Digoxin

increase heart contractility

decreases heart heart so make sure to check apical pulse for one full minute

0.6-2 (toxic)

halo vision, abdominal pain, anorexia, nausea

Malaise

discomfort

hydralazine

vasodilator

treat high blood pressure

crepitus

a popping, clicking or crackling sound in a joint. Joint popping sounds – what some may call bone cracking – may mean that air is moving in the joint, which is usually harmless.

infant

The normal blood pressure of an infant this age is about 90/56 mmHg.

20 to 40 breaths per minute

90 to 130 beats per minute

Bell’s palsy

occur abruptly with unilateral facial paralysis. This is accompanied by eyebrow sagging, diminished taste, decreased eye tearing, and drooping of the mouth on the affected side. paralysis facial nerve 7

• Nursing care is aimed at mitigating symptoms by using artificial tears and ointment.
• A client may also use an eye patch on the affected eye at night.

Phenelzine

is a monoamine oxidase inhibitor (MAOI) medication indicated for treating severe depression. Smoke bacon is contraindicated because it contains a high level of tyramine which may cause a client to develop a life-threatening hypertensive crisis. Other foods contraindicated when the client takes an MAOI for depression include bananas, raisins, cheeses, sour cream, yogurt, beer, red wines, and Italian green beans.

Diltiazem

is a calcium channel blocker that may adversely cause bradycardia and hypotension

should not be given to heart failure

Amoxicillin

is an antibiotic that is commonly used to treat Helicobacter pylori infections. When treating this infection, this medication is often coupled with a proton pump inhibitor such as esomeprazole

Episiotomy

is a surgical incision in the perineum to widen the vaginal opening and facilitate fetal head delivery. These methods may be used for labor dystocial during the second (pushing stage) stage.

Edentulous

is a medical term referring to the complete loss of all teeth (i.e., dentition). Edentulous clients lack teeth; therefore, a mechanical soft diet would be the diet most likely to be ordered for this client, as this diet would facilitate mastication.

Narcolepsy

is a syndrome in which a client has significant daytime sleepiness that often lessens after a nap.

✓ Stimulants such as modafinil and armodafinil are indicated in the management of narcolepsy as they promote wakefulness.

✓ Common side effects of modafinil include headache, nervousness, anorexia, and weight loss.

Airborne Precaution

hand hygiene, N-95, private/ cohort

Airborne Precaution

Tuberculosis, rubeola (measles), varicella (chickenpox), SARS, smallpox, zoster virus

Contact Precaution

PPE, hand hygiene

Contact Precaution

MRSA, VRE, conjunctivitis, diphtheria (cutaneous), RSV, herpes virus, pediculosis, scabies, polio, staph, C diff, norovirus, rotavirus

Droplet Precaution

hand hygiene, mask, private room/ cohort

Droplet Precaution

influenza, pertussis, mumps, rhinovirus, rubella, bacterial meningitis, epiglottis, parvovirus, diphtheria

Paget’s disease

a disease characterized by accelerated bone remodeling. This may cause an individual to be asymptomatic or have pain in the affected bone(s). The client will be at a higher risk for fracture during this disease process and may eventually develop bone deformities.

Janeway lesions

are an expected finding associated with bacterial endocarditis. These lesions are commonly found on the soles of the feet and the hands.

NSAIDs

include ibuprofen, naproxen, oxaprozin, and ketorolac

✓ NSAIDs are efficacious for pain or pyrexia

✓ NSAIDs are nephrotoxic; therefore, monitoring renal function (BUN and creatinine) is essential

✓ NSAIDs may adversely cause gastrointestinal bleeding, renal insufficiency, myocardial infarction (MI), or stroke

✓ Clients with peptic ulcer disease, congestive heart failure, renal injury, or a previous MI should not use NSAIDs

Naproxen

is a non-steroidal anti-inflammatory drug (NSAID). NSAIDs have been commonly implicated in causing adverse bleeding episodes

Post-maturity

refers to any baby born at or beyond 42 weeks gestation (42 0/7 weeks) or at or beyond 294 days from the first day of the mother's last menstrual period (LMP)

the post-term infant is at risk for hypoglycemia and hypothermia.

Additionally, the risk of meconium aspiration is high in the post-term fetuses and can cause respiratory distress when the baby is born. The nurse should prioritize and assess this post-term infant first.

