UWORLD
Refeeding syndrome
• Serious complication of nutritional replenishment. phosphorus,
potassium, and/or magnesium (mnemonic PPM). Clients can also develop
fluid overload. Low-calorie
feedings and a gradual increase in calories can prevent refeeding
syndrome. Electrolytes should be monitored frequently
Air Embolism
• To prevent air embolism when discontinuing a central venous catheter, it is
important for the nurse to pull the line cautiously, have the client in a supine
position, have the client bear down or exhale, and apply an air-occlusive
dressing
Fat embolism syndrome (FES)
• Respiratory problems (eg, dyspnea, tachypnea, hypoxemia) to
impaired gas exchange and acute respiratory failure.
• Neurologic changes (eg, altered mental status, confusion, restlessness)
• Petechial rash (eg, pin-sized purplish spots that do not blanch with
pressure) around neck & chest. This defining characteristic differentiates
a fat embolus from a PE
• Fever (>101.4 F [38.6 C])
Thrombolytic agents
• Thrombolytic agents (eg, alteplase, tenecteplase, reteplase) place clients
at risk for bleeding. Contraindicated in active bleeding, recent trauma,
aneurysm, arteriovenous malformation, hx of hemorrhagic stroke, and
uncontrolled HTN.
Stroke
• A stroke is not considered stabilized until 48 hrs have passed without
changes. The client's risk of losing the gag reflex is still high as the
stroke could be evolving.
Phenytoin (Dilantin)
• An anticonvulsant drug used to treat generalized tonic-clonic seizures. The
therapeutic is 10-20 mcg/mL. Early signs of toxicity include horizontal
nystagmus and gait unsteadiness. These may be followed by slurred speech,
lethargy, confusion, and even
coma. Bradyarrhythmias and hypotension are usually seen with IV phenytoin.
Gingival hyperplasia is a common expected S/E & does not indicate toxicity.
• Stevens-Johnson syndrome is an immune-mediated reaction triggered by
certain classes of drugs (eg, sulfonamide antibiotics, allopurinol,
anticonvulsants”phenytoin”). It
is characterized by blistered lesions on the face, trunk, and palms and may be
fatal if left untreated.
• least amount of time that the nurse can safely admin this med is 2 mins
Digoxin
• Improve cardiac output and efficiency in clients with HF. Sucralfate
(Carafate) taken at the same time as digoxin can decrease absorption of the
latter, thereby increasing symptoms of HF. Clients should take sucralfate at
,least 2 hrs after digoxin.
, • For infant, hold med if the apical pulse rate is <90 bpm. In adults hold if the
apical pulse rate is <60 bpm.
TNF (eg, etanercept, infliximab, adalimumab)
• These drugs reduce the manifestations of (RA) and slow the progression of
joint damage by inhibiting the inflammatory response. Causes
immunosuppression and increased susceptibility for infection and
malignancies. Major adverse effects include severe infections and bone
marrow suppression. TB reactivation is a major concern. Therefore, all clients
must receive a Tuberculin Skin Test(TST) to r/o latent TB.
Mucositis
• Measures to minimize oral mucositis from chemoradiotherapy include
rinsing the mouth with normal saline, brushing with a soft-bristle
toothbrush, using a water-soluble lubricating agent, avoidance of hot liquids
and spicy/acidic foods, and application of
prescribed viscous lidocaine.
Ethics
• Nonmaleficence is doing no harm, fidelity is loyalty and commitment. It exhibits
loyalty and fulfilling commitments made to oneself and others. It includes
meeting the expected responsibilities of professional nursing practice and
provides the basis
of accountability, justice is equal treatment for all, beneficence is doing good for
the client's best interest, and autonomy is making decisions for oneself.
RACE & PASS
• RACE- Fires in inpatient settings (Rescue, Alarm, Confine, &
Extinguish/Evacuate).
• PASS- Using a fire extinguisher (Pull, Aim, Squeeze, and Sweep).
Creatinine clearance
• Measures GFR. Requires a 24-hour urine specimen & a blood specimen. The
1st urine specimen is discarded & the time is noted.
Renal Calculi-
• Provide adequate analgesia for pain, encourage increased fluid intake, and
assist with ambulation as tolerated to promote clearance of calculi. All
urine should be strained to retrieve any stones for analysis to determine
preventive measures.
Diabetic neuropathy
• Autonomic neuropathy is nerve damage to the autonomic nervous system, the
system responsible for involuntary body functions such as BP, HR & digestion.
