Exam 2 January 17, 2025 PDF

Exam 2 January 17, 2025 1. Dose Calculations, Oral Dose Calculation, Metric Conversions, Parenteral Calculations? - Dose Calc: desired dose over available dose - Metric Conversions: KHD\_dcm...mcg - Parenteral: Desired Dose x Volume of Stock over Available Dose - WHAT GALLO SAYS IS...

Exam 2 January 17, 2025 1. Dose Calculations, Oral Dose Calculation, Metric Conversions, Parenteral Calculations? - Dose Calc: desired dose over available dose - Metric Conversions: KHD\_dcm...mcg - Parenteral: Desired Dose x Volume of Stock over Available Dose - WHAT GALLO SAYS IS IMPORTANT: 2. DVT, Definition, Risk Factors, Signs, Symptoms, Treatment, Nursing Considerations, Teaching? - Deep Vein Thrombosis is the formation of a blood clot in a deep vein, typically in the legs. An Ultrasound diagnoses it. - Risk Factors: Age, Smoking, Obesity, Surgery, Trauma, Immobility, Genetic clotting disorders, pregnancy - S&S: Swelling, warmth, tenderness, erythema or pallor, low-grade fever, Positive Homan's sign (Pain upon dorsiflexing foot) - Treatment: Anticoagulation therapy prevents clot growth (does not dissolve clot), heparin is used IV (fast acting monitor the APTT), Warfarin (coumadin) is used orally, and long-term clot prevention (takes 5 days for effects monitor the INR), Thrombolytics: dissolves the clots, IVC filter: filter inserted in IVC to catch clots and prevent from going to the heart & lungs. - Nursing Considerations: watch for signs of pulmonary embolism (sudden SOB increased HR&RR, Hypoxia), and encourage hydration and range of motion exercises for immobile patients. Monitor leg circumference. During active DVT, do not apply SCDs or massage or rub the area it can dislodge the clot) - Teaching: Recognizing complications, the importance of compression socks, taking anticoagulants at the same time daily, avoiding smoking, and Bed rest. - WHAT GALLO SAYS IS IMPORTANT: Approx. half of the DVT happens when pt is in the hospital. Bed rest for more than 2 days, history of fractures, taking estrogen, Afib do not apply SCDs or massage or rub the area it can dislodge the clot 3. CML, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - Chronic Myelogenous Leukemia, genetic mutation - Risk Factors: older age, males, history of radiation therapy or exposure - S&S: Fever, night sweats, Pain on the left side and below ribs, fatigue, weight loss - Treatment: Chemotherapy with or without stem cell transplant and targeted therapy, immunotherapy, Donor lymphocyte infusion (DLI), surgery - Nursing Considerations: Assess pain and vital signs, appetite, any sig wt loss, - Teaching: Frequent rest breaks, eat small frequent meals, wash hands frequently to prevent infection - WHAT GALLO SAYS IS IMPORTANT: Genetic mutation, Philadelphia chromosome, 4. Iron deficient Anemia, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - Diagnosed when pt's hgb is low, due to deficiency in iron - Risk factors: Sex, age, poor nutritional status, GI disorders, gastric bypass, pregnancy, heavy menstrual periods, autoimmune disorders such as Ulcerative colitis, Crohn\'s, IBS, Rheumatoid arthritis, extreme blood loss, prolonged use of PPI's - S/S: fatigue, SOB, palpitations, dizziness, headaches, chest pain, pallor, "hearing heartbeat in ears" Gallo's words - Treatment: Ferrous sulfate, blood transfusions, treating the cause if caused by menorrhagia oral contraceptives may be given, Iron Supplements, Vitamin C (increases the Iron absorption), Iron Rich Foods - Nursing considerations: monitor BP, HR and o2 sats, fall risk, give iron on empty stomach (can cause GI upset) , and not with antacids, monitor H&H labs, ferritin levels, TIBC - Teachings: Heme-iron-rich foods: red meats, chicken, turkey, and fatty fish non-heme foods: fortified cereals, dark green leafy vegetables (spinach and collard greens), black beans, lentils, tofu, raisins, and other dried fruits. If consumed with foods high in Vitamin C (tomatoes, citrus juices, berries) absorption is higher. Monitor stool for blood, stool may become dark green or black, take rest periods, and stay hydrated. - WHAT GALLO SAYS IS IMPORTANT: Someone who eats a lot of processed foods, Hearing the