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Pharm 3
The Nursing Process
ADPIE
Assessment
Diagnosis
Planning
Implementation
Evaluation
2 mins
6 Rights of Medication Administration
Right Patient
Right Medication
Right Dose
Right Time
Right Route
Right Documentation
Nursing Considerations
Three Checks
Check for Allergies
Assess the Patient
Education
2 mins
5 Rights of Delegation
Right Task
Right Circumstance
Right Person
Right Direction/Communication
Right Supervision/Evaluation
1 min
Routes of Administration Part One
Enteral Administration
Oral
Sublingual
Buccal
Rectal
Tubes
Topical or Mucous Membrane Administration
Transdermal
Drops/Spray
Vaginal
Inhalation Administration
Inhalation
2 mins
Alendronate (Fosamax)
Mechanism
Inhibits Osteoclasts
Indications
Osteoporosis
Paget's Disease
Side Effects
Esophageal Ulcers
Musculoskeletal Pain
Vision Changes
Atrial Fibrillation
Osteonecrosis of the Jaw
Considerations
Take on Empty Stomach
Remain Upright
2 mins
Carbamazepine (Tegretol)
Mechanism
Inactivates Na+ Channels
Indications
Seizures
Bipolar Disorder
Trigeminal Neuralgia
Side Effects
Nystagmus
Ataxia
Hepatotoxicity
Blood Dyscrasias
Water Retention
Stevens-Johnson Syndrome
Considerations
Avoid Grapefruit Juice
2 mins
Iron (Ferrous Sulfate)
Mechanism
Ferrous Salts
Indications
Anemia
Side Effects
GI Distress
Nausea and Vomiting
Dark Stools
Considerations
Take Between Meals
Liquid can Stain Teeth
Keep out of Reach from Children
Caution with GI Disorders
Avoid Antacids
3 mins
Hydralazine (Apresoline)
Indications
Severe Hypertension
CHF
Reduced Afterload
Pregnancy
Mechanism of Action
Vasodilates Arterioles
Side Effects
Drug-induced Lupus
Reflex Tachycardia
Hypotension
Considerations
Combined with Diuretic and Beta Blocker
1 min
Spironolactone (Aldactone)
Mechanisms
Inhibition of Aldosterone
Potassium Retention
Indications
Hypertension
Edema
Heart Failure
Side Effects
Hyperkalemia
Endocrine Effects
Consideration
Avoid Potassium Supplements
2 mins
Lithium
Mechanism of Action
Mood Stabilizer
Unknown Mechanism
Indications
Bipolar Disorder
Side Effects
Nephrogenic Diabetes Insipidus
Hypothyroidism
Tremor
Heart Block
Contraindication
Pregnancy
Considerations
Monitor Plasma Levels
2 mins
NSAIDs
Indications
Anti-inflammatory
Analgesic
Fever
Closure of Patent Ductus Arteriosus
Mechanism of Action
Reversible Inhibition of COX-1 and COX-2
Block Prostaglandin Synthesis
Side Effects
Interstitial Nephritis
Gastric Ulcer
Renal Ischemia
1 min
Theophylline (Theo-24)
Mechanism
Bronchial Smooth Muscle Relaxation
Indications
Asthma
Side Effects
Insomnia
Restlessness
Arrhythmias
Seizures
Considerations
Narrow Therapeutic Range
Monitor Plasma Levels
1 min
Macrolides
End in "-thromycin"
Mechanism of Action
Bacteriostatic
Indications
Alternative for Penicillin Allergy
Respiratory Infections
Pneumonia
Side Effects
QT Prolongation and Sudden Death
C.Diff Overgrowth
GI Distress
Considerations
Slow IV Infusion
2 mins
Routes of Administration Part Two (Parenteral)
Parenteral Administration
Intradermal
Subcutaneous
Intramuscular (IM)
Intravenous
Epidural
Intrathecal
Intraosseous
Intraperitoneal
2 mins
Transdermal Medication Administration
Application
Patch or Disc
Directly on Skin of Arms, Chest, Upper Back
Benefits
Avoids First Pass Metabolism
Sustained Administration of Medication
Nursing Considerations
Clean Skin After Removal
Rotate Sites of Patches
Apply to Dry Skin
Avoid Shaved Skin
Avoid Heat
Nitro Effects Lost After 24 Hours
2 mins
Needle Sizes and Uses
Adjust Size Based on Height/Weight
Subcutaneous Injections
3/8 or 5/8 inch
Intramuscular (IM)
1-1.5 inches
1 min
Intramuscular Medication (IM) Administration
Risks
Injury to Nerves, Bone, and Blood Vessels
Sites
Deltoid
Vastus Lateralis
Ventrogluteal
Nursing Considerations
Selection of Needle Length
Aseptic Technique for Drawing Up
Z-Track
90 Degree Angle
Max Amount (2-5 mL Adult, 1 mL Child)
Techniques to Reduce Pain
2 mins
Acetaminophen
Indications
Fever
Pain
Mechanism of Action
Reversibly Inhibits COX
Acts Primarily in CNS
Side Effect
Hepatic Necrosis
N-acetylcysteine Antidote
51 secs
Warfarin (Coumadin)
Mechanism of Action
Inhibits Clotting Factors
Indications
Atrial Fibrillation
Venous Thrombosis
Pulmonary Embolism
Assessment
PT/INR Levels
Observe for Bleeding
Contraindications
Pregnancy
Nursing Considerations
Vitamin K and Fresh Frozen Plasma
Prolonged Therapeutic Onset
Maintain Same Diet
2 mins
Ibuprofen (Advil, Motrin)
Mechanisms
NSAID
COX Inhibitor
Indications
General Pain
Fever
Inflammatory Conditions
Side Effects
GI Ulcers
Nephrotoxicity
Rash
Considerations
Avoid with Alcohol
Risk of Thrombotic Event
2 mins
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