NSAIDS—can cause GI bleeds or ulcers…So, teach patient to take with what?

And after using

bathroom check for what?
What NSAID could be taken without food?
Before giving a Loop diuretic, we should check: VS (BP & HR), Electrolytes, the Pt for Tinnitus
or S/S of Hypocalcemia (Chvostek & Trousseau’s)
How do we actually check for Chvostek’s sign? Trousseau’s Sign?
Should we give a Loop diuretic if Pt is already prescribed ASA? Digoxin? Lithium?
Know the normal range for Na (Sodium)…what drug gets toxic if Sodium Na level is low?
What are the 2 Indications for Mannitol?
What are the side effects of Steroids again?
Which drugs were meant for Males, and shouldn’t generally be given to, or touched by Pregnant
females or Female RNs!? (From Week 4)
What are the Indications for K+ Potassium supplements? NVD, Pt on Loop / Thiazide Diuretics /
Pt taking Steroids / etc.
ESRD = End Stage Renal Disease…which is similar to CRF chronic renal failure….patients with
kidney problems…Pt can acutely get kidney / renal problems also? How tell? Look at Bun / Cr
Aren’t able to excrete Potassium or Phosphorus so they become High (Hyperkalemia /
Hyperphosphatemia)…So, we don’t
Give patients with bad kidneys Potassium supplements or Potassium sparing diuretics.
One way to tell if kidneys are bad? They have High Bun / Creatinine. *Know normal ranges for
the test.
Which drugs were ‘Vessicant’ medications…and therefore a risk for Extravasation?
What were RN interventions for Extravasation?
Probiotics – given to prevent Superinfections (C-Diff, Candidiasis) after receiving Antibiotics.
S/S of C-Diff? Candidiasis?
What was the BIG use /Indication for Loop diuretics in the hospital?
What supplements do we give people with N/V/D?
Do NSAIDS reduce inflammation? What about Apap?
Treatment for Infiltration vs Extravasation?
Indications for Calcium Carbonate?
S/S of DVT? What drugs might cause?
Gout is problem of High Uric Acid (Hyperuricemia)…what drugs to treat?
Should we give Loop diuretics to Patients with Gout?
Should we give Loop diuretics to Patients taking Aspirin?
Bismuth Subsalicylate – what used for? What weird thing can it
Remember that when giving drugs via NG tube you would have to crush them...so make sure
you know the abbreviations (suffixes) that CANT be crushed. What does USP stand for? What
is difference between Agonist vs Antagonist? If a drug has a narrow Therapeutic Range /
Index..what does that mean? What is the BEST goal for patient teachings? What does MEC
mean? Onset? Duration? Toxic Level? Teratogen? Synergistic vs Additive effects? Drug
Efficacy? Know what Adrenergic effects are. Know what Cholinergic effects are. Probs w Liver /
Kidney….how would that affect Dosing? What about Old age? Obese? Very Active Pt?
Some other things for Test 1: Probs w Liver / Kidney….how would that affect Dosing? What
about Old age? Obese? Very Active Pt? WHY is the Doctor checking the Peak Level? Trough
Level? What are the Dosage Adjustments in response to different Peak & Trough levels?
Dosage Adjustments in Liver problems? Kidney problems? PO to IV? Adrenergic vs Adrenergic
Blocker effects? Cholinergic vs Anticholinergic effects?
Diphenhydramine (Benadryl) can be used for multiple Therapeutic Uses like treating Insomnia,
can be used for motion sickness, can be used to treat allergies, and can be used to treat severe
allergic reaction (anaphylaxis). What actions do we take when the patient is in Anaphylaxis?
Give Oxygen, Administer Epinephrine, Give Diphenhydramine, Ensure the patient has an open
Airway.
What Drug from Week 2 lecture makes you sweaty, tachycardic, and insomniac? What drug can
cause gynecomastia and erectile dysfunction? What drug from can help treat Cachexia? What
drug from might lower Na levels? Promethazine/Dimenhydrinate...what pharmacologic class are
they? Side effects? What was the order of effectiveness of the antacids? How does Misoprostol
act to improve gastric ulcers? Is Sucralfate given prior to meals? How does Sucralfate work?
Bad Adverse Effects of Prochlorperazine? (What do they look like in a real
patient?).....Amoxicillin, Clarithromycin, Pantoprazole are what type of drugs? What disease did
we talk about last lecture that we would use all 3 of these to treat a patient?
