergies to opioids - Side effects: constipation, tachycardia, dizziness, ileus - Monitor liver function as medication is excreted by the liver - Insure that client is taking medication as prescribed and not double dosing

Answer 64

Diphenoxylate / Atropine (Lomotil) class: anticholinergic, antidiarrheal Indication: Treatment for diarrhea Action: Inhibits GI motility via anticholinergic effects Nursing Considerations: - Contraindicated with angle-closure glaucoma, dehydration - Structurally related to opioids so use caution with patients that have allergies to opioids - Side effects: constipation, tachycardia, dizziness, ileus - Monitor liver function as medication is excreted by the liver - Insure that client is taking medication as prescribed and not double dosing

Answer 65

Diphenoxylate / Atropine (Lomotil) class: anticholinergic, antidiarrheal Indication: Treatment for diarrhea Action: Inhibits GI motility via anticholinergic effects Nursing Considerations: - Contraindicated with angle-closure glaucoma, dehydration - Structurally related to opioids so use caution with patients that have allergies to opioids - Side effects: constipation, tachycardia, dizziness, ileus - Monitor liver function as medication is excreted by the liver - Insure that client is taking medication as prescribed and not double dosing

Answer 66

Divalproex (Depakote) class: Anticonvulsant, vascular headache suppressants Indication: seizures, manic episodes, prevention of headache Action: increases the level of GABA in CNS Nursing Considerations: - may cause suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity, pancreatitis - increases risk for bleeding with Warfarin - use caution with MAOIs - monitor liver function tests

Answer 67

Divalproex (Depakote) class: Anticonvulsant, vascular headache suppressants Indication: seizures, manic episodes, prevention of headache Action: increases the level of GABA in CNS Nursing Considerations: - may cause suicidal thoughts, agitation, dizziness, insomnia, hepatotoxicity, pancreatitis - increases risk for bleeding with Warfarin - use caution with MAOIs - monitor liver function tests

Answer 68

Dobutamine (Dobutrex) class: beta-adrenergic agonist, inotropic Indication: short term management of heart failure Action: Dobutamine has a positive inotropic effect (increases cardiac output) with very little effect on heart rate. Stimulates Beta1 receptors in the heart. Nursing Considerations: - Monitor hemodynamics: hypertension, ↑HR, PVCs - Skin reactions may occur with hypersensitivity - Beta blockers may negate therapeutic effects of dobutamine - Monitor cardiac output - Monitor peripheral pulses before, during, and after therapy - DO NOT confuse dobutamine with dopamine

Answer 69

Dobutamine (Dobutrex) class: beta-adrenergic agonist, inotropic Indication: short term management of heart failure Action: Dobutamine has a positive inotropic effect (increases cardiac output) with very little effect on heart rate. Stimulates Beta1 receptors in the heart. Nursing Considerations: - Monitor hemodynamics: hypertension, ↑HR, PVCs - Skin reactions may occur with hypersensitivity - Beta blockers may negate therapeutic effects of dobutamine - Monitor cardiac output - Monitor peripheral pulses before, during, and after therapy - DO NOT confuse dobutamine with dopamine

Answer 70

Dopamine (Intropin) class: inotropic, vasopressor, adrenergic Indication: used to improve blood pressure, cardiac output, and urine output Action: -Smaller doses result in renal vasodilation -Doses 2-10mcg/kg/min result in cardiac stimulation by acting on beta1 receptors -Doses >10mcg/kg/min stimulate alpha receptors leading to vasoconstriction (↑SVR) Nursing Considerations: -Monitor hemodynamics closely: BP, HR, EKG, CVP, and PAOP if available - Obtain parameters for hemodynamic values - Titrate to obtain appropriate BP (more potent vasoconstrictors may be required) - Irritation may occur at IV site - Beta blockers may counteract therapeutic effects

Answer 71

Dopamine (Intropin) class: inotropic, vasopressor, adrenergic Indication: used to improve blood pressure, cardiac output, and urine output Action: -Smaller doses result in renal vasodilation -Doses 2-10mcg/kg/min result in cardiac stimulation by acting on beta1 receptors -Doses >10mcg/kg/min stimulate alpha receptors leading to vasoconstriction (↑SVR) Nursing Considerations: -Monitor hemodynamics closely: BP, HR, EKG, CVP, and PAOP if available - Obtain parameters for hemodynamic values - Titrate to obtain appropriate BP (more potent vasoconstrictors may be required) - Irritation may occur at IV site - Beta blockers may counteract therapeutic effects

Answer 72

Enalapril (Vasotec) class: ACE Inhibitor, antihypertensives Indication: hypertension, management of CHF Action: block conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation Nursing Considerations: - can cause neutropenia - check WBCs regularly - use cautiously with potassium supplements and potassium sparing diuretics. - use cautiously with diuretic therapy - administer 1 hour before meals - monitor blood pressure often - monitor weight and fluid status - monitor renal profile - monitor CBC frequently - dry cough

Answer 73

Enalapril (Vasotec) class: ACE Inhibitor, antihypertensives Indication: hypertension, management of CHF Action: block conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation Nursing Considerations: - can cause neutropenia - check WBCs regularly - use cautiously with potassium supplements and potassium sparing diuretics. - use cautiously with diuretic therapy - administer 1 hour before meals - monitor blood pressure often - monitor weight and fluid status - monitor renal profile - monitor CBC frequently - dry cough

Answer 74

Enoxaparin (Lovenox) class: antithrombotic Indication: prevention of VTE, DVT, and PE Action: prevents thrombus formation by potentiating the inhibitory effect of antithrombin on factor Xa and thrombin Nursing Considerations: - contraindicated in pork hypersensitivity - monitor for signs of bleeding - administer in subcutaneous tissue - DO NOT eject air bubble prior to injection - DO NOT aspirate or massage site

Answer 75

Enoxaparin (Lovenox) class: antithrombotic Indication: prevention of VTE, DVT, and PE Action: prevents thrombus formation by potentiating the inhibitory effect of antithrombin on factor Xa and thrombin Nursing Considerations: - contraindicated in pork hypersensitivity - monitor for signs of bleeding - administer in subcutaneous tissue - DO NOT eject air bubble prior to injection - DO NOT aspirate or massage site

Answer 76

Epinephrine (Adrenalin, EpiPen) class: adrenergic agonist, antiasthmatic, bronchodilator, vasopressor Indication: Asthma and COPD exacerbations, allergic reactions, cardiac arrest, anesthesia adjunct Action: Affects both beta1 and beta2 also has alpha agonist properties. Results in bronchodilation, increases in HR and BP Nursing Considerations: - Side effects include: angina, tachycardia, hypertension, restlessness, nervousness, hyperglycemia - Use with MAOI may lead to hypertensive crisis - Patients should not use stimulants (caffeine, guarana, etc) - Excessive use may cause bronchospasm - Assess lung sounds, pulse, BP, and other hemodynamic parameters - Monitor for chest pain - Instruct patient to use as directed - Patient should insure adequate fluid intake to liquefy secretions - Mouth should be rinsed after inhalation - Beta blocker may negate effects - May increase blood glucose levels

Answer 77

Epinephrine (Adrenalin, EpiPen) class: adrenergic agonist, antiasthmatic, bronchodilator, vasopressor Indication: Asthma and COPD exacerbations, allergic reactions, cardiac arrest, anesthesia adjunct Action: Affects both beta1 and beta2 also has alpha agonist properties. Results in bronchodilation, increases in HR and BP Nursing Considerations: - Side effects include: angina, tachycardia, hypertension, restlessness, nervousness, hyperglycemia - Use with MAOI may lead to hypertensive crisis - Patients should not use stimulants (caffeine, guarana, etc) - Excessive use may cause bronchospasm - Assess lung sounds, pulse, BP, and other hemodynamic parameters - Monitor for chest pain - Instruct patient to use as directed - Patient should insure adequate fluid intake to liquefy secretions - Mouth should be rinsed after inhalation - Beta blocker may negate effects - May increase blood glucose levels

Answer 78

Epoetin (Epogen) class: antianemics, hormones Indication anemia Action: stimulates erythropoesis Nursing Considerations: - contraindicated in albumin hypersensitivity - may cause seizures, CHF, MI, CVA, HTN - monitor blood pressure during therapy - monitor for signs of anemia - assess dialysis shunts - monitor bleeding times - initiate seizure precautions - do not shake vial

Answer 79

Epoetin (Epogen) class: antianemics, hormones Indication anemia Action: stimulates erythropoesis Nursing Considerations: - contraindicated in albumin hypersensitivity - may cause seizures, CHF, MI, CVA, HTN - monitor blood pressure during therapy - monitor for signs of anemia - assess dialysis shunts - monitor bleeding times - initiate seizure precautions - do not shake vial

Answer 80

Erythromycin (E-Mycin) class: macrolide, anti-infective Indication useful in place of penicillin when patient cannot take penicillin, upper and lower respiratory tract infections, otitis media, skin infections, pertussis, syphilis, rheumatic fever Action: suppresses bacterial protein synthesis, bacteriostatic Nursing Considerations: - Causes QT prolongation, ventricular arrhythmias - diarrhea - asses infection - monitor liver function tests - instruct patient to finish medication dosage even if they are feeling better - medication should not be shared

Answer 81

Escitalopram (Lexapro) class: SSRI, antidepressant Indication major depressive disorder, anxiety disorder, PCD, PTSD, social phobia Action: selectively inhibits reuptake of serotonin Nursing Considerations: -contraindicated with MAOI - may cause suicidal thoughts, insomnia, drowsiness, diarrhea, nausea, serotonin syndrome - may cause QT prolongation with certain medications - assess for sexual dysfunction - may take 4-6 weeks for full affect to take place

Answer 82

Escitalopram (Lexapro) class: SSRI, antidepressant Indication major depressive disorder, anxiety disorder, PCD, PTSD, social phobia Action: selectively inhibits reuptake of serotonin Nursing Considerations: -contraindicated with MAOI - may cause suicidal thoughts, insomnia, drowsiness, diarrhea, nausea, serotonin syndrome - may cause QT prolongation with certain medications - assess for sexual dysfunction - may take 4-6 weeks for full affect to take place

Answer 83

Famotidine (Pepcid) class: Histamine H2 antagonist Indication short term treatment of active ulcer, GERD, treatment of heartburn, indigestion, management of Zollinger Ellison syndrome, prevention of GI bleeding in critically ill patients, management of symptoms associated with overuse of NSAIDs Action: blocks action of histamine located in gastric parietal cells, inhibits gastric acid secretion Nursing Considerations: - may cause arrythmias, agranulocytosis, aplastic anemias - assess for abdominal pain and occult blood - monitor CBC - instruct pt to increase fluid and fiber intake to prevent constipation

Answer 84

Famotidine (Pepcid) class: Histamine H2 antagonist Indication short term treatment of active ulcer, GERD, treatment of heartburn, indigestion, management of Zollinger Ellison syndrome, prevention of GI bleeding in critically ill patients, management of symptoms associated with overuse of NSAIDs Action: blocks action of histamine located in gastric parietal cells, inhibits gastric acid secretion Nursing Considerations: - may cause arrythmias, agranulocytosis, aplastic anemias - assess for abdominal pain and occult blood - monitor CBC - instruct pt to increase fluid and fiber intake to prevent constipation

