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describe actions of stool softeners
Doesn't make you go, makes it easier to go
describe actions of the irritant laxatives
Stimulates peristalsis
describe actions of bulk forming laxatives
Balances stools to make them more regular and normal
describe actions of saline laxatives
Attracts water to stimulate peristalsis
why should mineral oil not be given with meals
Increased risk of aspiration and it interferes with vitamins A,D,E & K absorption
list several times when laxatives may be ordered
Immoblity, hemorrhoids, diagnostic procedures, before surgery, worm infestation
list several times when laxatives may be contraindicated
Undiagnosed abdominal pain, obstruction, impaction
why are narcotic analgesics listed as controlled substances?
Because they tend to be addictive
list several drug classified as opiates
Morphine, codiene, fentanyl, oxycodone, dilauded
list several indications for the use of narcotic analgesics
Severe pain, pre-op sedation, anti-tussive, anti-diarrheal, heart attack
describe typical effects of narcotic analgesics
An analgesic effect, decreases awareness of pain, and reduces the emotional response to pain
describe side effects of narcotic analgesics
Decreases respirations, peristalsis, stimulates vomiting center, contracts smooth visceral muscle, causes miosis and constipation
what 2 vital signs are most influenced by narcotic analgesics and describe how they are influenced
Respirations ans blood pressure
what does the term miosis mean?
Constricts pupils
what does the term antitussive mean?
Prevents cough
differentiate between the properties of aspirin and non-aspirin analgesics
aspirin - anticoagulant, anti-infalmatory, antpyretic, analgesic non-aspirin - anti-pyretic, analgesic
for what reason would aspirin products be contraindicated?
Chindren due to the increase risk of Reyes syndrome, people already on anticoagulant therapy, people at risk of bleeding
list typical needle sizes for IM injections
20 or 21 gauge for viscous meds and 21 or 22 gauge for aqueous meds. 1" to 1.5" long
list typical needle sizes for SQ injections
1/2 to 5/8 long and 24 to 26 gauge
list typical needle sizes for ID injections
3/8 to 1/2 long and 26 to 28 gauge
what 2 meds are typically given SQ?
Insulin and heparin
what types of meds are typically given ID?
Allergy and mantoux
list the 4 intramuscular injection sites
Deltoid, dorsogluteal, ventralgluteal, and vastus lateralis
list the landmarks for the deltoid IM site
acromion process and the axilla
list the landmarks for the dorsogluteal IM site
muscle: gluteus minimus, posterior superior iliac spine and the greater trochanter
list the landmarks for the ventrogluteal IM site
Palm on greater trochanter and index finger pointed to the umbilicus. Between the index and middle fingers
list the landmarks for the vastus lateralis IM site
Greater trochanter and knee, middle 1/3
What does onset mean?
How long it takes a med to start working
what does peak mean?
How long it takes to reach the maximum level of a drug in the body
what does duration mean?
How long a med stays in the body
what does u100 mean?
Insulin that has 100 units per ml
what does lipodystrophy mean?
Abnormal distribution of fat - either fat atrophy or fat hypertrophy (hardening lump)
what is the onset, peak, and duration of regular insulation?
Onset - 30 min to 1 hour Peak - 2 to 3 hours Duration - 5 to 7 hours
what is the onset, peak, and duration of NPH insulation?
Onset - 1 to 2 hours Peak - 8 to 12 hours Duration - 18 to 24 hours
how do oral hypoglycemics differ from insulin?
Oral hypoglycemics work by stimulating the liver to manufacture more insulin, insulin is given when the liver is unable to produce insulin
what is the main reason cardiac glycosides (digoxin) given?
To make the heartbeat slower and stronger, therefore more effectively
differentiate between the digitalizing and the maintenance dose of digoxin
Digitalizing dose is a large dose given over 24 hours to create the peak level in the blood and the maintenance dose is to keep levels in the blood
describe digitalis toxicity
Excessive digitalis levels in the blood
list several symptoms of digitalis toxicity
GI problems first - nausea, vomiting, anorexia, abdominal discomfort; visual disturbances - blurring, flickering lights, yellow edges on dark objects; restlessness; fatigue; cardiac abnormalities.
what effect does low potassium have on a patient who is taken digitalis
Increases the risk of digitalis toxicity
differentiate the action of anticoagulants from thrombolytics
Anticoagulants prevent the enlargement of an existing clot and prevent more from forming and thrombolytics break up clots
list the onset, route, and antidote for coumadin
Onset - 1-3 days Route - oral Antidote - vitamin K
list the onset, route, and antidote for heparin
Onset - immediately Route - sub Q injection or IV Antidote - protamine sulfaste
list several types of drugs that can be used as antihypertensives
vasodilators, diuretics, calcium channel blockers, beta blockers, ACE inhibitors, mild tranquilizers
list several uses for diuretics
Treatment of edema associated with liver disease, HTN, CHF, pregnancy, or medications
describe nursing responsibilities when dealing with patients on diuretics
Assess efficacy of med, fluid changes, urine output, visable edema reduction, weights, sodium and potassium levels
under what conditions is oral iron best absorbed?
best absorbed on an empty stomach and taken with orange juice
what is the treatment for pernicious anemia?
vitamin B12 injections monthly
list several side effects of oral iron
black tarry stools, GI upset,
how does z-track differ from regular IM?
Z-track is drawn up with an airlock, the needle is changed and the skin is pulled to one side before injection.
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