heartbeat in your eats, carving ice cubs 5. Vitamin B12 Deficient Anemia, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - Vitamin deficiency anemia results from fewer healthy RBCs due to the body's low vitamin B12 and folate levels. - Risk Factors: Vitamin B12 deficiency includes a lack of intrinsic factors, which makes absorption of vitamin B12 possible, or a history of gastric surgery due to difficulty absorbing vitamin B12. Lifestyle habits such as excessive alcohol consumption can make the absorption of vitamin B12 more difficult for the body. Anti-seizure medications can affect how the body absorbs vitamin B12. Pt over the age of 75 are at risk due to slowed metabolism. - S&S: Fatigue, SOB, headaches, pallor, dizziness, difficulty walking, tingling or pain in the extremities, confusion, forgetfulness, irritability, visual deficits, diarrhea, and weight loss. Beefy red tongue. GI upset. - Treatment: Vitamin B12 deficiency is based on its severity; some pt may need treatment for life, and some may require treatment until their vitamin B12 level returns to normal. Vitamin B12 is a water-soluble vitamin and can be given as an intramuscular injection, nasal spray, gel, or oral supplement that will be administered daily. - Nursing Considerations: Assess the pt for manifestations of fatigue, SOB, headaches, and dizziness, note the skin color, texture, and how it feels. - Teaching: educate the pt on their nutritional choices to improve their vitamin B12. - WHAT GALLO SAYS IS IMPORTANT: Dairy, eggs (scrambled), fish, not green leafy vegs 6. PVD, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - Peripheral venous disease veins are either damaged from infection or injury, occluded from blood clot, or altered due to congenital defect - Risk factors: abnormal structure in veins, functional abnormalities that lead to venous reflux, valvular incompetency, genetics, progesterone, family history, obesity, smoking, pregnancy, history of thrombosis, standing for extended amounts of time - S/S: varicose veins, brown pigmentation around ankles, edema, pruritis, open sores, restless legs, feeling heaviness in lower extremities - Treatment: elevation of legs, exercise, compression therapy, vein stripping, ultrasound guided foam sclerotherapy, radiofrequency and laser ablation. Medications: Flavonoids anti-inflammatory, pentoxifyilline (Trental) hemorheological agent, aspirin, saponins anti-inflammatory - Nursing considerations: pts may have unsteady gait, thorough assessment of extremities, and wound care if open ulcers develop, manage pain, elevated legs and apply compression devices - WHAT GALLO SAYS IS IMPORTANT: For swollen and large veins, inspect legs daily, size, color, and temperature , ankle brachial index key test 7. Blood Transfusion, Procedure, Nursing Considerations, Teaching? - Procedure: Pre: verify blood type and compatibility with donor's blood with another RN, verify allergies, history of any previous transfusions/reactions, any history of circulatory issues (CHF,ESRD) verify consent to transfuse is signed, check vital signs! Temp, HR, BP, RR, pulse ox, prime Y tubing with 0.9% Normal Saline Solution ONLY, must be run on a pump, must be completed in 4 hours, blood can only be out of refrigerator maximum 4 hours or return to lab, DO NOT leave patient for 15mins, check vitals at 15 min mark, and 30 mins once transfusion is complete. Check vitals every hour x4 or facility protocols. Monitor for any signs of reaction - WHAT GALLO SAYS IS IMPORTANT: 8. Blood Transfusion Reactions, Types, Symptoms, Nursing Considerations, Teaching? - Types: Anaphylactic= allergic to something in donor's blood, Hemolytic= pt's immune system attempts to destroy the transfused RBC's, Febrile Non-hemolytic =most common type, indicated by increase of temp by 1 degree or more, TACO= pt experiences circulatory overload due to transfusion, TRALI= transfusion related acute lung infection, Septic= caused by contaminated blood products - S/S: fever, rash, urticaria, dyspnea, flank pain, back pain, tachycardia, dark or reddish urine, headache, wheezing, dizziness, vomiting - Nursing considerations: if reaction occurs, STOP the transfusion immediately,hang