Term
|
Definition
| are all cyps present at birth? |
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Term
|
Definition
| cyp that peaks shortly after birth |
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Term
|
Definition
| cyp that increases rapidly after birth |
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Term
|
Definition
| 3 cyps that appear within the first month of life |
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Term
|
Definition
| cyp whose activity comes between 1-3 months |
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Term
|
Definition
| 3 cyps that exceed adult capacity by 6-12 months of life |
|
|
Term
| alcohol dehydrogenase and epoxide hydrolase (mEH) |
|
Definition
| two non - cytochrome p450 enzymes that we are deficient in at birth |
|
|
Term
|
Definition
| is glucoronidation increased or decreased at birth? Have about ?% of adult values? (Phase II conjugation reaction) |
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Term
|
Definition
| ? activity in neonates and infants exceeds adult values (type of Phase II metabolsim conjugation reaction) |
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Term
|
Definition
| is acetylation increased on decreased compared to adult levels at birth? (type of phase II metabolsim reaction) |
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|
Term
| CFTR, chloride, decreased, increased |
|
Definition
| in cystic fibrosis, the transmembrane regulator ? which is a ? channel is dysfunctional and usually results in ? chloride secretion and ? sodium absorption? |
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Term
|
Definition
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|
Term
| 29 days to less than 12 months |
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Definition
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Term
|
Definition
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Term
|
Definition
|
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Term
|
Definition
| age from the date of the mother's first day of last menstrual period to date of birth |
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Term
|
Definition
| infants born at 38 weeks gestation or more are said to be what |
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Term
|
Definition
| infants born before 37 weeks of gestation are said to be what |
|
|
Term
|
Definition
| neonates with birth weight below the 10th percentile among neonates of the same gestational age |
|
|
Term
|
Definition
| neonates with birth weight above the 90th percintile among neonates of the same gestational age |
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|
Term
| chronological or postnatal age |
|
Definition
| age from birth to present, measured in days, weeks, months, or years |
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|
Term
| corrected or adjusted age; chronological age in months - [(40 - GA at birth in weeks) / 4 weeks] |
|
Definition
| may be used to describe the age of a premature child up to 3 years of age? what is the formula? |
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Term
|
Definition
| premature infant with birth weight between 1500 and 2500 grams |
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Term
|
Definition
| premature infant with birth weight of 1000g to less than 1500g |
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|
Term
|
Definition
| premature infant with birth weight less than 1000g |
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Term
|
Definition
| antibiotic therapy is indicated in ? different situations over the course of CF |
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|
Term
| IV antipseudomonal B lactam plus and aminoglycoside |
|
Definition
| antibiotic regimens in severe CF exacerbations usually invlude ? and ? |
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Term
|
Definition
| CF patients have a ? volume of distribution for many antibiotics due to an increased ratio of lean body mass to total body mass and lower fat stores |
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|
Term
|
Definition
| CF patients have an ? total body clearance although the exact mechanism has not been determined |
|
|
Term
| steatorrhea, stool output, and abdominal symptoms |
|
Definition
| titration of pancreated enzyme doses is baed on control of what three things |
|
|
Term
|
Definition
| CF related diabetes results from ? insufficiency |
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Term
|
Definition
| ? is an inherited multiorgan system disorder affecting children and an ever growing adult population; it is the most common life threatening genetic disease among caucasians and the major cause of severe chronic lung disease and pancreatic insufficiency in children |
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|
Term
| recessive; 25; heterozygous |
|
Definition
| CF is inherited an and autosomal ? trait and approximately 1 in ? caucasians are ? carriers? |
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Term
|
Definition
| the gene mutation for CF is found on the long arm of chromosome ? which encodes for the ? protein; what is the mutation that is most common in the united states in people with CF |
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Term
|
Definition
| CF is a disease of ? gland epithelial cells where CFTR expression is prevalent |
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|
Term
|
Definition
| chronic ? disease is a hallmark in CF patients resulting in the death of ?% of patients |
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|
Term
| Staphylococcus aureus and nontypeable Haemophilus influenzae which is not prevented by childhood immunizations |
|
Definition
| In CF patients, early bacterial infection is caused by what two bacteria? |
|
|
Term
|
Definition
| in CF patients, ? infection also occurs early in life and is the most significant CF pathogen among all CF age groups (cause lung inflammation) |
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|
Term
|
Definition
| maldigestion due to ? deficiency is present in 85 - 90% of CF patients |
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|
Term
|
Definition
| patients with CF will have decreased abosroption of ? soluble vitamins |