Answer 85

Fentanyl (Sublimaze) class: Opioid Analgesic Indication supplement to general anesthesia, continuous IV infusion for purpose of analgesia Action: binds to opiate receptors in CNS altering perception of pain, producing CNS depression Nursing Considerations: - use caution with increased ICP, head trauma, adrenal insufficiency - avoid use with MAOIs - may cause apnea, laryngospasm, decreased respirations, bradycardia, hypotension - do not consume grapefruit while taking this medication - monitor hemodynamics during administration - assess patient pain scale frequently

Answer 86

Fentanyl (Sublimaze) class: Opioid Analgesic Indication supplement to general anesthesia, continuous IV infusion for purpose of analgesia Action: binds to opiate receptors in CNS altering perception of pain, producing CNS depression Nursing Considerations: - use caution with increased ICP, head trauma, adrenal insufficiency - avoid use with MAOIs - may cause apnea, laryngospasm, decreased respirations, bradycardia, hypotension - do not consume grapefruit while taking this medication - monitor hemodynamics during administration - assess patient pain scale frequently

Answer 87

Ferrous sulfate (Feosol) class: iron supplements Indication prevention and treatment of iron-deficiency anemia Action: Iron is essential for hemoglobin, myoglobin and enzymes, it is transported to organs where it becomes part of iron stores Nursing Considerations: - may cause seizures, hypotension, constipation, epigastric pain, diarrhea, skin staining, anaphylaxis - assess nutritional status, bowel function - monitor hemoglobin, hematocrit, iron levels - may cause elevated liver enzymes - take on an empty stomach to increase absorption/vitamin c helps with absorption - use z-track for IM injections

Answer 88

Ferrous sulfate (Feosol) class: iron supplements Indication prevention and treatment of iron-deficiency anemia Action: Iron is essential for hemoglobin, myoglobin and enzymes, it is transported to organs where it becomes part of iron stores Nursing Considerations: - may cause seizures, hypotension, constipation, epigastric pain, diarrhea, skin staining, anaphylaxis - assess nutritional status, bowel function - monitor hemoglobin, hematocrit, iron levels - may cause elevated liver enzymes - take on an empty stomach to increase absorption/vitamin c helps with absorption - use z-track for IM injections

Answer 89

Fluoxetine (Prozac) class: SSRI, antidepressant Indication depressive disorder, OCD, bulimia, panic disorder, bipolar, anorexia, ADHD, DM neuropathy, obesity Action: inhibits reuptake of serotonin Nursing Considerations: - do not use while taking MAOIs - may cause suicidal thoughts, drowsiness, anxiety, sexual dysfunction, insomnia, palpitations - monitor closely for serotonin syndrome - concurrent use with certain medications may lead to QT prolongation - monitor mood changes and assess for suicidal ideation - monitor nutrition status - may cause elevated liver enzymes - instruct pt to maintain good oral hygiene

Answer 90

Fluoxetine (Prozac) class: SSRI, antidepressant Indication depressive disorder, OCD, bulimia, panic disorder, bipolar, anorexia, ADHD, DM neuropathy, obesity Action: inhibits reuptake of serotonin Nursing Considerations: - do not use while taking MAOIs - may cause suicidal thoughts, drowsiness, anxiety, sexual dysfunction, insomnia, palpitations - monitor closely for serotonin syndrome - concurrent use with certain medications may lead to QT prolongation - monitor mood changes and assess for suicidal ideation - monitor nutrition status - may cause elevated liver enzymes - instruct pt to maintain good oral hygiene

Answer 91

Fluticasone (Flovent) class: corticosteroids, anti-asthmatics, anti-inflammatory (steroid) Indication prophylactic asthma treatment Action: locally acting anti-inflammatory Nursing Considerations: - use cautiously with untreated infections and suppressed immune function - may cause headache, insomnia, bronchospasm, nasal congestion, adrenal suppression - monitor patient's respiratory status - may lead to decreased bone density - instruct patients using corticosteroids and bronchodilators that they need to use bronchodilators first. - instruct patient to stop smoking

Answer 92

Fluticasone (Flovent) class: corticosteroids, anti-asthmatics, anti-inflammatory (steroid) Indication prophylactic asthma treatment Action: locally acting anti-inflammatory Nursing Considerations: - use cautiously with untreated infections and suppressed immune function - may cause headache, insomnia, bronchospasm, nasal congestion, adrenal suppression - monitor patient's respiratory status - may lead to decreased bone density - instruct patients using corticosteroids and bronchodilators that they need to use bronchodilators first. - instruct patient to stop smoking

Answer 93

Furosemide (Lasix) class: loop diuretics Indication edema, hypertension Action: prevents reabsorption of sodium and chloride in the kidneys, increase excretion of water, sodium, chloride, magnesium, potassium. Nursing Considerations: - use caution with liver disease - may cause hypotension, dry mouth, excessive urination, dehydration, electrolyte abnormalities, metabolic alkalosis - hypokalemia may lead to increase risk of digoxin toxicity - monitor renal panel - use caution with other anithypertensives - causes arthritic symptoms/do not administer with aminoglycosides due to ototoxicity

Answer 94

Furosemide (Lasix) class: loop diuretics Indication edema, hypertension Action: prevents reabsorption of sodium and chloride in the kidneys, increase excretion of water, sodium, chloride, magnesium, potassium. Nursing Considerations: - use caution with liver disease - may cause hypotension, dry mouth, excessive urination, dehydration, electrolyte abnormalities, metabolic alkalosis - hypokalemia may lead to increase risk of digoxin toxicity - monitor renal panel - use caution with other anithypertensives - causes arthritic symptoms/do not administer with aminoglycosides due to ototoxicity

Answer 95

Gabapentine (Neurontin) class: analgesic adjuncts, therapeutic, anticonvulsants, mood stabilizers Indication seizures, peripheral neuropathy, neuropathic pain, prevention of migraines Action: exact method of action unknown Nursing Considerations: - may cause suicidal thoughts, confusion, depression, drowsiness, ataxia, facial edema, hypertension - monitor pt closely for changes in behavior and depression - assess seizure activity - assess pain level - patient should take medications exactly as prescribed

Answer 96

Gabapentine (Neurontin) class: analgesic adjuncts, therapeutic, anticonvulsants, mood stabilizers Indication seizures, peripheral neuropathy, neuropathic pain, prevention of migraines Action: exact method of action unknown Nursing Considerations: - may cause suicidal thoughts, confusion, depression, drowsiness, ataxia, facial edema, hypertension - monitor pt closely for changes in behavior and depression - assess seizure activity - assess pain level - patient should take medications exactly as prescribed

Answer 97

Gentamicin (Cidomycin) class: Aminoglycoside, anti-infectants Indication Treatment of gram negative infections when penicillin is ineffective Action: Inhibits bacterial protein synthesis Nursing Considerations: - causes tinnitus-hearing loss/do not administer with penicillin - use caution in renal impairment - assess for infection - obtain cultures prior to therapy - monitor liver function tests - monitor blood levels of drug

Answer 98

Gentamicin (Cidomycin) class: Aminoglycoside, anti-infectants Indication Treatment of gram negative infections when penicillin is ineffective Action: Inhibits bacterial protein synthesis Nursing Considerations: - causes tinnitus-hearing loss/do not administer with penicillin - use caution in renal impairment - assess for infection - obtain cultures prior to therapy - monitor liver function tests - monitor blood levels of drug

Answer 99

Glipizide (Glucotrol) class: sulfonylureas, anti-diabetic Indication type 2 diabetes mellitus Action: stimulates release and sensitivity to insulin to lower blood glucose Nursing Considerations: - may cause aplastic anemias, hypoglycemia, photosensitivity, dizziness, drowsiness, headache, diarrhea - monitor CBC, assess for allergy to sulfonamides - beta blockers may create signs of hypoglycemia - instruct patient on how to check blood sugars and - instruct patient on importance of carrying source of sugar in case of hypoglycemia

Answer 100

Glipizide (Glucotrol) class: sulfonylureas, anti-diabetic Indication type 2 diabetes mellitus Action: stimulates release and sensitivity to insulin to lower blood glucose Nursing Considerations: - may cause aplastic anemias, hypoglycemia, photosensitivity, dizziness, drowsiness, headache, diarrhea - monitor CBC, assess for allergy to sulfonamides - beta blockers may create signs of hypoglycemia - instruct patient on how to check blood sugars and - instruct patient on importance of carrying source of sugar in case of hypoglycemia

Answer 101

Glucagon (GlucaGen) class: pancreatics Indication Severe hypoglycemia, antidote for Beta Blockers and calcium channel blockers Action: Stimulates production of glucose, relaxes Gi tract, Nursing Considerations: - may cause anaphylaxis - may cause hypotension - assess for signs of hypoglycemia, neuro status - monitor serum glucose levels - teach patient signs of hypoglycemia

Answer 102

Glucagon (GlucaGen) class: pancreatics Indication Severe hypoglycemia, antidote for Beta Blockers and calcium channel blockers Action: Stimulates production of glucose, relaxes Gi tract, Nursing Considerations: - may cause anaphylaxis - may cause hypotension - assess for signs of hypoglycemia, neuro status - monitor serum glucose levels - teach patient signs of hypoglycemia

Answer 103

Guaifenesin (Robitussin) class: allergy, cold and cough remedies, expectorant Indication Cough suppression, expectorant Action: Decreases viscosity of and mobilizes secretions Nursing Considerations: - patient should avoid over the counter cold medications - assess lung sounds - maintain adequate fluid intake

Answer 104

Guaifenesin (Robitussin) class: allergy, cold and cough remedies, expectorant Indication Cough suppression, expectorant Action: Decreases viscosity of and mobilizes secretions Nursing Considerations: - patient should avoid over the counter cold medications - assess lung sounds - maintain adequate fluid intake

Answer 105

Haloperidol (Haldol) class: Atypical Antipsychotic Indication Schizophrenia, mania, aggressive and agitated patient Action: Alters the effect of dopamine Nursing Considerations: - *extrapyramidal symptoms* - use caution in QT prolongation - may cause seizures, constipation, dry mouth, agranulosytosis - assess for hallucinations - monitor hemodynamics - monitor for neuroleptic malignant syndrome - monitor CBC with differential

Answer 106

Haloperidol (Haldol) class: Atypical Antipsychotic Indication Schizophrenia, mania, aggressive and agitated patient Action: Alters the effect of dopamine Nursing Considerations: - *extrapyramidal symptoms* - use caution in QT prolongation - may cause seizures, constipation, dry mouth, agranulosytosis - assess for hallucinations - monitor hemodynamics - monitor for neuroleptic malignant syndrome - monitor CBC with differential

Answer 107

Heparin (Hep-Lock) class: antithrombotic Indication Venous thromboembolism prophylaxis and treatment, low dose used to ensure patency of IV catheters Action: increases the inhibitory effect of antithrombin on factor Xa Nursing Considerations: - monitor for signs of bleeding - monitor platelet count - may cause hyperkalemia - have patient report any signs of bleeding

Answer 108

Heparin (Hep-Lock) class: antithrombotic Indication Venous thromboembolism prophylaxis and treatment, low dose used to ensure patency of IV catheters Action: increases the inhibitory effect of antithrombin on factor Xa Nursing Considerations: - monitor for signs of bleeding - monitor platelet count - may cause hyperkalemia - have patient report any signs of bleeding

Answer 109

Hydralazine (Apresoline) class: vasodilator, anti-hypertensive Indication hypertension Action: arterial vasodilator Nursing Considerations: - may cause tachycardia, sodium retention, arrhythmias, angina - use caution with MAOIs - monitor blood pressure - instruct patient on how to take blood pressure

