A patient is taking zyrtec (cetirizine)…might might they have as a side effect?
Drowsiness
Prednisone - diabetic should increase amount of daily Humulin NPH insulin. T/F?
TRUE
A client is receiving bethanecol (urecholine) - the nurse realizes that the actin of the drug is to treat what?
Urinary retention.
What are some possible adverse effects of morphine?
Constipation, respiratory depression/urinary retention, sedation, orthostatis HOTN, cough suppression
Methotrexate - what are we most concerned about?
Bone marrow suppression.
Nurse should hold cephalosporin for patients with an allergy. T/F?
True
More education needed when the patient says they will use morphine FOR SEVERE pain - why?
We want to stay ahead of the pain.
Allergy testing - should avoid benadryl 14 days before testing. T/F?
TRUE
When taking warfarin, avoid high amounts of cabbage of broccoli. T/F?
TRUE
Acyclovir - helps prevent herpes breakouts. T/F?
True
PTT - 70 for heparin. T/F?
True
Patient is taking heparin for pulmonary embolism - what should we monitor for?
crackles in the lungs!
UC - contraindication for acetaminophen?
YES
Nitro - store in dark area at room temp?
YES
Diabetic medication - watch for excessive saliva?
YES
Desmopression - what does it decrease?
Decreases urine?
For a question about arthroplasty, take the __ out of the syringe. T/F?
True
Older lady with fentanyl patch and she has bad pain - what should she pain?
Hydrocodone
Statins - should watch for muscle aches and pains. T/F?
TRUE
Albuterol-inhaled short acting
Formoterol, salmeterol-inhaled long acting.
Terbutaline-oral - long acting.
T/F?
True
What are some adverse effects of asthma meds?
Tachycardia, angina, tremors, etc.
Beta-blockers - do we give with asthma meds?
YES
Beclomethasone - inahled or oral?
Prednisone - inhaled or oral?
Bec = inhaled.
Pred = oral.
what is the action of a glucocorticoid for asthma?
Prevent inflammation, suppress airway mucus production and promote responsiveness of beta2 receptors in the bronchial tree
Anaphylactic reaction - epi, bronchiodiolators, antihistamine, provide respiratory support, inform provider?
YES
Digoxin - can it cause hypokalemia?
Yes (watch for nausea, vomiting, weakness)
Quinidine - increases risk of digoxin toxicity. T/f?
TRUE
Should a patient take digoxin at the same time each day AND observe for signs of digoxin toxicity?
YES & YES.
Signs = fatigue, weakness, vision changes, GI effects.
What are some tricyclic antidepressants?
Amitryptiline, imipramine, doxepin, nortriptyline, amoxapine, trimipramine
What are TCA’s used for?
Depression, depressive episodes of bipolar disorder, neuropathic pain, fibromyalgia, anxiety, insomnia
Orthostatic hypotension - side effect of TCA?
YES
TCA - can they have anticholinergic effects like blurred vision, dry mouth, etc?
YEs
TCA - photophobia doesn’t happen. T/F?
Void before taking?
Constipation risk?
FALSE, it does -wear sunglasses.
YEs - it can cause anticholinergic effects/retains your pee.
Constipation risk for sure!
TCA - take when?
At bedtime r/t risk of sedation.
TCA - toxicity s/s?
Dysrhythmia’s, mental confusion, agitation, seizure, coma, death, monitor vitals, baseline ECG, notify provider if toxicity is present, decreased seizure threshold
TCA - concurrent use with MAOI’s and St John’s worth leads to what?
Serotonin syndrome.
TCA - avoid alcohol, antihistamine’s, and anticholinergic’s - t/f?
TRUE
Levothyroxine - can increase the anticoagulant effects of warfarin by breaking down vitamin K. T/f?
true
What are some drugs for irritable bowel?
Alosetron, Lubiprostone
Heparin - APT normal level + __ to __ seconds, PT = __ - __ seconds, INR =
60-80 = apt 18-24 = PT INR = 2-3
What’s the antidote for HEPARIN?
Protamine
Fursemide - what kind of diruetic is it?
High ceiling, so it blocks reabsorption of soidum and chloride to prevent reabsorption of water so you pee a TON
What are some side effects of furosemide?
dehydration, hyponatremia, hypochloremia, hypotension, ototixicity (avoid gentamicin!!!), hypokalemia, hyperglycemia, hyperuricemia, decreased ca/mag levels
What are some CNS stimulants for children?
Methylphenidate, dexmethylpehnidate, dextroamphetamine, amphetamine mixture, lisdexametamine
CNS stimulants for kids - these meds increase levels of what? WHat are they used for?
increase NE, serotonin, dopamine - used for ADHD/conduct disorder.
What are some S/e of CNS stimulants? Give when?
CNS stimulation (insomnia/restlessness) so give after 4pm!!!!!!
CNS stimulants - should we monitor for weight and compare to baseline?
YES
CNS stimulants - monitor vitals/ECG and observe for effects that aren’t good. T/F?
True
CNS stimulants - what should we do if the patient is hallucinating?
D/C med and report it
CNS stimulants - do we stop them suddenly?
NO
Hypersensitivity skin reaction - should we remove CNS patch and notify doctor?
YES