Term
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Definition
| return client to homeostasis. |
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Term
| most critical nursing responsibility regarding IV therapy |
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Definition
| maintaining the patency of the IV access |
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Term
| how are IV fluids described |
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Definition
| according to their osmolality |
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Term
| The normal osmolality of vascular fluids |
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Definition
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Term
| how To maintain the patency of an intravascular access |
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Definition
| nurse would use 0.9% NaCl |
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Term
| The nurse should assess the client receiving IV therapy every |
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Definition
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Term
| IV tubing should be changed every |
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Definition
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Term
Infusing antibiotics too rapidly will cause |
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Definition
| Pain, a complication of IV therapy. |
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Term
| The nurse is assessing the IV accessing the IV access and finds pain, heat, and redness from the insertion site what do you do? |
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Definition
| The nurse’s next action should be to discontinue the IV access. |
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Term
| Priming all administration setups before use helps prevent: |
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Definition
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Term
| If a client is to receive a 14 day course of IV antibiotics, the nurse should |
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Definition
| collaborate with the health care provider for the initiation of a peripherally inserted central catheter. |
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Term
| Client teaching for the safety of the client receiving IV therapy at home should include |
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Definition
| written instructions concerning home health nurse referral, Phone numbers of persons to call if client needs assistance, IV site dressing changes, flushes, and use of aseptic sterile technique. |
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Term
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Definition
| is the amount of hydrostatic pressure needed to move particles and fluids in and out of vascular volume. |
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Term
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Definition
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Term
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Definition
| is the force water exerts against vessel walls. |
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Term
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Definition
| solutions that create osmotic pressure by dissolved ion movement. |
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Term
| One part of preparing to deliver an IV med to your client |
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Definition
| priming the IV infusion equipment. |
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Term
| IV infusion pumps provide |
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Definition
| more accurate flow rate than gravity drip systems. |
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Term
| Plasma expanders are administered to |
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Definition
| restore circulatory hemodynamics. |
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Term
| Hickman catheter dressings must be changed using |
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Definition
| strict sterile technique. |
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Term
| The most common potential complication that may occur during IV therapy is |
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Definition
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Term
| Hypertonic fluid is used to |
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Definition
| to increase vascular volume and dehydrate the cells, causing them to shrink. |
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Term
| When administering meds via IV push (bolus), the safest rate is |
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Definition
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Term
| After administering meds via IV push, therapeutic or adverse effects will be seen |
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Definition
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Term
| The most commonly used colloids are |
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Definition
| albumin, plasmanate and dextran. |
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Term
| One of the most common electrolytes added to IV fluids |
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Definition
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Term
| When the natural balance of this electrolyte is disrupted, |
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Definition
| cardiac disturbances occur that may prove fatal. |
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Term
| Take special care to ensure potassium remains within the |
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Definition
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Term
| The client with a central venous access device (CVAD) should be monitored for |
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Definition
| an increase in temp every 4 hrs. |
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Term
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Definition
| Tissue damage, breakdown, and sloughing following infiltration of an IV delivering a toxic medication |
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Term
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Definition
| Causes fluids to move out of the capillaries and into the cells. This results in cellular swelling. 0.45 NaCl, ½ NS |
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Term
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Definition
| These are used to increase vascular volume and dehydrate the cells causing them to shrink. These solutions cause fluids to be pulled from the cells into vascular compartments. Higher solute concentration than plasma. D5 NS, D10 W, D5 ½ NS |
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Term
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Definition
| These fluids stay in the vascular space. Same osmolality as body fluids. 0.9 NS, D5W, Lactated Ringers, D5 ¼ NS |
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Term
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Definition
