NUR 2474 Exam 1 Study Guide
TERMS
Steps of the Nursing Process:
1. Assessment
○ Critical thinking
○ Data collection
2. Diagnosis
○ Nursing diagnosis
3. Planning
○ Patient specific goals
○ Care plan
4. Implementation
○ Carry out plan
▪ Nursing interventions
▪ Meds
▪ O2
▪ Direct and indirect care
5. Evaluation
○ Assess outcome
Half-Life: Amount of time for half of the dose given to be metabolized
Allergic Reaction: Abnormal immune response to a medication
Adverse Effect: Unexpected or dangerous reaction
Receptors: Chemical structures receiving and transducing signals
Side Effects: Unintended effects occuring within therapeutic range
Drug Tolerance: Decreased effect due to heightened metabolism of the drug
Extrapyramidal Effects:
Caused due to dopamine blocking effects of anti-psychotics (too much acetylcholine)
- Parkinsonian tremor & shuffling
- Stiff neck
- Akathesia (restless movements)
- Tardive dyskinesia (permanent)
Treatment = anticholinergics (restore balance)
- Prepare for: urine retention, constipation, dry mouth, blurred vision, tachycardia
Tardive Dyskinesia:
Side-effect of antipsychotics causing stiff, jerky movements
- "Worm-like" tongue movements
- Facial tics
Serotonin Syndrome:
High levels of built up in the body
- Can begin within 2-72 hours of starting treatment
- Can be fatal
- Unexplained fever, flushing, sweats
, - Poor coordination, rigidity, tremors
- Rapid changes in BP
- Agitation & restlessness
- Hallucinations & AMS
Hold Rx if suspected
AVOID triptans, tricyclics, Fentanyl, Tramadol, lithium, Buspar, St. Jonh's wart
Neuroleptic Syndrome:
Malignant reaction to neuroleptics (life threatening; hold Rx and notify provider)
First generation is more at risk than second
- Sudden high fever
- Rigidity
- Dysphasia
- Labile BP
- Tachycardia/dysrhythmias
- Incontinence
- Diaphoresis
- Altered LOC (confusion to coma)
Noncompliance: Refusal or failure to comply to medication regimen
Drug Addiction: Physical and psychological dependence on a substance and without control of usage
LAB REFERENCES
Phenytoin 10-20 mcg/ml
Lithium 0.6-1.2 mEq/L Toxicity starts at 1.5 mEq/L
- Course hand tremor
- EKG changes
- Seizures
- Death
Valproic Acid 50-100 mcg/mL
Oxcarbazepine 3-40 mcg/mL
DRUGS
Levodopa/Carbidopa (Dopaminergic Drugs) Sinemet
- Increases dopamine to match ACh
- DO NOT give with antipsychotics
- Improves motor function but DOES NOT slow disease progression
- Levodopa: crosses BBB to be converted into dopamine
- Carbidopa: blocks peripheral absorption of levodopa to increase passage into BBB
○ Does not convert into dopamine
- Side effects
○ GI upset
○ Dyskinesia
○ Orthostatic BP
- Education
○ Hydration
○ Increased sodium intake
○ Avoid high protein food
○ Take on empty stomach
○ Do not crush
○ ALWAYS take exactly on time
TERMS
Steps of the Nursing Process:
1. Assessment
○ Critical thinking
○ Data collection
2. Diagnosis
○ Nursing diagnosis
3. Planning
○ Patient specific goals
○ Care plan
4. Implementation
○ Carry out plan
▪ Nursing interventions
▪ Meds
▪ O2
▪ Direct and indirect care
5. Evaluation
○ Assess outcome
Half-Life: Amount of time for half of the dose given to be metabolized
Allergic Reaction: Abnormal immune response to a medication
Adverse Effect: Unexpected or dangerous reaction
Receptors: Chemical structures receiving and transducing signals
Side Effects: Unintended effects occuring within therapeutic range
Drug Tolerance: Decreased effect due to heightened metabolism of the drug
Extrapyramidal Effects:
Caused due to dopamine blocking effects of anti-psychotics (too much acetylcholine)
- Parkinsonian tremor & shuffling
- Stiff neck
- Akathesia (restless movements)
- Tardive dyskinesia (permanent)
Treatment = anticholinergics (restore balance)
- Prepare for: urine retention, constipation, dry mouth, blurred vision, tachycardia
Tardive Dyskinesia:
Side-effect of antipsychotics causing stiff, jerky movements
- "Worm-like" tongue movements
- Facial tics
Serotonin Syndrome:
High levels of built up in the body
- Can begin within 2-72 hours of starting treatment
- Can be fatal
- Unexplained fever, flushing, sweats
, - Poor coordination, rigidity, tremors
- Rapid changes in BP
- Agitation & restlessness
- Hallucinations & AMS
Hold Rx if suspected
AVOID triptans, tricyclics, Fentanyl, Tramadol, lithium, Buspar, St. Jonh's wart
Neuroleptic Syndrome:
Malignant reaction to neuroleptics (life threatening; hold Rx and notify provider)
First generation is more at risk than second
- Sudden high fever
- Rigidity
- Dysphasia
- Labile BP
- Tachycardia/dysrhythmias
- Incontinence
- Diaphoresis
- Altered LOC (confusion to coma)
Noncompliance: Refusal or failure to comply to medication regimen
Drug Addiction: Physical and psychological dependence on a substance and without control of usage
LAB REFERENCES
Phenytoin 10-20 mcg/ml
Lithium 0.6-1.2 mEq/L Toxicity starts at 1.5 mEq/L
- Course hand tremor
- EKG changes
- Seizures
- Death
Valproic Acid 50-100 mcg/mL
Oxcarbazepine 3-40 mcg/mL
DRUGS
Levodopa/Carbidopa (Dopaminergic Drugs) Sinemet
- Increases dopamine to match ACh
- DO NOT give with antipsychotics
- Improves motor function but DOES NOT slow disease progression
- Levodopa: crosses BBB to be converted into dopamine
- Carbidopa: blocks peripheral absorption of levodopa to increase passage into BBB
○ Does not convert into dopamine
- Side effects
○ GI upset
○ Dyskinesia
○ Orthostatic BP
- Education
○ Hydration
○ Increased sodium intake
○ Avoid high protein food
○ Take on empty stomach
○ Do not crush
○ ALWAYS take exactly on time
