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NaCl - Side effects and symptoms
hypernatremia: altered mental status, decreased LOC
KCl - MOA
No IV push/bolus - only oral orSLOWLY through line - it's very irritating
Sodium Bicarbonate - MOA
neutralizes acids in the blood and other body fluids
oral give 2-3 hours before meals/meds
Sodium Bicarb - side effects and symptoms
metabolic alkalosis: CNS stimulation, convulsions
slow irregular pulse
slow respirations to hold onto CO2
Stop infusion first, THEN notify phycisian
Spirinolactone - side effects/symptoms
hyponatremia: n+v, cramping, anorexia, confusion, lethargy, coma
Spirinolactone - drug/drug interaction
With ACE Inhibitors increased risk of hyperkalemia so monitor the HEART
Spirinolactone - Patient Education
Aviod potassium rich foods - hyperkalemia!
and hawthorn - hypotension!
Safety precautions in patients with renal problems
Start with lower doasges.... need to clarify this
PUD - tx indicated
Start drugs when diagnosed, used to reduce incidence of complications ( bleeding, perforartion, obstruction)
IBDs, Chron's, Ulcerative Colitis - tx indictated
depends on clinical picture, maintain as normal lifestyle as possible, prevent nutritional deficiencies, minimize psyche and social impact of dz
Nausea/Vomiting - Tx indicated
after waiting 24 hours to see if symptoms abate and when these are not symptoms of an underlying condition that requires immediate attention
Prilosec - side effects/symptoms
Long Term: increased acid so you can get gastric cancer
Prilosec - Admin Alert
Take 30 minutes prior to eating usually before breakfast, Eating yougurt is beneficial to replace bacteria.
Enteric coated cannot be chewed or crushed must dissolve in stomach
Ranitidine - side effects/symptoms
lower WBC, RBC and plateletts
Pernicous anemia because b12 is not absorbed well
Aluminum hydroxide - uses
in combination with other drugs for relief of heartburn due to GERD or PUD
Aluminum hydroxide - admin alerts
take 2 hours before other meds so that absorption is not decreases
Pepto-Bismul - MOA
added to antibiotics, inhibits bacterial growth, prevents h. pylori from adhering to the stomach wall
Sulfucrate - MOA
sucrose plus aluminum hydroxide (antacid) produces a thick gel like substance that coats the ulcer protecting it against further erosion and promoting healing
misoprostole - MOA, uses
inhibits acid and stimulates mucus production
prevents peptic ulcers in patinets taking NSAIDs and corticosteriods
psillium mucilloid - side effects/symptoms
may cause obstruction in the esophagus or intestines if patinet doesn't drink enough water
docusate - MOA
stool softener causes more water/fat to be absorbed into the stool . most often used to prevent constipation
mineral oil - MOA
lubricate stool and colon mucosa
can interfere with absorption of fat soluble vitamines
Milk of Magnesia and Fleet phospho-soda - MOA
saline/osmotics not absorbed in the intestine. They pull water into the fecal mass.
Dont use regularly, work quickly
bisacodyle - ducolax- MOA
stimulant that promotes peristalsis by irritaing the bowel mucosa - rapid acting, cause diarrhea and cramping, dont use often
prochloperazine - MOA
blocks dopamine receptors in brainwhich inhibits signals to vomit center in medulla
prochloperazine - side effects/symptoms
dose related anticholinergic effects
-dry mouth, sedation constipation
- orthostatic hypotension, tachycardia
- extrapyramidal symptoms with prolonged use
Meds to administer for bowel prep surgery
tap water enema
Assess kidney function (creatine levels)
Why is culture & sensitivity testing done?
to identify sensitive or resistent bacteria
Broad spectrum antibiotics may be started before culture is completed
What symptoms might the patient present with that might warrant a provider ordering culture and sensitivity testing?
Sepsis, systemic infection, severe symptoms whose underlying cause is not identifiable.
How/why are superinfections are caused by anti-infective therapy ?
antibiotics kill microrganisms (host flora) normally present in bidy which allows pathogenic microorganisms to multiply and take over
Penicillin G - uses
Strep, Pneumonia, Staph infections that DON'T produce penicilinase.
Penicillin G - side effects/symtpoms
super infections ( yeast)
Penicillin G - interactions/admin alert
decreases effectiveness of oral contraceptives
pbserve for 30m. after perenteral admin. especially afetr first dose
cefotaxime - uses
Treats infections of:
lower repiratory tract
bones, blood, joint
cefotaxime - admin alerts
CI in pt.s allergic to penicillin
IM in a deep large muscle mass to prevent injury to surrounding tissues
Tetracycline - side effects/symptoms
-toxic to body as it's similar to protiens found in the body
GI - n/v, pain, diarrhea
Tetracycline - admin alert
caution in children under 8
dcreases effects of oral contraceptives
Admin on empty stomach 1 hour before or 2-3 hours after meal/meds
MILK reduces absorpotion
gentamycin - side effects/symptoms
don't give to patinets with hearing problems cause you can't measure toxicity
Vancomycin - admin alert
if upper bosy rash, decreased urine out put/ hearing - HOLD next dose THEN notify physician
Fluconazale - MOA
interferes with sythesis of ergosterol in the fungal cell membrane causing them to become permeable
metronidazole (Flagyl) - interaction
don't drink alcohol while opn or 3 days after meds, take 1h before or 2h after meals
zidovudine - uses
used iwth otherantiretrovirals for HIV clienety
used prophylactively for exposed healthcare workers
reduces rate of transmisioin from mom to fetus
Advantages of HAART
reduces viral load to below the limit of detection, reducies the risk of drug resistance
laboratory tests associated with HIV/AIDlaboratory tests associated with HIV/AIDS
CD4-T cell count- determines immune functionand predicts for opportunistic infection
measurement of HIV RNA in plasma - detrmines viral load
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