| IV fluids used to supply caloric intake, supply nutrients and electrolytes, provide free water for hydration and promote renal function. |
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Term
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Definition
| Solutions that create osmotic pressure by the movement of dissolved ions. These can freely move across the semi-permeable membrane of the vessel walls into interstitial spaces. They do not cross the cellular membranes. |
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Term
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Definition
| Increase oncotic pressure by having a greater molecular weight in protein and pull fluids from the cells into vascular spaces. |
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Term
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Definition
| The development of fever and chills often associated with N/V and headache. |
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Term
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Definition
| Occurs when the needle becomes dislodged from or pierces the vein or from weak, over-extended stretched veins, permitting fluid to collect in the tissues surrounding the vein. Signs of this complication include: swelling around the insertion site, pain, coldness of the skin under the swelling, loss of IV blood flow. If this occurs, discontinue the infusion and restart it using a sterile needle to another site. |
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Term
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Definition
| Fluid being infused escapes from the vein into surrounding tissues. Fluid may have damaged surrounding tissue – possible necrosis if pt receives a vesicant. If this occurs, discontinue the IV infusion and change to a different site. Approved treatment protocols are to be followed and crucial documentation. |
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Term
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Definition
| The formation of a blood clot and inflammation of the vein. If this occurs, discontinue the infusion, and place a warm, moist pack on the area, then report development to the Dr. Signs of this complication include: pt may complain of pain, nurse may note heat, redness, swelling, possible loss of motion in body part. |
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Term
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Definition
| Occurs when irritating drugs such as KCl are being infused, esp, when superficial veins are uses or/and med is infused too rapidly or is inadequately diluted. If this occurs, check for tension, gently move the hub of the needle to see if pain decreases, and/or change the rate of flow, change to larger vein. |
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Term
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Definition
| An overload of the circulatory system that may be due to the excessive or too rapid infusion of fluid. Most common in children and clients with impaired cardiovascular or renal systems. If this occurs, slow the infusion and call someone to evaluate the patient. Signs of this complication include moist respirations, dyspnea, cough. |
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Term
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Definition
| Tissue damage with the breakdown and sloughing that occurs after infiltration of infusions containing some of the toxic drugs (such as antineoplastics). If this occurs, discontinue infusion immediately and treat according to hospital procedures., |
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Term
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Definition
The presence of pathogenic microorganisms at the insertion site and possible disseminating
through the vascular access into the bloodstream. If this occurs, call the physician STAT. |
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Term
| MED calculations and gtts per minute |
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Definition
1000 g = 1 kg 1 mL = 15 gtt
1000 mg = 1 mg 1 minim = 1 gtt
1000 ng = 1 mcg 1 t = 60 gtt
1000 mcg = 1 mg 3 t = 1 T
1000 mL= 1 L 1 oz = 2 T
100 mL = 1 dL 1 dram = 50 grains
1 kg = 2.2 lbs
To calculate the flow rate using the ratio and proportion method:
1. Determine the number of ml the client will receive in an hour
2. Determine the number of ml the client will receive in a minute
3. Determine the drops per minute that will equal the number of ml computed in step 2. The drop rate specified for the IV set being used must be considered in this step. The drop is expressed as a ratio of gtt/mL.
Example: The HCP prescribes 3000 mL of D5W IV over a 24 hr period. If the IV set is calibrated to deliver 15 gtt/mL, how many drops must be administered per minute?
Calculate mL/hr 3000 mL = x mL
24 hr 1 hr X = 125 mL/hr
Calculate mL/min 125 mL = x mL
60 min 1 min x = 2 ml/min
Calculate gtt/min 15 gtt = x gtt
1 mL 2 mL/min x = 30 gtt/min
Example: How long will it take to complete an IV infusion of 1.t L of D5W being administered at the rate of 45 gtt/min? The IV set is calibrated to deliver 15 gtt/mL.
1. Determine mL /min being infused: Drop rate of IV set = 15 gtt = 45 gtt
1 ml x mL 15x = 45 X = 3 mL/min
Calculate mL/hr:
3 mL/min X 60 min/hr = 180 mL/hr
Calculate hrs required to administer total volume of solution. If 180 mL are delivered each hr, then how many hrs are required to administer 1500 mL?
180 mL = 1500 mL
1 hr X hr 180 x = 1500 X = 8.3 hr or 8 hr 20 min |
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Term
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Definition
antigout – short term
Usual dosage: PO- 0.6 mg for acute attack; 0.6mg for prophylaxis.
IV- 2 mg initially followed by 0.5 mg q6hr til pain is controlled.
Monitor effectiveness of therapy.
Monitor for toxicity.
Monitor uric acid levels.
IV administration can cause phlebitis.
Should be taken at the first sign of gout attack.
Side effects- Nausea, vomiting, aplastic anemia, alopecia, agranulocytosis, & diarrhea
Assess for diarrhea or nausea. |
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Term
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Definition
antigout – Long term
Usual dosage: PO- 200-800 mg/day
IV- 200-400 mg/m2/day
Keep urine slightly alkaline to prevent uric acid stones from forming.
IV dose should be given as a single infusion.
Side effects- Pruritic, maculopapular rash, fever, malaise.
Fluid intake is encourages. Avoid foods high in purines – anchovies, bacon, beer, codfish, goose, haddock, herring, mackerel, mussels, organs meats, salmon, sardines, scallops, smelts, trout, turkey, veal, venison. Avoid high fat diet and thiazide diuretics. |
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Term
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Definition
Bronchodilator
Nebulizer page 90 (Accuneb, Airet, albuterol, proventil, salbutamol, ventodisk, ventolin)
FUNCTION CLASS: Adrenergic B-agonist, sympathomimetic, bronchodilator
ACTION: Causes bronchodilation by action on B2 (pulmonary) receptors by increasing levels of cAMP, which relaxes smooth muscle, produces bronchodilation, CNS< cardiac stimulation, as well as increased dieresis and gastric acid secretion; longer acting than isoproterenol.
