ATI Pharmacology in Nursing Predictor
Review
Standard Conversion Factors - ANS 1 mg = 1,000 mcg
1 g = 1,000 mg
1 kg = 1,000 g
1 kg = 2.2 lb
60 mg = 1 gr
30 mL = 1 oz
5 mL = 1 tsp
15 mL = 1 tbsp
1 tbsp = 3 tsp
Six rights of medication administration - ANS Right patient, right drug, right dose, right route,
right time, right documentation
Infiltration - ANS Prevention: use smallest catheter for prescribed therapy, stabilize port-access,
assess blood return
Treatment: stop infusion, remove peripheral catheters, apply COLD compress, ELEVATE
extremity, insert new catheter in OPPOSITE extremity.
Extravasation - ANS Prevention: know vesicant potential before giving medication
Treatment: stop infusion, discontinue administration set, aspirate drug if possible, apply COLD
compress, document condition of site (may photograph).
Phlebitis/thrombophlebitis - ANS Prevention: rotate sites every 72-96 hrs; secure catheter; use
aseptic technique; for PICCs, avoid excessive activity with the extremity.
Treatment: stop infusion; remove peripheral IV catheter; apply HEAT compress; insert new
catheter in opposite extremity.
Hematoma - ANS Prevention: avoid veins not easily seen or palpated; obtain hemostasis after
insertion
Treatment: remove IV device and apply light pressure if bleeding; monitor for signs of phlebitis
and treat
,catheter embolus - ANS Prevention: do not reinsert stylet needle into catheter
Treatment: Immediately apply tourniquet high on extremity to limit venous blood flow. Prepare
for removal under x-ray
Care and Maintenance of TPN - ANS - Before administering, verify prescription and solution
with another nurse
- Administer via infusion pump
- Monitor DW
- Monitor and record I&O, noting fluid balance
- Monitor BG levels every 4-6 hours
- Monitor for signs of infection
- Change dressing every 48 to 72 hours or per facility policy
- Change IV tubing and fluids every 24 hours
- If TPN is temporarily unavailable, administer dextrose 10% in water to prevent hypoglycemia
Antidote for Acetaminophen - ANS Acetylcysteine
Antidote for Benzodiazepines - ANS Flumazenil
Antidote for Curare - ANS Edrophonium
Antidote for cyanide poisoning - ANS Methylene blue
Antidote for Digitalis - ANS Digoxin immune FAB
Antidote for Ethylene poisoning - ANS Fomepizole
Antidote for Heparin and Enoxaparin - ANS Protamine sulfate
Antidote for Iron - ANS Deferoxamine
Antidote for Lead - ANS Succimer
Antidote for Magnesium sulfate - ANS Calcium gluconate 10%
Antidote for Narcotics - ANS Naloxone
Antidote for Warfarin (Coumadin) - ANS Phytonadione (Vitamin K)
Common Drug Class Suffixes - ANS - Calcium channel Blockers (-dipine)
- ACE inhibitors (-pril)
- Benzodiazepines (-pam, -lam)
- Beta blockers (-olol)
,- Proton pump inhibitors (-prazole)
- SSRIs (-pram, -ine)
Antihypertensives: Nursing Interventions - ANS - Assess weight, vitals, and hydration status
- Assess orthostatic BP
- Assess lab profiles (renal function, coagulation)
- Teach patient to take medication at the same time every day
- Patients should avoid hot tubs and saunas
- Do not discontinue medications abruptly
- Prevent orthostatic hypotension
Antihypertensives: Angiotensin-Converting Enzyme (ACE) Inhibitors & Angiotensin II Receptor
Blockers (ARBs) - ANS ACE Inhibitors:
--> "pril"
--> Captopril, Enalapril, Enalaprilat (IV route), Fosinopril, Lisinopril
ARBs:
--> "sartin"