Chvostek Sign

tapping on the face just below and in front of the ear to trigger facial twitching of one side of the mouth, nose, and cheek

✓ Trousseau's Sign may be elicited by placing a blood pressure cuff around the arm, inflating the cuff to greater than the client's systolic pressure, and keeping the cuff inflated for 1 to 4 minutes

✓ Severely low levels of magnesium or calcium may cause the presence of these signs

Rhonchus (rhonchi)

lower in pitch and sounds like continuous snoring. These sounds arise from the large airways and usually can be cleared with coughing.

Coarse crackles

are lower-pitched, coarse, rattling sounds caused by fluid or secretions in large airways, likely to change with coughing or suctioning.

Stridor

is a medical emergency and indicates that the upper airways (larynx or pharynx) are closing.

Pleural friction rub

is characterized by loud, rough, grating, scratching sounds caused by the inflamed surfaces of the pleura rubbing together, often associated with pain on deep inspirations.

Wheezing

creates squeaky, musical, continuous sounds associated with air rushing through narrowed airways; it may be heard without a stethoscope. Wheezes originate from the small airways and usually do not clear with coughing. Treatment for wheezing is bronchodilators and inhaled anticholinergics.

SIADH

• Lower urine output
• Higher urine osmolality
• Higher urine-specific gravity (concentrated urine)
• Low serum osmolality
• Low serum sodium (hyponatremia)

abruptio placentae

The uterine tone increases, and therefore, the uterus feels hard/ rigid even in between the contractions

Buspirone

is a non-controlled medication indicated in the treatment of anxiety.

✓ This medication does not cause dependence or withdrawal symptoms.

✓ Essential patient teaching points include –

• The onset time may be delayed up to two weeks to four weeks.
• This medication should be taken consistently with or without food.
• The medication is not a benzodiazepine and should not be taken during acute anxiety. Instead, this medication helps attenuate the response to triggers of anxiety.
• Sexual dysfunction is unlikely with this medication.

Hemophilia

Severe forms of the disease may cause significant internal bleeding from a slight fall, a bruise, or the loss of deciduous teeth

✓ Bleeding is commonly found in the joints that manifest as joint stiffness, limited range of motion, and swelling

✓ A client with hemophilia should be educated to avoid contact sports, the manifestations of bleeding, and adherence to follow-up care

✓ Clients with hemophilia should avoid aspirin and nonsteroidal anti-inflammatory drugs (NSAIDs) because they inhibit platelet function

Bupropion

an atypical antidepressant medication primarily indicated in major depressive disorder, seasonal affective disorder, smoking cessation, and antidepressant-induced smoking cessation

✓ Bupropion causes weight loss

✓ Bupropion is contraindicated for individuals with anorexia nervosa, seizures, and bulimia nervosa

✓ The blood pressure may increase while a client takes bupropion

Albuterol

is a beta-adrenergic agonist used to manage acute (asthma attack, bronchospasm) and chronic respiratory conditions (emphysema).

✓ Albuterol is a short-acting bronchodilator, is a priority treatment in acute asthma exacerbations, and is given emergently via nebulizer.

✓ Side effects of this medication include nervousness, palpitations, insomnia, and increased heart rate. hypokalemia and hyperglycemia

Hepatitis C

is often asymptomatic and frequently goes unrecognized until the manifestation of chronic liver disease occurs, making detection and testing difficult. Many clients are asymptomatic and do not have jaundice, although some have malaise, anorexia, fatigue, and nonspecific upper abdominal discomfort.

Piaget's theory of cognitive development

1. Sensorimotor stage - birth to 2 years
2. Preoperational stage - 2 to 7 years
3. Concrete operational - 7 to 11 years
4. Formal operational - 11 years to adulthood

• The sensorimotor stage is when the individual imagines and solves problems through senses and movement. They are learning about reality and its functionality.
• The preoperational stage is when the child is egocentric and can think in terms of past, present, and future.
• The concrete operational stage is when the child can sort and classify facts and develop abstract thinking.
• The formal operational stage is when the individual increases their ability to think abstractly and logically. Logical problem-solving improves during this stage.

Nitroglycerin

is a potent vasodilator (it decreases preload and afterload). It is indicated in angina. It is given in a variety of preparations, including sublingual, translingual, and topical.