USES: Prevention of exercise induced asthma, acute bronchospasm, bronchitis, emphysema, bronchiectasis, or other reversible airway obstruction. UNLABELED USES: Hyperkalemia in dialysis patients.
SIDE EFFECTS: bronchospasm, tremors, anxiety, restlessness |
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Term
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Definition
Bronchodilator
Leukotriene Receptor Antagonist =LRA-decrease inflammation and bronchial edema Side effects: dyspepsia, N/V, diarrhea, rash, asthenia, Dizziness, fatigue, headache, abdominal pain, influenza, cough, nasal congestion. Nursing considerations: Asses CBC, blood chemistry, respiratory rate, rhythm, depth, auscultate lung fields; administer in PM daily |
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Term
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Definition
Xanthine Bronchodilator
Monitor client for tachycardia, development of toxicity; avoid coffee, tea, cocoa, chocolate, and cola. Observe for CNS stimulation, diuresis, and changes in cardiac functioning or convulsive activity. Give loading dose of 5 mg/kg; followed by 2-4 mg/kg q6-8 hr. Used for bronchial asthma, bronchospasm of COPD, chronic bronchitis, emphysema. Side effects: anxiety, restlessness, insomnia, dizziness, Seizures, palpitations, sinus tachycardia, Dysrhythmias, N/V, anorexia. Monitor theophylline blood levels 5-15 mcg/ml; toxicity over 20 mcg/ml. Monitor I/O; signs of toxicity, resp. rate; allergic reactions. |
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Term
| Benadryl (diphenhydramine) |
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Definition
antihistamine (1st generation, nonselective)
Uses: allergy symptoms, rhinitis, motion sickness, antiparkinsonism, nighttime sedation, infant colic, nonproductive cough. Side effects: dizziness, drowsiness, urinary retention, Seizures, Thrombocytopenia, Agranulocytosis, Hemolytic anemia, Anaphylaxis; photosensitivity. Nursing considerations: Assess CBC, resp; urinary retention, frequency, dysuria – disc drug. |
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Term
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Definition
| Theophylline, Aminophylline,caffeine. Used in ancient times. Produce diuresis. Loss of potassium ions threatens the neurotransmission in cardiac muscle. Threat of tachycardia; Medication is to be infused using a continuous IV info pump to ensure rate does not exceed 25 mg/min. Client must be placed on cardiac monitor. Xanthenes also stimulate the CNS – monitor for insomnia, hyperexcitability and potential for seizure activity. Individualized dosages. |
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Term
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Definition
| Calcium channel blocker; antihypertensive; antianginal. Produces relaxation of coronary vascular smooth muscle; dilates coronary arteries; decreases SA/AV node conduction; dilates peripheral arteries. Used for chronic, stable, vasospastic, unstable angina; dysrhythmias, HTN, Supraventricular tachycardia, atrial flutter or fibrillation. Also used for migraines, recumbent nocturnal leg cramps. Side effects: headache, drowsiness, anxiety, weakness, insomnia, edema, CHF, bradycardia, palpitations, AV block, nausea, constipation, increased LFTs, gingival hyperplasia. Nursing considerations: Assess: cardiac status; I/O, wt daily; |
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Term
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Definition
Loop diuretic
Inhibits reabsorption of Na & Cl in the loop of Henle. Used for pulmonary edema; edema in CHF, hepatic disease, nephrotic syndrome, ascities, and HTN. Side effects: orthostatic hypotension, hypokalemia, ECG changes, circulatory collapse, loss of hearing, hypomagnesemia, hypocalcemia, hyponatremia, metabolic alkalosis, Hyperglycemia, N/V, anorexia, polyuria, renal failure, thrombocytopenia, agranulocytosis, leukopenia, neutropenia, anemia, rash, pruritus. Nursing considerations: Assess: signs of metabolic alkalosis, signs of hypokalemia, rashes, temperature; confusion, hearing, weight, I/O daily; respiration; BP; electrolytes; BUN, blood glucose, CBC, creatinine; blood pH, ABGs, uric acid, calcium, magnesium levels; skin turgor, edema; glucose; allergies to sulfonamides, thiazides. Increase fluid intake to 2-3 L/day. Monitor for confusion and muscle weakness. |
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Term
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Definition
| Lasix, Bumex – act by inhibiting the reabsorption of Na & Cl in the loop of Henle, thereby reducing the ability of the kidneys to concentrate urine. The loop diuretics are more potent than the thiazides in promoting Na and fluid excretion. However, the use of these agents has also been associated with hearing loss, particularly when administered parenterally in high doses. Antihypertensives |
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Term
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Definition
