1. List common CNS side effects of Famotidine (Pepcid):
• Hallucinations, confusion, agitation, depression, anxiety, insomnia, convulsion in client
with impaired renal functions
2. Describe adverse effects associated with aminoglycoside antibiotics: Neurotoxicity,
ototoxicity, nephrotoxicity, ataxia, vertigo.
3. Discuss purpose of using Naloxone (Narcan) with opioids; know therapeutic actions:
• Competitively blocks the effects of opioids, including CNS and respiratory depression,
without producing any agonist (opioid like) effects. Reversal of signs of opioid excess.
4. Describe what comprises Balanced or Neuroleptic Anesthesia:
• The combing of several drugs, each with a specific effect, to achieve analgesia, muscle
relaxation, unconsciousness, and amnesia. Balanced anesthesia involves the following
agents:
Preoperative meds: the use of anticholinergics that decrease secretions to facilitate intubation
and prevent bradycardia associated with neural depression.
Sedative-hypnosis: to relax the patient, facilitate amnesia and decrease sympathetic
stimulations.
Antiemetic: to decrease nausea and vomiting associated with the slowing of the GI activity.
Antihistamines: to decrease the chance of allergic reactions and help to dry up secretions.
Narcotics: to aid analgesia and sedation.
5. Identify the antidote or reversal agent for Pancuronium bromide (Pavulon) used in
General Anesthesia:
• (Regonol) Pyridostigmine bromide injection, neostigmine, or edrophonium, in
conjunction with atropine or glycopyrrolate, will usually antagonize the skeletal muscle
relaxant action of Pancuronium bromide (pavulon) by adequacy of respiration a
peripheral nerve stimulator may also be used to monitor restoration of twitch response.
6. Identify uses for Aminophylline and list common/serious side effects:
• Uses: Treats and prevent wheezing and trouble breathing caused by ongoing lung
disease like asthma, emphysema, and chronic bronchitis.
, • Common side effects: Upset stomach, stomach pain, diarrhea, headache, restlessness,
insomnia, irritability.
• Serious side effects: Vomiting, increasing or rapid heart rate, irregular heartbeat,
seizures, skin rash.
7. Describe lifelong medication therapy & diagnostic test(s) appropriate for
Pernicious Anemia:
Lifelong medication therapy:
• A shot of B12 once a month (if a client has severe low B12 may get more shots at the
beginning).
• B12 supplements by mouth (for some patients a high dose of B12 tablets work well and
don't need shots)
• A certain type of B12 may be given though the nose.
Diagnostic tests:
Physical exam, bone narrow examination (only if diagnostic is unclear), CBC, reticulocyte
count, schilling test, LDH, methyl/malonic acid (MMA) level, B12 level.
8. List states in which folic acid deficiency may exist:
• Occurs secondary to increased demand (as in pregnancy or growth spurts).
• As a result of absorption problems in the small intestines.
• Because of drugs that cause folate deficiencies. Secondary to malnutrition of
alcoholism.
9. Identify agents used to treat hyperthyroidism and nursing interventions/teaching:
Anti-thyroid agents:
• Thioamides: Methimazole (tapazole), propylthiouracil.
• Iodine solutions: sodium iodide 1131 (generic radioactive iodine); strong iodine solution,
potassium iodine (thyro-block)
Nursing interventions:
• Assess hyperthyroidism (palpitations, nervousness, loss of hair, insomnia, heat
intolerance, weight loss, diarrhea).
• Assess hypothyroidism (constipation, dry skin, weakness, fatigue, headache, weight
gain).