Answer 110

Hydralazine (Apresoline) class: vasodilator, anti-hypertensive Indication hypertension Action: arterial vasodilator Nursing Considerations: - may cause tachycardia, sodium retention, arrhythmias, angina - use caution with MAOIs - monitor blood pressure - instruct patient on how to take blood pressure

Answer 111

Hydrochlorothiazide (HydroDiuril) class: antihypertensives, diuretics Indication Hypertension, CHF, renal dysfunction, cirrhosis, glucocorticoid therapy Action: Increases sodium and water excretion produces arterial dilation Nursing Considerations: -May cause dizziness, hypokalemia, hyponatremia, hypophosphatemia, hypomagnesemia, dehydration - Hypokalemia can increase risk for digoxin toxicity - Monitor blood pressure and intake and output - Monitor electrolyte levels - Patient should take medication at the same time each day even if feeling better - Instruct patient on how to take blood pressure

Answer 112

Hydrochlorothiazide (HydroDiuril) class: antihypertensives, diuretics Indication Hypertension, CHF, renal dysfunction, cirrhosis, glucocorticoid therapy Action: Increases sodium and water excretion produces arterial dilation Nursing Considerations: -May cause dizziness, hypokalemia, hyponatremia, hypophosphatemia, hypomagnesemia, dehydration - Hypokalemia can increase risk for digoxin toxicity - Monitor blood pressure and intake and output - Monitor electrolyte levels - Patient should take medication at the same time each day even if feeling better - Instruct patient on how to take blood pressure

Answer 113

Hydrocodone / Acetaminophen (Norco) class: opioid agonists, nonopioid analgesic combinations Indication management of moderate to severe pain Action: alters the perception and reaction to pain by binding to opiate receptors in the CNS, also suppresses the cough reflex Nursing Considerations: -use caution with concurrent use of MAOI - avoid use within 14 days of each other - hypotension - monitor hemodynamics and respirations after administering - may increase ICP use caution with head trauma - Narcan is the antidote for overdose - do not exceed 4g of acetaminophen per day

Answer 114

Hydrocodone / Acetaminophen (Norco) class: opioid agonists, nonopioid analgesic combinations Indication management of moderate to severe pain Action: alters the perception and reaction to pain by binding to opiate receptors in the CNS, also suppresses the cough reflex Nursing Considerations: -use caution with concurrent use of MAOI - avoid use within 14 days of each other - hypotension - monitor hemodynamics and respirations after administering - may increase ICP use caution with head trauma - Narcan is the antidote for overdose - do not exceed 4g of acetaminophen per day

Answer 115

Hydrocodone / Acetaminophen (Norco) class: opioid agonists, nonopioid analgesic combinations Indication management of moderate to severe pain Action: alters the perception and reaction to pain by binding to opiate receptors in the CNS, also suppresses the cough reflex Nursing Considerations: -use caution with concurrent use of MAOI - avoid use within 14 days of each other - hypotension - monitor hemodynamics and respirations after administering - may increase ICP use caution with head trauma - Narcan is the antidote for overdose - do not exceed 4g of acetaminophen per day

Answer 116

Hydromorphone (Dilaudid) class: opioid agonist Indication moderate to severe pain Action: alters the perception and reaction to pain by binding to opiate receptors in the CNS, also suppresses the cough reflex Nursing Considerations: -Assess BP, respirations, and pulse before and during administration - medication causes general CNS depression - Narcan is the antidote for overdose - use caution with concurrent use of MAOI - avoid use within 14 days of each other - may be used as an antitussive - advised to dilute with NS prior to administration and to administer slowly to decrease CNS depression

Answer 117

Hydromorphone (Dilaudid) class: opioid agonist Indication moderate to severe pain Action: alters the perception and reaction to pain by binding to opiate receptors in the CNS, also suppresses the cough reflex Nursing Considerations: -Assess BP, respirations, and pulse before and during administration - medication causes general CNS depression - Narcan is the antidote for overdose - use caution with concurrent use of MAOI - avoid use within 14 days of each other - may be used as an antitussive - advised to dilute with NS prior to administration and to administer slowly to decrease CNS depression

Answer 118

Ibuprofen (Advil / Motrin) class: antipyretics, antirheumatics, nonopioid analgesics, nonsteroidal anti-inflammatory agents (NSAIDS) Indication Mild to moderate pain, inflammatory states Action: Decreases pain and inflammation by inhibiting prostaglandins Nursing Considerations: -may cause GI bleeding, hepatitis, Stevens-Johnson Syndrome - may cause anaphylaxis - monitor for headache, nausea, vomiting, constipation - therapy should be discontinued after first sign of rash - monitor renal and liver labs - patient should avoid using alcohol

Answer 119

Ibuprofen (Advil / Motrin) class: antipyretics, antirheumatics, nonopioid analgesics, nonsteroidal anti-inflammatory agents (NSAIDS) Indication Mild to moderate pain, inflammatory states Action: Decreases pain and inflammation by inhibiting prostaglandins Nursing Considerations: -may cause GI bleeding, hepatitis, Stevens-Johnson Syndrome - may cause anaphylaxis - monitor for headache, nausea, vomiting, constipation - therapy should be discontinued after first sign of rash - monitor renal and liver labs - patient should avoid using alcohol

Answer 120

Ibuprofen (Advil / Motrin) class: antipyretics, antirheumatics, nonopioid analgesics, nonsteroidal anti-inflammatory agents (NSAIDS) Indication Mild to moderate pain, inflammatory states Action: Decreases pain and inflammation by inhibiting prostaglandins Nursing Considerations: -may cause GI bleeding, hepatitis, Stevens-Johnson Syndrome - may cause anaphylaxis - monitor for headache, nausea, vomiting, constipation - therapy should be discontinued after first sign of rash - monitor renal and liver labs - patient should avoid using alcohol

Answer 121

Indomethacin (Indocin) class: antirheumatics, ductus arteriosus patency adjuncts (IV only), nonsteroidal anti-inflammatory agents Indication Inflammatory disorders when patients do not respond to other medications Action: Decreases pain and inflammation by inhibiting prostaglandin synthesis Nursing Considerations: -Monitor for hepatitis and GI bleeding - Monitor for dizziness, drowsiness, and headache - Assess for anaphylactic reaction - Aspirin may decrease effectiveness - Monitor renal labs - Shake suspension before administration - Patient should wear sunscreen and protective clothing to protect against photosensitivity

Answer 122

Indomethacin (Indocin) class: antirheumatics, ductus arteriosus patency adjuncts (IV only), nonsteroidal anti-inflammatory agents Indication Inflammatory disorders when patients do not respond to other medications Action: Decreases pain and inflammation by inhibiting prostaglandin synthesis Nursing Considerations: -Monitor for hepatitis and GI bleeding - Monitor for dizziness, drowsiness, and headache - Assess for anaphylactic reaction - Aspirin may decrease effectiveness - Monitor renal labs - Shake suspension before administration - Patient should wear sunscreen and protective clothing to protect against photosensitivity

Answer 123

Regular Insulin (Humulin R / Novolin R) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (short acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 124

Regular Insulin (Humulin R / Novolin R) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (short acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 125

NPH insulin (Humulin N, Novolin N) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (intermediate acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 126

Regular Insulin (Humulin R / Novolin R) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (short acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 127

NPH insulin (Humulin N / Novolin N) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (intermediate acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 128

NPH insulin (Humulin N / Novolin N) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (intermediate acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 129

Insulin Detemir / Insulin Glargine (Levemir, Lantus) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (long acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 130

Insulin Detemir / Insulin Glargine (Levemir, Lantus) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (long acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 131

Insulin Detemir / Insulin Glargine (Levemir, Lantus) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (long acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 132

Insulin Detemir / Insulin Glargine (Levemir, Lantus) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (long acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 133

Insulin Aspart (Novolog) Insulin Lispro (Humalog) Insulin Glulisine (Apidra) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (rapid acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 134

Insulin Aspart (Novolog) Insulin Lispro (Humalog) Insulin Glulisine (Apidra) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (rapid acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 135

Insulin Aspart (Novolog) Insulin Lispro (Humalog) Insulin Glulisine (Apidra) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (rapid acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 136

Insulin Aspart (Novolog) Insulin Lispro (Humalog) Insulin Glulisine (Apidra) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (rapid acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 137

Insulin Aspart (Novolog) Insulin Lispro (Humalog) Insulin Glulisine (Apidra) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (rapid acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 138

Insulin Aspart (Novolog) Insulin Lispro (Humalog) Insulin Glulisine (Apidra) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (rapid acting) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 139

Lispro mixture, Aspart mixture, NPH/regular (Humalog Mix, NovoLog Mix, Humulin 70/30, Novolin 70/30) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (insulin mixtures) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 140

Lispro mixture, Aspart mixture, NPH/regular (Humalog Mix, NovoLog Mix, Humulin 70/30, Novolin 70/30) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (insulin mixtures) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 141

Lispro mixture, Aspart mixture, NPH/regular (Humalog Mix, NovoLog Mix, Humulin 70/30, Novolin 70/30) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (insulin mixtures) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 142

Lispro mixture, Aspart mixture, NPH/regular (Humalog Mix, NovoLog Mix, Humulin 70/30, Novolin 70/30) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (insulin mixtures) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 143

Lispro mixture, Aspart mixture, NPH/regular (Humalog Mix, NovoLog Mix, Humulin 70/30, Novolin 70/30) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (insulin mixtures) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 144

Lispro mixture, Aspart mixture, NPH/regular (Humalog Mix, NovoLog Mix, Humulin 70/30, Novolin 70/30) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (insulin mixtures) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 145

Lispro mixture, Aspart mixture, NPH/regular (Humalog Mix, NovoLog Mix, Humulin 70/30, Novolin 70/30) class: antidiabetics, hormones Indication hyperglycemia with diabetes type 1 and 2, diabetic ketoacidosis Action: stimulates uptake of glucose into muscle and fat cells, inhibits production of glucose in the liver, prevents breakdown of fat and protein (insulin mixtures) Nursing Considerations: -assess for symptoms of hypoglycemia or hyperglycemia - monitor body weight over time - may cause decreased inorganic phosphates, potassium, and magnesium - monitor blood sugars every 6 hours, monitor A1C every 3-6 months

Answer 146

Radioactive iodine class: Antithyroid Agent Indication: thyroidectomy pretreatment, thyrotoxic crisis, radiation exposure Action: inhibits the release of thyroid hormones Nursing Considerations: -may cause GI bleeding, diarrhea, hypothyroidism, goiter - monitor for hypersensitivity

Answer 147

Isoniazide (INH) class: Antitubercular Indication tuberculosis Action: Inhibits synthesis of mycobacterial cell wall Nursing Considerations: -can cause jaundice - may cause peripheral neuropathy, seizures, hepatitis - patient should avoid high amounts of tyramine (pickled meats, aged/smoked meats, alcohol, exotic/aged cheese) - monitor liver function tests - complete full course of therapy (6-12 months) - often used in combination with Rifampin

Answer 148

Ketorolac (Toradol) class: nonsteroidal anti-inflammatory agents, nonopioid analgesics Indication pain Action: Pain relief due to prostaglandin inhibition Nursing Considerations: -may cause GI bleeding, Stevens-Johnson Syndrome, anaphylaxis, drowsiness - should not exceed 5 days of therapy - bleeding risk increased with garlic, ginger, and ginkgo - may decrease effectiveness of hypertensive medications and diuretics