| HCTZ – antihypertensive; sulfonamide derivative. Acts on distal tubule and ascending limb of loop of Henle by increaseing excretion of water, Na, Cl, and K. Used for edema, HTN, diuresis, CHF, edema in corticosteroid use, estrogen, NSAIDs, idiopathic lower extremity edema therapy. |
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Term
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Definition
diuretic, osmotic
Acts by increasing osmolarity of glomerular filtrate, which inhibits reabsorption of water and electrolytes and increases urinary output. Used for edema, cerebral edema, intraocular pressure, improve renal function in acute renal failure, chemical poisoning. Side effects: seizures, rebound increased ICP, confusion, thrombophlebitis, hypotension, HTN, tachycardia, chest pain, fever, chills, CHF circulatory overload, loss of hearing, blurred vision, fluid/electrolyte imbalances, acidosis, N/V, urinary retention, pulmonary congestion. Nursing considerations: wt, I/O daily; respiration, BP; electrolytes, signs of metabolic acidosis; signs of hypokalemia, rashes, temp; confusion, hydration; blurred vision; neurologic checks, edema. |
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Term
| HCTZ – hydrochlorothiazide |
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Definition
thiazide diuretic, antihypertensive
Acts on distal tubule and ascending limb of loop of Henle by increaseing excretion of water, Na, Cl, and K. Used for edema, HTN, diuresis, CHF, edema in corticosteroid use, estrogen, NSAIDs, idiopathic lower extremity edema therapy. Side effects: dizziness, fatigue, weakness, orthostatic hypotension, hypokalemia, hypercalcemia, hyponatremia, hypochloremia, hypomagnesemia, N/V, anorexia, hepatitis, urinary frequency, uremia, glucosuria, aplastic anemia, hemolytic anemia, leukopenia, agranulocytosis, thrombocytopenia, neutropenia, rash, hyperglycemia, hyperuricemia, increased creatinine, BUN. Nursing considerations: Wt, I/O daily; respirations; BP; electrolytes; renal function; confusion; administer potassium if lower than 3mg/dl. |
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Term
| Aldactone (spirinolactone) |
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Definition
Potassium sparing diuretic -- aldosterone antagonist
Results in excretion of NaCl, water, retention of K, phos. Used for edema of CHF, HTN, diuretic-induced hypokalemia, primary hyperaldosteronism (diagnosis, short term, long term tx); edema of nephrotic syndrome, cirrhosis of liver with ascites. Side effects: Hyperkalemia, bleeding, hepatocellular toxicity, agranulocytosis, diarrhea, vomiting, rash, pruritus. Nursing considerations: Assess: electrolytes; wt, I/O daily; ECG periodically; signs of metabolic acidosis; rashes, temp; confusion; hydration; Avoid foods with high potassium (bananas, oranges, salt substitutes, dried apricots, dates. |
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Term
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Definition
antihyperlipidemic; cholesterol absorption inhibitor.
Inhibits absorption of cholesterol by the small intestine. Side effects: myalgias, arthralgias, cough, URI, pharyngitis, chest pain, back pain, liver dysfunction, myositis, rhabdomyolysis. Nursing considerations: Assess 12 hr fasting lipid profile; hepatic studies; increased CPK levels; muscle tenderness (rhabdomyolysis); renal studies (BUN, I/O, creatinine). |
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Term
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Definition
Antilipidemic
Inhibits HMG-CoA reductase enzyme, which reduces cholesterol synthesis. Used as an adjunct in primary hypercholesterolemia (types 1a, 1b); dysbetalipoproteinemia, elevated TG levels, prevention of CVD by reduction of heart risk in those with mildly elevated cholesterol. Side effects: liver dysfunction, rhabdomyolysis, abdominal cramps, constipation, diarrhea, flatus, heartburn, Photosensitivity. Nursing considerations: Assess: diet history; cholesterol/tri-glyceride levels periodically; hepatic studies; AST, ALT, LFTs may be increased; renal studies – BUN, I/O, creatinine; for muscle pain, tenderness, obtain CPK baseline – drug may need to be discontinued. |
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Term
| Niacin (Vit B3, antihyperlipidemic) |
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Definition
Nicotinamide water soluble vitamin
Needed for conversion of fats, protein, carbs, by oxidation reduction; acts directly on vascular smooth muscle, causing vasodilation, reduces LDL, HDL, TG, and lipoprotein A. Used for pellagra, hyperlipidemia (types 4,5), peripheral vascular disease that presents a risk of pancreatitis. Side effects: jaundice, hepatotoxicity, glycosuria, hypoalbuminemia. Nursing considerations: Assess hepatic studies; blood glucose; cardiac status; nutritional status; hepatic dysfunction; CNS symptoms; for symptoms of niacin deficiency (N/V, anemia, poor memory, confusion, dermatitis); for lipid, TG, cholesterol level. Report clay colored stool, anorexia, jaundiced sclera, skin; dark urine, hepatotoxicity may occur. |
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Term
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Definition
The only agent used in cancer pts, prescribed only by subq dosing.