a new bag of IV NSS, assess for any signs of reaction during transfusion, stay with patient, call provider, return blood tubing and blood back to blood bank for inspection, watch for signs of reaction post transfusion as they could occur 4 hours post transfusion. Transfusion is given if HGB less than 7.0 - Teachings: inform pts to report any urticaria, feeling flush, rash, SOB, flank pain, back pain - WHAT GALLO SAYS IS IMPORTANT: 9. Propranolol, Use, Side Effects, Nursing Considerations, Teaching? - Nonselective beta blocker. Slows HR and closes calcium channels. - Side effects: Bradycardia, Heart failure, peripheral arterial insufficiency, cold fingers and toes, confusion, fatigue, dizziness - Nursing considerations: DO NOT stop abruptly MI can occur, dose must be tapered, monitor HR, monitor for signs of CHF=SOB, peripheral edema, night cough, monitor color, pulses, and temperature in extremities, check BP and HR before administering - WHAT GALLO SAYS IS IMPORTANT: Contraindicates someone who has asthma 10. Hypertension, Definition, Risk Factors Chart of blood pressures, Signs, Symptoms, Treatment, Nursing Considerations, Teaching? - High blood pressure is characterized by stage 1, stage 2, and hypertensive crisis. Norm 120/80 ATI says hypertension stage 1 is greater than 130-139/ 80-90, stage 2 is greater than 140/90, hypertensive crisis 180/120 or higher. Elevated BP 120-130/80 - Risk factors: age, obesity, genetics, family history, smoking, hyperlipidemia, excessive salt intake, excessive alcohol consumption, diet - S/S: headaches, blurred vision, chest pain, dizziness, nosebleeds - Treatment: diet, limit sodium intake, exercise, maintain a healthy weight, and take medications --there are so many to list! ACE inhibitors (prils), ARBs (losartan), aldosterone antagonists (eplerenone), DRI's (aliskiren), Calcium channel blockers, alpha 1 blockers (doxazosin), beta-blockers (-lols), centrally acting alpha 2 antagonists (clonidine), alpha/beta blockers (carvedilol, labetalol), direct-acting vasodilators (hydralazine) - Nursing considerations: monitor BP, encourage a heart-healthy diet, limit salt, promote exercise, weight management, limit stress, monitor lipid panel (LDL's, triglycerides, cholesterol levels), no smoking, limit alcohol. Hot tubs elevate your BP - WHAT GALLO SAYS IS IMPORTANT: - 2 or more high readings 2 weeks apart, 11. Hydrochlorothiazide, Use, Side Effects, Nursing Considerations, Teaching? - Thiazide diuretic, blocks reabsorption of sodium and chloride - Treats: Heart failure, hypertension, cirrhosis, and renal failure - Side effects: hypokalemia, dehydration, hyponatremia, hypochloremia, hyperglycemia, increased uric acid levels. - Nursing considerations: Monitor electrolytes, monitor for electrolyte imbalances, eat potassium-rich foods (citrus fruit juices, potatoes, bananas), Raise blood sugar, monitor I&O - WHAT GALLO SAYS IS IMPORTANT: Daily weight: take the med early in the day 12. Epistaxis, Definition, Risk Factors, Signs, Symptoms, Treatment, Nursing Considerations, Teaching? - Nosebleed - Dry air, meds, blood thinners, decongestants, - S&S: blood in the throat, nose - WHAT GALLO SAYS IS IMPORTANT: High fowlers position, use ice to bridge of nose 13. Right-Sided Stroke, CVA, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - Controls the left side of the body - Weakness or paralysis on the left side of the body and face. Decreased feeling or sensation on the left side of the body. Vision problems, which may include loss of vision on the left side of both eyes, Lack of awareness of impairment (left-sided neglect), Behavioral changes, such as impulsivity and inappropriateness, Decrease in judgment, problem-solving and decision making, and memory impairment. - Organizing information, Abstract meaning, Context, Spatial relationships (like map reading or shaped recognition), Visual Information, Face recognition, Intuition, Emotion, Imagination, Detecting motion, Music and Art Awareness. - Injuries on the right side of the brain can cause: - Impairments in attention - Left neglect. - Memory issues - Decreased awareness of deficits - Loss of "big picture" thinking - Altered creative or music