Answer 149

Ketorolac (Toradol) class: nonsteroidal anti-inflammatory agents, nonopioid analgesics Indication pain Action: Pain relief due to prostaglandin inhibition Nursing Considerations: -may cause GI bleeding, Stevens-Johnson Syndrome, anaphylaxis, drowsiness - should not exceed 5 days of therapy - bleeding risk increased with garlic, ginger, and ginkgo - may decrease effectiveness of hypertensive medications and diuretics

Answer 150

Lactulose (Kristalose) class: laxative Indication Constipation, portal-systemic encephalopathy Action: Draws water into the stool and softens stool, inhibits ammonia passing into the colon Nursing Considerations: -use caution with DM - may cause cramps, abdominal distention, hyperglycemia - assess mental status, ammonia levels, abdominal distention - patient should average 2-3 bowel movements per day

Answer 151

Lactulose (Kristalose) class: laxative Indication Constipation, portal-systemic encephalopathy Action: Draws water into the stool and softens stool, inhibits ammonia passing into the colon Nursing Considerations: -use caution with DM - may cause cramps, abdominal distention, hyperglycemia - assess mental status, ammonia levels, abdominal distention - patient should average 2-3 bowel movements per day

Answer 152

Lamotrigine (Lamictal) class: anticonvulsant Indication Seizures r/t epilepsy, bipolar Action: Inhibits sodium transport in neurons Nursing Considerations: - May cause suicidal thoughts, dizziness, behavior changes, nausea, vomiting, photosensitivity, rash, Stevens-Johnson Syndrome - Use caution with oral contraceptive use - Assess mental status - Assess for seizures - Do not discontinue use abruptly

Answer 153

Levetiracetam (Keppra) class: anticonvulsants Indication Seizures Action: Decreases severity and incidence of seizures Nursing Considerations: -May cause suicidal thoughts, dizziness, weakness - May alter RBC, WBC, and liver function - May cause somnolence - Should be infused over 15 minutes

Answer 154

Lamotrigine (Lamictal) class: anticonvulsant Indication Seizures r/t epilepsy, bipolar Action: Inhibits sodium transport in neurons Nursing Considerations: - May cause suicidal thoughts, dizziness, behavior changes, nausea, vomiting, photosensitivity, rash, Stevens-Johnson Syndrome - Use caution with oral contraceptive use - Assess mental status - Assess for seizures - Do not discontinue use abruptly

Answer 155

Levetiracetam (Keppra) class: anticonvulsants Indication Seizures Action: Decreases severity and incidence of seizures Nursing Considerations: -May cause suicidal thoughts, dizziness, weakness - May alter RBC, WBC, and liver function - May cause somnolence - Should be infused over 15 minutes

Answer 156

Levofloxacin (Levaquin) class: fluoroquinolone, Anti-infective Indication urinary tract infections, gonorrhea, respiratory tract infections, bronchitis, pneumonia, skin and bone infections Action: Inhibits DNA synthesis in bacteria Nursing Considerations: -contraindicated in allergies - may cause QT prolongation, avoid use with other drugs that can cause QT prolongation - can cause seizures, arrythmias, pseudomembranous colitis, anaphylaxis, Stevens Johnson syndrome - may decreased of phenytoin - monitor renal panel - assess for infection, obtain cultures prior to therapy - monitor liver function tests

Answer 157

Levofloxacin (Levaquin) class: fluoroquinolone, Anti-infective Indication urinary tract infections, gonorrhea, respiratory tract infections, bronchitis, pneumonia, skin and bone infections Action: Inhibits DNA synthesis in bacteria Nursing Considerations: -contraindicated in allergies - may cause QT prolongation, avoid use with other drugs that can cause QT prolongation - can cause seizures, arrythmias, pseudomembranous colitis, anaphylaxis, Stevens Johnson syndrome - may decreased of phenytoin - monitor renal panel - assess for infection, obtain cultures prior to therapy - monitor liver function tests

Answer 158

Levothyroxine (Levothroid) class: hormone Indication thyroid hormone replacement in hypothyroidism Action: replaces thyroid hormone increasing metabolism, promotes gluconeogenesis, stimulates protein synthesis, restores normal hormone balance and suppresses thyroid cancer Nursing Considerations: -assess pulse and monitor for tachyarrythmias and chest pain - monitor TSH levels - overdose is presented as hyperthyroidism - start with low doses and increase as indicated - therapy is lifelong - take directly after breast feeding

Answer 159

Levothyroxine (Levothroid) class: hormone Indication thyroid hormone replacement in hypothyroidism Action: replaces thyroid hormone increasing metabolism, promotes gluconeogenesis, stimulates protein synthesis, restores normal hormone balance and suppresses thyroid cancer Nursing Considerations: -assess pulse and monitor for tachyarrythmias and chest pain - monitor TSH levels - overdose is presented as hyperthyroidism - start with low doses and increase as indicated - therapy is lifelong - take directly after breast feeding

Answer 160

Lithium (Lithizine) class: Mood Stabilizer Indication: mania Action: alters cation transport and neurotransmitter reuptake Nursing Considerations: - do not administer with NSAIDs - monitor drug blood levels frequently - may cause seizures, arrhythmias, fatigue, confusion, nausea, anorexia, hypothyroidism, tremors - Ace Inhibitors may increase serum levels - instruct patient to maintain adequate fluid intake - therapeutic level: 0.5-1.5 mEq/L

Answer 161

Lisinopril (Prinivil) class: ACE Inhibitor, anti-hypertensive Indication hypertension, management of CHF Action: block conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation Nursing Considerations: -Dry cough - 1st dose hypotension - use cautiously with potassium supplements and potassium sparing diuretics. - use cautiously with diuretic therapy - administer 1 hour before meals - monitor blood pressure often - monitor weight and fluid status - monitor renal profile - monitor liver function tests

Answer 162

Lisinopril (Prinivil) class: ACE Inhibitor, anti-hypertensive Indication hypertension, management of CHF Action: block conversion of angiotensin I to angiotensin II, increases renin levels and decreases aldosterone leading to vasodilation Nursing Considerations: -Dry cough - 1st dose hypotension - use cautiously with potassium supplements and potassium sparing diuretics. - use cautiously with diuretic therapy - administer 1 hour before meals - monitor blood pressure often - monitor weight and fluid status - monitor renal profile - monitor liver function tests

Answer 163

Lithium (Lithizine) class: Mood Stabilizer Indication: mania Action: alters cation transport and neurotransmitter reuptake Nursing Considerations: - do not administer with NSAIDs - monitor drug blood levels frequently - may cause seizures, arrhythmias, fatigue, confusion, nausea, anorexia, hypothyroidism, tremors - Ace Inhibitors may increase serum levels - instruct patient to maintain adequate fluid intake - therapeutic level: 0.5-1.5 mEq/L

Answer 164

Loperamide (Imodium) class: antidiarrheal Indication acute diarrhea, decrease drainage post ileostomy Action: inhibits peristalsis, reduces the volume of feces while increasing the bulk and viscosity Nursing Considerations: -may lead to constipation - insure proper use - assess bowel function - assess fluid and electrolyte levels

Answer 165

Loperamide (Imodium) class: antidiarrheal Indication acute diarrhea, decrease drainage post ileostomy Action: inhibits peristalsis, reduces the volume of feces while increasing the bulk and viscosity Nursing Considerations: -may lead to constipation - insure proper use - assess bowel function - assess fluid and electrolyte levels

Answer 166

Lorazepam (Ativan) class: Benzodiazepine Indication: anxiety, sedation, seizures Action: general CNS depression Nursing Considerations: - use caution with COPD and sleep apnea - avoid alcohol use - antidote is Flumazenil (Romazicon) - may cause apnea, cardiac arrest, bradycardia, hypotension - use caution with other CNS depressants - administer slowly and dilute to decrease complications

Answer 167

Lorazepam (Ativan) class: Benzodiazepine Indication: anxiety, sedation, seizures Action: general CNS depression Nursing Considerations: - use caution with COPD and sleep apnea - avoid alcohol use - antidote is Flumazenil (Romazicon) - may cause apnea, cardiac arrest, bradycardia, hypotension - use caution with other CNS depressants - administer slowly and dilute to decrease complications

Answer 168

Losartan (Cozaar) class: angiotensin II receptor antagonist, antihypertensives Indication hypertension, DM neuropathy, CHF Action: inhibits vasoconstrictive properties of angiotensin II Nursing Considerations: -may cause hypotension, tacycardia, angiodema, hyperkalemia - may increase digoxin levels - assess blood pressure and heart rate - assess fluid levels - monitor daily weights with CHF - monitor renal and liver - instruct patient on how to take blood pressure

Answer 169

Losartan (Cozaar) class: angiotensin II receptor antagonist, antihypertensives Indication hypertension, DM neuropathy, CHF Action: inhibits vasoconstrictive properties of angiotensin II Nursing Considerations: -may cause hypotension, tacycardia, angiodema, hyperkalemia - may increase digoxin levels - assess blood pressure and heart rate - assess fluid levels - monitor daily weights with CHF - monitor renal and liver - instruct patient on how to take blood pressure

Answer 170

Magnesium sulfate (MgSO4) class: minerals/electrolytes Indication: treatment of hypomagnesaemia, hypertension, preterm labor, torsade de pointes, asthma, anticonvulsant with eclampsia Action: magnesium plays a role in muscle excitability Nursing Considerations: -use caution with renal insufficiency - may cause decreased respiratory rate, arrythmias, hypotension, muscle weakness - monitor EKG and respiratory status - monitor Mg levels - ensure dosage with secondary practitioner - Calcium gluconate is the antidote -Magnesium toxicity results in respiratory depress and loss of deep tendon reflexes

Answer 171

Magnesium sulfate (MgSO4) class: minerals/electrolytes Indication: treatment of hypomagnesaemia, hypertension, preterm labor, torsade de pointes, asthma, anticonvulsant with eclampsia Action: magnesium plays a role in muscle excitability Nursing Considerations: -use caution with renal insufficiency - may cause decreased respiratory rate, arrythmias, hypotension, muscle weakness - monitor EKG and respiratory status - monitor Mg levels - ensure dosage with secondary practitioner - Calcium gluconate is the antidote -Magnesium toxicity results in respiratory depress and loss of deep tendon reflexes

Answer 172

Mannitol (Osmitrol) class: osmotic diuretic Indication increased ICP, oliguric renal failure, edema, intraocular pressure Action: inhibits reabsorption of water and electrolytes by increasing osmotic pressure, excreted by kidneys Nursing Considerations: - may cause phlebitis at IV site - may cause dehydration, fluid and electrolyte imbalances - monitor neuro status - administer via a filter

Answer 173

Mannitol (Osmitrol) class: osmotic diuretic Indication increased ICP, oliguric renal failure, edema, intraocular pressure Action: inhibits reabsorption of water and electrolytes by increasing osmotic pressure, excreted by kidneys Nursing Considerations: - may cause phlebitis at IV site - may cause dehydration, fluid and electrolyte imbalances - monitor neuro status - administer via a filter

Answer 174

Meperidine (Demerol) class: Opioid Analgesic Indication moderate to severe pain, sedation Action: Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. Nursing Considerations: -may cause alterations in mentation, hypotension, constipation, nausea, vomiting - assess BP, pulse, and respiratory rate prior to administration and frequently during administration - use caution if patient is receiving MAOIs - Narcan (naloxone) is the antidote for opioid agonists - can cause seizure - may increase pancreatic enzyme levels - assess bowel function

