Summary NUR 239/ NUR239 Pathophysiology and Pharmacotherapeutics I: ATI Patho Pharm Earnback _ Complete A+ Guide

Name; Safety and Infection Control ATI Patho Pharm Earnback 1. Antibiotics Affecting the Bacterial Cell Wall: Identifying Medication Cross-Sensitivity Requiring a Clarification from The Provider • Clients who have a penicillin allergy are at a cross-sensitivity risk to cephalosporins. • Stop the medication administration and notify the provider if indications of an allergic reaction appear such as urticaria, rash, hypotension, or dyspnea. • Notify the provider if the client reports a history of an allergic reaction to a penicillin or a cephalosporin. Psychosocial Integrity 2. Substance Use Disorders: Expected Findings for Opioid Abstinence Syndrome • Opioid abstinence syndrome occurs when a client withdraws from a substance that they had a physical dependence on. • A client going through abstinence syndrome can experience manifestations that cause severe distress and can lead to coma or death. • A client experiencing abstinence syndrome will show signs of irritability, nervousness, restlessness, insomnia, and difficulty concentrating. Pharmacological and Parenteral Therapies 3. Antibiotics Affecting Protein Synthesis: Priority Laboratory Values to Report • Antibiotics that affect protein synthesis are bacteriostatic or bactericidal and are used to treat respiratory, gastrointestinal, urinary, and reproductive tract infections. • For clients taking aminoglycosides, I&O, BUN, and creatinine levels should be monitored and reported if elevated. • For patients taking erythromycin concurrently with warfarin, it is important to monitor the PT and INR levels. 4. Antibiotics Affecting the Bacterial Cell Wall: Administering Clindamycin to a Client Who Has a Penicillin Allergy • Ask clients if they have a prior allergy to penicillin and if they do, they should wear an allergy identification bracelet • After administration of the medication, clients should be observed for allergic reactions for 30 minutes. • Stop administration and report signs of an allergic reaction such as rash, urticaria, hypotension, and dyspnea to the provider. 5. Bipolar Disorders: Analyzing Laboratory Data • Clients should adhere to appointments to monitor the effects of lithium and assess for observe effects. • Advise clients that there is a high risk of toxicity due to the narrow therapeutic range when taking lithium for bipolar disorder. • Lithium levels should be tested at least 5 days after starting therapy or after and dosage change and should continue to be tested until therapeutic levels have been achieved. 6. Cardiac Glycosides and Heart Failure: Identifying Finding of Digoxin Toxicity • Therapeutic levels of digoxin should be kept between 0.5 and 0.8 ng/mL to prevent digoxin toxicity. • Signs of digoxin toxicity include fatigue, weakness, vision changes, and GI effects. • When taking digoxin, potassium levels should be monitored, and for levels less than 3.5 mEq/L, administer potassium IV or by mouth for management of digoxin toxicity. 7. Cardiac Glycosides and Heart Failure: Risk Factors for Digoxin Toxicity • Hypokalemia, increased serum digoxin levels, and heart disease are conditions that increase the risk of developing digoxin-induced dysrhythmias. • Quinidine can increase the risk of digoxin toxicity when taken with digoxin since it displaces it from its binding site and reduces kidney excretion. • Older adult clients are at an increased risk for developing digoxin-induced dysrhythmias. 8. Connective Tissue Disorders: Contraindications to Prednisone Therapy • Clients who have hyperglycemia should not take prednisone. • In patients where NSAIDs are not available to take for acute gout, patients should take prednisone. • Clients with diabetes mellitus may need to adjust their hypoglycemia agents when taking prednisone as it may make them more hyperglycemic. 9. Endocrine Disorders: Adverse Effects of Thyroid Hormone • Overmedication of thyroid hormone can lead to anxiety, tachycardia, palpations, altered appetite, abdominal cramping, heat intolerance, fever, diaphoresis, weight loss, and menstrual irregularities. • TSH levels should be monitored at least once a year. • Chronic overtreatment can lead to an increased risk of fractures from bone loss and can cause atrial fibrillation. 10. Dosage Calculation: Calculating Erythromycin • Round the value up by adding 1 to the number to the left if the number to the right is greater than or equal to 5. • Rounding down is done by dropping the number to the right and leaving the number to the left as it is if the number to the right is less than 5. • Round to the nearest tenth for dosages greater than 1.0. 11. Antilipemic Agents: Medications for High Cholesterol • HMG-CoA reductase inhibitors (statins) are used to decrease manufacture of LDL and VLDL cholesterol and increase manufacture of HDL. ********************************CONTINUED************************