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Colloid Solutions TX: hypovolemic shock (burns) MOA: Plasma proteins that keep fluid in vessels Ex: Lactated Ringers Crystalloid Solutions TX: fluid replacement MOA: Contain electrolytes that mimic extracellular fluids Hypotonic Solutions Tx: Hypernatremia MOA: Shifts fluid out of vessels a...

Colloid Solutions TX: hypovolemic shock (burns) MOA: Plasma proteins that keep fluid in vessels Ex: Lactated Ringers Crystalloid Solutions TX: fluid replacement MOA: Contain electrolytes that mimic extracellular fluids Hypotonic Solutions Tx: Hypernatremia MOA: Shifts fluid out of vessels and into cells Hypertonic Solutions Tx: Brain swelling MOA: Shift fluid out of cells and into vessels Ex: 3% hypertonic saline & D5 NS (5% dextrose, 0.9% NS) Isotonic Solutions Tx: Dehydration (vomiting) MOA: Maintain vascular expansion (no fluid shift) Sodium Bicarbonate (Antacid→ baking soda) Tx: Acidosis AE: Metabolic Alkalosis (muscle weakness, spasms, numbness, irritability) Hyponatremia Tx: 3% NA CL NI: Monitor NA levels every 2 hours (Slowly raises) Hyperkalemia Tx: \*if no cardio/heart problems → IV Insulin + Dextrose \*if cardio/heart problems→ Calcium Gluconate \*if lab range slightly high (5.5-5.7) → Polystyrene Sulfonate (Kayexelate), PO, Laxitive Hypokalemia \*Never give via push (causes cardiac arrest) → Give piggyback (avoid burning if slow) Dextran 40 Tx: For fluid volume excess SE: Tachycardia, Dyspnea (feeling SOB, coughing) Bolus Monitor: Fluid volume overload NI: Listen to lung sounds before, during, after TPN NI: Central Line Tubing must be changed every 24 hours Remove from refrigerator 30 min before admin Check blood sugar every 6 hours Enteral Feedings Concern: Patient receiving enough water (supplement) Vitamin A AE: fetal malformation if taken in excess (Give preg test before admin/HCG) Folic Acid (B9) Tx: Alcoholism + Pregnancy suppliment Ondansetron (Zofran) NI: Give prior to trigger causing nausea Monitor: Constipation AE: Dysrythmias Bismuth Salicylate (Pepto Bismol) MOA: Binds and eliminates toxins H2 Receptor Agonists Tx: Ulcers (Dental) MOA: Decreases acid AE: ineffective if taken with antacids Antacids Tx: Heartburn (temporary relief) MOA: Neutralizes acids (Changes PH of stomach acid) Onset → 20-40 min Ex: Calcium Bicarbonate (tums) Sucralfate Tx: Prevent and treat duodenal ulcers MOA: Coats stomach and heals gastric erosion Teaching: Take before eating PPI's Tx: GERD, PUD MOA: Inhibit enzyme that generates gastric acid Takes 4-8 weeks to work AE: Long-term use causes Osteoporosis Sulfasalazine Tx: Ulcerative Colitis AE: Hepatotoxicity (Contraindicated in pts with liver failure) Psyllium Mucilloid Tx: 1st line laxative treatment of constipation, treats cholesterol Teaching: takes several days to work, contains fiber, fluids must be increased Stool Softeners MOA: Increases water absorption in stool Methylnaltrexone Tx: Constipation in patients using opioids for pain MOA: Stimulant laxitive Emergency Contraceptive Tx: prevent pregnancy depending on time frame of intercourse MOA: Prevents implantation, not for abortion Tocolytics Tx: Stops premature labor (24-72 hrs) NI: Allows time to give surfactant (helps baby's lungs develop) Ex: Terbutaline (Tx: Asthma) → BBW: use greater than 48-72 hours = fetal death Nifedipine (Tx: BP) Magnesium Sulfate Tx: Delay preterm labor S/S: early overdose: Flushing of skin overdose: Decreased DTR Oxytocin Tx: Regulates contractions to give rest to mother/baby Stops postpartum bleeding/hemmorageing MOA: Smooth muscle contractions to stimulate and promote birth SE: Rapid, painful contractions (Tachysystoli) Misoprostol TX: PUD + Abortion MOA: Inhibits gastric acid production + stimulates production of mucus Norethindrone Tx: Oral Contraceptive Teaching: Take at same time every day SE: Photosensitivity Medroxyprogesterone Tx: Long term BC, 3 months, IM injections Teaching: NO St. John's Wart Aging: HRT Tx: Menopausal symptoms AE: Breast cancer, dementia, DVT, MI Other: Don't give if someone taking Birth Control or has Seizures Finasteride Class: 5 alpha-reductase inhibitor Tx: Benign Prostatic Hyperplasia (BPH) MOA: Promotes shrinkage of enlarged prostate SE: Sexual dysfunction, headache, dizziness Teaching: No blood transfers/donations, not for pregnant women Conjugated Estrogen Tx: Used for menopause symptoms Risk: in women \>35 risk of blood clots or DVT Contraindications: abnormal uterine bleeding, smoking, taking oral contraceptive Sildenafil Tx: Erectile Dysfunction Contraindicated: Use of nitrates, Pts with cardiac issues/workup Teaching: Doesn't cause erection (Only enhances) Testosterone Tx: Breast cancer to reduce tumor size Pt Teaching: Rotate patch site