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HESI RN CASE STUDY EVOLVE PRACTICE TEST BSN

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HESI RN CASE STUDY EVOLVE PRACTICE TEST BSN Antacids • neutralize gastric acids and keep pH of 3.5 or above Lactulose • 2 or 3 soft stools per day is the indicated result Digoxin • For CHF • ***ASSESS serum K POTASSIUM level before administering** • VOMITING, ANOREXIA, ABDOMINAL PAIN are early indications of digitalis toxicity • Combo with Lipitor increases digitalis toxicity (VOMITING req’s immediate intervention) • Client @ GREATEST RISK FOR HYPOKALEMIA Nitroglycerin • Relieves chest pain Captopril • ACE inhibitor for CHF to reduce HF (decreases BP and prevents vasoconstriction) • Report dizziness Propylthiouracil (PTU) • Hyperthyroidism tx • Inhibits synthesis of T3 and T4 by thyroid gland Carbidopa-levodopa (Sinemet) • Lessens tremors Warfarin • Measure prothrombin time (PT/INR) regularly at discharge Valsartan (Diovan) • Reduces BP aka tx hypertension • Angiotensin receptor blocker Meperidine (Demerol) • If adverse s&s, decrease IV infusion rate Alendronate (Fosamax) • Osteoporosis • -Take med, go for 30 min walk, then eat breakfast • (30 min before eating) remain upright for 30 minutes after taking d/t reflux Metoprolol (Lopressor) • Obtain BP Procainamide (Pronestyl) • 4 doses = q6h Adenosine (Adenocard) • Antiarrhythmic drug • Cardiac monitoring Dopamine and IV saline 50 ml/hr • 20 ml/hr urine output = notify HCP ***Atorvastatin (Lipitor) • Muscle pain and weakness make appointment with HCP ***** • b/c serious s/e • “myopathy” leg pain and weakness Angiotensin-2 receptor antagonist • Irbesartan • Risk for injury • Hypotension and dizziness Clonidine (Catapres) • Transdermal patch • BP from 180/120 to 140/70 Methylprednisolone (Solu-Medrol) 40 mg • Increase in serum glucose • Hyperglycemia Morphine and ketorolac • Can be given together according to prescription Isosorbide dinitrate (Imdur) • If h/a still administer 60 mg dose but add acetaminophen (Tylenol) Acetaminophen (Tylenol) • Controls h/a • Toxic can lead to liver damage • Assess RUQ of abdomen Aspirin and Pepto Bismol • Caution taking high doses of aspirin for arthritis with bismuth subsalicylate (pepto bismol) Aspirin • Notify HCP immediately if ringing of ears • Aka salicylate toxicity • Discontinue med Opioids • Assess respiratory depression • PCA pump stopped in rr below 12 Naloxone • Effective if RR normal • Reverses resp depression of opiates OD Edrophonium chloride (tensilon) • Decreases muscle weakness (MG) • Short duration Levodopa then Sinemet (already took levodopa 0800) • Begin Sinemet this evening but DON’T take any more levodopa Penicillin allergy • Caution w/ Cephalosporins TOO


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