What signs/symptoms you would expect to see in patient taking prednisone? -
ANSWER
When joan says you have a poor immune system, what does that mean?
What should the nurse should be on the look out for? - ANSWER unable to fight off
infections, low WBC's, low neutrophil count
signs of infection and poor wound healing
What does Prednisone cause?
Can they be stopped?
What do you have to do before surgery? - ANSWER decreased wound healing, takes
longer to heal
Going to have to be boosted with the steroid before surgery because we can't just stop
them.
What class of drug is aspirin?
Is there an antidote?
What are the complications? - ANSWER anti-platelet, prevents platelet aggregation in
the vessels (clotting factor)
no antidote
Complications = bleeding, ototoxicity nerve deafness/renal toxicity, ulcers
You are the nurse in the hospital, and you check your patient's blood glucose, and
found that glucose = 60. What would you do? - ANSWER If conscious: Give OJ, and
then 15 grams carbs.
If unconscious: Give Glucagon subcutaneous or IM
How can you give glucagon? - ANSWER subq or IM only
,If a pt is allergic to penicillin can they give a cephalosporin? - ANSWER yes, but monitor
the pt for signs of an allergic reaction
What are the s/s of hypoglycemia? - ANSWER Sweating
Confusion
Dizziness
Tremors
Agitation
Pallor
You have a patient that is experiencing hypoglycemia what would you do FIRST? Then
what would you do? - ANSWER Check the blood sugar first
If it is low then give OJ and 15 grams of carbs
You have a patient that is on high doses of steroids.
What would you do yourself?
What would you educate your patient to do? - ANSWER Wash your hands because
steroids make immune system weaker
steroids should be taken with food, in the morning
take regularly
they should wash their hands frequently throughout the day
Signs/symptoms of thyroid storm - ANSWER fever
fatigue
tachycardia
agitation
nervousness
What causes a thyroid storm? - ANSWER Switching from generic to non-generic steroid
medication (or vise versa)
What is one of the major symptoms of thyroid storm that would make you be in the
hospital? - ANSWER fever
What drug is needed to reverse thyroid storm? - ANSWER Propylthiouracil: PTU
Would a thyroid storm patient need to be on a cardiac monitor?
Until when? - ANSWER yes
until the thyroid storm is over
, Patient on steroids has the following vitals: BP 156/78, P 104, Glucose 138, T 101.
Which would be the greatest concern? - ANSWER The fever = 1st sign of infection. It's
the most important because of their compromised immune system.
Elevated blood pressure, heart rate, and glucose is a normal side effect of steroids
Teach me about insulin - ANSWER rotate the sites of injection because of lipodystrophy
roll the vial, don't shake it
If you are mixing NPH and Regular insulin you:
Inject air into NPH, then inject air into Regular, then draw up the regualr, then draw up
the NPH
Do little bubbles matter in insulin? - ANSWER yes
Can you mix Lantus with anything? - ANSWER no
Should I throw away cloudy NPH? - ANSWER no, NPH is supposed to be cloudy
What are some problems that Diabetic patients have? - ANSWER poor circulation
(circulatory issues)- leading to neuropathy
poor wound healing
complications with medication and diet
they can't see the numbers on syringe if they draw up their own insulin because
diabetes can lead to eye problems- diabetic retinopathy
susceptible to UTI's
When teaching a Diabetic patient to draw up insulin and they can't see the numbers
what can you suggest? - ANSWER use 2 syringes
There's a 50u and 100u syringe, they should use the smaller syringe or pens that can
be dialed up
insulin is always orange topped
use an insulin pen if possible
What would you use give an UNCONSCIOUS Diabetic patient who's sugar = 30? -
ANSWER glucagon
given subq or IM