• Dosing for sublingual nitroglycerin is one tablet under the tongue every five minutes (as long as the chest pain is persisting). The maximum tablet (or sprays) is three.
• The client should be instructed that emergency care should be sought if the pain is not relieved after the first dose.
• Nitroglycerin expires after six months, and the client should be instructed to keep their supply current.
• Nitrates are contraindicated if the client is taking medications such as vardenafil, tadalafil, or sildenafil.
• The client should take the nitroglycerin in a sitting or laying down position because sudden movement changes may cause orthostatic hypotension.
• Headache is an expected side effect of this medication and may be treated with acetaminophen.

Quickening

refers to the first perception of fetal movements by the mother, and it is often described as a fluttering or gentle rolling sensation. This typically occurs between 18 to 25 weeks of gestation and is a positive sign of fetal well-being.

pre-interaction phase

professional goals

orientation phase

purpose, nature, time, trust

working phase

active problem solving

termination

achieved goals, ended relationship

Heparin

- given IV or SubQ

- works immediately

- cannot be given for more than 3 weeks (21 days) because after 21 days the body starts making antibodies against heparin. EXCEPT for Lovenox (enoxaparin)

- antidote: protamine sulfate

LAB: PTT

- can be given to pregnancy

Coumadin/ Warfarin

- given only PO, takes a few days or a week to work

- can take longterm

- Antidote: vitamin K

- LAB: PT/INR

- can not be given to pregnant women

IM injections

- pick the answer in which both answer have a "1" in them

- "I" in IM looks like "1"

- use a 21-gauge, 1-inch long needle

SubQ injection

5 looks like an "S" in SubQ

- pick the answer that has "5s" in it

- Use a 25-gauge, 0.5 inch needle

Betamethasone

- used to mature fetal lung

- it is a steroid

- given only mother, IM, given before the baby is born

Side

Surfactant

- used to mature fetal lung

- it is a steroid

- given only mother, IM, given before the baby is born

Side effect: increase glucose

Lactulose

- used to mature fetal lung

- given to the baby

- given transtracheal route after the baby is born

Methergine

- stimulate and strengthen labor

- causes HTN- it contracts blood vessels it makes sense that this increases BP

Lochia Rubra

red

Lochia serosa

(if your cheeks are rosy) think pink

Lochia Alba

(albino) white

What is the best way to determine if a pt has thrombophlebitis?

The best way is to measure bilateral calf circumference

Rectal Temp

- gives accurate body temp

- should not be given to patient with history of rectal surgery, clients with diarrhea, newborns under 12 weeks to avoid the risk of rectal perforation.

- Rectal temp should be avoided to patient who are post MI because the thermometer can slow the heart rate by stimulating the vagus nerve. should be avoided in neutropenic patients

Doxycycline

- tetracycline antibiotics

- treats bacterial infections including acne, pelvic inflammatory disease, Lyme disease, STI, anthrax, malaria

Side effects: teeth staining in children under 8, heartburn, photosensitivity

- Avoid calcium, antacids, in pregnancy

Sitagliptin

used to manage type 2 diabetes

- adverse effects vomiting and pancreatitis (abdominal pain, nausea)

heat exhaustion

flulike (nausea, vomiting, weakness)

increase temp, perspiration, abnormal electrolyte

heat stroke

body temp more than 104

- hot and dry skin

- hypotension, tachycardia, tachypnea

- altered mental status

- hyponatremia, hypokalemia

pneumothorax

• Sudden-onset chest pain
• Shortness of breath and difficulty breathing.
• Rapid and shallow breathing
• Cyanosis
• Decreased or absent breath sounds on the affected side of the chest during auscultation.
• Tachycardia

pancreatitis

to prevent or treat AMS

It acts by causing a bicarbonate diuresis, which rids the body of excess fluid and induces metabolic acidosis.

HCTZ

like other thiazide diuretics, can increase the skin's sensitivity to sunlight, leading to exaggerated sunburn reactions. The client should be instructed to wear appropriate sunscreen and arrange to complete outdoor activities in the early morning or later evening hours.

hydroxyurea

This medication increases fetal hemoglobin and decreases hemoglobin S. By increasing fetal hemoglobin, the sickling effect can be reduced, and oxygen carrying capacity can be improved.

Heparin-induced thrombocytopenia (HIT)

a life-threatening complication of exposure to heparinoids. The treatment for HIT Is to discontinue exposure to the heparin product immediately and to continue the anticoagulation with a non-heparin product. Agents that may be safely used include apixaban, dabigatran, or rivaroxaban.

