NUR 226 HESI Final Exam NOTES

NUR 226 HESI Final Exam Key concepts: to guide your studies Nursing Process • Assessment • Analysis (Diagnosing) • Planning • Implementation • Evalu ation Client Needs • Safe/Effective Environment • Management of Care (RN) • Safety & Infection Control • Health Promotion and Maintenance • Psychosocial Integrity • Physiological Integrity • Basic care/Comfort • Pharmacology & Parenteral Treatment • Reduce Risk Potential • Physiological Adaptation Medications: Know action, therapeutic levels where appropriate, adverse reactions, implications, how to determine if the drug is effective; expected outcome, dietary concerns, when to call the provider: Albuterol (Proventil) AND Maxair (pirbuterol) (bronchodilator) Albuterol = SABA, for acute asthma attack Hit within 5-10 min 15 min before exercise Dosed every 4 hours Direct effect on the lungs allowing for bronchodilation (relaxation) HR will go up but tell them it’s normal and it will slow down, feeling jittery is normal Watch out for bronchospasm Know efficient by seeing decrease serum K+ If 2 puffs needed, make sure 1-3 min in between each puff Using glucocorticoid inhaler as well → 5-15 min before using inhaler containing steroids Maxair = LABA Management of reversible airway disease due to intermittent asthma or COPD quick-relief agent Onset within 5 min 2 inhalations dosed every 4-6 hours Direct effect on the lungs allowing for bronchodilation (relaxation) Both can cause tachycardia, restlessness, nervousness, jitters, palpitation → can be uncomfortable for pt but they will go away Monitor for Paradoxical bronchospasm Can lead to hyperactivity in children RINSE MOUTH Check for cardiac dysrhythmias Naloxone Narcan Opioid Antagonist IV onset 1-2 min, IM onset 2-5 min, Intranasal onset 8-13 min Action: prevent the effects of opioid agonists, block opioid activity by blocking mu and kappa receptors Results/Adverse Reactions: Can result in BP increase, RR increase, N/V/drowsy/tremors Implications: repeat Q 2-3mins until desired effect Will need to monitor for recurrence CNS/Resp depression (repeated OD as med wears off), and might need to re-administer naloxone again later d/t short half-life Risk of hepatotoxicity AE: ventricular arrythmias