Test 3 NSG 307 Flashcards
(41 cards)
How is Lovenox given?
Lovenox (enoxaparin) is a low molecular weight heparin. It is given subcutaneously, most often from pre filled syringes). Most common site is the abdomen. Stay at least 2” from belly button, do not aspirate before inject, NEVER massage site afterwards.
Never give with heparin, do this by preforming a double check.
What labs go with things - Like what labs go with heparin? What labs go with Coumadin?
- Heparin= PTT: (Partial thromboplastin time) test that looks at how long it takes for blood to clot.
- Coumadin=*PT: (Prothrombin time) measures amount of time it takes for plasma in blood to clot.
- INR= (international normalized ratio) standardizes results of PT tests
Heart failure patient education
- recording daily weight & reporting gains of > 2 lbs a day
- -Notify provider if you experience SOB, Edema, chest pain, syncope, dizziness, blurred vision, or unexplained rapid weight gain (i.e. 2lbs in a day)
What are the adverse effects of ace inhibitors?
- Hypotension, dizziness, dry cough, fatigue, angioedema, hyperkalemia, first dose HTN
- A characteristic adverse effect that occurs is a dry, nonproductive cough BUT is reversible with discontinuation of the therapy.
what do ace inhibitors do?
These are drugs that inhibit angiotensin converting enzyme which converts angiotensin I to angiotensin II. Their effects are primarily cardiovascular and renal. This reduces BP by decreasing systematic vascular resistance, and prevents sodium and water reabsorption by reducing aldosterone secretion.
indications for ace inhibitors?
first line drugs for CHF and hypertension. They are drugs of choice for diabetic clients with cardiovascular disease.
What is Plavix for?
- Plavix is used to prevent blood clots, and in people with certain disorders of the heart or blood vessels.
- -Indications: Reducing the risk of stroke, MI, vascular death, peripheral arterial disease in high-risk patients, acute coronary syndrome, transient ischemic attack (TIA), unstable angina.
what is plavix?
- Also known as Clopidogrel,
- – it is an antiplatelet (like aspirin)
What are the adverse effects of the anticoagulants?
- –Risk of excessive bleeding (hemorrhages) is primary
- –Blood in urine, black feces, severe bruising, nosebleeds, blood in vomit, coughing blood, unusual headaches, difficulty breathing.
- The most serious adverse reactions are hemorrhage, agranulocytosis, leukopenia, eosinophilia, and thrombocytopenia, depending on the specific product.
Montelukast (Singular): (Pt teaching).
Take at night (to combat morning secretions)
- Do not take if you are going to start Rafampin, or phenobarbital as these drugs will increase singulars concentrations.
- do not use if you have a lactose allergy
Xanthine Derivative: indications and adverse effects.
- Not commonly used.
- Indications: Theophylline is the most commonly used and is given IV to pts who have Status Asthmaticus and do not respond to fast acting beta agonist such as ephedrine. as well as adults 12 and older as a prophylaxis and long term treatment of asthma.
- Adverse effects include: liver dysfunction, and common (N/V, dizziness, insomnia, headache)
What would you give to thin secretions?
-An Expectorant such as Guaifenesin (Mucinex)
Thrush is a side effect if what is inhaled?
- Inhaled Corticosteroid
- You should instruct the client to rinse mouth thoroughly with water and spit it out. (This will remove excess steroid and reduce the risk to contract Thrush/ Candidas)
Emphysema – know & understand what emphysema is.
- Type of COPD.
- Can’t exhale (no cough or sputum). The surface area that gas exchange takes place is reduced because enzymes that are released from Leukocytes in response to inflammation in the alveolar have destroyed lung tissue.
- Caused by smoking.
What is an asthma attack?
An asthma attack is a sudden worsening of asthma symptoms caused by the tightening of muscles around your airways (bronchospasm
what happens during and asthma attack?
-lining of the airways also becomes swollen or inflamed and thicker mucus
– more than normal – is produced.
All of these factors – bronchospasm, inflammation, and mucus production
– cause symptoms of an asthma attack such as difficulty breathing, wheezing, coughing, shortness of breath, and difficulty performing normal daily activities. Most are short, and normal breathing is subsequently recovered. However, an asthma attack may be prolonged and may not respond to a typical drug therapy
What role antihistamines have in allergies?
What can they do? What cant they do? what do they reduce? what kind of effect does is cause in the nervous system?
- -They compete with histamine for H1 receptors (Histamine antagonists). Ex. Benadryl and Zyrtec (cetirizine). They prevent the adverse consequence of histamine. Vasodilation, increased GI and respiratory secretions, increased capillary permeability. For the immune system in response to an allergic reaction they bind to the receptors that the mast cells would usually bind to thus preventing inflammation
- -They can’t knock off the histamine that has already been bound so taking it early works better.
- –Benadryl is fast acting there as Zyrtec (cetirizine) needs to be taken before the allergy happens.
- *Don’t give them to the elderly mostly Benadryl.** —If it makes you tired than take it at bedtime.
- –More effective in preventing the actions then reversing them.
- – For smooth muscles they reduce salivary, gastric, and respiratory secretions.
- —Skin: reduces capillary permeability to stop itching. Has a anticholinergic effect: drying effect that reduces secretions (tears, nasal).
what are the indications of antihistamines?
for the management of nasal allergies, seasonal or perennial allergic rhinitis, and some of the typical symptoms of the common cold.
Adverse effects of antihistamines; contraindication.
Drying, difficulty urinating (BPH), constipation, blurry vision, drowsiness. *Can’t see, can’t pee, can’t spit, can’t shit (anticholinergic type effects)
pt teaching: antihistamines
Pt. Teaching: report excessive sedation, confusion, or hypotension. Don’t take with other sedative OTC drugs. Avoid driving, drinking alcohol. If dry mouth use hard candy. Preform good oral care (pg. 577).
Why would a doc prescribe intranasal/inhaled corticosteroids over oral corticosteroids?
Intranasal spray works locally without systemic adverse effects and works immediately. Flonase. Decreases the inflammation response in the nasal cavity. Less adverse effects. Can have rebound congestion
What are the side effects of albuterol (sympathomimetic)
HTN, tachycardia, tremor, headache
What are the levels of the stepwise asthma plan? (bronchodilator 1st & corticosteroid 2nd - understand the theory behind the steps
First use bronchodilator like albuterol to open up the alveoli then use the corticosteroid. This way your lungs will be super open and absorb lots of steroids
What do bronchodilators actually do?
SABA (short acting beta agonist) Albuterol which is a rescue inhaler and Atrovent which is a preventive bronchodilator.
–They relax bronchial smooth muscle which caused dilation of the bronchi that are narrowed from inflammation or bronchospasm