-pril

is an angiotensin-converting enzyme (ACE) inhibitor used to treat hypertension and heart failure. While ACE inhibitors can affect potassium levels, they are more likely to cause hyperkalemia

Gentamicin

a weight-based medication requiring the client's pretreatment body weight to calculate the correct dosage. For this reason (and to clarify the above order), it would be reasonable for the nurse to contact the health care provider (HCP) to clarify the above order prior to administration. Regarding the administration of gentamicin, the medication may be given intramuscularly or by intravenous infusion. An additional form of gentamicin is available in eyedrop form. When administering a single dose of intravenous gentamicin, the medication is diluted in 50 to 200 mL of normal saline solution or 5% dextrose in water and intravenously infused over a period of 30 minutes to two hours.

phenytoin

treats seizures

10-20

Urticaria

hives often triggered by allergens, such as foods, medications, insect stings, or environmental factors.

Magnesium sulfate

to prevent or treat AMS

It acts by causing a bicarbonate diuresis, which rids the body of excess fluid and induces metabolic acidosis.

HCTZ

treatment of mild, moderate, and severe Alzheimer's disease and dementia

- efficacy may be seen in 1 month

- side effects: gastric distress, insomnia, bradycardia

pruritus- itching

This medication increases fetal hemoglobin and decreases hemoglobin S. By increasing fetal hemoglobin, the sickling effect can be reduced, and oxygen carrying capacity can be improved.

Presumptive signs of pregnancy

• Amenorrhea
• Nausea and vomiting
• Fatigue
• Urinary frequency
• Quickening (slight fluttering movement usually between 16-20 weeks gestation)

Probable signs of pregnancy

• Chadwick's sign (bluish appearance of the cervix)
• Goodell's sign (softening of the cervix)
• Hegar's sign (softening of the isthmus of the cervix)
• Ballottement (sudden tap on the cervix during the vaginal examination may cause the fetus to rise in the amniotic fluid and then rebound to its original position)
• Braxton hicks contractions
• Positive pregnancy test
• Palpation of fetal outline

Gentamicin

• Fetal movements detected by an examiner
• Auscultation of fetal heart sounds
• Visualization of embryo or fetus

Bell's palsy

is a lower motor neuron facial nerve palsy that can result in the weakness of facial muscles and the muscles responsible for eye closure (orbicularis oculi). A client with Bell's palsy who cannot blink would be unable to close the affected eye. As a result, the cornea becomes overly dry, leading to an increased risk of corneal ulceration and scarring. Eye lubricant (i.e., typically artificial tears) must be applied as often as every hour during the day to keep the eye moist and prevent corneal drying.

Impetigo

hives often triggered by allergens, such as foods, medications, insect stings, or environmental factors.

Magnesium sulfate

is administered to prevent seizures in preeclampsia, but excessive levels can lead to hyporeflexia or areflexia, respiratory depression, and cardiac arrest.

- treatment with mag sulfate will induce hypermagnesemia

- HR will go down, BP go down, Reflexes go down, LOC go down

Donepezil

Blood with mucus in the stool indicates an inflammatory or infectious condition, and currant jelly–like stools

Erythema

pyrexia- fever

One of the earliest findings associated with compartment syndrome is

paresthesia, and because of the lack of perfusion, coolness to the extremity develops

Pain in the affected extremity

Swelling to the affected area

Cellulitis

is an infectious process that does not cause impairment in sensation.

Pain in the affected extremity

Swelling to the affected area

Intact sensation

Warmth and erythema to the extremity

Bupropion

It can treat depression and help people quit smoking. It can also prevent depression caused by seasonal affective disorder (SAD).

ortho tri-cyclen

Combination birth control pills are a daily medication that contains 2 hormones (estrogen and progestin) to prevent pregnancy.

Splints

hold bones and joints in place so they can heal after a fracture (broken bone), injury, or surgery.

Heparin infusions

require an actual and accurate weight of the client. This information and the baseline labs are necessary before administering heparin. Platelet count also needs to be monitored during the duration of the heparin infusion because of the potential adverse event of heparin-induced thrombocytopenia (HIT).

prescribed warfarin

• whose INR is now 2.7, which is therapeutic as the goal is to have the INR between 2-3 when the client is receiving warfarin.
• The normal INR for a client not receiving warfarin is 0.9-1.2.

Isotretinoin

utilized in the treatment of moderate to severe acne vulgaris as it has demonstrated its ability to shrink the sebaceous glands.

