Therapeutic responses - evaluated by comparing pts current status with baseline data. Must know the reason the drug was given, criteria to evaluate, expected time course.
Adverse drug reactions and interactions - must know which adverse effects are likely to occur, how the manifest, and probable time course.
Adherence to the prescribed regimen - measurement of plasma drug levels, interviewing
the pt, and counting pills. Determines pts understanding about when to take meds, what dose, and technique of administration.
Satisfaction with treatment - dissatisfaction includes unacceptable side effects,
inconvenient dosing schedule, difficulty of administration, and high cost.
Type 1 cell death, necrosis, develops due to cell injury
This injury can be due to infection or hypoxia, loss of membrane integrity
That cell will swell, Na (sodium) rushes into the cell and fills with water and ruptures
This sets up an inflammatory response
With necrosis, cell death is not tidy because cells that die as a result of acute injury swell, burst, and spill their contents all over their neighbors, causing a likely damaging inflammatory response
Sites of necrotic cellular death can cause accumulations of calcium resulting in pathologic calcification. Whenever this happens, an accumulation of calcium, it means the area is hardened
Fluid balance: cells live in fluid environment with electrolytes and acid base concentration, disturbances can be life-threatening
Fluid fluctuations affect blood volume and cell function
Dehydration will be loss of extracellular fluid and sodium caused by vomiting, diarrhea, bleeding(hemorrhage) burns (as you lose fluid with burns), and other causes.
signs and symptoms: weight loss, poor turgor, dry mucous membranes, rapid pulse, decrease in B/P, decrease in specific gravity, decrease in peripheral circulation
can cause fluid shifts if there is a severe enough fluid loss. With dehydration, we can either keep the Na where it is or it can increase or decrease depending on the fluid shifts in the body.
Nurse should anticipate the doctor will order IV fluid of 0.9 normal saline.
Patient can go into hypovolemic shock if they have too great a deficit of fluid balance
can cause death
Electrolyte balance: in ECF and ICF affects maintenance of electroneutrality between intracellular and extracellular compartments
ECF: Na, Cl, bicarb; small amounts of K, Ca
ICF: K, Mg, PO4
Indications: Pulmonary edema, edema, Hypertension (acute conditions requiring rapid intervention)
adverse effects: decrease vascular fluid volume, cardiac output and Blood Pressure, decrease electrolytes (EVERYTHING HYPO), dehydrated, increase uric acid levels
Administration: Give slowly, monitor vital signs, blood pressure, and fluid loss, give during day
major intracellular cation/electrolyte, found inside cells, regulates acid-base balance, maintains membrane potential, nerve conduction, electrical conductivity, needed for cardiac contraction, major causes of dysrhythmias
Mild hypokalemia: increase K through dietary intake
Severe hypokalemia: Parenteral
Never give potassium IV push- must be diluted, give slow
Peripheral line: 10 meq over 1 hour
Central line: 10-20 meq over 1 hour
Ex. Can have 4 bags of 10 MEQ, 1 bag per hour, or 2 bags of 20 MEQ, 1 bag per hour
No more than 40 meq at during a replacement
Do not crush extended release tabs
Give with food and plenty of fluid
7th Edition•ISBN: 9780323087896 (1 more)Julie S Snyder, Linda Lilley, Shelly Collins 7th Edition•ISBN: 9780323402118Gary A. Thibodeau, Kevin T. Patton 1st Edition•ISBN: 9780071849050David Standaert, Erik Roberson, Franklin Amthor, W. Anne Burton Theibert 20th Edition•ISBN: 9781260149920Clem Thompson, R T Floyd