perception. - Stroke on the right side of the brain damage: - Paralyzed left side: Hemiplegia. - Left-sided neglect. - Spatial-perceptual deficits - Tends to deny or minimize problems. - Rapid performance, short attention span - Impulsive; safety problems - Impaired judgment - Impaired time concepts - WHAT GALLO SAYS IS IMPORTANT: Inability to recognize family 14. Left-Sided Stroke, CVA, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - It controls the right side of the body. - Weakness or paralysis on the right side of the body and face. Decreased feeling or sensation on the right side of the body. Vision problems may include loss of vision on the right side or both eyes. Problems with speech and understanding language. Behavioral changes, such as cautiousness and hesitancy. Impaired ability to organize and reason, Memory impairment. - Speaking, Reading, Writing, Listening, Grammar, Number skills, Computation skills, Analyzing information, Reasoning, Logic, Sequential thinking, and Time awareness. - Injuries on the left side of the brain can cause: - Difficulty understanding and expressing spoken & written language. - Changes in speech - Verbal memory issues - Impaired logic - Sequencing difficulties - Stroke on the left side of the brain damages: - Paralyzed right side: hemiplegia. - Impaired speech-language (aphasias) - Impaired right-left discrimination. - Slow performance, cautious - Aware of deficits: depression, anxiety. - Impaired comprehension related to language and math - WHAT GALLO SAYS IS IMPORTANT: Can't think right Language and math skills impaired 15. Sickle Cell Anemia, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - It affects RBCs making them rigid, forming them into a "C" or "sickle" shape. Shape causes blood to flow slowly or block tissues. Genetic - Risk factors: both parents must carry the gene for kid to get it, seen mainly in African Americans, Mediterranean, or Middle Eastern ancestry. Pts with sickle cell higher risk of infection, MI, stroke, Pulmonary emboli - S/S: Extreme pain may need hospitalization for pain control during crisis, fatigue, anxiety, depression, and stress due to pain. - Treatment: Pain management, hydration, and sometimes blood transfusions if hgb low - Medications are given along with pain meds: hydroxyurea, L-glutamine, Crizanlizumab, and voxelotor. - Nursing considerations: keep patient hydrated, monitor o2 saturation to keep above 95% and administer oxygen if needed, provide comfort and psychosocial support, assess for any signs of infections, and vaccines for prophylactic treatment. - Teaching: No smoking, advise no extreme changes in temperature, avoid high altitudes, prepare food safely to avoid bacteria ingestion, stress the importance of staying hydrated, speak to support group or therapist for further support with coping - WHAT GALLO SAYS IS IMPORTANT: Sleepiness, anxiety, depression, pain, and fewer RBC's because of the blood cells being sickle-shaped, Make sure to know the importance of frequent eye exams 16. Leukemia, Definition, Risk Factors, Signs & Symptoms, Treatment, nursing Considerations, Teaching? - ALL Leukemia, Acute Lymphoblastic Leukemia, type of cancer affecting the blood and bone marrow. By the uncontrolled production of abnormal WBCs. - Risk Factors: Past exposure to radiation or chemotherapy and exposure to high levels of environmental radiation. Others include being a white male over the age of 70 years of age, and some genetic disorders such as Down Syndrome. Immune system suppression. - S&S: Fatigue, weakness, easy bruising, nosebleeds, pale skin, persistent low-grade fever - Treatment: Chemotherapy with or without stem cell transplant, Radiation therapy, and Targeted therapy is another type that uses drugs or substances that target specific cancer cells this therapy will not be as harmful to normal healthy cells as chemotherapy or radiation. Immunotherapy is in clinical trials, and it uses the pts immune system to fight cancer. - Nursing Considerations: Assess the t for pain, fatigue, and bleeding, and check vital signs. Monitor labs for signs of infection. - Teaching: Encourage the pt to eat the food they can tolerate. ALL causes an increase