• This medication is highly teratogenic, and the client should be counseled on reliable contraception.
• A negative pregnancy test is required prior to the start of treatment.
• Laboratory monitoring of the client’s liver function tests and triglycerides is essential. This medication may cause a liver injury and raise triglyceride levels.

lumbar puncture

may take up to 15-30 minutes. Following the procedure, the client is asked to lie flat for about one to two hours. Lying flat may reduce the intensity of post-lumbar puncture headache, although it may not prevent it. A need to urinate during or immediately after the procedure interrupts this protocol. Therefore, as an additional comfort measure, the client should be reminded to empty their bladder before the procedure begins. This should be the first action of the nurse.

Clozapine

This medication is used to treat schizophrenia as well as mood disorders that may cause significant aggression or violence. This medication carries serious effects, including agranulocytosis, myocarditis, sialorrhea, and weight gain. The client will require frequent laboratory work to monitor their neutrophil count.

sentinel event

an event that has reached the patientand caused harm (death, permanent harm, or severe, temporary harm).

postmortem care

focus is on maintaining the body's appearance and dignity for family viewing

septic shock

Hypotension is a hallmark feature of septic shock, and despite receiving intravenous fluids, the blood pressure remains low due to widespread vasodilation and reduced vascular tone.

• Fever, temperature higher than 38 C, or hypothermia, temperature lower than 36 C
• Tachycardia with a heart rate higher than 90 beats per minute in adult patients or less than two standard deviations for age in pediatric patients
• Tachypnea with respiratory rate greater than 20 breaths per minute in adult patients or more than two standard deviations for age in pediatric patients

✓ If hypotension persists despite adequate fluid resuscitation, vasopressor medications may be required to support blood pressure and maintain adequate perfusion to vital organs. Nurses should carefully monitor the client's hemodynamic response and titrate vasopressor dosages as needed.

✓ Continuous monitoring of vital signs, including blood pressure, heart rate, respiratory rate, and oxygen saturation, is crucial in septic shock. Early signs of deterioration should be promptly identified to guide interventions and prevent complications.

ear drops

✓ For children three and younger, the pinna should be pulled down and back.

✓ For children older than three, the pinna should be pulled up and back.

iron deficiency anemia

caused by iron deficiency diet, chronic alcoholism, malabsorption syndrome, gastrostomy, rapid metabolic need in pregnancy, adolescents, children

✓ Manifestations associated with this anemia include pagophagia (craving for ice), pica, fatigue, mild pallor, and tachycardia

Aplastic anemia

stop making red blood cells from the bone marrow

Autism

• Clinical features of this disorder range from mild to severe. These features include language impairments, absent or limited interest in socialization with others, insistence on routine and rituals, and intolerance of high environmental stimulation.
• ✓ Nursing care for a client with autism incorporates routine into their care by having the same caregivers, structure for activities, and maintaining a predictable environment with low stimuli. ✓ Assess and address sensory sensitivities. Some children with autism may have specific sensory preferences (e.g., weighted blankets, and calming sensory items) that can be incorporated into their care.

Peripheral arterial disease

atherosclerosis in the arteries that become smaller, plaques form, and become stiff resulting to poor blood flow

caused from hypertension, hyperlipidemia, and diabetes mellitus

Antitubercular medications

isoniazid, rifampicin, and pyrazinamide are very hepatotoxic

- Isoniazid: avoid tyramine food--- can cause skin redness and itching. Administer Pyridoxine vitamin B6 for overdose to prevent neuropathy

- Rifampin: blood fluids may turn reddish orange, use soft contact lenses. Administer on empty stomach, monitor BUN

spinal cord injury

Absent bowel sounds, gastric distention, bradycardia, hypotension, and flaccid paralysis are concerning findings for spinal shock.

Diverticulosis

is when the client develops small herniations in the large bowel

✓ A common cause of this condition is a low-fiber diet, and it causes manifestations such as abdominal cramping in the left lower quadrant, bloating, flatulence, and blood in the stool

✓ The client is instructed to increase their fiber and water intake as these measures are key in promoting bowel motility

Delirium Tremens

a medical emergency and may cause autonomic hyperactivity, resulting in tachycardia, diaphoresis, fever, anxiety, insomnia, and hypertension.

peptic ulcer disease

will need to reduce the stress in their life to mitigate some of the symptoms. Ulcers are caused by excessive use of non-steroidal anti-inflammatory drugs, alcoholism, H. pylori infections, and stress.