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|
Term
|
Definition
| CF related diabets (CFRD) has characteristics of type ? diabets but is categorized separately |
|
|
Term
| 2;60;pilocarpine iontophoresis (sweat test) |
|
Definition
| the diagnosis of CF is based on ? elevated sweat chloride concentrations of ? meq/L or higher obtained through ? |
|
|
Term
|
Definition
| more than 70% of CF diagnoses are make by ? months of age and nearly all diagnoses are made by ? years of age |
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|
Term
|
Definition
| CF is usually diagnosed in neonated due to ? |
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|
Term
|
Definition
| most CF patients have an ? calorid need due to increased energy expenditure through increased work of breathing, increased basal metabolism, and maldigetion |
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|
Term
| airway clearance; bronchodilation; mucolytic |
|
Definition
| to treat pulmonary issues associated with CF, ? therapy is usually accompanied by ? treatment such as albuterol given in the form of a nebulizer or metered dose inhaler as well as a ? agent to reduce sputum viscosity and enhance clearnace; can also use nebulization of ? 2.5 mg once or twice daily which improves pulmonary symptoms and functions, reduces pulmonary exacerbations, and improves quality of life |
|
|
Term
| hypertonic; bronchodilator |
|
Definition
| ? saline for inhalation is sometimes used as an add-on mucolytic agent or for sputum induction; this muste be preceded by a ? due to a greater incidence of bronchospasm and may not be tolerated by some patients |
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|
Term
|
Definition
| many patients with CF also have reactive airways or concurrent asthma and befefit from long acting ? |
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|
Term
|
Definition
| inhaled ? may also attenuate reactive airways and reduce airway inflammation in some pateints; however, clear benefit in CF has not been established |
|
|
Term
|
Definition
| drug delivery to the site of inflammation is limited by the severity of lung disease which may limit the efficacy of these drugs. Patients on inhaled corticosteroids and/or long acting beta agonists should administer these medications after ? therapies to optimize drug delivery |
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|
Term
|
Definition
| long term systemic ? have been shown to reduce airway inflammation and improve lung function in patients with CF |
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|
Term
| ibuprofen; neutrophil, inflammation |
|
Definition
| high dose ? has been shown to slow progression of disease, particularly in children 5 to 13 years of age with mild lung disease; if given at low doses can actually increase ? migration therefore increasing ? which is bad |
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|
Term
|
Definition
| ? is a macrolide antibiotic commonly used in CF as an anti - inflammatory agent; has been shown to improve overall ? function although the mechanism is unclear |
|
|
Term
|
Definition
| Due to its long tissue half life, azithromycin is typically dosed ? days per week with a dose of ?mg for patients weighing at least 40 kg and ?mg for patients weight 25 to 39 kg |
|
|
Term
| antibiotic, year, empiric |
|
Definition
| ? selection is based on periodic culture and sensitivity data, typically coverin |
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|
Term
|
Definition
| severity of ? symptoms also guides selection of antibiotic regimens for treatment of acut exacerbations |
|
|
Term
|
Definition
| for recently onset or mild symptoms, patients may be treated with outpatient oral and inhaled antibiotics for ? to ? days |
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|
Term
| fluoroquinolones; tobramycin; colistin |
|
Definition
| oral ? are a mainstay among CF patients infected with P. aeruginosa, even in children despite tendon toxicity issues; to prevent development of resistance and promote synergy, inhaled ? or ? is usually added for double coverage |
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|
Term
| augmentin, dicloxacillin, cephalosporins, bactrim, clindamycin |
|
Definition
| Methicillin - sensitve S. aureus bay be treated with oral ?, ?, or first or second generation ?, ? or ? |
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|
Term
| bactrim, clindamycin, minocycline, or linezolid |
|
Definition
| Methicillin resistane S. aureus (MRSA) may be treated with oral ?, ?, ?, or ? |
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|
Term
| beta lactamases, augmentin, cephalosporin, bactrim |
|
Definition
| H. influenzae often produces ? but can usually be treated with ?, a ?, or ? |
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|
Term
|
Definition
| oral ? or ? may be used to treat S. maltophilia |
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|
Term
| cephalosporins; 8; AZtreonam; positive; Meropenem |
|
Definition
| For severe CF infections, ? tend to be better tolerated and offer the benefit of administration every ? hours; ? offers the added benefit of little cross reactivity in penicillin or cephalosporin allergic patients however it offers no gram ? coverage; ? should be reserved for organisms resistant to all other antibiotics to minimize development of resistance in the carbapenem drug class, as it is the last line of defense against extended spectrum beta lactamase producing organisms |
|
|
Term
| tobramycin; gentamicin; amikacin |
|
Definition
| ? IV is generally the first line aminoglycoside used in the treatment of severe cases of CF; isolates are generally resistant to ? and ? is reserved for tobramycin resistant cases |
|
|
Term
|
Definition
| in general, ? peak serum concentrations are targeted to maximize and efficacy and lower serum ? levels are targeted to reduce the risk of toxicity |
|
|
Term
|
Definition
| because aminoglycosides exhibit concentration dependent killing, ? daily administration may optimize this effect although this doesn't apply for children |
|
|
Term
| fluoroquinolones, bactrim, minocycline, linezolid |
|
Definition
| due to excellent bioavailability, oral ?, ?, ?, and ? should be used whenever possible in the antibiotic treatment of CF |
