Summary NR293 FINAL EXAM Study Guide 2021/2022.

NR293 FINAL EXAM Study Guide 2021/2022. Antianginals: Nitroglycerin  3 tablets every 5 minutes x15 minutes  Call 911 after 1st tab  Do not take with ED drugs (sildenafil=Viagra)  Antidysrhythmics: Digoxin Including norm digoxin levels as well as signs and symptoms of Digoxin Toxicity  Therapeutic 0.5-2.0  Toxicity: affects colored vison, halos, low potassium (hypokalemia)  Always check pulse, hold if HR below 60  Antidote: digibind  Antihypertensive: Calcium Channel Blockers, ACE inhibitors, Nonselective Beta Blockers, Beta Blockers (Metoprolol, Atenolol) Including pathophysiology indications  Calcium Channel Blockers  ACE inhibitors  Beta blockers -LOL  Non selective beta blockers: Timolol  Glaucoma  Decreases aqueous humor production, decrease IOP  Hold gentle pressure on the nasolacrimal duct 30-60 seconds after application  overdose can cause systemic effects  Antilipemics: Statins  Cholesterol, lowers LDL  Diet and exercise first  medication  Adverse effects: Rhabdomyolysis = muscle weakness, tea colored urine  Take them in the evening for natural rhythm  No warfarin or grapefruit  Diuretics: o Loop: Furosemide “Furiously getting rid of sodium and water”  Lasik/Bumex  Quick acting  emergency  Lithium toxicity (low sodium)  Hypokalemia (low potassium)  Push slowly  ototoxicity  Give early in the morning This study source was downloaded by from CourseH on :40:48 GMT -05:00 Chamberlain College of Nursing NR 293 Final Study Guide  Check weight daily, same time, same clothes  o Potassium Sparing: Spironolactone  Aldactone  Hyperkalemia - avoid foods high in potassium/salt substitutes (licorice)  Interferes with lithium, NSAIDS, ACE  Irregular menses, post-menopausal bleeding, impotence o Thiazide: Hydrocholorthiazide  Similar to LOOP but NOT QUICK acting  Hypokalemia/ hypoglycemia  Blurred vision, impotence o Mannitol (Osmitrol) IV only  Intracranial pressure  Increased ocular pressure  Adverse: convulsions, pulmonary congestion  Contraindications: IC bleeding  Antiemetics – nausea/vomiting o Ondansetron - Zofran  Before chemo, radiation, post op, pregnant morning sickness  Sudden cardiac death  Extra pyramidal movements – tardive dyskinesia (excessive movements of eyes, lips or face)  IV or PO (dissolves under tongue) o Metoclopramide – Reglan  Facilitates peristalsis  Extra pyramidal symptoms – tardive dyskinesia (excessive movements of eyes, lips or face)  Causes drowsiness/sedation – don’t drive  Laxatives: o Docusate o Bisacodyl o Lactulose– Cephulac  Decrease ammonia levels and improve mental status  For people with liver enlargement/liver failure  Take with full glass of water  Increase motility and fiber This study source was downloaded by from CourseH on :40:48 GMT -05:00 Chamberlain College of Nursing NR 293 Final Study Guide  Nursing: check ammonia levels 1 hour after administration o Herbal Supplements used for Constipation  Senna  Vitamins & Mineral Supplements: o Calcium - Endocrine Drugs  Antidiabetics: o Insulin  Rapid acting: lispro  Onset: 5-15 minutes  Peak: 30 mins to 1 hour  Always give with food  Short acting: regular insulin – Humulin R  Onset: 30 minutes – 1 hour  Peak: 2.5 hours  Give to DKA  Intermediate: NPH  Onset: 1-2 hours  Peak: 4-12 hours  Can combine with regular insulin  Long acting: glargine – Lantus  Onset: 1-2 hours  NO PEAK  Duration: 24 hours  Never mix!!  Glucagon and Dextrose 50 = emergency hypoglycemia  Never shake, always roll o o Oral Anti-diabetic  Metformin – Glucophage (MOA liver)  Type 2 diabetes  Stop taking 24 hours before surgery/procedure  Don’t take 48 hours after surgery/procedure  Take with food  Lactic acidosis (diarrhea, dizzy, hypotension, brady, weakness), metallic taste, weight loss  Does NOT cause hypoglycemia  Can take with B12 vitamin  Sulfonylurea – glimepiride, glipizide, glyburide (MOA pancreas)  Type 2 diabetes only This study source was downloaded by from CourseH on :40:48 GMT -05:00 Chamberlain College of Nursing NR 293 Final Study Guide  Increases insulin release from pancreas  Hypoglycemia, photosensitivity, joint pain, weight gain Thyroid drugs: o Levothyroxine – Synthroid (synthetic T3 and T4)  For hypothyroidism  can lead to hyperthyroidism  Monitor T4 and TSH labs  Take before breakfast on empty stomach (6 am is best time)  Life long treatment  no cure