Vitamin B12 (cobalamin)

help the body convert food (carbohydrates) into fuel (glucose)

pernicious anemia- A decrease in red blood cells when the body can't absorb enough vitamin B-12.

Five Deadly “Ds”• The following are 5 prioritypts based on their lab values

o K+ >6

o pH in the 6s

o CO2 in the 60s

o pO2 <60

o Platelets <40,000

Phenothiazines

• First generation or typical antipsychotics• All end in “ZINE”

o Example: Thorazine, Compazine

major tranquilizers

Side effects: anticholingeric, blurred vision, constipation, drowsiness, EPS (tremors, Parkinson), photo sensitivity, agranulocytosis (low WBC count)

Nursing Diagnosis: safety

Tricyclic Antidepressants

NSSRI (Non-selective serotonin reuptake inhibitor)

- mood elevators use to treat depression

Ex: Elavil (elevate), Trofranil, Aventyl, Desyrel

Side effects: anticholinergic, blurred vision, drowsiness, euphoria (happy joy joy lol)

Must take meds for 2 to 4 weeks for beneficial effects

Benzodiazepines

- Always have "ZEP" in the name (think Zzzz)

- "lam" "pam"

- used for anxiety, preop induction of anesthesia, sedation, and reduce seizures, ETOH withdrawal medication

Side effects: anticholinergic, blurred vision, constipation, drowsiness

Nursing Diagnosis: safety

Monamine Oxidase (MAO) Inhibitors

- Antidepressant

Ex: MARplan, NARdil, PARnate the beginnings—all rhyme

Side effects: anticholinergic, blurred vision, constipation, drowsiness

Avoid tyramine-containing food … May cause Hypertensive Crisis

- Avoid salad “BAR”: Bananas, Avocados (guacamole), Raisins (driedfruit), yeast, no meats, no age cheese, no alcohol or chocolate

- DO NOT TAKE OVER THE COUNTER MEDS

Lithium

used to treat bipolar disorder, decrease mania

Side effects: polyuria, diarrhea, paresthesia (numb and tingling)

Toxic effects: tremors, metallic taste, severe diarrhea

Nursing Intervention: give patient fluids, monitor sodium (low sodium makes lithium toxic, high sodium lithium ineffective)

Prozac (fluoxetine)

SSRI, mood elevator

Side effects: anticholinergic, blurred vision, drowsiness, euphoria (happy joy joy lol)

Causes insomnia so give before noon

When changing doses, watch for suicidal risk in adolescents/ young adult

HALDOL (haloperidol)

First generation antipsychotics

Tranquilizers (basically same as Thorazine)

Side effects: anticholingeric, blurred vision, constipation, drowsiness, EPS (tremors, Parkinson), photo sensitivity, agranulocytosis (low WBC count)

• Pts may develop NMS (neuroleptic malignant syndrome) from overdose (high fever over 105, anxiety, tremors)

o Seen in elderly and young white schizophrenic pts

Clozaril (clozapine)

2nd generation Atypical antipsychotics

Second generation antipsychotics end in “Zapine”

Side effect: aGranulocytosis! It is worse than cancer drugs and can trash the pt’s bone marrow (very low WBC= increase infection)

Monitor WBC

Phenothiazines

has a black box warning• Prolong the QT interval, which can cause sudden cardiac arrest• Do not use in pts with cardiac condition

atypical (second generation) antipsychotic indicated in psychotic disorders such as schizophrenia. If the client reported decreasing thoughts of persecution (and was observed to have fewer thoughts of persecution), this would be a therapeutic effect.

(Sertraline)

- SSRI treats antidepressants

- Can cause insomnia

• Interact with the followings because they are not metabolized in the liver:

o St. John’s Wort and Sertraline can cause serotonin syndrome

o Warfarin and Sertraline cause bleeding

Side effects: Sweating, Apprehensive (impending sense of doom), Dizzyness, Headache

: The nurse should anticipate lowering the dose of sertraline (Zolof) of a pt on St. John’sWort and Warfarin

Infectious mononucleosis (IM) requires standard precautions

- Always have "ZEP" in the name (think Zzzz)

- "lam" "pam"

- used for anxiety, preop induction of anesthesia, sedation, and reduce seizures, ETOH withdrawal medication

Side effects: anticholinergic, blurred vision, constipation, drowsiness

Nursing Diagnosis: safety

prostate cancer

A diet high in animal fat, especially red meat, is a strong risk factor for prostate cancer. Strong risk factors for prostate cancer include -

• African American ethnicity
• Increasing age, especially after age 40

Rubella

is a maternal infection that is known to increase the risk that the fetus will have a congenital heart defect. All mothers should be tested for rubella, and if found to be positive, should have a fetal echocardiogram performed to evaluate the fetus' heart more closely.