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|
Term
|
Definition
| inpatient treatment of MRSA is best treated with IV ? |
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|
Term
|
Definition
| Because of phamacokinetic changes associated with CF patients, ? doses of almost all meds are needed to achieve target serum levels and promate adequate tissue penetration |
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|
Term
|
Definition
| although most CF patients have shorter half lives and larger volumes of distribution than non - CF patients, somepatients exhibit decreased ? so have to keep this in mind when dosing certain meds |
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|
Term
|
Definition
| most enzyme products are formulated as capsules containing ? coated microspheres or microtablets to avoid inactivation of enzymes by gastric acid; instead they disolve in the more alkaline environment of the ? |
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|
Term
|
Definition
| ? may slow the progression of liver disease in patients with CF |
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|
Term
|
Definition
| ? indicates there is a problem with enzymes and enzyme replacement therapy should be started or modified if patient is already undergoing this therapy |
|
|
Term
|
Definition
| there is a direct correlation between nutritional status and ? function in patients with CF |
|
|
Term
|
Definition
| if a patient with CF is below the fifth percentile in weight they fall into the ? category |
|
|
Term
|
Definition
| ? is the most significant pathogen in all patients with CF |
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|
Term
|
Definition
| the first stool of life is called ? |
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|
Term
|
Definition
| ? is the number two killer associated with patients with CF |
|
|
Term
|
Definition
| ? is fat in the stool; if there is fat in the stool this means that the patient is having trouble with the absorption/digesion of fats and this could be an indication of CF |
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|
Term
|
Definition
| everyone with CF has a problem with CFTR but want to figure out what the specific ? is |
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|
Term
|
Definition
| pancreatic enzyme replacement therapies are deactivated by ? substances; should give no more than ? lipase units/kg/day |
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|
Term
|
Definition
| ? is the determinant for how well pancreatic enzyme replacement therapy is working |
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|
Term
|
Definition
| For ever patient with CF that has pancreatic insufficiency, it is required that they have ? supplementation |
|
|
Term
|
Definition
| must be how old to receive bactrim therapy to treat staph aureus |
|
|
Term
| clarythromycin; erythromycin; D |
|
Definition
| in CF, bacteria is sensitive to ? but not sensitive to ? which have similar chemical structures; if patient has a positive ? test, clarithromycin may be used but may only be effective for a couple doses |
|
|
Term
|
Definition
| In treating CF, want to use the agent that covers the ? microorganisms so that we can give less total medication and increase patient ? |
|
|
Term
|
Definition
| total body water (TBW) is directly related to body ? |
|
|
Term
|
Definition
| TBW constitutes approximately ?% of lean body weight in healthy females and ?% of lean body weight in healthy males |
|
|
Term
|
Definition
| The percentage of TBW decreases as body fat ? and/or with ? |
|
|
Term
|
Definition
| unless the patient is ? (body weight greater than 120% of ideal body weight) clinicians typically use a patient's actual body weight when calculating TBW |
|
|
Term
|
Definition
| in obese patients, it is customary to estimate TBW using lean body weight or IBW as calculated by the ? method |
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|
Term
| intracellular; electrolytes, 2/3 |
|
Definition
| the ? fluid represents the water contained within cells and is rich in ?; the ICF is approximately ? of TBW regardless of gender |
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|
Term
| extracellular; sodium; chloride; bicarbonate; 1/3; 2; interstitial fluid; intravascular fluid |
|
Definition
| the ? fluid is the fluid located outside the cell and is rich in ?, ?, and ?; The ECF is approximately ? of TBW and is subdivided into ? compartments, the ? and the ? |
|
|
Term
|
Definition
| the ? fluid represents the fluid occupying spaces between cells and is about ?% of TBW |
|
|
Term
|
Definition
| the ? fluid, also known as plasma, represents the fluid within the blood vessels and is about ?% of TBW |
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|
Term
|
Definition
| serum electrolytes are routinely measured from the ? |
|
|
Term
|
Definition
| the ? fluid includes the viscous components of the peritoneum, pleural space, and pericardium, as well as the cerebrospinal fluid, joint space fluid, and the GI digestive juices. |
|
|
Term
|
Definition
| although the transcellular fluid only makes up about ?% of TBW, this amount can ? significantly during various illnesses favoring fluid collection in one of these spaces |
|
|
Term
|
Definition
| the accumulation of fluid in the trancellular space is often referred to as ? |
|
|
Term
|
Definition
| to maintain fluid balance, the total amount of fluid gained throughout a day (input or "ins") must ? the total amount of fluid lost (output or "outs") |
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|
Term
|
Definition
| fluid outpus such as urinary and stool losses are easily measured and are referred to as ? |
|
|
Term
| dehyration; gradual,chronic |
|
Definition
| TBW depletion, often referred to as ?, is typically a ?,? problem |
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|
Term
|
Definition
| Because TBW depletion represents a loss of ? fluid (proportionally more water is lost than sodium) from all body compartments, a primary disturbance of ? is usually seen |
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|
Term
| CNS; thirst; dry; decreased; increased; increased; concentrated; acute |
|
Definition