Magnetic resonance cholangiopancreatography
• Uses MRI to visualize the biliary and hepatic ductal system. Contra ,
pregnancy, the presence of certain metal implants, and an allergy to
gadolinium (ie, noniodine contrast agent)
Sodium nitroprusside
Refeeding syndrome
• Serious complication of nutritional replenishment. phosphorus,
potassium, and/or magnesium (mnemonic PPM). Clients can also develop
fluid overload. Low-calorie
feedings and a gradual increase in calories can prevent refeeding
syndrome. Electrolytes should be monitored frequently
Air Embolism
• To prevent air embolism when discontinuing a central venous catheter, it is
important for the nurse to pull the line cautiously, have the client in a supine
position, have the client bear down or exhale, and apply an air-occlusive
dressing
Fat embolism syndrome (FES)
• Respiratory problems (eg, dyspnea, tachypnea, hypoxemia) to
impaired gas exchange and acute respiratory failure.
• Neurologic changes (eg, altered mental status, confusion, restlessness)
• Petechial rash (eg, pin-sized purplish spots that do not blanch with
pressure) around neck & chest. This defining characteristic differentiates
a fat embolus from a PE
• Fever (>101.4 F [38.6 C])
Thrombolytic agents
• Thrombolytic agents (eg, alteplase, tenecteplase, reteplase) place clients
at risk for bleeding. Contraindicated in active bleeding, recent trauma,
aneurysm, arteriovenous malformation, hx of hemorrhagic stroke, and
uncontrolled HTN.
Stroke
• A stroke is not considered stabilized until 48 hrs have passed without
changes. The client's risk of losing the gag reflex is still high as the
stroke could be evolving.
Phenytoin (Dilantin)
• An anticonvulsant drug used to treat generalized tonic-clonic seizures. The
therapeutic is 10-20 mcg/mL. Early signs of toxicity include horizontal
nystagmus and gait unsteadiness. These may be followed by slurred speech,
lethargy, confusion, and even
coma. Bradyarrhythmias and hypotension are usually seen with IV phenytoin.
Gingival hyperplasia is a common expected S/E & does not indicate toxicity.
• Stevens-Johnson syndrome is an immune-mediated reaction triggered by
certain classes of drugs (eg, sulfonamide antibiotics, allopurinol,
anticonvulsants”phenytoin”). It
is characterized by blistered lesions on the face, trunk, and palms and may be
fatal if left untreated.
• least amount of time that the nurse can safely admin this med is 2 mins
Digoxin
• Improve cardiac output and efficiency in clients with HF. Sucralfate
(Carafate) taken at the same time as digoxin can decrease absorption of the
latter, thereby increasing symptoms of HF. Clients should take sucralfate at
,least 2 hrs after digoxin.
, • For infant, hold med if the apical pulse rate is <90 bpm. In adults hold if the
apical pulse rate is <60 bpm.
TNF (eg, etanercept, infliximab, adalimumab)
• These drugs reduce the manifestations of (RA) and slow the progression of
joint damage by inhibiting the inflammatory response. Causes
immunosuppression and increased susceptibility for infection and
malignancies. Major adverse effects include severe infections and bone
marrow suppression. TB reactivation is a major concern. Therefore, all clients
must receive a Tuberculin Skin Test(TST) to r/o latent TB.
Mucositis
• Measures to minimize oral mucositis from chemoradiotherapy include
rinsing the mouth with normal saline, brushing with a soft-bristle
toothbrush, using a water-soluble lubricating agent, avoidance of hot liquids
and spicy/acidic foods, and application of
prescribed viscous lidocaine.
Ethics
• Nonmaleficence is doing no harm, fidelity is loyalty and commitment. It exhibits
loyalty and fulfilling commitments made to oneself and others. It includes
meeting the expected responsibilities of professional nursing practice and
provides the basis
of accountability, justice is equal treatment for all, beneficence is doing good for
the client's best interest, and autonomy is making decisions for oneself.
RACE & PASS
• RACE- Fires in inpatient settings (Rescue, Alarm, Confine, &
Extinguish/Evacuate).
• PASS- Using a fire extinguisher (Pull, Aim, Squeeze, and Sweep).
Creatinine clearance
• Measures GFR. Requires a 24-hour urine specimen & a blood specimen. The
1st urine specimen is discarded & the time is noted.
Renal Calculi-
• Provide adequate analgesia for pain, encourage increased fluid intake, and
assist with ambulation as tolerated to promote clearance of calculi. All
urine should be strained to retrieve any stones for analysis to determine
preventive measures.
Diabetic neuropathy
• Autonomic neuropathy is nerve damage to the autonomic nervous system, the
system responsible for involuntary body functions such as BP, HR & digestion.
Magnetic resonance cholangiopancreatography
• Uses MRI to visualize the biliary and hepatic ductal system. Contra ,
pregnancy, the presence of certain metal implants, and an allergy to
gadolinium (ie, noniodine contrast agent)
Sodium nitroprusside