Answer 175

Meperidine (Demerol) class: Opioid Analgesic Indication moderate to severe pain, sedation Action: Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. Nursing Considerations: -may cause alterations in mentation, hypotension, constipation, nausea, vomiting - assess BP, pulse, and respiratory rate prior to administration and frequently during administration - use caution if patient is receiving MAOIs - Narcan (naloxone) is the antidote for opioid agonists - can cause seizure - may increase pancreatic enzyme levels - assess bowel function

Answer 176

Metformin (Glucophage) class: Anti-diabetic Indication: management of Type II DM, PCOS Action: decreases glucose production in the liver, decreases absorption, increases cellular insulin sensitivity. Nursing Considerations: - do not use with renal dysfunction, metabolic acidosis - may cause diarrhea, nausea, vomiting, lactic acidosis - monitor patient closely for ketoacidosis and lactic acidosis, discontinue medication immediately if acidotic - may cause metallic taste - instruct patient that medication does not cure diabetes

Answer 177

Metformin (Glucophage) class: Anti-diabetic Indication: management of Type II DM, PCOS Action: decreases glucose production in the liver, decreases absorption, increases cellular insulin sensitivity. Nursing Considerations: - do not use with renal dysfunction, metabolic acidosis - may cause diarrhea, nausea, vomiting, lactic acidosis - monitor patient closely for ketoacidosis and lactic acidosis, discontinue medication immediately if acidotic - may cause metallic taste - instruct patient that medication does not cure diabetes

Answer 178

Methadone (Mathadose) class: opioid analgesic Indication withdrawal symptoms, pain Action: Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. Suppresses withdrawal symptoms. This depression also causes a decrease in the cough reflex and GI motility. Nursing Considerations: -use caution if patient is receiving MAO Inhibitors - may cause QT prolongation, hypotension, respiratory depression, dependence, confusion, sedation - assess pain, vital signs, bowel function - may increase pancreatic enzyme levels - assess withdrawal symptoms

Answer 179

Methadone (Mathadose) class: opioid analgesic Indication withdrawal symptoms, pain Action: Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. Suppresses withdrawal symptoms. This depression also causes a decrease in the cough reflex and GI motility. Nursing Considerations: -use caution if patient is receiving MAO Inhibitors - may cause QT prolongation, hypotension, respiratory depression, dependence, confusion, sedation - assess pain, vital signs, bowel function - may increase pancreatic enzyme levels - assess withdrawal symptoms

Answer 180

Methylergonovine (Methergine) class: oxytocic Indication treatment of post-partum hemorrhage Action: stimulates uterine muscles causing uterine contraction Nursing Considerations: -can cause hypertension, cramps, nausea, vomiting, dyspnea - monitor BP, heart rate, uterine response - assess calcium levels - effectiveness ↓ with hypocalcemia - monitor uterine bleeding and notify physician of any changes

Answer 181

Methylergonovine (Methergine) class: oxytocic Indication treatment of post-partum hemorrhage Action: stimulates uterine muscles causing uterine contraction Nursing Considerations: -can cause hypertension, cramps, nausea, vomiting, dyspnea - monitor BP, heart rate, uterine response - assess calcium levels - effectiveness ↓ with hypocalcemia - monitor uterine bleeding and notify physician of any changes

Answer 182

Methylphenidate (Ritalin) class: central nervous system stimulant Indication: ADHD, narcolepsy Action: improves attention span in ADHD by producing CNS stimulation Nursing Considerations: -can cause sudden death, hypertension, palpitations, anorexia, hyperactivity, insomnia - may decrease effects of Warfarin and Phenytoin - do not use with MAOIs - monitor cardiovascular system - monitor for behavioral changes - monitor for dependence - do not consume caffeinated beverages -"Drug Holiday" used to assess dependence and status

Answer 183

Methylphenidate (Ritalin) class: central nervous system stimulant Indication: ADHD, narcolepsy Action: improves attention span in ADHD by producing CNS stimulation Nursing Considerations: -can cause sudden death, hypertension, palpitations, anorexia, hyperactivity, insomnia - may decrease effects of Warfarin and Phenytoin - do not use with MAOIs - monitor cardiovascular system - monitor for behavioral changes - monitor for dependence - do not consume caffeinated beverages -"Drug Holiday" used to assess dependence and status

Answer 184

Methylprednisone (Solu-medrol) class: Corticosteroids Indication: Inflammation, allergy, autoimmune disorders, prevent organ rejection Info: Methylprednisolone is part of a potent class of anti-inflammatory agents, known as corticosteroids. Corticosteroids are used to treat many inflammatory diseases.

Answer 185

Methylprednisone (Solu-medrol) class: Corticosteroids Indication: Inflammation, allergy, autoimmune disorders, prevent organ rejection Info: Methylprednisolone is part of a potent class of anti-inflammatory agents, known as corticosteroids. Corticosteroids are used to treat many inflammatory diseases.

Answer 186

Metoclopramide (Reglan) class: antiemetic Indication: prevention of nausea, vomiting, hiccups, migraines, gastric stasis Action: accelerates gastric emptying by stimulating motility Nursing Considerations: - don't use with GI obstruction - may cause extrapyramidal reaction, neurolyptic malignant syndrome, tardive dyskinesia, arrhythmias, blood pressure alterations, hematologic alterations, facial movements, sedation - can decrease effects of levodopa - assess nausea/vomiting - monitor liver function tests

Answer 187

Metoclopramide (Reglan) class: antiemetic Indication: prevention of nausea, vomiting, hiccups, migraines, gastric stasis Action: accelerates gastric emptying by stimulating motility Nursing Considerations: - don't use with GI obstruction - may cause extrapyramidal reaction, neurolyptic malignant syndrome, tardive dyskinesia, arrhythmias, blood pressure alterations, hematologic alterations, facial movements, sedation - can decrease effects of levodopa - assess nausea/vomiting - monitor liver function tests

Answer 188

Metoprolol (Lopressor) class: beta blocker Indication tachyarrhythmias, HTN, angina, prevention of MI, heart failure management, may be used for migraine prophylaxis Action: blocks the stimulation of beta1 receptors in the SNS with does not usually effect on beta2 receptors (cardioselective) Nursing Considerations: - monitor hemodynamics - may lead to bradycardia, pulmonary edema - use caution with MAOIs - assess I&Os and monitor for signs of CHF

Answer 189

Metoprolol (Lopressor) class: beta blocker Indication tachyarrhythmias, HTN, angina, prevention of MI, heart failure management, may be used for migraine prophylaxis Action: blocks the stimulation of beta1 receptors in the SNS with does not usually effect on beta2 receptors (cardioselective) Nursing Considerations: - monitor hemodynamics - may lead to bradycardia, pulmonary edema - use caution with MAOIs - assess I&Os and monitor for signs of CHF

Answer 190

Metronidazole (Flagyl) class: anti-infectives, antiprotozoals, antiulcer agents Indication: intra-abdominal infections, gynecoligical infections, skin infections, bone and joint infections, CNS infections, septicemia, endocarditis, amebic liver abscess, peptic ulcer disease Action: Inhibits DNA and protein synthesis in bacteria, bactericidal Nursing Considerations: - do not take with alcohol-disulfiram reaction - assess for infection before and during treatment - obtain cultures before therapy - monitor neurologic status: parasthesia, weakness, ataxia, or seizures - monitor intake and output, daily weights - may alter liver enzyme tests

Answer 191

Metronidazole (Flagyl) class: anti-infectives, antiprotozoals, antiulcer agents Indication: intra-abdominal infections, gynecoligical infections, skin infections, bone and joint infections, CNS infections, septicemia, endocarditis, amebic liver abscess, peptic ulcer disease Action: Inhibits DNA and protein synthesis in bacteria, bactericidal Nursing Considerations: - do not take with alcohol-disulfiram reaction - assess for infection before and during treatment - obtain cultures before therapy - monitor neurologic status: parasthesia, weakness, ataxia, or seizures - monitor intake and output, daily weights - may alter liver enzyme tests

Answer 192

Midazolam (Versed) class: Benzodiazepine Indication: sedation, conscious sedation, anesthesia, status epilepticus Action: Acts to produce CNS depression, may be mediated by GABA. Nursing Considerations: - assess level of sedation during and for 2-6 hours following - monitor blood pressure, pulse, respirations during IV administration - The antidote for overdose is flumazenil

Answer 193

Midazolam (Versed) class: Benzodiazepine Indication: sedation, conscious sedation, anesthesia, status epilepticus Action: Acts to produce CNS depression, may be mediated by GABA. Nursing Considerations: - assess level of sedation during and for 2-6 hours following - monitor blood pressure, pulse, respirations during IV administration - The antidote for overdose is flumazenil

Answer 194

Montelukast (Singulair) class: Leukotriene Antagonist, bronchodilators Indication: prevent or treat asthma, manage seasonal allergies, prevent exercise-induced bronchoconstriction Action: disrupts the effects of leukotrienes which effect airway edema, smooth muscle constriction, and cellular activity Nursing Considerations: - assess respiratory status - assess liver function tests - medication does not treat acute asthma attacks

Answer 195

Montelukast (Singulair) class: Leukotriene Antagonist, bronchodilators Indication: prevent or treat asthma, manage seasonal allergies, prevent exercise-induced bronchoconstriction Action: disrupts the effects of leukotrienes which effect airway edema, smooth muscle constriction, and cellular activity Nursing Considerations: - assess respiratory status - assess liver function tests - medication does not treat acute asthma attacks

Answer 196

Morphine (MS Contin) class: opioid agonist Indication: pain, pulmonary edema, MI Action: Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. This depression also causes a decrease in the cough reflex and GI motility. Nursing Considerations: - may cause alterations in mentation, hypotension, constipation, nausea, vomiting - assess BP, pulse, and respiratory rate prior to administration and frequently during administration - use caution if patient is receiving MAO Inhibitors - Narcan (naloxone) is the antidote for opioid agonists

Answer 197

Morphine (MS Contin) class: opioid agonist Indication: pain, pulmonary edema, MI Action: Binds to opiate receptors in the CNS and alters perception of pain while producing a general depression of the CNS. This depression also causes a decrease in the cough reflex and GI motility. Nursing Considerations: - may cause alterations in mentation, hypotension, constipation, nausea, vomiting - assess BP, pulse, and respiratory rate prior to administration and frequently during administration - use caution if patient is receiving MAO Inhibitors - Narcan (naloxone) is the antidote for opioid agonists

Answer 198

Nalbuphine (Nubain) class: opioid agonists/analgesics Indication: pain, analgesia during labor, sedation before surgery, supplement to balance anesthesia Action: alters perception and response to pain, causes CNS depression Nursing Considerations: - use caution with head trauma - can cause dizziness, headache, nausea, vomiting, respiratory depression - do not use with MAOIs - assess pain - asses hemodynamic parameters - may elevate pancreatic enzymes - narcan (naloxone) is the antidote

Answer 199

Nalbuphine (Nubain) class: opioid agonists/analgesics Indication: pain, analgesia during labor, sedation before surgery, supplement to balance anesthesia Action: alters perception and response to pain, causes CNS depression Nursing Considerations: - use caution with head trauma - can cause dizziness, headache, nausea, vomiting, respiratory depression - do not use with MAOIs - assess pain - asses hemodynamic parameters - may elevate pancreatic enzymes - narcan (naloxone) is the antidote