| the signs and symtoms of TBW depletion include ? disturbances, excessive ?, ? moucous membranes, ? skin turgor, ? serum sodium, ? plasma osmolality, ? urine, and ? weight loss |
|
|
Term
|
Definition
| the volume of water required to correct TBW depletion equals the ? fluid requirement plus ongoing exceptional losses plus the fluid ? |
|
|
Term
|
Definition
| fluid deficity = ? TBW - ? TBW |
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|
Term
|
Definition
| The choice of fluids used for replacement is guided by the presence of concurrent ? abnormalities |
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|
Term
| acutely; organ; isotonic; osmolality |
|
Definition
| Compared to TBW depletion, ECF depeletion tends to occur ?. In this setting, rapid and aggressive fluid replacement is required to maintain adequate ? perfusion. Because ECF depletion is generally due to the loss of ? fluid (proportional losses of sodium and water), major disturbances of plasma ? are not common |
|
|
Term
| decreased; dizziness, orthostasis, tachycardia, decreased, increased, decreased, hyovolemic |
|
Definition
| ECF depletion manifests clinically as signs and symptoms associated with ? tissue perfusion: ?, ?, ?, ? urine output, ? hematocrit, ? central venous pressure, and/or ? shock |
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|
Term
| crystalloid, colloidal, oxygen |
|
Definition
| therapeutic IV fluids include ? solutions, ? solutions, and ? carrying resuscitation solutions |
|
|
Term
|
Definition
| crystalloids are composed of ? and ? all of wich pass freely through semipermeable membranes and remain in the intravascular space for shorter periods of time |
|
|
Term
|
Definition
| crystalloids are classified based on their ? |
|
|
Term
|
Definition
| ? solutions have a tonicity equal to that of the ? and do not shift the distribution of water between the ECF and the ICF |
|
|
Term
|
Definition
| ? solutions have greater tonicity that the ICF so they draw water from the ? into the ? |
|
|
Term
|
Definition
| ? solutions have less tonicity than the ICF leading to osmotic pressure gradient that favors shifts of water from the ? into the ? |
|
|
Term
|
Definition
| the tonicity of crystalloid solutions is directly related to their ? concentration |
|
|
Term
|
Definition
| excessive administration of any fluid replacement therapy, regardless of tonicity, can lead to fluid overload, particulary in patients with ? or ? insufficiency |
|
|
Term
|
Definition
| ? is often added to hypotonic crystalloids in amounts that result in isotonic fluids |
|
|
Term
|
Definition
| normal saline is an isotonic solution composed of ?, ?, and ? |
|
|
Term
|
Definition
| normal saline provieds primarily ? replacement and can be used for virtually any cause of TBW depletion |
|
|
Term
| shock, hemorrhage, burn, hyptensive, oliguric, hyponatremia, alkalosis |
|
Definition
| common uses of normal saline include volume resuscitation of ?, ? or ? patients, fluid challenges in ? or ? patients, and ?. Normal saline can also be used to treat metabolic ? |
|
|
Term
| shock, hemorrhage, burn, hyptensive, oliguric, hyponatremia, alkalosis |
|
Definition
| common uses of normal saline include volume resuscitation of ?, ? or ? patients, fluid challenges in ? or ? patients, and ?. Normal saline can also be used to treat metabolic ? |
|
|
Term
|
Definition
| ? saline is a hypotonic solution that provides free water in relative excess when compared to the sodium concentration |
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|
Term
|
Definition
| half - normal saline is generally used to treat patients who are hypertonic due to primary depletion of the ? |
|
|
Term
|
Definition
| because half - normal saline is hypotonic, serum ? must be closely monitored during administration |
|
|
Term
|
Definition
| ? saline is hypertonic and provides a significant sodium load to the intravascular space |
|
|
Term
|
Definition
| hypertonic saline is used very infrequently given the potential to cause significant shifts in the water balance between the ? and the ? |
|
|
Term
| hyponatremia; intracranial |
|
Definition
| hypertonic saline is usually used to treat patients with severe ?; hypertonic saline in concentrations of 7.5% to 23.4% have been used to acutely lower ? pressure in the setting of traumatic brain injury and stroke |
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|
Term
| Ringer's Lactate; sodium, chloride, potassium, lactate |
|
Definition
| ? is an isotonic volume expander that contains ?, ?, ?, and ? in concentrations that approximate the fluid and electrolyte composition of the blood |
|
|
Term
|
Definition
| Ringer's Lactate provides ? replacement and is most often used in the ? setting, and for patinets with lower ? fluid losses, burns or dehydrations |
|
|
Term
|
Definition
| the ? portion of Ringer's lactate acts as a buffer to ? the ph and can therefore cause metabolic alkalosis |
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|
Term
|
Definition
| Ringer's lactate should be given cautiously to patients with ? disease as they are unable to metabolize lactate sufficiently |
|
|
Term
|
Definition
| ? is a solution of free water and dextrose that provides a modest amount of ? but no electrolytes |
|
|
Term
|
Definition
| D5W is technically an ? solution, it acts as a ? solution in the body |
|
|
Term
|
Definition
| D5W is commonly used to treat severe ? and is also used in small volumes to dilute many IV medications or to keep the vein open in medications that are given at a ? infusion rate |
|
|
Term
|
Definition
| when determining the appropriate fluid to be utilized, it is important to first determine the type of fluid problem (? or ? depletion) |
|
|
Term
| intravascular; normal saline |
|
Definition
| for patients demonstrating signs of impaired tissue perfusion, the immediate therapeutic goal is to increase the ? volume and restore tissue perfusion; the standard therapy is ? |
|
|
Term
|
Definition
| normally the number of anions and the number of cations in each fluid compartment are ? |
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|
Term
|
Definition
| serum electrolyte measurements reflect the stores of ? electrolytes rather than that of ? electrolytes |
|
|
Term
| sodium, chloride, potassium, phosphate |
|
Definition