When blood pressure is obtained in the leg

the systolic blood pressure is increased by up to 10 to 40 mm Hg compared to blood pressure obtained over the brachial artery. The higher SBP is due to the calcification in the distal arteries, which raises the SBP. DBP in the lower extremities is usually the same when compared to the upper extremiti

HALDOL (haloperidol)

a calcium channel blocker indicated in the treatment of atrial fibrillation, hypertension, and peripheral arterial disease. Diltiazem and other calcium channel blockers should not be taken with grapefruit because of the risk of serious potentiation of the drug, leading the client to develop profound bradycardia and hypotension.

Oseltamivir

is an antiviral agent approved for the treatment of influenza. This medication should be initiated within 48 hours of symptom onset.

Geodon (ziprasidone) risperidone

has a black box warning• Prolong the QT interval, which can cause sudden cardiac arrest• Do not use in pts with cardiac condition

atypical (second generation) antipsychotic indicated in psychotic disorders such as schizophrenia. If the client reported decreasing thoughts of persecution (and was observed to have fewer thoughts of persecution), this would be a therapeutic effect.

Hirschprung's disease

Various surgical approaches may be utilized, and the lining of the diseased part of the colon is stripped away. Then, the normal section is pulled through the colon from the inside and attached to the anus, such as a colectomy. In some cases, an endorectal pull-through procedure is performed, where a surgeon removes the segment of the large intestine lacking nerve cells and connects the first part to the anus.

Medication reconciliation

was designed to prevent omission and duplicate errors related to medication administration.

Amlodipine

is a calcium channel blocker that reduces blood pressure and treats certain vascular disorders, such as peripheral arterial disease.

Amlodipine is a medication to treat vascular disorders such as hypertension.

When administering an intramuscular (IM) injection for an adult or a child

the dorsogluteal site should be avoided because the needle may pierce a nerve and cause damage. Thus, giving an IM ventrogluteal is acceptable.

the nurse should obtain a prescription for EMLA (eutectic mixture of local anesthetics [lidocaine and prilocaine]) cream and apply it 60 minutes at the site to lessen the pain.

Electrical burns

are serious and require the client to undergo cardiac monitoring because of the risk of dysrhythmias. The nurse's priority action is to obtain telemetry monitoring or perform a 12-lead electrocardiogram.

insulin

This client was administered regular insulin that peaks within two to four hours. Additionally, this client received NPH insulin which peaks within four to twelve hours. It would be appropriate for the nurse to assess the client for hypoglycemia when the regular insulin peaks as it peaks sooner.

Acute osteomyelitis

Osteomyelitis is a serious infection that requires six to twelve weeks of antibiotic therapy. The most common cause of osteomyelitis is staphylococcal bacteria

Acute osteomyelitis is manifested by localized bone pain, a fever, and swelling to the affected extremity.

Combination antiretroviral therapy

The treatment goals for a client with HIV is to reduce their viral load (VL) to an undetectable level and to increase their CD4/CD8 count, which is the target cell of the virus.

A rapid-acting insulin

is the most common insulin used in insulin pumps. A rapid-acting insulin is correctional insulin and should be appropriately dosed 5-10 minutes before a client's meal or while actively eating. Short-acting (regular) insulin may be alternatively loaded into an insulin pump.

valproic acid

mood stabilizer

The valproic acid administered intravenously will assist in breaking the mania. Valproic acid may cause hepatotoxicity and blood dyscrasias such as thrombocytopenia. These are essential monitoring parameters for the nurse.

