NUR 3420 Final Exam
Loop diuretics nursing implications
-monitor K
-monitor dehydration
-monitor low BP
-assess lung sounds/peripheral edema
What do you do for a patient with a STEMI?
go to Cath lab for stent to be placed and give TPA (MONITOR
BLEEDING)
What labs do you look at for MI?
troponin and electrolytes
When a patient comes with very low BP, what do you do first?
IV fluids
How to treat hypovolemic shock?
-fluids, blood, electrolytes
-raise BP by treating underlying cause
-recumbent position
-give adrenergic agent
Norepinephrine (Levophed)
-give only through central line (extravasation)
-monitor LOC
-monitor peripheral perfusion
-monitor MAP
,(treats severe hypotension and shock after fluid volume
replacement)
Corticosteroid examples
Glucocorticoid, Mineralocorticoids (ALDOSTERONE), adrenal
sex hormones, prednisone, hydrocortisone
What can corticosteroids cause?
hyperglycemia, PUD, kidney/liver damage, osteoporosis,
psychosis, infections, HTN, cushingoid changes
Do you give corticosteroids with food?
Yes
What to monitor with corticosteroids?
weight, BP, Pt with DM, TAPER DOSE, monitor disorientation
Can insulin be given to treat hyperkalemia?
yes
How to treat hypoglycemia?
-follow rule of 15
-BG under 70
Metformin
-biguanide
-decrease glucose production
-discontinued while in hospital when studies with contrast dye
Levothyroxine
, -hypothyroid / replacement therapy
-6am on empty stomach (take same time daily)
-dose in mcg
-cardiac dysrhythmia most significant adverse effect
-do not switch brand without telling provider
Type 1 vs Type 2 HIT
1:
decreased platelet can continue drug
2:
major reduction platelets, stop heparin, administer protamine
sulfate
Thrombolytic drug adverse effects and nursing administration
bleeding and cardiac dysrhythmias
-check baseline INR, aPTT, and platelets
Antacids
-take 1 hr after meals
-prevents absorption of most drugs
Amphojel
-aluminum antacid
-slow onset, large doses
-constipation
Mylanta
-magnesium
-hypermagnesmia, diarrhea, fast onset
Loop diuretics nursing implications
-monitor K
-monitor dehydration
-monitor low BP
-assess lung sounds/peripheral edema
What do you do for a patient with a STEMI?
go to Cath lab for stent to be placed and give TPA (MONITOR
BLEEDING)
What labs do you look at for MI?
troponin and electrolytes
When a patient comes with very low BP, what do you do first?
IV fluids
How to treat hypovolemic shock?
-fluids, blood, electrolytes
-raise BP by treating underlying cause
-recumbent position
-give adrenergic agent
Norepinephrine (Levophed)
-give only through central line (extravasation)
-monitor LOC
-monitor peripheral perfusion
-monitor MAP
,(treats severe hypotension and shock after fluid volume
replacement)
Corticosteroid examples
Glucocorticoid, Mineralocorticoids (ALDOSTERONE), adrenal
sex hormones, prednisone, hydrocortisone
What can corticosteroids cause?
hyperglycemia, PUD, kidney/liver damage, osteoporosis,
psychosis, infections, HTN, cushingoid changes
Do you give corticosteroids with food?
Yes
What to monitor with corticosteroids?
weight, BP, Pt with DM, TAPER DOSE, monitor disorientation
Can insulin be given to treat hyperkalemia?
yes
How to treat hypoglycemia?
-follow rule of 15
-BG under 70
Metformin
-biguanide
-decrease glucose production
-discontinued while in hospital when studies with contrast dye
Levothyroxine
, -hypothyroid / replacement therapy
-6am on empty stomach (take same time daily)
-dose in mcg
-cardiac dysrhythmia most significant adverse effect
-do not switch brand without telling provider
Type 1 vs Type 2 HIT
1:
decreased platelet can continue drug
2:
major reduction platelets, stop heparin, administer protamine
sulfate
Thrombolytic drug adverse effects and nursing administration
bleeding and cardiac dysrhythmias
-check baseline INR, aPTT, and platelets
Antacids
-take 1 hr after meals
-prevents absorption of most drugs
Amphojel
-aluminum antacid
-slow onset, large doses
-constipation
Mylanta
-magnesium
-hypermagnesmia, diarrhea, fast onset