| In the ECF, ? is the most common cation and ? is the most abundant anion, ? is the primary cation and ? is the main anion in the ICF |
|
|
Term
|
Definition
| ? is a measure of the number of osmotically active particles per unit of solution, independent of the weight or nature of the particle |
|
|
Term
|
Definition
| Water moves freely across all cell membranes, making ? osmolality an accurate reflection of the osmolality within all body compartments |
|
|
Term
|
Definition
| an increase in osmolality is equated with a loss of ? greater than the loss of ? and vice versa |
|
|
Term
|
Definition
| under normal circumstances, the osmolar gap should ?mOsm/L or less |
|
|
Term
| alcohol, mannitol, lorazepam |
|
Definition
| an increased osmolar gap suggests the presence of a small, osmotically active agent and is most commonly seen with ingestion of ? or medications such as ? or ? |
|
|
Term
| KCl, potasssium phosphate, 9 |
|
Definition
| the 2005 National Patient Safety Goals published by the Joint Comission on Accreditation of Healthcare Organizations (JCAHO) recommends that concnetrated electrolyte solutions (?, ?, and Nacle greater than ?%) be removed from patient care areas |
|
|
Term
|
Definition
| what is normal serum sodium concentrations |
|
|
Term
|
Definition
| ? is the primary factor in establishing the osmotic pressure relationship between the ECF and the ICF |
|
|
Term
|
Definition
| hypotnatremia is very common in hospitalized patients and is defined as a serum sodium concentration below ? mEq/L although clinical signs and symptoms don't appear until this concentration gets below ? mEq/L |
|
|
Term
| hypertonic, ECF, ECF, ECF |
|
Definition
| hyponatremia is further defined as ? hyponatremia, hypotonic hyponatremia with an increased ? volume, hypotonic hyponatremia with a normal ? volume, and hyopotonic hyponatremia with a decreased ? volume |
|
|
Term
|
Definition
| hypertonic hyponatremia is usually associated with significant ? |
|
|
Term
| hypervolemic hyponatremia; TBW, sodium |
|
Definition
| hypotonic hyponatremia with an increase in ECF is called ?. In this scenario patients have an excess of total body sodium and TBW, however the excess ? is greater than the excess in ? |
|
|
Term
|
Definition
| treatment of hypervolemic hyponatremia includes ? and ? restriction along with treatment of the underlying disorder |
|
|
Term
| euvolemic hyponatremia; TBW, sodium |
|
Definition
| hypotonic hyponatremia with a normal ECF volume is called ?. In this case patients have excess of ? with relatively normal ? content. |
|
|
Term
|
Definition
| euvolemic hyponatremia is most frequently seen in patients with the syndrom of inappropriate ? hormone secretions (SIADH) |
|
|
Term
|
Definition
| treatment of euvolemic hyponatremia generally consists of ? restriction alone. Hypertonic saline can be used only when the sodium concentration is less than ? mEq/L |
|
|
Term
| hypovolemic hyponatremia; sodium, water, sodium, TBW |
|
Definition
| hypotonic hyponatremia with a decreased ECF volume is called ?. Patients usually have a deficit of body total body ? and total body ? but the ? deficit exeeds the ? deficit |
|
|
Term
| sodium, water, sodiu, water, hypertonic |
|
Definition
| the treatment of hypovolemic hyponatremia includes the administration of ? to correct the sodium defict and ? to correct the TBW deficity. Although both sodium and water are needed ? needs to be provided in excess of ? to fully correct this abnormality. As such ? saline is often used. |
|
|
Term
|
Definition
| Depending on the severity of the hyponatremia, 0.9%, 3%, or 5% NaCl can be utilized. Most patients can be adequately managed with ?% saline rehydration and is generally the safest agent. Hypertonic saline is generally reserved for patients with sever hyponatremia which is less than ? mEq/L. |
|
|
Term
|
Definition
| hypernatremia is a serum sodium concentration greater than ? mEq/L. The classic causes of hypernatremia are associated with ? depletion. |
|
|
Term
|
Definition
| normal serum potassium concentration is ? to ? mEq/L. |
|
|
Term
|
Definition
| Hyperkalemia is routinely seen in patients with ? pH. Potassium regulation is primarily under the control of the ? with excess dietary postassium being exreted in the ? |
|
|
Term
|
Definition
| hypokalemia is defined as a serum potassium concentration of less than ? mEq/L. Patients with hypokalemia are generally ? but signs and symptoms of hypokalemia include cramps, muscle weakness, polyuria, ECG changes (flattened T waves and the presence of U waves) and cardiac arrhythmias. |
|
|
Term
|
Definition
| ? lower potassium via cellular redistribution |
|
|
Term
|
Definition
| ? diminished intracellular potassium concentration and produces potassium wasting |
|
|
Term
| potassium acetate and KCl |
|
Definition
| ? and ? are the two most common potassium salts available |
|
|
Term
|
Definition
| when hypokalemia occurs in the setting of alkalosis, ? is the preferred agent |
|
|
Term
|
Definition
| moderate hypokalemia is defined as a serum potassium of ? to ? mEq/L without ? changes. In this setting potassium replacement can usually be given ? at a dose of 40 to 120 mEq/day. |
|
|
Term
| 2.5; ECG; cardia arrhythmias; IV |
|
Definition
| severy hypokalemia is defined as a serum potassium of less than ? mEq/L of hypokalemia of any magnitude that is associated with ? changes or ?. In these situations ? replacement whould initiated urgently. |
|
|
Term
|
Definition
| postassium infusion at rates exceeding ? mEq/hour requires cardiac monitoring given the potential for cardiac arrhythmias. |
|
|
Term
|
Definition
| the more concentrated the IV potassium solution is the greater chance of ? irritation |
|
|
Term
| magnesium, hypokalemia, magnesium, potassium |
|
Definition
| patients with a low serum ? will have exagerrated potassium losses from the kidneys and GI tract leading to refractory ?. In this case the ? deficit must be corrected in order to successfully treat the concurrent ? deficiency. |
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Term
|
Definition
| hyperkalemia is defined as a serum potassium concentration of greater than ? mEq/L and signs and symptoms include muscle weakness, paresthesias, hypotension, ECG changes, cardiac arrythmias and a decreased pH. |