PTU/Methimazole....what labs do we need to monitor? When do we give antiemetic drugs like
Ondansetron / Metoclopramide when the patient is about to receive Chemo or Radiation
Treatments?
Know what Cachexia is…what drug could we give this pt for this? If your client has an Ostomy,
what med might help decrease its watery output? If a patient had surgery and we don't want
them to strain afterwards, what laxative class might we use? What was the purpose of
Saccharomyces Boulardii? What were the contraindications for Anticholinergic medications? (or
drugs with Anticholinergic-like effects?) Fun Fact: Clients undergoing Chemo or Radiation
therapy for Cancer can both get extreme nausea and vomiting. When do we administer
Antiemetics for these patients? Could we use Metoclopramide for these patients? Who can we
NOT use Metoclopramide for because of its ability to increases peristalsis and bowel motility?
Why do we use Saccharomyces Boulardii (Probiotics) in the hospital? Promethazine can have
anticholinergic-like side effects...who should not receive anticholinergic meds? Desmopressin /
Vasopressin are used to Tx what Disorder? What expect to happen? What type of drug was
Glargine? Onset? Half-life?
What do Low T3, T4 Levels mean? What drug would be prescribed? DKA – what’s the
treatment? How do we administer TPN? What do we watch out for? Aluminum & Calcium
antacids can lower the patient’s Phosphorous levels. S/S? of Hypoglycemia? Tachycardia,
Diaphoresis, Tremors, Shakiness. S/S of Hypokalemia? Kidney Failure Patients (ESRD) – what
happens to their Phosphorus levels? How Treat? Which laxatives were the strongest? Which
was the “Correctional” Insulin? Sucralfate PO Liquid – take it 1 hr before meals…don’t take
other drugs within 2 hours of it. Q: What drugs could we use to treat Hypoglycemia / Insulin
Overdose? A: D50 or Glucagon. Sulfasalazine can cause Photosensitivity!
(Part 2) Make sure you are Reading your Textbook People (McCuistion
Pharmacology)...Concepts to know for the Paralytics / Pain Test: What is diff between
Retrograde and Anterograde? When do we use Buspirone vs Benzodiazepines? Cyclosporine -
what are the patient teachings? Gout - Acute vs chronic meds? What's the major s/s of DVT?
What drugs did we talk about this week which cause this (DVT)? NMBs...know all the safety
stuff! What should we have in the room? How do we Reverse the Paralytic (ium…) drugs? What
are the really bad side effects of ASA? Who is CI for ASA? What was the NSAID which could
cause a MI? What were the contraindications for giving Propofol? What are side effects of
Muscarinic Antagonists (aka - Rest & Digest BLOCKERS, aka Anticholinergics)
(Part 3) It bears Repeating that: The Triptan drugs (for Migraine headaches) are CI for pts with
history of Heart attack or severe Coronary artery disease...Also, Calcium Supplements are used
to DECREASE the Phosphorous levels in many patients (Such as Pts with Chronic Kidney
problems, or on Dialysis). Also, we said that NSAIDS can cause gastric ulcers...so we take them
with what?...Also the patient needs to report any blood in their stool or tarry stools when taking
NSAIDS as this could be bleeding ulcers! Lam & Pam drugs / Chlordiazepoxide will drop the
blood pressure some, but it not usually a problem unless its < 90 SBP. Q: Contraindication and
AEs of Propofol? Opioid Toxicity Triad? S/S of Malignant Hyperthermia and how do we treat it?
What drugs cause it? What was Bethanechol again? MTX: SInce it hurts the _ you should not
drink __. What was the definition of Efficacy again? (the one I gave you)
(Part 4) What are the Indications for Paralytic drugs? Surgery, Intubation, Pt on Ventilator What
is the Max # of Lidocaine patches a patient can have on at one time? What are Bismuth
Subsalicylate Contraindications? Pt Teaching? Is the black tongue / poop harmful? What are
some Indications for ASA besides mild pain? What makes the NSAID drug Meloxicam special?
What were Sumatriptan pt teaching? Contraindications? What were the signs / symptoms of
Opioid Abstinence syndrome? What was off-label use for the Opioid Meperidine?
What was special about the Opioid Nalbuphine? Make sure you know VS normal ranges!
Contraindications for Triptans? What drugs are Contraindicated if the patient has SULFA
allergy?