in fatigue, so pt should be reminded to make sure they take time to rest. Educate the pt on when to contact the provider and ensure they continue all therapies and treatments prescribed. - WHAT GALLO SAYS IS IMPORTANT: Limit the amount of IM injections you give 17. CAD, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - Coronary Artery Disease - Risk Factors: Plaque-blocked arteries, chronic disease, age, gender, family history, sedentary lifestyle, obesity - S&S: Lack of Sleep (over time), Angina, Tightness, and Pressure in the midsternal area - Treatments: Nitroglycerin, ACE Inhibitors, Beta Blockers, Calcium Channel Blockers, Anticoagulants, a Heart-healthy diet, maintaining a healthy weight, physical activity, 7-9 hours of good quality sleep, Coronary Artery Bypass Graft, COQ10 - Nursing Considerations: If there is a Family History of CAD, Looking at Cholesterol levels, C-reactive protein, Troponin 1 & 2, Electrocardiogram, Medication Administration, Frequent Vital Signs - Teaching: Weight, Diet, Sedentary lifestyle, Smoking, hypertension, Hyperlipidemia, Diabetes - WHAT GALLO SAYS IS IMPORTANT: Can drink alcohol, limit amount of fast foods 18. Right-Sided Heart Failure, Definition, Risk Factors, Signs, Symptoms, Treatment, Nursing Considerations, Teaching? - Right-sided heart Failure occurs when the right ventricle loses its ability to pump blood efficiently to the lungs. This leads to a backup of blood in the systemic circulation, causing fluid accumulation in the body, particularly in the lower extremities, abdomen, and other tissues. - Risk Factors: Underlying Cardiac Conditions, Lung Conditions, Lifestyle Factors - S&S: Sob, Chest discomfort, S3 Murmurs, Palpitations, Peripheral edema, Enlarged liver and spleen, JVD (jugular vein distention) - Treatment: Drug Therapy: Diuretics, ACE inhibitors, Beta-blockers. Lifestyle: Weight management, smoking cessation. Surgical Therapy: Valve repair or replacement, Ventricular assist devices. - Nursing Considerations: Monitor signs for fluid overload, Assess for JVD, regularly measure and document weight, and Elevate legs to reduce peripheral edema. - Teaching: Stress the importance of not smoking, and teach when to contact the healthcare provider for sudden swelling, severe fatigue, or chest pain. - WHAT GALLO SAYS IS IMPORTANT: Dependant edema (when dangling legs they are swollen), abdominal distention 19. Left-Sided Heart Failure, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - The left ventricle is unable to pump blood efficiently to the systemic circulation. This results in blood backing up into the pulmonary circulation, leading to pulmonary congestion and reduced oxygen delivery to the body. Often categorized into systolic heart failure (heart cannot contract forcefully enough) and Diastolic Heart Failure (heart cannot relax and fill properly) - Risk Factors: Hypertension, CAD, myocardial infarction, valvular heart disease, obesity, hyperlipidemia, smoking, diabetes mellitus, arrhythmias. - S&S: SOB, Orthopnea, pulmonary edema, fatigue, weakness, Restlessness, Oliguria - Treatment: Drug Therapy: diuretics, ACE inhibitors, Beta-blockers, Nitrates, and hydralazine. Lifestyle: weight management and smoking cessation. Surgical: valve repair or replacement and implantable devices. - Nursing Consideration: Monitor for signs of pulmonary congestion and assess for worsening symptoms such as increased SOB or weight gain, - Teaching: explain the purpose and correct usage along with the side effects of the medication, teach about a low sodium diet and how to read food labels, and teach them when to contact their provider when symptoms get worse. - WHAT GALLO SAYS IS IMPORTANT: Hacking cough, breathlessness, 20. Digoxin, Use, Side Effects, Nursing Considerations, Teaching? - AKA digitalis, treats cardiac dysrhythmias, a fib, atrial flutter, and paroxysmal atrial tachycardia - Side effects: dysrhythmias, nausea, anorexia, vomiting, fatigue, blurred vision, halos around dark objects, yellow tinge to vision - Nursing considerations: Must take an apical pulse for 1 min before giving this med, do not give if HR less than 60, monitor digoxin blood levels and K levels (hypokalemia