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|
Term
| potassium, medications, salt |
|
Definition
| patients with hyperkalemia should discontinue all ? supplements, potassium - sparing ?, and potassium rich ? substitutes |
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|
Term
|
Definition
| if a patient's serum potassium concentration is greater than 7 mEq/L and/or ECG changes are present, IV ? is provided to stabilize the myocardium. |
|
|
Term
| dextrose and insulin; beta 2 agonists |
|
Definition
| ? and ? are typically given at the time of calcium therapy in order to redistribut epotassium into the intracellular space. ? can also be used for this purpose |
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|
Term
|
Definition
| more than 99% of total body calcium ins found in ? with the remaining 1% located in the ECF and ICF |
|
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Term
|
Definition
| ? plays a critical role in the transmission of nerve impulses, skeletal muscle contraction, myocardial contractions, maintenance of normal cellular permeability, and the formation of bones and teeth. |
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|
Term
| 8.6, 10.2; phosphate, protein, albumin |
|
Definition
| There is a reciprocal relationship between the serum calcium concentration (normall ? to ? mEq/L) and the serum ? concentration. Serum calcium has significant ? binding so the serum calcium measurement must be corrected in patients who have low ? concentrations. |
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Term
|
Definition
| clinical manifestations of hypocalcemia are seen with total serum concentrations of less than ? mg/dL or an ionized calcium of less than ? mmol/L. |
|
|
Term
|
Definition
| ? sign and ? sign are signs of hypocalcemia |
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|
Term
|
Definition
| hypocalcemia can also be caused by ? |
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|
Term
| calcium gluconate; intramuscularly |
|
Definition
| ? is the calcium therapy that is preferred for peripheral use because it is less irritating to the veins; it may also be given ?. |
|
|
Term
| calcium gluconate and calcium chloride |
|
Definition
| what are the two IV calcium replacement products |
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Term
|
Definition
| calcium chloride is assocated with venous irritation and extravasation and is generally reserved for administration via a ? line |
|
|
Term
| 10.2, 10.3 - 12, 12.1 - 13, 13 |
|
Definition
| hypercalcemia is defined as a calcium concentration greater than ? mg/dL and can be categorized as mild if total serum calcium is ? to ? mg/dL, moderate if levels are between ? and ?, or severe when total serum calcium conentration is greater than ? mg/dL. |
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|
Term
| rehydration; loop diuretic; kidney; hemodialysis |
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Definition
| all patients with hypercalcemia should be treated with aggressive ? with normal saline. This may be enough for patients with mild hypercalcemia. With moderate and severe cases, once fluid administration has repleted the ECF, forced diuresis can be initiated with a ? which requires normal ? function. ? is an alternate therapy in patients with renal failure. |
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|
Term
|
Definition
| Phosphorous is primarily found in ? and ? |
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|
Term
|
Definition
| normal serum phosphorous concentration is ? to ? mg/dL. Hypophosphatemia is defined by a serumm phosphorous concentration less than ? mg/dL and severe hypophosphatemia is less than ? mg/dL |
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|
Term
|
Definition
| severe hypophosphatemia can result in impaired ? contractility and acute respiratory failure. |
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|
Term
|
Definition
| for mild hypophosphatemia, patients should be encouraged a high ? diet including eggs, nuts, whole grains, mean, fish, poultry, and mild products. |
|
|
Term
|
Definition
| for moderate hypophosphatemia (? to ? mg/dL), ? supplementation is usually adequate. |
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|
Term
|
Definition
| injectable phosphate products are reserved for patients with ? hypophosphatemia or those in the intensive care unit |
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|
Term
| sodium, potassium; hypokalemia |
|
Definition
| available agents for phosphate replacement therapy are provided as ? or ? salts; however, unless concurrent ? is present, sodium phosphate is usually used. |
|
|
Term
|
Definition
| hyperphosphatemia is defined by a serum phosphorous concentration of greater than ? mg/dL. The manifestations of hyperphosphatemia are similar to findings of ? and include paresthesias, ECG changes, and metastatic calcifications. |
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|
Term
|
Definition
| hyperphosphatemia is generally ? and rarely needs aggressive therapy. ? restriction of phosphate and protein is effective for most minor elevations. |
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|
Term
|
Definition
| for some patients with hyperphosphatemia, phosphate binders such as ? based antacids may be necessary, typically those with chronic ? failure. If patients exhibit findings of hypocalcemia, IV ? should be administered emperically. |
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|
Term
|
Definition
| normal serum magnesium concentration is ? to ? mg/dL |
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|
Term
|
Definition
| hypomagnesia is defined as a serum magnesium of less than ? mg/dL and is most frequently seein in the intensive care and postoperative settings |
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|
Term
| hypokalemia and hypocalcemia |
|
Definition
| hypomagnesia often occurs in the setting of ? and ? |
|
|
Term
|
Definition
| in order for potassium and calcium concnetrations to normalize, ? supplementation is often required |
|
|
Term
|
Definition
| there is a strong correlation between hypokalemia and ? |
|
|
Term
|
Definition
| asymptomatic mild magnesium deficiencies can be managed with increased ? intake of magnesium containing foods or with oral supplementation. |
