Complete Solutions
0.45% (1/2) Normal Saline Correct Answers Hypotonic → less
concentrated than plasma (<250 mOsm/kg) which allows
movement of fluid from bloodstream into the cells causing cells
to expand
Uses:
Treat hypernatremia
Water replacement
Replace gastric fluid loss from NG suctioning or vomiting
Special Considerations:
Excessive use can cause cardiovascular collapse (from vascular
fluid depletion) & ↑ intracranial pressure (from fluid shifting
into brain cells)
Fluid replacement for patients who don't need extra glucose
(diabetics)
Acetaminophen
(Tylenol)
Non-opioid analgesics Correct Answers Action: Inhibits
synthesis of prostaglandins in CNS that serve as mediators of
pain/fever
Indication: Tx of mild pain/fever
Adverse Rxn: Hepatotoxicity (↑ doses), n/v, headache,
inching/rash
,RN Considerations: Assess r/o developing hepatotoxicity, drugs
taken OTC c acetaminophen, r/o ↑ renal damage, level of pain,
temp of fever; Teach pt. do not consume c alcohol
Effectiveness: Relief of mild-moderate pain/reduction of fever
Acetylcysteine
(Mucomyst)
Mucolytic Correct Answers Action: Degrades mucus, allowing
easier mobilization and expectoration, lowers viscosity of mucus
Indication: Mucolytic in the management of conditions
associated c thick viscid mucous secretions
Adverse Rxn: ANAPHYLAXIS, AGIOEDEMA, bronchospasm,
n/v, rash
RN Considerations: Assess respiratory function (lung sounds,
dyspnea), color, amount, consistency of secretions a & p Tx;
Teach pt. to clear airway by coughing deeply before taking
aerosol Tx; Inform pt. of unpleasant odor of drug becomes less
noticeable as Tx progresses & medicine dissipates
Effectiveness: Decreased dyspnea & clearing of lung sounds
Albumin
(3.5-5.5 mg/dL) Correct Answers Monitor pt.'s nutritional status
↑ d/t dehydration, ↑ protein intake
,↓ d/t malnutrition, pregnancy, liver disease, third-space losses,
overhydration
If ↓ → assess for edema, ↑ protein intake, administer IV albumin
THINK EDEMA, monitor I/O
Albuterol
(Proventil)
Adrenergic agonist Correct Answers Action: Binds to B2-
adrenergic receptors in airway smooth muscle, relaxing airways
→ bronchodilation
Indication: Opens airway to treat acute bronchospasm
Adverse Rxn: PARADOXICAL BRONCHOSPASM,
nervousness, restlessness, tremor, chest pain, palpitations,
tachycardia
RN Considerations: Assess O2, RR, HR, lung sounds; Observe
for paradoxical bronchospasm
Effectiveness: Prevention/relief of bronchospasm, ↑O2, ↓RR,
clearer lung sounds
Alpha- & Beta - Adrenergic Agonists Correct Answers Action:
Vasoconstriction; ↑ HR, ↑ myocardial contractility;
bronchodilation & ↑ RR/depth; glycogenolysis occurs
throughout the body
, Indication: Tx of HF, shock, or bronchospasm
Adverse Rxn: CARDIAC ARRHYTHMIAS, HTN, palpitations,
angina, dyspnea, nervousness, restlessness, tremor, n/v,
constipation, HA, sweating, anxiety, extravasation of drug to the
tissue if given intravenously
RN Considerations: Assess baseline respiratory, cardiac
assessments, VS & ECG, renal & liver function tests; Monitor
electrolytes (K+ & Mg+); Ensure proper dosage calculations /
independent RN checks; Monitor I/O; Have phentolamine on
standby in case of intravenous extravasation; Provide comfort
measures and safety precautions; Proper patient teaching to
increase knowledge and promote compliance
Effectiveness: Tx of HF, shock, or bronchospasm
Angiotensin Converting Enzyme (ACE) Inhibitor
"-pril" Correct Answers Action: Blocks angiotensin-converting-
enzyme (ACE) from converting angiotensin I to angiotensin II;
Prevents vasoconstriction, causes ↓ BP and ↓ aldosterone
production
Indication: Tx mild-severe HTN, adjunctive Tx for HF (↑ the
ability of pt's. to function & ↓ mortality rates), prevent or delay
the progression of kidney disease caused by diabetes (diabetic
nephropathy)
Adverse Rxn: r/t the effects of vasodilation & alterations in
blood flow (tachycardia, chest pain, HF, cardiac arrhythmias),