--> Losartan, Valsartan, Irbesartan herapeutic use:
--> HTN, HF, MI, diabetic neuropathy
Therapeutic Use:
--> HTN, HF, MI, Diabetic neuropathy
Precautions/Interactions:
--> Use with caution if diuretic therapy is in place
--> Monitor Potassium levels
Nursing Interventions and Client Education:
--> Captopril should be taken 1 hour before meals
--> Monitor BP
--> Monitor for angioedema and promptly administer epinephrine 0.5 mL of 1:1,000 solution
subcutaneously
Antihypertensives: Calcium-Channel Blockers - ANS Medications:
--> "dipine"
--> Nifedipine, Verapamil, Diltiazem, Amlodipine
Therapeutic Use:
--> Angina, HTN
--> Verapamil and Diltiazem may be used for A-Fib, A-flutter, or SVT
Precautions/Interactions:
--> Use cautiously in patients taking digoxin and beta blockers
, --> Contraindicated for patients who have HF, heart block, or bradycardia
--> DO NOT consume grapefruit (toxic effects)
Side/Adverse Effects:
--> Constipation, reflex tachycardia, peripheral edema, toxicity
Nursing Interventions and Client Education:
--> Do not crush or chew sustained-released tabs
--> Administer IV injection over 2-3 minutes
--> Slowly taper does if discontinuing
--> Monitor HR and BP
Antihypertensives: Alpha Adrenergic Blockers (Sympatholytics) - ANS Medications:
--> Prazosin, Doxazosin mesylate
Therapeutic Use:
--> Primary HTN
--> Doxazosin mesylate may be used in treatment of BPH
Precautions/Interactions:
--> Increased risk of hypotension and syncope if given with other antihypertensives, beta
blockers, or diuretics
--> NSAIDs may decrease the effect of prazosin
Side/Adverse Effects:
--> Dizziness, fainting
Nursing Interventions and Client Education:
--> Monitor HR and BP
--> Take medication at bedtime to minimize effects of hypotension
--> Advise to notify HCP of adverse reactions
--> Consult HCP before taking OTC medications
Antihypertensives: Centrally Acting Alpha2 Agonists - ANS Medications:
--> Clonidine, Guanfacine HCI, Methyldopa
Therapeutic Use:
--> Primary HTN (may be used in combination with diuretics or other antihypertensives)
--> Hypertensive crisis
--> Severe cancer pain (parenteral administration via epidural)
Precautions/Interactions:
--> Contraindicated with anticoagulant therapy, hepatic failure
--> Do not administer to clients taking MAOIs
Review
Standard Conversion Factors - ANS 1 mg = 1,000 mcg
1 g = 1,000 mg
1 kg = 1,000 g
1 kg = 2.2 lb
60 mg = 1 gr
30 mL = 1 oz
5 mL = 1 tsp
15 mL = 1 tbsp
1 tbsp = 3 tsp
Six rights of medication administration - ANS Right patient, right drug, right dose, right route,
right time, right documentation
Infiltration - ANS Prevention: use smallest catheter for prescribed therapy, stabilize port-access,
assess blood return
Treatment: stop infusion, remove peripheral catheters, apply COLD compress, ELEVATE
extremity, insert new catheter in OPPOSITE extremity.
Extravasation - ANS Prevention: know vesicant potential before giving medication
Treatment: stop infusion, discontinue administration set, aspirate drug if possible, apply COLD
compress, document condition of site (may photograph).
Phlebitis/thrombophlebitis - ANS Prevention: rotate sites every 72-96 hrs; secure catheter; use
aseptic technique; for PICCs, avoid excessive activity with the extremity.
Treatment: stop infusion; remove peripheral IV catheter; apply HEAT compress; insert new
catheter in opposite extremity.
Hematoma - ANS Prevention: avoid veins not easily seen or palpated; obtain hemostasis after
insertion
Treatment: remove IV device and apply light pressure if bleeding; monitor for signs of phlebitis
and treat
,catheter embolus - ANS Prevention: do not reinsert stylet needle into catheter
Treatment: Immediately apply tourniquet high on extremity to limit venous blood flow. Prepare
for removal under x-ray
Care and Maintenance of TPN - ANS - Before administering, verify prescription and solution
with another nurse
- Administer via infusion pump
- Monitor DW
- Monitor and record I&O, noting fluid balance
- Monitor BG levels every 4-6 hours
- Monitor for signs of infection
- Change dressing every 48 to 72 hours or per facility policy
- Change IV tubing and fluids every 24 hours
- If TPN is temporarily unavailable, administer dextrose 10% in water to prevent hypoglycemia
Antidote for Acetaminophen - ANS Acetylcysteine
Antidote for Benzodiazepines - ANS Flumazenil
Antidote for Curare - ANS Edrophonium
Antidote for cyanide poisoning - ANS Methylene blue
Antidote for Digitalis - ANS Digoxin immune FAB
Antidote for Ethylene poisoning - ANS Fomepizole
Antidote for Heparin and Enoxaparin - ANS Protamine sulfate
Antidote for Iron - ANS Deferoxamine
Antidote for Lead - ANS Succimer
Antidote for Magnesium sulfate - ANS Calcium gluconate 10%
Antidote for Narcotics - ANS Naloxone
Antidote for Warfarin (Coumadin) - ANS Phytonadione (Vitamin K)
Common Drug Class Suffixes - ANS - Calcium channel Blockers (-dipine)
- ACE inhibitors (-pril)
- Benzodiazepines (-pam, -lam)
- Beta blockers (-olol)
,- Proton pump inhibitors (-prazole)
- SSRIs (-pram, -ine)
Antihypertensives: Nursing Interventions - ANS - Assess weight, vitals, and hydration status
- Assess orthostatic BP
- Assess lab profiles (renal function, coagulation)
- Teach patient to take medication at the same time every day
- Patients should avoid hot tubs and saunas
- Do not discontinue medications abruptly
- Prevent orthostatic hypotension
Antihypertensives: Angiotensin-Converting Enzyme (ACE) Inhibitors & Angiotensin II Receptor
Blockers (ARBs) - ANS ACE Inhibitors:
--> "pril"
--> Captopril, Enalapril, Enalaprilat (IV route), Fosinopril, Lisinopril
ARBs:
--> "sartin"
--> Losartan, Valsartan, Irbesartan herapeutic use:
--> HTN, HF, MI, diabetic neuropathy
Therapeutic Use:
--> HTN, HF, MI, Diabetic neuropathy
Precautions/Interactions:
--> Use with caution if diuretic therapy is in place
--> Monitor Potassium levels
Nursing Interventions and Client Education:
--> Captopril should be taken 1 hour before meals
--> Monitor BP
--> Monitor for angioedema and promptly administer epinephrine 0.5 mL of 1:1,000 solution
subcutaneously
Antihypertensives: Calcium-Channel Blockers - ANS Medications:
--> "dipine"
--> Nifedipine, Verapamil, Diltiazem, Amlodipine
Therapeutic Use:
--> Angina, HTN
--> Verapamil and Diltiazem may be used for A-Fib, A-flutter, or SVT
Precautions/Interactions:
--> Use cautiously in patients taking digoxin and beta blockers
, --> Contraindicated for patients who have HF, heart block, or bradycardia
--> DO NOT consume grapefruit (toxic effects)
Side/Adverse Effects:
--> Constipation, reflex tachycardia, peripheral edema, toxicity
Nursing Interventions and Client Education:
--> Do not crush or chew sustained-released tabs
--> Administer IV injection over 2-3 minutes
--> Slowly taper does if discontinuing
--> Monitor HR and BP
Antihypertensives: Alpha Adrenergic Blockers (Sympatholytics) - ANS Medications:
--> Prazosin, Doxazosin mesylate
Therapeutic Use:
--> Primary HTN
--> Doxazosin mesylate may be used in treatment of BPH
Precautions/Interactions:
--> Increased risk of hypotension and syncope if given with other antihypertensives, beta
blockers, or diuretics
--> NSAIDs may decrease the effect of prazosin
Side/Adverse Effects:
--> Dizziness, fainting
Nursing Interventions and Client Education:
--> Monitor HR and BP
--> Take medication at bedtime to minimize effects of hypotension
--> Advise to notify HCP of adverse reactions
--> Consult HCP before taking OTC medications
Antihypertensives: Centrally Acting Alpha2 Agonists - ANS Medications:
--> Clonidine, Guanfacine HCI, Methyldopa
Therapeutic Use:
--> Primary HTN (may be used in combination with diuretics or other antihypertensives)
--> Hypertensive crisis
--> Severe cancer pain (parenteral administration via epidural)
Precautions/Interactions:
--> Contraindicated with anticoagulant therapy, hepatic failure
--> Do not administer to clients taking MAOIs