increases digoxin toxicity), give at same time every day, when giving with diuretics toxicity risk increases - Teaching: make sure pts know how to check pulse, report any signs of muscle weakness, n/v, headaches, visual disturbances, palpitations, loss of appetite, do not skip or double doses, herbal ginseng increases possible toxicity, St. John's Wort decreases digoxin levels - WHAT GALLO SAYS IS IMPORTANT: Treat CHF 21. Furosemide, Use, Side Effects, Nursing Considerations, Teaching? - Loop diuretic - Used to treat hypertension. Heart failure, pulmonary edema - Hypotension, Diarrhea, constipation, loss of appetite, hypokalemia, hyponatremia, dehydration, ototoxicity, hyperglycemia, increased uric acid - Monitor daily weight, lung sounds, dry mouth, monitor electrolytes - Monitor for orthostatic hypotension - Eat K rich foods, low Na diet - Give with food, if giving IV push SLOW, protect from light - WHAT GALLO SAYS IS IMPORTANT: Watch potassium levels! And sodium levels 22. Valvular Heart Disease, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - Valves that are damaged or diseased are not able to fully open and close causing the heart to work harder and become an inefficient pump. - Risk Factors: Over age 75, inactivity, unhealthy eating habits, smoking, obesity, family history, medical procedures, and medical devices. - S&S: Dizzy spells, fainting, lethargy, weight loss, SOB, chest discomfort, swelling of the legs, palpitations. - Treatment: Drug Therapy; Diuretics, Beta-blockers, Digoxin, Calcium Channel blockers, vasodilators. Surgery: valve repair, balloon valvuloplasty, valve replacement. - Nursing Considerations: assessing the pt if they are experiences such as fatigue, palpitations, chest pain, and dyspnea or orthopnea - Teaching: Importance of frequent follow-ups with their health care provider, tell them common signs and symptoms so they can report them to their health care provider. - WHAT GALLO SAYS IS IMPORTANT: 23. PAD, Definition, Risk Factors, Signs & Symptoms, Treatment, Nursing Considerations, Teaching? - Peripheral Artery Disease is a progressive disorder that affects blood flow to the arteries in the lower extremities. Plaque builds up in the artery walls, and causes decreased flow, blockage, or spasms, which affects the ability of the body to supply tissues with oxygen-rich blood. The most common cause of PAD is atherosclerosis, other causes include injury to the lower extremities, inflammation of the blood vessels, exposure to radiation, embolism or thrombosis of an artery, and vasospasms. - Risk Factors: Hypertension, BMI over 30, Diabetes, hypercholesterolemia, smoking, and a family history of cardiovascular disease. - S&S: The most common manifestation of PAD is intermittent claudication (pain in the buttocks, hips, thighs, calves, or feet with walking that is caused by lack of oxygen due to atherosclerosis), slow toenail growth, and decreased hair growth on the lower extremities. Wounds on the toes or food may heal slowly or not at all. The skin on the lower extremities will have a shiny appearance and will be pale in color. Bruits may be present over the iliac and femoral arteries, and pulses in the lower extremities will be diminished or absent. - Treatment: Nonpharmacological Treatments: exercise therapy, pt should move until they start having pain, at that time pt should stop and rest until they are no longer in pain. The exercise therapy should be done for 30-45 min three to four times a day a week for 12 weeks. Pharmacological treatments: Cilostazol, which causes vasodilation and has antiproliferative effects. Pentoxifylline is another medication prescribed to improve claudication by improving oxygen delivery to tissues. Surgical treatments: Balloon Angioplasty or the insertion of a stent is another option. Pt with severe manifestations may require either a bypass graft that directs the flow of the blood around the blocked artery or an endarterectomy where the plaque in the artery is removed. - Nursing Considerations: Ensure the patient is in a well-lit, climate-controlled room. - Teaching: Limiting time spent outside due to pollution being linked with PAD. Educate the patient on risk factor modification, management of the manifestations of the disease, recognition of manifestations, and compliance with medical treatment. - WHAT GALLO SAYS IS IMPORTANT: Lab and Diagnostic test: Ankle-Brachial Index, Dependant ruber? Redness? Pain while resting? 