Antianemic, biologic modifier, hormone. Amino acid polypeptide. Erythropoeitin is one factor controlling rate of RBC production, drug is developed by recombinant DNA technology. Used for anemia caused by reduced endogenous erythropoietin production, primarily end stage renal disease; to correct hemostatic defect in uremia; anemia due to AZT tx in HIV pts or chemotherapy; reduction of allogenic blood transfusion in surgery pts. Side effects: seizures; hypertensive encephalopathy; HTN. Nursing considerations: Assess: renal studies; urinalysis, BUN, creatinine; I/O; blood studies; ferritin, Hct; BP; CNS symptoms; seizures; for hypersensitivity reactions; for pure cell aplasia; in dialysis pts: thrill, bruit of shunts; monitor for circulation impairment. Take Iron supplements, Vit B12, folic acid as directed. |
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Term
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Definition
Antihypertensive – antianginal (beta-blocker)
Produces negative chronotropic activity, negative inotropic activity (decreases rate of SA node discharge, increases recovery time.), slows conduction of AV node, decreases HR, decreases O2 consumption in myocardium; also decreases renin-aldosterone-angiotensin system at high doses, inhibits B2 receptors in bronchial system in higher doses. Used for milk to moderate HTN, prophylaxis of angina pectoris; suspected of known MI (IV use). Side effects: insomnia, fatigue, dizziness, mental changes, memory loss, hallucination,
profound hypotension, bradycardia, CHF, cold extremities, postural hypotension, 2nd or 3rd degree heartblock, nausea, diarrhea, mesenteric arterial thrombosis, ischemic colitis, agranulocytosis, thrombocytopenia, purpura, bronchospasm, dyspnea, wheezing pulmonary edema. Nursing considerations: I/O, wt daily; BP, pulse before administration; notify prescriber of any significant changes (< 50 bpm); assess baselines in renal/hepatic studies before therapy begins. |
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Term
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Definition
Antihypertensive; ACE inhibitor
Suppresses renin-angiotensin-aldosterone system; inhibits ACE; preventing conversion of angiotensin I to angiotensin II. Used for HTN, CHG, left ventricular dysfunction after MI, diabetic nephropathy. Side effects:
hypotension, tachycardia, nephrotic syndrome, acute reversible renal failure, neutropenia, agranulocytosis, pancytopenia, thrombocytopenia, Angioedema, bronchospasm, dyspnea, cough. Nursing considerations: Assess: blood studies; decreased platelets; WBC with diff baseline; BP, pulse rates baseline, renal studies; protein, BUN, creatinine; baselines in renal, hepatic studies before therapy begins and periodically, increased LFTs uric acid and glucose may be increased; assess edema in feet, legs daily, wt daily in CHF; allergic reaction; disc drug if antihistamines fail to help; symptoms of CHF – edema, dyspnea, wet crackles, BP. Photosensitivity may occur. |
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Term
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Definition
Antidysrhythmic
Slows conduction through AV node, can interrupt reentry pathways through AV node, and can restore normal sinus rhythm in pts with PSVT. Uses, SVT, as a diagnostic aid to assess myocardial perfusion defects in CAD. Side effects: Orthostatic hypotension, Atrial tachydysrhythmias, facial flushing, nausea, dyspnea, chest pressure. Nursing considerations: Assess: IO, electrolytes, cardiopulmonary status; BP, pulse, resp, ECG intervals; transient dysrhythmias; resp status; CNS effects: dizziness, confusion, psychosis, paresthesias, convulsions; drug should be disc. |
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Term
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Definition
Antidepressants: Increases concentrations of endogenous epinephrine, norepinephrine, serotonin, dopamine in storage sites in CNS by inhibition of MAO; increased concentration reduces depression.
Dangerous side effects: hypotension, HTN, death. Nardil, Parnate – last effort – not 1st class. For all: avoid consumption of tyramine rich foods: routinely check VS, esp. BP. |
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Term
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Definition
| Used for depression, when uncontrolled by other means. Side effects: dizziness, drowsiness, orthostatic hypotension, HTN, dysrhythmias, Hypertensive crisis, SIADH – like syndrome, anorexia, anemia. Nursing considerations: Assess BP, pulse – hold drug if BP drops 20 mmHg; assess blood studies; hepatic studies; ALT, AST, bilirubin, hepatotoxicity may occur. Assess for toxicity; mental status changes; urinary retention, constipation, edema; withdrawal symptoms. Avoid high tyramine foods: cheese, sour cream, beer, wine, pickled products, liver, raisins, bananas, figs, avocados, meat tenderizers, chocolate, yogurts, increased caffeine. |
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Term
| Parnate (tranylcypromine) |
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Definition
| Used for depression, when uncontrolled by other means; bulimia, cocaine addiction, migraines, seasonal affective disorder, panic disorder. S/E: dizziness, drowsiness, orthostatic hypotension, HTN, dysrhythmias, anorexia, hypertensive crisis, SIADH – like syndrome. Nursing considerations: Assess: BP, blood studies; hepatic studies; toxicity; mental status changes; urinary retention, constipation, edema; take wt weekly, withdrawal symptoms; Avoid high tyramine foods. |
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Term
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Definition
| Anticonvulsant. Decreases polysynaptic responses and block post-tetanic potentiation. Used for tonic-clonic seizure, complex-partial, mixed seizures; trigeminal neuralgia, bipolar disorder. Side effects: drowsiness, paralysis, worsening of seizures, HTN, CHF, dysrhythmias, AV block; nausea, constipation, diarrhea, hepatitis, renal failure; thrombocytopenia, leukopenia, agranulocytosis, leukocytosis, aplastic anemia, eosinophilia, rash, Stevens-Johnson syndrome. Nursing considerations: Assess for seizures – character, location, duration, intensity, frequency, presence of aura; for trigeminal neuralgia – facial pain including location, duration, intensity, character, activity that stimulates pain; assess renal studies – urinalysis, BUN, urine creatinine q3 mo; Blood studies: RBC, Hct, Hgb, reticulocytes; Hepatic studies – ALT, AST, bilirubin; Drug levels – should remain at 4-12 mcg/ml; anorexia may indicate increased blood levels.; Mental status; eye problems; allergic reaction; blood dyscrasias; toxicity. Report immediately chills, light colored stools, dark urine, jaundice; abdominal pain, sore throat, mouth ulcers, bruising, blurred vision, dizziness. |
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Term
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Definition
antianxiety, anticonvulsant, skeletal muscle relaxant, central acting
**controlled substance schedule IV** Use direct rather than IV drip. Benzodiazepine
Potentiates action of GABA, in limbic system; enhances presympathetic inhibition. Uses: anxiety, acute alcohol withdrawal, adjunct in seizures disorders, preoperatively as a relaxant, skeletal muscle relaxation, rectally for acute repetitive seizures. Side effects: drowsiness, dizziness, orthostatic hypotension, blurred vision, ECG changes, tachycardia, neutropenia, respiratory depression. Nursing considerations: Assess BP, resp; blood studies; degree of anxiety; for alcohol withdrawal symptoms; for seizure control and type; hepatic studies; IV site for thrombosis or phlebitis; mental status; physical dependency, withdrawal symptoms; suicidal tendencies. Continuous infusion is NOT recommended. |
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Term
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Definition
| Hydantoin – used for tonic-clonic seizures. Dilantin level 5-20 mcg/mL. Anticonvulsant, antidysrhythmic. Inhibits spread of seizure activity in motor cortex by altering ion transport. Increases AV conduction. Uses: generalized tonic-clonic seizures; status epilepticus; nonepileptic seizures asst with Reye’s syndrome or after head trauma; migraines, trigeminal neuralgia, Bell’s palsy, ventricular dysrhythmias uncontrolled by antidysrhythmics. Side effects: V-fib, hepatitis, nephritis,agranulocytosis, leukopenia, aplastic anemia, thrombocytopenia, megaloblastic anemia, lupus erythematosus, Stevens-Johnson syndrome. Rapid IV infusion may cause cardiovascular arrest. Do NOT exceed an IV infusion rate of 50 mg/min in adults or 1-3 mg/kg/min in neonates. Do NOT infuse IV with dextrose, because glucose forms a precipitate; infuse with NS only. Nursing considerations: Assess for hypersensitivity; rash, temp, lymphadenopathy; may cause hepatotoxicity, renal failure, rhabdomyolysis; for beginning rash that may lead to Stevens-Johnson syndrome or toxic epidermal necrolysis. Assess drug level for seizures; blood studies; mental status; resp depression; blood dyscrasias. |
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Term
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Definition
thyroid hormone antagonist (antithyroid)
Blocks synthesis peripherally of T3, T4, inhibits organification of iodine. Used in preparation for thyroidectomy, thyrotoxic crisis, hyperthyroidism, thyroid storm. Side effects: drowsiness, headache, vertigo, ever, N/V, diarrhea, rash, urticaria, pruritus, alopecia, hyperpigmentation; Jaundice, Hepatitis; Nephritis; Agranulocytosis, Leukopenia, Thrombocytopenia, Hypothrombinemia; lymphadenopathy. Nursing considerations: Assess: BP, pulse, temp; I/O; edema; wt daily; T3, T4 which are increased; TSH which is decreased; free thyroxine index which is increased if dosage is too low; Assess blood studies: CBC for blood dyscrasias; leukopenia, thrombocytopenia, agranulocytosis: LFTs. Assess Overdose: peripheral edema, heat intolerance, diaphoresis,
palpitations, dysrhythmias, severe tachycardia, increased temp, delirium, CNS irritability; Hypersensitivity – rash, enlarged cervical lymph nodes; hypoprothrombinemia – bleeding, petechiae, ecchymosis; bone marrow depression. Seafood & iodine products may be restricted. |
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Term
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Definition
(T4) Synthroid thyroid hormone
Increases metabolic rate, controls protein synthesis, increases cardiac output, renal blood flow, O2 consumption, body temp, blood volume, growth development at cellular level. Uses: hypothyroidism, myxedema coma, thyroid hormone replacement, thyrotoxicosis, congenital hypothyroidism, some types of thyroid cancer. Side effects: anxiety, insomnia, tremors, tachycardia, palpitations, angina, dysrhythmias, thyroid storm, cardiac arrest. Nursing considerations: Assess: BP, Pulse, Wt daily; Ht, growth rate of a child; T3, T4, FTIs which are decreased; radioimmunoassay of TSH, which is increased; radio uptake, which is increased if pt is on too low a dose of meds; Pt may require decreased anticoagulant; check for bleeding, bruising; assess for increased nervousness, excitability, irritability, which may indicate too high dose of meds; Cardiac status – angina, palpitation, chest pain, change in VS. Administer in AM to decrease sleeplessness; only for hormone imbalances; not to be used for obesity, male infertility, menstrual conditions, or lethargy. Hairless is temporary. Avoid iodine food – soybeans, tofu, turnips, seafood, some bread. |
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Term
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Definition
Pituitary hormone; synthetic antidiuretic hormone.
Promotes reabsorption of water by action on renal tubular epithelium; causes smooth muscle constriction, increase in plasma factor VIII levels, which increases platelet aggregation resulting in vasopressor effect, similar to vasopressin. Uses: Hemophilia A, Von Willbrand’s disease type I, nonnephrogenic diabetes insipidus, symptoms of polyuria, polydipsia caused by pituitary dysfunction, nocturnal enuresis. Side effects: anaphylaxis (IV) Nursing considerations: Assess: pulse, BP when giving IV or subcut. I/O, wt daily; check for edema; water intoxication – lethargy, behavioral change, disorientations, neuromuscular excitability; Intranasal use – nausea, congestion, cramps, headache; For severe allergic reaction including anaphylaxis; urine vol/osmolality and plasma osmolality (diabetes insipidus); Factor VIII coagulant activity before using for hemostasis; nocturnal enuresis – frequency before and during treatment. |
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Definition
Pituitary hormone – growth hormone
Stimulates growth; somatropin is similar to natural growth hormone; both preparations developed by recombinant DNA. Uses: Pituitary GH deficiency (hypopituitary dwarfism), children with human GH deficiency, AIDS wasting syndrome, cachexia, adults with somatropin deficiency syndrome (SDS). Side effects: Hyperglycemia, ketosis, hypothyroidism, antibodies to GH; hypercalciuria. Nursing considerations: Assess GH antibodies if pt fails to respond to therapy; Assess thyroid functions tests: T3, T4, T7, TSH to identify hypothyroidism; allergic reaction; hypercalciuria – stones; groin, flank pain; N/V, urinary frequency, hematuria, chills; Growth rate of child at intervals during Tx. Tx may continue for years. Administered IM Subcut. |
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Definition
Cerebral stimulant
Uses: ADD, ADHD, narcolepsy; depression in geriatric, cancer, post-stroke pts, HIV, brain injury, improvement in pain control, sedation in pts receiving opiates. Side effects: hyperactivity, insomnia, restlessness, talkativeness, palpitations, tachycardia, seizures, dysrhythmias, leukopenia, anemia, thrombocytopenic purpura, exfoliative dermatitis. Nursing considerations: Assess: VS, BP, CBC, urinalysis; blood glucose, during glucose in diabetes; Ht, growth rate q3 mo/ children. Assess mental status; withdrawal symptoms; appetite, sleep, speech patterns, for attention span, decreased hyperactivity in ADHD pts. |
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Term
| Librium (chlordiazepoxide) ** controlled substance schedule IV** |
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Definition
| Benzodiazepine - antianxiety. Potentiates GABA actions, esp in limbic system, reticular formation. Used for short term management of anxiety, acute alcohol withdrawal, preoperatively for relaxation. Side effects: dizziness, drowsiness, orthostatic hypotension, blurred vision, ECG changes, tachycardia. Nursing considerations: Assess: BP, pulse; hold drug if BP drops 20 mmHg.; Assess blood studies: CBD; blood dyscrasias; hepatic studies – AST, ALT, bilirubin, creatinine, LDH, alk phos; I/O – may indicate renal dysfunction; for ataxia, oversedation in geriatric; mental status; physical dependency; withdrawal symptoms; suicidal tendencies, paradoxic reaction. |
