Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher |  Registered Nurse (RN) School Study Aid
Metabolic Alkalosis Assessment
- Increased pH > 7.45
 - Increased HCO3 > 26
 - Excitable State
 - Arrhythmias
 - Paresthesias
 - Muscle Cramps
 - Muscle Weakness
 - Decreased Respiratory Effort
 
Metabolic Acidosis Assessment
- Decreased pH < 7.35
 - Decreased HCO3 < 22
 - Abdominal Pain
 - CNS Depression
 - Coma
 - Hypotension
 - Arrhythmias
 - Increased Respirations
 - Kussmaul Respirations
 - Flushed, Warm, Dry Skin
 - Muscle Weakness
 
Mallory-Weiss
- Bleeding From Tears in Mucosa
 - Forceful Vomiting
 - Alcoholism
 - Eating Disorders (Bulimia)
 - Painful Hematemesis
 - Endoscopy
 - Observation
 
Promethazine (Phenergan)
- Histamine H1 Receptor Antagonist
 - Weak Dopamine Antagonist
 - Nausea and Vomiting
 - Motion Sickness
 - Respiratory Depression
 - Sedation
 - Anticholinergic Effects
 - Extrapyramidal Symptoms
 - Use Large Bore IV
 - Monitor for Tissue Necrosis
 
Chlorpromazine (Thorazine)
- Low Potency Antipsychotic
 - Schizophrenia
 - Hiccups
 - Sedation
 - Weight Gain
 - Orthostatic Hypotension
 - Anticholinergic Effects
 - QT Prolongation
 - Neuroendocrine Effects
 - Caution in Seizure Patients
 - Corneal Deposits
 
Mumps (Parotitis)
- Paramyxovirus
 - Fever
 - Headache
 - Earache
 - Orchitis
 - Pain and Swelling of Parotid Glands
 - MMR Vaccination
 
Gastroesophageal Reflux Disease (GERD) Assessment
- Relaxed Lower Esophageal Sphincter
 - Dyspepsia (Indigestion)
 - Belching
 - Nighttime Coughing
 - Dysphagia
 - Epigastric Pain
 - Regurgitation
 - Heartburn (Pyrosis)
 - Globus
 
Cimetidine and Famotidine (H2 Receptor Blockers)
- -tidine Suffix
 - H2 Receptor Blocker
 - Suppress Gastric Acid Secretion
 - Pneumonia
 - Anti-androgen Effects
 - CNS Changes
 
Omeprazole (Prilosec)
- "-prazole" Suffix
 - Zollinger-Ellison Syndrome
 - Gastritis
 - Peptic Ulcer
 - Gastroesophageal Reflux Disease (GERD)
 - Proton Pump Inhibitor (PPI)
 - Inhibit H+/K+/ATPase
 - Hip Fracture
 - Pneumonia
 
Dinoprostone and Misoprostol
- Prostaglandins
 - Promote Cervical Ripening
 - Prevent GI Ulcers
 - Medical Abortion
 - Fetal Distress
 - Hyperstimulation of Uterus
 - Vaginal Insertion
 - Give Before Induction of Labor
 
Sucralfate (Carafate)
- Creates Protective Barrier
 - GI Ulcers
 - Constipation
 - Require Acidic Environment
 - Give on Empty Stomach
 - Oral Suspension Available
 - May Decrease Absorption of Other Meds
 
Types of Hernias
- Hiatal
 - Gastroesophageal Reflux Disease (GERD)
 - Inguinal
 - Men
 - Femoral
 - Women
 - Incisional
 - Umbilical
 - Strangulation
 
NSAIDs
- Anti-inflammatory
 - Analgesic
 - Fever
 - Closure of Patent Ductus Arteriosus 
 - Reversible Inhibition of COX-1 and COX-2
 - Block Prostaglandin Synthesis
 - Interstitial Nephritis
 - Gastric Ulcer
 - Renal Ischemia
 
Peptic Ulcer Disease Assessment
- Helicobacter Pylori
 - NSAIDs
 - Increased Stomach Acid
 - Abdominal Pain
 - Heartburn (Pyrosis)
 - Melena
 - Weight Changes
 - GI Distress
 - Most Commonly in Duodenum
 - Duodenal: Pain Relieved by Eating
 - Gastric: Pain Caused by Eating
 
Hypertrophic Pyloric Stenosis (HPS) Assessment
- Hypertrophied Pylorus
 - Macrolide Use
 - 3-6 Weeks of Age
 - Projectile Vomiting After Feeding
 - No Pain or Discomfort
 - Weight Loss
 - Dehydration
 - Hungry Baby
 - Olive Mass
 
Hypertrophic Pyloric Stenosis (HPS) Interventions
- Pyloromyotomy
 - Stabilize Fluid and Electrolyte Balance
 - Nasogastric Tube
 - Monitor Feeding
 - Start Formula or Breastfeeding Within 24 Hours
 - Feedings Every 4-6 hours
 - Full Feeding Within 2 days
 
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
 - Two Antibiotics
 - Proton Pump Inhibitor (PPI)
 - Decrease Acid Secretion
 - Avoid NSAIDs
 - Diet and Lifestyle Changes
 
Tricyclic Antidepressants (TCAs)
- Inhibits Reuptake of Norepinephrine and Serotonin
 - Depression
 - Bipolar Disorder
 - Fibromyalgia
 - Sedation
 - Orthostatic Hypotension
 - Anticholinergic Effects
 - Cardiac Toxicity
 - Delayed Effect
 - Do Not Stop Abruptly