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|
Term
| magnesium sulfate; magnesium |
|
Definition
| patients who are severely deficient in magnesium and all deficient critically ill patients should be managed with IV ?; IV ? can also be used in the setting of status asthmaticuas, premature labore, and torsades de pointes |
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|
Term
|
Definition
| hypermagnesemia is defined as a serum magnesium concentration greater than ? mg/dL. Mild hypermagnesemia is between ? and ? mg/dL, moderate hypermagnesemia is between ? and ? mg/dL while severe hypermagnesemia is present if the serum magnesium concentration is greater than ? mg?dL |
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|
Term
| discontinued; normal saline, furosemide; calcium gluconate |
|
Definition
| all patients with hypermagnesemia should have all magnesium supplements or magnesium containing medicaions ?. Mild hypermagnesemia and moderate hypermagnesemia without cardiac findings can be treated with ? infusion and ? therapy. Moderate hypermagnesemia with cardiac irratibitliy and severe hypermagnesemia require concurrent IV ? to reverse the neuromuscular and cardiovascular effects. |
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Term
|
Definition
| the first ? weeks of gestation is when the embryo is most susceptible to death, although the embryo is not susceptible to teratogens during this time |
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Term
|
Definition
| drug or environmental agent that has potential to cause abnornmal fetal grown and development |
|
|
Term
|
Definition
| baby starts drawing from the mother's ? stores around week 20 |
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|
Term
|
Definition
| supplementation of ferrous sulfate 324 mg BID gives ? mg of elemental iron |
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|
Term
| prenatal vitamin; calcium, vitamin D |
|
Definition
| mother's should take iron supplements along with ? plus ? at 1000 elemental mg per day along with ? at 200 IU per day |
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|
Term
| GI upset and constipation |
|
Definition
| side effects of iron supplementation include ? and ? so patients like to spread out their dose and not take it all at one time to try to minimize these side effects |
|
|
Term
| neural tube; 0.4 mg to 1 mg |
|
Definition
| want to take folid acid, which is found in prenatal vitamins, if pregnant or planning to get pregnant because can prevent ? defects; want to give at dose of ? mg to ? mg three months before pregnancy |
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|
Term
| 4; valproic acid or carbamazepine |
|
Definition
| high risk mother's, who are mother's who have had previous children with neural tube defects, epilepsy, or pre - pregnancy diabets or if taking ? or ?, should take ? mg of folic acid per day in addition to the prenatal vitamin |
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Term
|
Definition
| when a mother is pregnant, VD is much ? because the mother has a lot more water content when pregnant |
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|
Term
| decreased; progesterone; increased; higher |
|
Definition
| pregnant women have ? GI transit time due to peak of hormone ?. This means that the drug will stay in the stomach longer and you will get ? absorption of drugs that are absorbed in the stomach. Pregnant women also have ? gastric pH. |
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|
Term
| increased; decreased; increased |
|
Definition
| pregnant women have an ? VD and ? protein binding meaning that there will be ? free drug for drugs like phenytoin |
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|
Term
| increased, decreased, 3A4, 2C19 |
|
Definition
| in pregnant women, some CYP activity is ? while some CYP activity is ? so will need to look up the drug and see where it is metabolized and then increase/decrease the dose accordingly. Have increased CYP? activity and decreased CYP? activity. |
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|
Term
| increased, increased, shorter |
|
Definition
| pregnant women have ? GFR and therefore ? clearance so dosing intervals will need to be ? |
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|
Term
|
Definition
| drugs weighing less that ? to ? daltons will cross the placenta and most drugs fall into the category so will cross the placenta |
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|
Term
|
Definition
| the degree of protein binding in the fetus is ? therefore you will get ? free drug in the fetus which is the active form of the drug |
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|
Term
| simple diffusion; 50% to 100% |
|
Definition
| maternal and fetal blood flow mixture occurs through ? and the fetal drug concentrations are about ?% to ?% of the mothers |
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|
Term
|
Definition
| Sometimes the concentration of the drug in the fetus can ? the concentration of the drug in the mother. Exrection of drugs by the fetus occurs in the ? and ?. |
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|
Term
| protein bound, high, short, |
|
Definition
| when choosing a drug for a mother who is breastfeeding, want to chose a drug that is highly ?, has a ? molecular weight, has a ? half - life, and has no metabolite. |
|
|
Term
|
Definition
| drug that mother is taking has to cross a semi - permable membrane in order to get into the breast milk and into the baby. Therefore, less than ?% of maternal drug actually makes it to the baby and the majority of the drug stays in the maternal vasculature and is ? |
|
|
Term
| promethazine/prochlorperazine or pyridoxine/doxylamine |
|
Definition
| first line therapy for nausea/vomiting in pregnant women |
|
|
Term
| metoclopramine or diphenhyramine |
|
Definition
| second line therapy for nausea and vomiting in pregnant women |
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|
Term
| polycarbophil or psyllium |
|
Definition
| first line therapy for constipation (decreased peristalsis) in pregnant women |
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|
Term
|
Definition
| first line therapy for treatment of hemorrhoids in pregnant women |
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|
Term
| antacids (but need to avoid aluminum containing antacids such as Maalox or Milanta), H2 blockers plus carafate, or proton pump inhibitors |
|
Definition
| first line therapy for heartburn relief in pregnant women |
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|
Term
| acetaminophen; first; PDA (patent ductus arteriosus) |
|
Definition
| ? is the drug of choice to treat pain in pregnant women. NSAIDs and aspirin can only be used during the ? trimester and if they are used after this can cause closure of the ? which is how babies blood gets oxygenated. |
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|
Term
| short term, long term, withdrawal |
|
Definition
| ? opiod treatment is okay to use in pregnant women to treat pain but ? treatment should be avoided because it will cause the baby to have ? symptoms at birth |
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|
Term
| dextromethorphan, codeine, guaifenesin, oxymetozoline, pseudoephedrine |
|
Definition
| first line therapy for treating cough and congestion in pregnant woment |
|
|
Term
|
Definition
| oxymetazoline should only be used for ? to ? days in pregnant women in order to avoid rebound congestion |
|
|
Term
|
Definition
| pseudoephedrine should only be used during the ? and ? trimesters because can cause intestines to be outside of belly when baby is born when taken during the ? trimester |
|
|
Term
| inhaled corticosteroids (Budesonide), chlorpheniramine, cetirizine, loratadine |
|
Definition
| first line therapy for allergic rhinitis in pregnant woment |
|
|
Term
| 3 day treatment with amoxicillin, cephalexin, or nitrofurantoin |
|
Definition
| first line treatment for bacteriuria in pregnant women |
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|
Term
| fluoroquinolones, bactrim, encephalopathy |
|
Definition
| when treating bacteriuria in pregnant women want to avoid ? due to risk of tendon toxicity as well as ? because it displaces billirubin which can lead to ? |
|
|
Term
| metronidazole or po clindamycin if metronidazole is not tolerated |
|
Definition
| first line therapy in the treatment of bacterial vaginosis in pregnant women |
|
|
Term
|
Definition
| what is the drug of choice in treating bacterial vaginosis in lactating women |
|
|
Term
|
Definition
| don't want to use clindamycin cream while pregnant because can cause ? labore and neonatal infection |
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|
Term
|
Definition
| pregnant women are slightly ? so want to treat them for longer periods of time than normal |
|
|
Term
| any topical "azole" cream for 7 days; oral fluconazole; symptomatic, condoms, diaphragms |
|
Definition
| first line therapy for vulvovaginal candidiasis in pregnant women; don't want to give what; only want to treat ? patiens and topical medications render ? and ? ineffective |
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|
Term
|
Definition
| in bacteriuria, want to repeat culture ? days after completion of therapy |
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|
Term
|
Definition
| in bacteria vaginosis, repeat culture ? month after completion of therapy |
|
|
Term
| asymptomatic, amoxicillin or azithromycin; doxycyline or azithromycin |
|
Definition
| in the treatment of chlamydia in pregnant women, treat ? patients and the drug of choic is ?; if the mother is breastfeeding the drug of choice is ? |
|
|
Term
| cefixime or ceftriaxone; tetracyclines and fluoroquinolones |
|
Definition
| first line therapy for treatment of gonorrhea in pregnant women and want to avoid what two types of drugs |
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|
Term
|
Definition
| first line therapy in treatment of herpes simplex virus in pregnant women |
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|
Term
|
Definition
| if mother has herpes simplex virus, may need to have a ? as opposed to vaginal birth |
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|
Term
|
Definition
| first line treatment of syphilis in pregnant women |
|
|
Term
| erythromycin or doxycycline |
|
Definition
| first line treatment of syphilis in lactating women |
|
|
Term
|
Definition
| treatment of syphilus in pregnant woman needs to be done before the ? week of pregnancy |
|
|
Term
|
Definition
| first line therapy for treatment of trichomoniasis in pregnant women |
|
|
Term
| antenatal corticosteroids; betamethasone (no repeat doses) |
|
Definition
| first line therapy for fetal lung maturation in pregnant women |
|
|
Term
| tocolytics; calcium channel blockers (drug of choice), indomethacin, magnesium, terbutaline |
|
Definition
| first line therapy for preventing preterm labor in pregnant women |
|
|
Term
|
Definition
| ? have the best benefit to risk ration in preventing preterm labor in pregnant women |
|
|
Term
| IV ampicillin and erythromycin for 48 hours and then oral amoxicillin and erythromycin for a total of 7 days |
|
Definition
| thought that bacteria may cause preterm labor to occur so want to give antibiotics to prevent this preterm labor. What do you give |
|
|
Term
| penicillin G or ampicillin |
|
Definition
| first line therapy to treat group B streptococcus in pregnant women |
|
|
Term
|
Definition
| in pregnant woment with hypothryoidism will need to ? their dose of synthroid to maintain their ? levels |
|
|
Term
|
Definition
| pregnant and lactating women require ? to prevent fetal neurologic damage |
|
|
Term
| prophylthiouracil at lowest dose possible |
|
Definition
| first line therapy to treay hyperthyroidism in pregnant women |
|
|
Term
|
Definition
| first line therapy for treatment of acute mastitis (breast infection) in pregnant women |
|
|
Term
| ketokonazole, nystatin, or miconazole (all should be applied topically to the nipple); oral nystatin |
|
Definition
| first line treatment of breast candidiasis in pregnant women; what should be given to the baby |
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|
Term
|
Definition
| first line therapy for lactation enhancement |
|
|
Term
|
Definition
| dopamine blocks the actions of ? which stimulates breast milk production in the mammary glands |
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