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Term
| Anesthetics administered by inhalationSemiclosed method |
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Definition
| A gas mixture from a reservoir containing the anesthetic is provided through a mask that is connected to it. Gas escapes through valves, preventing rebreathing of air. This can create a hazardous situation. |
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Term
Anesthetics administered by inhalation Closed method |
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Definition
| Completely closed system, part of an anesthetic machine that fits over the face of the client. Safer than semi closed method. INH anesthetics may cause side effects such as nausea and vomiting, lower B/P, and alter resp. rate and cardiac output. |
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Term
| Nitrous oxide (Laughing Gas |
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Definition
| most common gaseous anesthetic agent used. Usually administered in combo with O2. Colorless, odorless and nonirritating. Equivalent to 10 mg morphine sulfate. Weak and generally used in combination with another anesthetic. O2 should be used for several minutes after to prevent hypoxia. Cylinders are always blue. Not explosive. |
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| Anesthetics administered by IV injection |
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Definition
Generally used for induction of anesthesia before using inhaled agents.
Induction with these agents occurs rapidly (less than 30 sec.) Relative inability to stimulate salivation or emesis. Nonexplosive. Can cause apnea, coughing, hypo/hypertension, laryngospasm and bronchospasm. Difficult to control adverse side effects. Impossible to remove drug from body one it has entered the blood stream. May cause malignant hyperthermia( high fever 104*-105*) |
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Definition
| Usual dosage: Induction- 100-150 mcg/kg/min Maintenance- 50-200 mcg/kg/min Classified as an alkyl phenol Emulsion- need to shake well. Protect from light. Monitor client for apnea bradycardia. A hypnotic effect is produced within 40 sec of rapid IV bolus dose. Anesthesia maintained by administering drug by infusion or intermittent IV bolus injection. Should only be administered into a running IV catheter. Patients wake up quickly and do not remember anything. |
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Definition
| Usual dosage: IV- 0.15-0.35 mg/kg IM- 0.07-0.08 mg/kg Not to be used in pts with open angle glaucoma. Administer drug slowly. Chemically related to Valium. When administered intravenously it induces anesthesia with in 1.5-2.5 minutes. Often given intravenously to produce conscious sedation prior to short diagnostic or endoscopic procedures. |
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Definition
A combination of inhalation & IV medications. Most commonly used practice of administering general anesthesia. Effective and safe especially for elderly clients and those at high risk for pulmonary problems.
Provide analgesia, hypnosis, amnesia, muscle relaxation, and relaxation of neurological reflexes. Preanesthetic medications are used prior to the administration of an anesthetic to facilitate induction of anesthesia and to relieve anxiety and pain. |
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Definition
| The most common agents used to produce sedation. Midazolam HCI (Versed) Effects include sedative, hypnotic, antianxiety, muscle relaxation, and amnesic effects |
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Definition
| Commonly used to augment inhalation anesthesia as well as being primary agents in regional anesthesia. |
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Definition
| Belladonna alkaloids. Diminish salivation and can prevent laryngospasm and reflex slowing of the heart during general anesthesia. Must be used with caution in pts with a fever because they depress the sweating mechanism. |
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Definition
| Used to relax the jaw and throat muscles immediately following induction so an endotracheal tube can be placed to maintain a patent airway and facilitate alveolar ventilation during surgery. May cause circulatory compromise and respiratory muscle paralysis during the surgery. |
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Definition
| Anesthesia Cocaine was one of the first anesthetics to be discovered. These drugs prevent the generation and the conduction of the nerve impulse. Capable of causing CNS stimulation (restlessness, tremors, and clonic convulsions) followed by CNS depression, resp. depression, and death. |
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Term
| Selection of the proper agent should be selected by |
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Definition
| - Area to be anesthetized. - Agent’s duration of action. - Client’s history of allergies. - Healthcare provider s experience with the drug. |
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