24. Ferrous Sulfate, Use, Side Effects, Nursing Considerations, Teaching? - Oral form of iron supplement, treats iron deficiency anemia - Side effects: epigastric pain, nausea, diarrhea, constipation, metallic taste in mouth - Nursing considerations: Give on empty stomach for max absorption but if pt has GI upset can give with food, watch for iron toxicity, liquid form can stain teeth, lips, hairy tongue, antacids reduce absorption - Teaching: spread doses throughout waking hours, do not crush or chew unless its chewable form, advise iron rich diet- liver, egg yolks, muscle meats, whole grain cereals, leafy green vegetables, educate stools may become dark green or black this is normal, increase fiber and water intake to help with constipation, drink liquid iron through straw, rinse mouth after, give with vit C or citrus juices for max absorption - WHAT GALLO SAYS IS IMPORTANT: Take it with food but not milk or grapefruit 25. Pernicious Anemia, Definition, Risk Factors, Signs, Symptoms, Treatment, Nursing Considerations, Teaching? - Autoimmune disorder when terminal ileum can not absorb vitamin B12 - Risk factors: pt's over age 75,lack of intrinsic factor, gastric bypass, excessive alcohol use, use of anti-seizure meds, metformin use, PPI's, and oral contraceptives - S/S: fatigue, SOB, headaches, pallor, dizziness, if left untreated \...difficulty walking, tingling or pain in extremities, confusion, irritability, mood disturbances, visual deficits, diarrhea, and wt loss - Treatment: vitamin B12 IM, nasal spray, gel, or oral supplement. Lean red meat, chicken, fish, milk, dairy products, eggs, and cereals fortified with B12 - Nursing: monitor vital signs, o2 sats, HR, BP, instruct pt to follow up with repeat B12 lab testing, eat foods high in B12, assess for peripheral neuropathy - WHAT GALLO SAYS IS IMPORTANT: Swollen red tongue and gums 26. Orthostatic Hypotension, Definition, Risk Factors, Signs, Symptoms, Treatment, Nursing Considerations, Teaching? - A drop in systolic BP of more than 20mm Hg when a pt goes from lying to standing position. Diastolic drop of 10mm Hg - Risk factors: medications, heart failure, dehydration - S/S: Weakness, blurred vision, dizziness - Nursing: Change position slowly, monitor orthostatic bp's - WHAT GALLO SAYS IS IMPORTANT: A sudden drop in BP, fall risk 27. Atorvastatin, Use, Side Effects, Nursing Considerations, Treatment? - Treats hyperlipidemia, Reduces LDL cholesterol and triglycerides, Increases HDL cholesterol. - Side effects: Rash, memory loss, headaches, muscle pain (myopathy), rhabdomyolysis, hepatoxicity - Nursing considerations: Give at bedtime, monitor for muscle pain, check CK levels, requires iver function testing periodically - WHAT GALLO SAYS IS IMPORTANT: It causes Cataracts. COQ10 28. Nitroglycerin, Use, Side Effects, Nursing Considerations, Treatment? - Nitrate, treats and prevents chest pain, will drop BP - Side effects: headache, hypotension, tachycardia, reflux tachycardia - Nursing considerations: DO NOT TOUCH without gloves on, monitor HR and BP before giving and after, give 1 Sublingual tab wait 5 mins, check BP if pain still there give another wait 5 mins check BP, if still there give one more wait 5 mins call dr - OR ATI's method says- give 1 SL if pain persists call 911 - Apply to dry, hairless skin, wipe off any cream left from previous patch - WHAT GALLO SAYS IS IMPORTANT: 29. Losartan, Use, Side Effects, Nursing Considerations, Treatment? - Treats hypertension, prevents cerebral vascular accidents (strokes), manage diabetic neuropathy, management of CHF - Side effects: angioedema, dizziness, hypotension, headaches, insomnia - Nursing considerations: monitor BP, watch for any swelling of the face, mouth, throat, be careful standing up too fast due to potential dizziness, don't take when pregnant, NSAID's reduce effectiveness, takes 3-6 weeks to see max potential effects - WHAT GALLO SAYS IS IMPORTANT: