NURS 3301/ ATI Focus Review Pharmacology

ATI Focus Review PharmacologyATI Focus Review Pharmacology 1. Anxiety Disorders: Identifying Medications That Place a Client at Risk for Falls (RN QSEN - Safety, Active Learning Template - Basic Concept, RM Pharm RN 7.0 Chp 7) a. Sedative hypnotic anxiolytics: Benzodiazepines: Alprazolam b. Atypical anxiolytic/nonbarbiturate anxiolytic: Buspirone c. Selective serotonin reuptake inhibitors (SSRI antidepressants): Paroxetine 2. Substance Use Disorders: Priority Teaching for Varenicline (RN QSEN - Patient-centered Care, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 12) a. Instruct the client to take the medication after a meal b. Monitor blood pressure during treatment c. Monitor clients who have diabetes mellitus for loss of glycemic control 3. Antibiotics Affecting Protein Synthesis: Assessing for Contraindications to Tetracyclines (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 45) a. Tetracycline are pregnancy risk category D b. Taking tetracycline after the fourth month of pregnancy can stain the deciduous teeth, but the do not affect permanent teeth c. Use cautiously with liver and kidney disease 4. Antibiotics Affecting the Bacterial Cell Wall: Identifying an Allergic Reaction to Ampicillin/Sulbactam (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 44) a. If indications pf allergy appears (urticaria, rash, hypotension, dyspnea) b. Stop the medication immediately and notify the provider c. Instruct the client to report any signs of an allergic response such as dyspnea, a skin rash, itching, & hives. 5. Antibiotics Affecting the Bacterial Cell Wall: Plan of Care for Client Administered Antibiotics (Active Learning Template - Medication, RM Pharm RN 7.0 Chp 44) a. Instruct clients to take penicillin V, amoxicillin, and amoxicillin-clavulanate with meals. Tell them to take all others with 8 oz of water 1 hr before or 2 hr after meals b. Give IM injections cautiously to AVOID injecting into a nerve or artery c. Advise clients to complete the entire course of therapy, even if symptoms resolve. 6. Anxiety Disorders: Priority Finding of SSRIs (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 7) a. Advise clients to follow a well-balanced diet and exercise regularly b. After 5 to 6 weeks of therapy: sexual dysfunction may occur c. Serotonin syndrome usually begins 2 to 72 hours after the initiation of treatment 7. Chemotherapy Agents: Monitoring for Toxicity (Active Learning Template - Medication, RM Pharm RN 7.0 Chp 42) a. Mercaptopurine can cause liver toxicity: monitor liver enzymes & signs of jaundice b. Mercaptopurine can cause reproductive toxicity: advise female clients against becoming pregnant while taking these medications and for 6 months after c. Cisplatin can cause renal toxicity: monitor kidney function & increase fluids and give a diuretic if indicated 8. Chronic Neurologic Disorders: Medications That Interact With Carbamazepine (RN QSEN - Safety Active Learning Template - Medication, RM Pharm RN 7.0 Chp 13) a. Phenytoin and phenobarbital decrease effects of carbamazepine b. Carbamazepine causes a decrease in the effects of oral contraceptives c. Carbamazepine causes a decrease in the effects of warfarin: monitor the therapeutic effects of warfarin with PT & INR 9. Medications Affecting Coagulation: Laboratory Values to Report to the Provider (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 25) a. Monitor activated partial thromboplastin time when taking Heparin b. When taking Heparin, the aPTT levels should be between 60 to 80 seconds: this shows that therapy is effective c. When taking Warfarin, effectiveness can be evidenced by the following. PT 1.5 to 2 times control, INR of 2 to 3 for treatment of acute myocardial infarction, atrial fibrillation, pulmonary embolism, venous thrombosis, or tissue heart valves. 10. Nonopioid Analgesics: Manifestations of Salicylism (RN QSEN - Safety , Active Learning Template - Medication, RM Pharm RN 7.0 Chp 35) a. Tinnitus b. Sweating c. Headache 11. Opioid Agonists and Antagonists: Priority Assessment Findings (RN QSEN - Safety , Active Learning Template - Medication, RM Pharm RN 7.0 Chp 36) a. Respiratory depression: have naloxone and resuscitation equipment available b. Constipation: teach the client to increase fluid/fiber intake and physical activity c. Orthostatic hypotension: advise clients to sit or lie down if lightheadedness or dizziness occur 12. Peptic Ulcer Disease: Teaching About Ranitidine (RN QSEN - Patient-centered Care, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 28) a. Ranitidine can be taken with or without food b. Can be administered IV for acute situations c. Teach about complications such as: constipation, diarrhea, & nausea. & to report these effects to the provider 13. Anxiety Disorders: Evaluating the Therapeutic Effects of an SSRI (RN QSEN - Patient-centered Care, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 7) a. Verbalizing feeling less anxious and more relaxed b. Improved memory retrieval c. Maintaining regular sleep pattern 14. Bone Disorders: Identifying Therapeutic Uses of Raloxifene (Active Learning Template - Medication, RM Pharm RN 7.0 Chp 34) a. Prevent and treat postmenopausal osteoporosis to prevent spinal fractures in female clients b. Protect against breast cancer c. To increase bone density in women 15. Bipolar Disorders: Intervention for a Lithium Level (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 9) a. Lithium level is below 1.5 mEq/L: advise the client to withhold medication and notify the provider b. Lithium level is between 1.5 to 2.0 mEq/L: administer an emetic to clients who are alert c. Lithium level greater than 2.5 mEq/L: hemodialysis is required 16. Cardiac Glycosides and Heart Failure: Withholding Digoxin (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 21) a. With digoxin toxicity: stop digoxin and potassium-soaring medication immediately b. Monitor potassium levels. For levels less than 3.5 mEq/L, administer potassium IV or by mouth c. Monitor digoxin levels periodically during treatment and maintain therapeutic levels between 0.5 and 0.8 ng/mL to prevent digoxin toxicity. 17. Depressive Disorders: Adverse Effects of SSRIs (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 8) a. Early adverse effects: first few days/weeks: nausea, diaphoresis, tremor, fatigue, drowsiness b. Later adverse effects: after 5 to 6 weeks of therapy: sexual dysfunction c. Suicidal ideation: monitor and report manifestations of depression and thoughts of suicide 18. Medications Affecting Coagulation: Self-Administration of Enoxaparin (Active Learning Template - Medication, RM Pharm RN 7.0 Chp 25) a. Do not rub the sire for 1 to 2 minutes after the injection. Rotate and record injection sites. b. Instruct the clients to monitor for indications of bleeding (bruising, gums bleeding, abdominal pain, nose bleeds. c. Advise client to use an electric razor for shaving and to brush with a soft toothbrush 19. Opioid Agonists and Antagonists: Evaluating Medication Prescriptions (RN QSEN - Safety, Active Learning Template - Therapeutic Procedure, RM Pharm RN 7.0 Chp 36) a. Relief of moderate to severe pain b. Treatment of opioid dependence (buprenorphine) c. Relief of labor pain 20. Pharmacokinetics and Routes of Medication: Administering a Buccal Medication (RN QSEN - Safety, Active Learning Template - Nursing Skill, RM Pharm RN 7.0 Chp 1) a. Between the cheek and gum b. Clients should not eat or drink while the tablet is in place or until it has completely dissolved c. Instruct the clients to keep the medication in place until complete absorption occurs 21. Rheumatoid Arthritis: Client Teaching About Infliximab (RN QSEN - Patient-centered Care, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 33) a. IV infusion reactions (infliximab): flu-like findings, hypotension, possible anaphylaxis b. Stop the infusion and notify provider immediately for severe reactions c. Continue to monitor for reaction 2 hours after IV infusion 22. Safe Medication Administration and Error Reduction: The 6 Rights of Medication Administration (RN QSEN - Safety, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 2) a. Right client, Right documentation b. Right medication, Right route c. Right dose, Right time 23. Viral Infections, HIV, and AIDS: Client Teaching About Antivirals (Active Learning Template - Medication, RM Pharm RN 7.0 Chp 48) a. Instruct clients to complete the prescribed course of antimicrobials therapy, even though manifestations can resolve before the full course b. Advise the client to use barrier contraception if using antivirals c. Advise clients to practice good dental hygiene and seek dental care when taking Acyclovir to prevent gingival hyperplasia 24. Viral Infections, HIV, and AIDS: Teaching About Ritonavir (RN QSEN - Patient-centered Care, Active Learning Template - Medication, RM Pharm RN 7.0 Chp 48) a. Instruct clients to report all other medications, including OTC & herbal medications to the provider b. Advise clients to use a barrier form of contraception, such as condoms, in addition to a hormonal contraceptive c. Ritonavir can increase medication levels of sildenafil, tadalafil, and vardenafil: use with caution. Reduce dosages as needed.