Prednisone

can decrease potassium levels!!!, increase blood glucose, insomnia, GI upset, mood fluctuating

Determining the estimated date of delivery

take first day of last menstrual period (LMP), add 7 days and subtract3 months from it

The ideal weight gained during pregnancy

o 28 lbs, plus or minus 3 o Between 25 to 31 lbs

1st trimester

o 1 lb per month = Total of 3 lbs

• 2nd and 3rd trimesters

Add 1 lb every week

ideal weight gained during pregnancy

Take the number of weeks gestation minus 9

Fundal Height

• Fundal height cannot be palpated until week 12

That when the fundus is midway between the umbilicus and the pubic symphysis•

The fundus can be palpated at the umbilicus between 20 and 22 weeks

Positive Signs of Pregnancy

1. Fetal skeleton on x-ray

2. Presence of fetus on ultrasound

3. Auscultation of fetal heart (Doppler)

4.Examiner palpates fetal movement (outline)• Not the mother but the examiner

Most common presentation is ROA or LOA

• ROA (right occiput anterior)

• LOA (left occiput anterior)

• Pick ROA before LOA

Phase 1—Latent

Dilation from 0 to 4 cm

Contractions are 5 to 30 minutes apart

lasting 15 to 30 seconds

Mild intensity

Phase 2—Active

Dilation from 5 to 7 cm

Contractions are 3 to 5 minutes apart

lasting 30 to 60 seconds

Moderate intensity

Phase 3—Transition

dilation from 8 to 10 cm

Contractions are 2 to 3 minutes apart

lasting 60 to 90 seconds

Strong intensity

What is a sign of uterine tetany?

• Contraction more than 90 seconds and closer than 2 minutes

What parameters regarding uterine contraction would make you stop Pitocin?

• Contraction more than 90 seconds and closer than 2 minutes

What is uterine hyperstimulation?

• contraction more than 90 seconds and closer than 2 minutes

Uterine contraction

should be no longer than 90 seconds and no closer than 2 minutes

Painful Back pain—“OP” = Oh Pain. What do you do?

• Position—Push

• What position?

o KNEE-CHEST position then o PUSH with fist into sacrum to use counter pressure

Prolapsed Cord

Push head in off cord and position knee-chest or Trendelenburg

• Prep for C-section

• Think PUSH/POSTIONo Push head off the cord of fetus and position mother to knee-chest

Interventions for all other complications

o Left side (place mother on the left side)

o IV

o Oxygen

o Notify HCP

• Stop Pitocin (pit) if it was running—the first thing to do

avolition

Lack of motivation

Oligohydramnios

results from a severe reduction in the amount of amniotic fluid. It results in less than expected fetal growth. Also, because of the low amount of amniotic fluid, the fetus will be more easily outlined and palpated.

RACE

✓ R—Rescue and remove all clients in immediate danger.

✓ A—Activate the alarm. Always do this before attempting to extinguish even a minor fire.

✓ C—Confine the fire by closing doors and windows and turning off oxygen and electrical equipment.

✓ E—Extinguish the fire with an appropriate extinguisher.

third-degree heart block

is a medical emergency because electrical communication is lost between the atria and the ventricles. causes hypotension. Immediate management includes providing supplemental oxygen if the client has decreased pulse oximetry, pharmacological therapy with atropine, preparing the client for temporary transcutaneous pacing, and admission to the critical care unit for close monitoring. The cure for an irreversible complete heart block would be the placement of a permanent pacemaker.

Moro reflex

occurs in response to a slight drop, sudden movement of the crib, or a loud noise; the newborn quickly makes a symmetrical abduction of the extremities and places the index fingers and thumbs into a “C” shape.

Babinski

When the sole is stroked, the newborn’s big toe moves upward toward the top surface of the foot, and the other toes fan out.

Lumbar Puncture

After procedure, keep client flat for several hours, monitor for complication (increase ICP) and encourage fluid intake

Hepatitis A

is an infection contracted through the consumption of raw or undercooked food, fecal-oral route, or contaminated water. Most cases are self-limiting with complete clinical recovery within three to six months. Vaccination for hepatitis A is a two-dose series beginning as early as six months for international travel; 12 months for routine vaccination.

cerebral aneurysm

may develop from uncontrolled hypertension, which eventually may cause it to rupture.

✓ Adequate blood pressure control is essential in the prevention of an aneurysm and its rupture.

✓ Manifestations of a cerebral aneurysm include nausea, vomiting, severe headache, ataxia, and altered mental status.

Addison's disease

Vigorous exercise requires additional dosing of the client's steroid to prevent an adrenal crisis. Training for a marathon is strenuous and should alert the nurse that follow-up is needed to ensure that adequate dosing of the client's prescribed corticosteroid is sufficient. When engaging in vigorous exercise, the body demands more steroid production, and the hallmark of adrenal insufficiency is the inability of the body to meet that demand.