Answer 200

Naproxen (Aleve) class: nonsteroidal anti-inflammatory agents (NSAID), nonopioid analgesics, antipyretics Indication: pain, dismenorrhea, fever, inflammation Action: inhibits prostaglandin synthesis Nursing Considerations: - use caution with GI bleeding - may increase risk for stroke and MI - can cause GI bleeding, anaphylaxis, Steven's Johnson syndrome - aspirin can decrease blood levels and effectiveness - assess pain - patients should remain up-right for 30 minutes after administration

Answer 201

Nifedipine (Procardia) class: Ca Channel Blocker Indication: hypertension, angina, migraines, CHF Action: blocks calcium transport resulting in inhibition of contraction causing systemic vasodilatation Nursing Considerations: - use caution in heart block, decreased blood pressure - don't consume grapefruit juice while taking medication - may cause arrhythmias - may cause elevated liver function tests - may cause gingival hyperplasia, Steven's Johnson syndrome - monitor blood pressure and pulse - monitor calcium levels - instruct patient on taking heart rate and blood pressure

Answer 202

Nifedipine (Procardia) class: Ca Channel Blocker Indication: hypertension, angina, migraines, CHF Action: blocks calcium transport resulting in inhibition of contraction causing systemic vasodilatation Nursing Considerations: - use caution in heart block, decreased blood pressure - don't consume grapefruit juice while taking medication - may cause arrhythmias - may cause elevated liver function tests - may cause gingival hyperplasia, Steven's Johnson syndrome - monitor blood pressure and pulse - monitor calcium levels - instruct patient on taking heart rate and blood pressure

Answer 203

Naproxen (Aleve) class: nonsteroidal anti-inflammatory agents (NSAID), nonopioid analgesics, antipyretics Indication: pain, dismenorrhea, fever, inflammation Action: inhibits prostaglandin synthesis Nursing Considerations: - use caution with GI bleeding - may increase risk for stroke and MI - can cause GI bleeding, anaphylaxis, Steven's Johnson syndrome - aspirin can decrease blood levels and effectiveness - assess pain - patients should remain up-right for 30 minutes after administration

Answer 204

Nitroprusside (Nitropress) class: vasodilator, anti-hypertensive Indication: hypertensive crisis, cardiogenic shock Action: peripheral vasodilation of arteries and veins decreasing preload and afterload Nursing Considerations: - monitor HR, BP, and EKG continuously during therapy - may cause cyanide toxicity - sympathomimetics may decrease effectiveness - PAOP monitoring may help with MI and CHF patients

Answer 205

Nitroprusside (Nitropress) class: vasodilator, anti-hypertensive Indication: hypertensive crisis, cardiogenic shock Action: peripheral vasodilation of arteries and veins decreasing preload and afterload Nursing Considerations: - monitor HR, BP, and EKG continuously during therapy - may cause cyanide toxicity - sympathomimetics may decrease effectiveness - PAOP monitoring may help with MI and CHF patients

Answer 206

Norepinephrine (Levophed) class: vasopressor Indication: treatment of severe hypotension and shock Action: increase blood pressure and cardiac output by stimulating alpha-adrenergic receptors in the blood vessels, demonstrates minor beta activity Nursing Considerations: - monitor BP continuously if possible or every couple of minutes - double check all concentrations with additional nurse - may result in rebound hypotension due to tissue ischemia when discontinued - monitor EKG and CVP if possible - if patient is awake instruct them to report headaches, dizziness, or chest pain

Answer 207

Norepinephrine (Levophed) class: vasopressor Indication: treatment of severe hypotension and shock Action: increase blood pressure and cardiac output by stimulating alpha-adrenergic receptors in the blood vessels, demonstrates minor beta activity Nursing Considerations: - monitor BP continuously if possible or every couple of minutes - double check all concentrations with additional nurse - may result in rebound hypotension due to tissue ischemia when discontinued - monitor EKG and CVP if possible - if patient is awake instruct them to report headaches, dizziness, or chest pain

Answer 208

Nystatin (Mycostatin) class: Antifungal Indication: candidiasis, denture stomatitis Action: causes leakage of fungal cell contents Nursing Considerations: - may cause diarrhea, nausea, vomiting - can be used to soak dentures - assess mucus membrane

Answer 209

Nystatin (Mycostatin) class: Antifungal Indication: candidiasis, denture stomatitis Action: causes leakage of fungal cell contents Nursing Considerations: - may cause diarrhea, nausea, vomiting - can be used to soak dentures - assess mucus membrane

Answer 210

Olanzapine (Zyprexa) class: Antipsychotic, mood stabilizers Indication: schizophrenia, mania, depression, anorexia nervosa, nausea/vomiting related to chemotherapy Action: antagonizes dopamine and serotonin Nursing Considerations: - do not use while breastfeeding - can cause neurolyptic malignant syndrome, seizures, suicidal thoughts, insomnia, tardive dyskinesia, agranulocytosis, constipation, tremors - assess mental status - monitor hemodynamics - assess blood sugars - assess intake and output - monitor liver function tests

Answer 211

Olanzapine (Zyprexa) class: Antipsychotic, mood stabilizers Indication: schizophrenia, mania, depression, anorexia nervosa, nausea/vomiting related to chemotherapy Action: antagonizes dopamine and serotonin Nursing Considerations: - do not use while breastfeeding - can cause neurolyptic malignant syndrome, seizures, suicidal thoughts, insomnia, tardive dyskinesia, agranulocytosis, constipation, tremors - assess mental status - monitor hemodynamics - assess blood sugars - assess intake and output - monitor liver function tests

Answer 212

Omeprazole (Prilosec) class: proton-pump inhibitor, antiulcer agent Indication: GERD, ulcers, Zollinger-Ellison syndrome, reduce the risk of GI bleed in critically ill patients, heart burn Action: prevents the transport of H ions into the gastric lumen by binding to gastric parietal cells, ↓ gastric acid production Nursing Considerations: - take 30-60 minutes prior to eating - capsules should be swallowed whole - instruct patient to report black tarry stool

Answer 213

Omeprazole (Prilosec) class: proton-pump inhibitor, antiulcer agent Indication: GERD, ulcers, Zollinger-Ellison syndrome, reduce the risk of GI bleed in critically ill patients, heart burn Action: prevents the transport of H ions into the gastric lumen by binding to gastric parietal cells, ↓ gastric acid production Nursing Considerations: - take 30-60 minutes prior to eating - capsules should be swallowed whole - instruct patient to report black tarry stool

Answer 214

Ondansetron (Zofran) class: 5-HT3 antagonist, Antiemetic Indication: nausea/vomiting Action: blocks effects of serotonin on vagal nerve and CNS Nursing Considerations: - administer slowly over 2-5 minutes - fatal QT prolongation and VTach, respiratory arrest - may cause headache, constipation, diarrhea, dry mouth - asses nausea and vomiting - assess for extrapyramidal symptoms - monitor liver function tests

Answer 215

Ondansetron (Zofran) class: 5-HT3 antagonist, Antiemetic Indication: nausea/vomiting Action: blocks effects of serotonin on vagal nerve and CNS Nursing Considerations: - administer slowly over 2-5 minutes - fatal QT prolongation and VTach, respiratory arrest - may cause headache, constipation, diarrhea, dry mouth - asses nausea and vomiting - assess for extrapyramidal symptoms - monitor liver function tests

Answer 216

Oxycodone (Oxycontin) class: opioid agonists, opioid agonists/nonopioid, analgesic combinations Indication: pain Action: binds to opiate receptors in CNS altering the perception and sensation of pain Nursing Considerations: - may cause respiratory depression, constipation, confusion , sedation, hallucinations, urinary retention - use caution with increased intracranial pressure - don't use with MAOIs - assess hemodynamics - assess pain - may elevate pancreatic enzymes - can cause physical dependence - assess bowel function

Answer 217

Oxycodone (Oxycontin) class: opioid agonists, opioid agonists/nonopioid, analgesic combinations Indication: pain Action: binds to opiate receptors in CNS altering the perception and sensation of pain Nursing Considerations: - may cause respiratory depression, constipation, confusion , sedation, hallucinations, urinary retention - use caution with increased intracranial pressure - don't use with MAOIs - assess hemodynamics - assess pain - may elevate pancreatic enzymes - can cause physical dependence - assess bowel function

Answer 218

Oxytocin (Pitocin) class: oxytocics Indication: labor induction, postpartum bleeding Action: stimulates uterine smooth muscle Nursing Considerations: - can cause ICH in fetus - can cause asphyxia in fetus - may cause coma and seizures in mother - may cause painful contractions - assess fetus - assess contractions - monitor blood pressure - assess maternal electrolytes - may cause uterine tetany

Answer 219

Oxytocin (Pitocin) class: oxytocics Indication: labor induction, postpartum bleeding Action: stimulates uterine smooth muscle Nursing Considerations: - can cause ICH in fetus - can cause asphyxia in fetus - may cause coma and seizures in mother - may cause painful contractions - assess fetus - assess contractions - monitor blood pressure - assess maternal electrolytes - may cause uterine tetany

Answer 220

Pancrelipase (Creon) class: pancreatic enzyme Indication: pancreatic insufficiency, ductal obstruction Action: replacement of pancreatic enzymes: lipase, amylase, protease Nursing Considerations: - contraindicated with pig products allergy - can cause shortness of breath, nausea, diarrhea, rash - assess nutritional status - monitor for steatorrhea - may increase uric acid levels - instruct patient to follow diet - take with meals and snacks

Answer 221

Pancrelipase (Creon) class: pancreatic enzyme Indication: pancreatic insufficiency, ductal obstruction Action: replacement of pancreatic enzymes: lipase, amylase, protease Nursing Considerations: - contraindicated with pig products allergy - can cause shortness of breath, nausea, diarrhea, rash - assess nutritional status - monitor for steatorrhea - may increase uric acid levels - instruct patient to follow diet - take with meals and snacks

Answer 222

Pantoprazole (Protonix) class: proton-pump inhibitors, anti-ulcer agent Indication: GERD, heartburn, reduce the risk of GI bleed in critically ill patients Action: prevents the transport of H ions into the gastric lumen by binding to gastric parietal cells, ↓ gastric acid production Nursing Considerations: - can cause hyperglycemia, abdominal pain - decreases absorption of certain drugs - may increase bleeding with warfarin - assess for occult blood - assess liver enzymes - assess symptoms of heart burn

Answer 223

Pantoprazole (Protonix) class: proton-pump inhibitors, anti-ulcer agent Indication: GERD, heartburn, reduce the risk of GI bleed in critically ill patients Action: prevents the transport of H ions into the gastric lumen by binding to gastric parietal cells, ↓ gastric acid production Nursing Considerations: - can cause hyperglycemia, abdominal pain - decreases absorption of certain drugs - may increase bleeding with warfarin - assess for occult blood - assess liver enzymes - assess symptoms of heart burn

Answer 224

Paroxetine (Paxil) class: SSRI, antianxiety agent, antidepressant Indication: major depressive disorder, OCD, anxiety, PTSD Action: block reuptake of serotonin in CNS Nursing Considerations: - do not use with MAOIs - can cause neurolyptic malignant syndrome, suicidal thoughts, serotonin syndrome, constipation, diarrhea, insomnia - decrease effectiveness of digoxin - increase bleeding with warfarin - assess for suicidal thoughts

Answer 225

Paroxetine (Paxil) class: SSRI, antianxiety agent, antidepressant Indication: major depressive disorder, OCD, anxiety, PTSD Action: block reuptake of serotonin in CNS Nursing Considerations: - do not use with MAOIs - can cause neurolyptic malignant syndrome, suicidal thoughts, serotonin syndrome, constipation, diarrhea, insomnia - decrease effectiveness of digoxin - increase bleeding with warfarin - assess for suicidal thoughts

Answer 226

Phenazopyridine (Pyridium) class: nonopioid analgesics Indication: urological pain Action: provides analgesia to the urinary tract mucosa Nursing Considerations: - will turn urine red or orange - may cause headache, vertigo, hepatic toxicity - monitor renal function

Answer 227

Phenazopyridine (Pyridium) class: nonopioid analgesics Indication: urological pain Action: provides analgesia to the urinary tract mucosa Nursing Considerations: - will turn urine red or orange - may cause headache, vertigo, hepatic toxicity - monitor renal function

Answer 228

Phenytoin (Dilantin) class: antiarrhythmics, anticonvulsants Indication: tonic clonic seizures, arrhythmias, neuropathic pain Action: interferes with ion transport, shortens action potentials and decreases automaticity. Blocks sustained high frequency repetitive firing of action potentials. Nursing Considerations: - monitor serum phenytoin levels - therapeutic levels 10-20 mcg/mL - use cautiously in all patients - can cause suicidal thoughts, ataxia, extrapyramidal symptoms, hypotension, tachycardia, arrhythmias, gingival hyperplasia, nausea, rash, drug induced hepatitis, agranulocytosis, Steven's Johnson syndrome - concurrent administration of enteral feedings may decrease absorption - monitor for hypersensitivity - assess seizures - assess hemodynamics

Answer 229

Phenytoin (Dilantin) class: antiarrhythmics, anticonvulsants Indication: tonic clonic seizures, arrhythmias, neuropathic pain Action: interferes with ion transport, shortens action potentials and decreases automaticity. Blocks sustained high frequency repetitive firing of action potentials. Nursing Considerations: - monitor serum phenytoin levels - therapeutic levels 10-20 mcg/mL - use cautiously in all patients - can cause suicidal thoughts, ataxia, extrapyramidal symptoms, hypotension, tachycardia, arrhythmias, gingival hyperplasia, nausea, rash, drug induced hepatitis, agranulocytosis, Steven's Johnson syndrome - concurrent administration of enteral feedings may decrease absorption - monitor for hypersensitivity - assess seizures - assess hemodynamics

Answer 230

Procainamide class: antiarrhythmic (Class IA Na Channel Blocker) Indication: wide variety ventricular and atrial arrhythmias, PAC, PVC, VTach, post cardioversion Action: decreases excitability and slows conduction velocity Nursing Considerations: - may cause ventricular arrhythmias, seizure, asystole, heart block - monitor EKG continuously may cause widening of QRS complex - may cause hypotension keep patient supine - monitor for signs of agranulocytosis monitor CBC frequently - can cause drug induced lupus syndrome

Answer 231

Promethazine (Promethacon) class: antiemetic, antihistamine, sedative/hypnotic Indication: allergic reactions, nausea and vomiting, sedation Action: blocks the effects of histamine, histamine plays a role in the immune response. Also plays an inhibitory role on the chemoreceptor trigger zone in the medulla leading to an antiemetic effect. Possess anticholinergic properties producing CNS depression. Nursing Considerations: - IV administration may cause damage to tissue, hypertension, impaired liver function - Monitor for neuroleptic malignant syndrome, confusion, sedation - May cause CNS depression - assess sedation level and anticholinergic effects

Answer 232

Promethazine (Promethacon) class: antiemetic, antihistamine, sedative/hypnotic Indication: allergic reactions, nausea and vomiting, sedation Action: blocks the effects of histamine, histamine plays a role in the immune response. Also plays an inhibitory role on the chemoreceptor trigger zone in the medulla leading to an antiemetic effect. Possess anticholinergic properties producing CNS depression. Nursing Considerations: - IV administration may cause damage to tissue, hypertension, impaired liver function - Monitor for neuroleptic malignant syndrome, confusion, sedation - May cause CNS depression - assess sedation level and anticholinergic effects

Answer 233

Propofol (Diprivan) class: general anesthetic Indication: anesthesia, induction, sedation Action: hypnotic, produces amnesia Nursing Considerations: - use cautiously with CVD, lipid disorder, increased ICP - can cause apnea, bradycardia, hypotension - burning and pain at insertion site - can turn urine green - assess respiratory status and hemodynamics - maintain patent airway - assess level of sedation

Answer 234

Propofol (Diprivan) class: general anesthetic Indication: anesthesia, induction, sedation Action: hypnotic, produces amnesia Nursing Considerations: - use cautiously with CVD, lipid disorder, increased ICP - can cause apnea, bradycardia, hypotension - burning and pain at insertion site - can turn urine green - assess respiratory status and hemodynamics - maintain patent airway - assess level of sedation

Answer 235

Propranolol (Inderal) class: beta blocker Indication: hypertension, angina, arrythmias, cardiomyopathy, alcohol withdrawal, anxiety Action: blocks Beta 1&2 adrenergic receptors Nursing Considerations: - Contraindicated in CHF, pulmonary edema, cardiogenic shock, bradycardia, heart block - monitor hemodynamic parameters (HR, BP) - May cause bradycardia, CHF, pulmonary edema - Masks symptoms associated with diabetes mellitus - advise to change positions slowly to prevent orthostatic hypotension - instruct patient on how to take blood pressure - stopping abruptly may result in life threatening arrhythmias - monitor daily intake and output - advise patient to notify physician for difficulty breathing

Answer 236

Propranolol (Inderal) class: beta blocker Indication: hypertension, angina, arrythmias, cardiomyopathy, alcohol withdrawal, anxiety Action: blocks Beta 1&2 adrenergic receptors Nursing Considerations: - Contraindicated in CHF, pulmonary edema, cardiogenic shock, bradycardia, heart block - monitor hemodynamic parameters (HR, BP) - May cause bradycardia, CHF, pulmonary edema - Masks symptoms associated with diabetes mellitus - advise to change positions slowly to prevent orthostatic hypotension - instruct patient on how to take blood pressure - stopping abruptly may result in life threatening arrhythmias - monitor daily intake and output - advise patient to notify physician for difficulty breathing

Answer 237

Propylthiouracil (PTU) class: Antithyroid Agent Indication: hyperthyroidism Action: inhibits thyroid hormones Nursing Considerations: - hepatotoxicity, nausea, vomiting, agranulocytosis - monitor symptoms of hyperthyroidism - monitor for hypothyroidism - monitor WBC and liver function tests - weight patient frequently - may cause leukopenia, thrombocytopenia, jaundice - take with meals

Answer 238

Propylthiouracil (PTU) class: Antithyroid Agent Indication: hyperthyroidism Action: inhibits thyroid hormones Nursing Considerations: - hepatotoxicity, nausea, vomiting, agranulocytosis - monitor symptoms of hyperthyroidism - monitor for hypothyroidism - monitor WBC and liver function tests - weight patient frequently - may cause leukopenia, thrombocytopenia, jaundice - take with meals

Answer 239

Quetiapine (Seroquel) class: Antipsychotic, mood stabilizers Indication: schizophrenia, depressive disorder, mania Action: dopamine and serotonin antagonist Nursing Considerations: - may cause neurolyptic malignant syndrome, seizures, dizziness, palpitations, weight gain, anorexia - QT interval prolongation - don't use with CNS depressants - assess weight frequently - monitor liver function test and CBC - may increase cholesterol

Answer 240

Quetiapine (Seroquel) class: Antipsychotic, mood stabilizers Indication: schizophrenia, depressive disorder, mania Action: dopamine and serotonin antagonist Nursing Considerations: - may cause neurolyptic malignant syndrome, seizures, dizziness, palpitations, weight gain, anorexia - QT interval prolongation - don't use with CNS depressants - assess weight frequently - monitor liver function test and CBC - may increase cholesterol

Answer 241

Ranitidine (Zantac) class: histamine H2 antagonists Indication: duodenal ulcers, GERD, heartburn, esophagitis, GI bleed Action: inhibits action of histamine in gastric parietal cells, decreases gastric acid secretion Nursing Considerations: - may cause arrhythmias, agranulocytosis, aplastic anemia, confusion - assess abdominal pain - monitor for blood in stool - monitor CBC

Answer 242

Ranitidine (Zantac) class: histamine H2 antagonists Indication: duodenal ulcers, GERD, heartburn, esophagitis, GI bleed Action: inhibits action of histamine in gastric parietal cells, decreases gastric acid secretion Nursing Considerations: - may cause arrhythmias, agranulocytosis, aplastic anemia, confusion - assess abdominal pain - monitor for blood in stool - monitor CBC

Answer 243

Rifampin (Rimactane) class: Antitubercular Indication: tuberculosis Action: inhibits RNA synthesis Nursing Considerations: - can turn body fluids red - may cause diarrhea, nausea, vomiting, confusion - assess lung sounds and sputum characteristics - evaluate renal and liver function tests - instruct patient not to skip or double dose - must complete entire dose (6-12 month therapy)

Answer 244

Rifampin (Rimactane) class: Antitubercular Indication: tuberculosis Action: inhibits RNA synthesis Nursing Considerations: - can turn body fluids red - may cause diarrhea, nausea, vomiting, confusion - assess lung sounds and sputum characteristics - evaluate renal and liver function tests - instruct patient not to skip or double dose - must complete entire dose (6-12 month therapy)

Answer 245

Salmeterol (Serevent) class: adrenergic, bronchodilators Indication: reversible airway obstruction, exercise induced asthma Action: bronchodilation through stimulation of beta 2 adrenergic receptors Nursing Considerations: - instruct patient to avoid excessive use - can cause headache palpitations tachycardia, abdominal pain, paradoxical bronchospasm - beta blockers and decrease effectiveness - assess respiratory status - may increase glucose levels - always take bronchodialtor first

Answer 246

Salmeterol (Serevent) class: adrenergic, bronchodilators Indication: reversible airway obstruction, exercise induced asthma Action: bronchodilation through stimulation of beta 2 adrenergic receptors Nursing Considerations: - instruct patient to avoid excessive use - can cause headache palpitations tachycardia, abdominal pain, paradoxical bronchospasm - beta blockers and decrease effectiveness - assess respiratory status - may increase glucose levels - always take bronchodialtor first

Answer 247

Sertraline (Zoloft) class: SSRI, anti-depressants Indication: major depressive disorder, OCD, anxiety Action: inhibits uptake of serotonin Nursing Considerations: - don't use with MAOIs - can cause neurolyptic malignant syndrome, suicidal thoughts, drowsiness, insomnia, diarrhea, dry mouth, tremors, serotonin syndrome, sexual dysfunction - monitor mood changes in patient - takes 1-4 weeks for therapy to be effective.

Answer 248

Sertraline (Zoloft) class: SSRI, anti-depressants Indication: major depressive disorder, OCD, anxiety Action: inhibits uptake of serotonin Nursing Considerations: - don't use with MAOIs - can cause neurolyptic malignant syndrome, suicidal thoughts, drowsiness, insomnia, diarrhea, dry mouth, tremors, serotonin syndrome, sexual dysfunction - monitor mood changes in patient - takes 1-4 weeks for therapy to be effective.

Answer 249

Spironolactone (Aldactone) class: potassium sparing diuretics Indication: potassium loss, hypertension, edema, CHF Action: inhibits sodium reabsorption while sparing potassium and hydrogen Nursing Considerations: - contraindicated with hyperkalemia - monitor intake and output - monitor blood pressure - monitor potassium levels and renal panel

Answer 250

Spironolactone (Aldactone) class: potassium sparing diuretics Indication: potassium loss, hypertension, edema, CHF Action: inhibits sodium reabsorption while sparing potassium and hydrogen Nursing Considerations: - contraindicated with hyperkalemia - monitor intake and output - monitor blood pressure - monitor potassium levels and renal panel

Answer 251

Streptokinase (Streptase) class: Thrombolytic Indication: pulmonary embolism, DVT, occluded lines, arterial thrombus Action: converts plasminogen to plasmin which degrades fibrin clots Nursing Considerations: - contraindicated with active bleeding, hypersensitivity, bronchospasm, intracranial hemorrhage, hypotension - begin therapy as soon as possible - monitor vital signs continuously - monitor closely for bleeding - monitor hemodynamics - avoid invasive procedures

Answer 252

Streptokinase (Streptase) class: Thrombolytic Indication: pulmonary embolism, DVT, occluded lines, arterial thrombus Action: converts plasminogen to plasmin which degrades fibrin clots Nursing Considerations: - contraindicated with active bleeding, hypersensitivity, bronchospasm, intracranial hemorrhage, hypotension - begin therapy as soon as possible - monitor vital signs continuously - monitor closely for bleeding - monitor hemodynamics - avoid invasive procedures

Answer 253

Scralfate (Carafate) class: antiulcer agent Indication: management of GI ulcers, GI injury prevention from high dose aspirin and NSAID treatment Action: reacts with gastric acid to form a paste that adheres to ulcer Nursing Considerations: - use caution in renal failure patients - concurrent use of antacids may decrease the effect of sucralfate - administer 30 min before or after - administer on empty stomach 1 hour before meals

Answer 254

Scralfate (Carafate) class: antiulcer agent Indication: management of GI ulcers, GI injury prevention from high dose aspirin and NSAID treatment Action: reacts with gastric acid to form a paste that adheres to ulcer Nursing Considerations: - use caution in renal failure patients - concurrent use of antacids may decrease the effect of sucralfate - administer 30 min before or after - administer on empty stomach 1 hour before meals

Answer 255

Serbutaline (Brethaire) class: bronchodilators, adrenergic Indication: asthma, COPD, preterm labor Action: produces bronchodilation Nursing Considerations: - may cause nervousness, restlessness, tremors - beta blockers can reduce effect - assess respiratory status - monitor maternal/fetal vital signs if using for preterm labor - monitor for hypoglycemia - may cause decreased potassium level

Answer 256

Serbutaline (Brethaire) class: bronchodilators, adrenergic Indication: asthma, COPD, preterm labor Action: produces bronchodilation Nursing Considerations: - may cause nervousness, restlessness, tremors - beta blockers can reduce effect - assess respiratory status - monitor maternal/fetal vital signs if using for preterm labor - monitor for hypoglycemia - may cause decreased potassium level

Answer 257

Tetracycline (Doxycycline) class: Tetracyclines, anti-infective Indication: treatment of infection, gonorrhea & syphilis with penicillin allergy, chronic bronchitis Action: bacteriostatic by inhibiting protein synthesis Nursing Considerations: - use caution with liver impairment - may cause pseudomembranous colitis, diarrhea, nausea, vomiting, photosensitivity, rash - may increase effects of warfarin - assess for infection - obtain culture prior to initiating therapy - monitor renal and liver labs - instruct patient to complete entire dose

Answer 258

Tetracycline (Doxycycline) class: Tetracyclines, anti-infective Indication: treatment of infection, gonorrhea & syphilis with penicillin allergy, chronic bronchitis Action: bacteriostatic by inhibiting protein synthesis Nursing Considerations: - use caution with liver impairment - may cause pseudomembranous colitis, diarrhea, nausea, vomiting, photosensitivity, rash - may increase effects of warfarin - assess for infection - obtain culture prior to initiating therapy - monitor renal and liver labs - instruct patient to complete entire dose

Answer 259

Trimethoprim / Sulfamethoxazole (Bactrim/TMP-SMZ) class: anti-infectives, antiprotozoals Indication: bronchitis, UTI, diarrhea, pneumonia, multiple types of infection Action: bacteriacidal by preventing metabolism of folic acid Nursing Considerations: - may cause renal damage, Steven Johnsons Syndrome - rash, pseudomembranous colitis, nausea, vomiting, diarrhea, rash, agranulocytosis, aplastic anemia, phlebitis - contraindicated with sulfa allergies - monitor CBC - obtain cultures prior to initiating therapy - monitor intake and output - instruct patient to complete dose - drink 8-10 glasses of water

Answer 260

Trimethoprim / Sulfamethoxazole (Bactrim/TMP-SMZ) class: anti-infectives, antiprotozoals Indication: bronchitis, UTI, diarrhea, pneumonia, multiple types of infection Action: bacteriacidal by preventing metabolism of folic acid Nursing Considerations: - may cause renal damage, Steven Johnsons Syndrome - rash, pseudomembranous colitis, nausea, vomiting, diarrhea, rash, agranulocytosis, aplastic anemia, phlebitis - contraindicated with sulfa allergies - monitor CBC - obtain cultures prior to initiating therapy - monitor intake and output - instruct patient to complete dose - drink 8-10 glasses of water

Answer 261

Trimethoprim / Sulfamethoxazole (Bactrim/TMP-SMZ) class: anti-infectives, antiprotozoals Indication: bronchitis, UTI, diarrhea, pneumonia, multiple types of infection Action: bacteriacidal by preventing metabolism of folic acid Nursing Considerations: - may cause renal damage, Steven Johnsons Syndrome - rash, pseudomembranous colitis, nausea, vomiting, diarrhea, rash, agranulocytosis, aplastic anemia, phlebitis - contraindicated with sulfa allergies - monitor CBC - obtain cultures prior to initiating therapy - monitor intake and output - instruct patient to complete dose - drink 8-10 glasses of water

Answer 262

Trimethoprim / Sulfamethoxazole (Bactrim/TMP-SMZ) class: anti-infectives, antiprotozoals Indication: bronchitis, UTI, diarrhea, pneumonia, multiple types of infection Action: bacteriacidal by preventing metabolism of folic acid Nursing Considerations: - may cause renal damage, Steven Johnsons Syndrome - rash, pseudomembranous colitis, nausea, vomiting, diarrhea, rash, agranulocytosis, aplastic anemia, phlebitis - contraindicated with sulfa allergies - monitor CBC - obtain cultures prior to initiating therapy - monitor intake and output - instruct patient to complete dose - drink 8-10 glasses of water

Answer 263

Vancomycin (Vancocin) class: anti-infectives Indication: life threatening infections, sepsis Action: bactericidal Nursing Considerations: - can cause ototoxicity, nausea, vomiting, nephrotoxicity, anaphylaxis, red-man syndrome - assess for infection - obtain culture prior to initiating therapy - monitor blood pressure - dose dependent draw serum trough levels frequently - administer over at least 60 minutes to avoid skin irritation

Answer 264

Vancomycin (Vancocin) class: anti-infectives Indication: life threatening infections, sepsis Action: bactericidal Nursing Considerations: - can cause ototoxicity, nausea, vomiting, nephrotoxicity, anaphylaxis, red-man syndrome - assess for infection - obtain culture prior to initiating therapy - monitor blood pressure - dose dependent draw serum trough levels frequently - administer over at least 60 minutes to avoid skin irritation

Answer 265

Vasopressin (Pitressin) class: antidiuretic hormone Indication: management of diabetes insipidus, VT/VF unresponsive to initial shock, GI hemorrhage Action: increases water permeability of the kidney's collecting duct and distal convoluted tubule leading to water retention, also increases peripheral vascular resistance leading to increased BP Nursing Considerations: - use caution with HF and CV disease - contraindicated in renal failure and hypersensitivity to pork - monitor BP, HR, and EKG during therapy - monitor urine specific gravity and osmolality - weigh patient and assess for edema - monitor electrolyte panel - do not use with alcohol

Answer 266

Vasopressin (Pitressin) class: antidiuretic hormone Indication: management of diabetes insipidus, VT/VF unresponsive to initial shock, GI hemorrhage Action: increases water permeability of the kidney's collecting duct and distal convoluted tubule leading to water retention, also increases peripheral vascular resistance leading to increased BP Nursing Considerations: - use caution with HF and CV disease - contraindicated in renal failure and hypersensitivity to pork - monitor BP, HR, and EKG during therapy - monitor urine specific gravity and osmolality - weigh patient and assess for edema - monitor electrolyte panel - do not use with alcohol

Answer 267

Verapamil (Isoptin) class: Ca Channel Blocker Indication: hypertension, angina, SVT, migraine Action: prevents transport of calcium, leading to decreased contraction, decreases SA and AV node conduction Nursing Considerations: - don't use with 2nd and 3rd degree heartblock - don't use with systolic BP < 90 - may cause anxiety, confusion, cough, dyspnea, arrhythmias, CHF, bradycardia, hypotension, elevated liver enzymes, Steven's Johnson syndrome, hyperglycemia, gingival hyperplasia - grapefruit juice can increase effects - can increase levels of digoxin - monitor heart rhythm, intake and output, blood pressure - assess angina

Answer 268

Verapamil (Isoptin) class: Ca Channel Blocker Indication: hypertension, angina, SVT, migraine Action: prevents transport of calcium, leading to decreased contraction, decreases SA and AV node conduction Nursing Considerations: - don't use with 2nd and 3rd degree heartblock - don't use with systolic BP < 90 - may cause anxiety, confusion, cough, dyspnea, arrhythmias, CHF, bradycardia, hypotension, elevated liver enzymes, Steven's Johnson syndrome, hyperglycemia, gingival hyperplasia - grapefruit juice can increase effects - can increase levels of digoxin - monitor heart rhythm, intake and output, blood pressure - assess angina

Answer 269

Warfarin (Coumadin) class:Anticoagulant Indication: venous thrombosis, pulmonary embolism, A-fib, myocardial infarction Action: disrupts liver synthesis of Vitamin K dependent clotting factors Nursing Considerations: - contraindicated with bleeding, severe hypertension - can cause bleeding - aspirin and NSAIDs can increase risk of bleeding - azole antifungals increase effects of warfarin - cimetadine(Tagamet) increases warfarin levels - obtain full history of supplements and herbs - large amounts of vitamin K may antagonize effects of warfarin - assess for signs of bleeding - therapeutic levels: PT 1.3-1.5, INR 2.5-3.5 - instruct patient to report any signs of bleeding - patient should not drink alcohol - bleeding times need to be monitored frequently - vitamin K is antidote

Answer 270

Warfarin (Coumadin) class:Anticoagulant Indication: venous thrombosis, pulmonary embolism, A-fib, myocardial infarction Action: disrupts liver synthesis of Vitamin K dependent clotting factors Nursing Considerations: - contraindicated with bleeding, severe hypertension - can cause bleeding - aspirin and NSAIDs can increase risk of bleeding - azole antifungals increase effects of warfarin - cimetadine(Tagamet) increases warfarin levels - obtain full history of supplements and herbs - large amounts of vitamin K may antagonize effects of warfarin - assess for signs of bleeding - therapeutic levels: PT 1.3-1.5, INR 2.5-3.5 - instruct patient to report any signs of bleeding - patient should not drink alcohol - bleeding times need to be monitored frequently - vitamin K is antidote

Answer 271

Treat HIV (entricitabine)

Meds Flashcards

(299 cards)