https://quizlet.com/253879840/rn-fundamentals-flash-cards/
Preparing for exam 1 discussions
Discuss the half life and time of onset for Haldol.
● The half life of Haldol is 21-24 hours. Onset varies depending on the route given. If given
po, onset is 2 hours, with peak being at 2-6 hours, and duration of 8-12 hours. If given
IM, onset is within 20-30 minutes, peak at 30-45 minutes, and duration 4-8 hours. IM is
what will be given in acute situations, such as delirium or hallucinations while
hospitalized. Max dose is 100 mg per day.
● Haldol is used to treat acute psychosis as you reported. It may also be used in the elderly
with end stage dementia. It is used with caution in the elderly as it may cause
hypotension. Haldol may also be used for nausea and other indications in palliative care.
It is also used in patients with schizophrenia.
● Haldol can cause tardive dyskinesia, motor restlessness. In dementia patients it can cause
muscle rigidity, and death. It also can cause anti-cholinergic effects such as dry mouth,
blurred vision, and constipation.
Discuss the symptoms of Serotonin Syndrome.
● Serotonin syndrome will present itself with a variety of symptoms and levels of severity.
From the time patients receive an increase in a serotonergic agent, patient will show mild
symptoms within 6-24 hours including hypertension, tachycardia, diaphoresis, high body
temperature, dilated pupils, increased reflexes, tremors, and hyperreflexia, and more
severe symptoms including hyperthermia, delirium, and muscle rigidity.
If you have a patient taking Depakote, what patient teaching would you provide?
● It will be important to teach a patient taking Depakote that physical dependency may
result from extended use. Avoid driving or other activities that will require alertness until
effects of medications are determined. Take the medication as directed, if a dose is missed
take as soon as remembered. If on a multiple dose schedule, take forgotten dose within 6
hours of scheduled time. Abrupt withdrawal may lead to status epilepticus. Notify health
care provider immediately of any suicidal thoughts or ideation, depression or anxiety.
Notify health care provider of abdominal pain, nausea, vomiting, yellow skin or eyes,
fever, sore throat or loss of seizure control. Female patients should notify health care
provider if pregnant, or planning pregnancy. Swallow tablets or capsules whole; do not
break, crush or chew. Take with food or milk to decrease GI symptoms.
What are the side effects of Atropine, an anticholinergic?
● Anticholinergics, such as Atropine, have side effects that are similar to turning off the
parasympathetic nervous system. Side effects include symptoms-like tachycardia, dry
mouth, urinary retention, and blurred vision
, Of the medications you have read about, what medications may cause urinary retention?
Provide your rationale.
● Cholinergic blockers (cholinergic antagonists) may cause urinary retention. These drugs
include Parkinson’s medications, such as Sinemet (carbidopa-levodopa). Other drugs
include Benadryl, Zyprexa (olanzapine), quetiapine (Seroquel).
● These may cause urinary retention by decreasing the motility of the urinary tract. The
nurse should monitor patient taking an anticholinergic for urinary hesitancy and retention;
palpate bladder is retention occurs.
In contrast, what type of effects would you expect from a cholinesterase inhibitor?
● Cholinesterase inhibitors: physostigmine. Block the normal breakdown of ACh. Used in
the treatment of dementia.
Discuss some antidotes or reversal agents you have learned about in these modules.
● I learned about the opiate antidote of Narcan, or naloxone. Narcan is an opioid blocker
and works by competing with opioids at opioid receptor sites. This is given IV,
subcutaneous or IM. This is given to opioid dependent adult patients at a dose of 0.1-0.2
mg every 2-3 minutes, and to non-opioid dependent adult patients at a dose of 0.4 mg
every 2-3 minutes with a max dose of 10 mg.
● Another antidote is flumazenil for benzodiazepines overdose/toxicity. This works by
antagonizing the actions of benzodiazepines on the CNS, competitively inhibiting the
activity at the benzodiazepines receptor complex. This is given to adult patients through
IV, first injecting 0.2 mg over 15 seconds, wait 45 seconds, then give 0.2 mg. If
consciousness still does not occur, this may be repeated at 60 second intervals as needed
with a max of 3 mg/hr, or 1 mg/5 min.
What are some teaching considerations for patients taking aspirin?
● Some important teaching considerations for patients taking aspirin include taking aspirin
with 8 oz of water and sitting upright for 30 minutes after dose to facilitate product
passing into the stomach. Discard tablets if vinegar-like smell is present. Do not exceed
recommended dosage as acute poisoning may result. Be wary of OTC medications, read
their labels as they may contain aspirin as well. Avoid alcohol consumption as GI bleed
may result. Notify health provider if tinnitus, confusion, diarrhea, sweating or
hyperventilation occur. Inform health care provider if surgery is planned as aspirin may
need to be held prior. Take aspirin at prescribed dose as increasing dose has not been
shown to provide additional benefits.
Dilemmas in Medication Administration
Preparing for exam 1 discussions
Discuss the half life and time of onset for Haldol.
● The half life of Haldol is 21-24 hours. Onset varies depending on the route given. If given
po, onset is 2 hours, with peak being at 2-6 hours, and duration of 8-12 hours. If given
IM, onset is within 20-30 minutes, peak at 30-45 minutes, and duration 4-8 hours. IM is
what will be given in acute situations, such as delirium or hallucinations while
hospitalized. Max dose is 100 mg per day.
● Haldol is used to treat acute psychosis as you reported. It may also be used in the elderly
with end stage dementia. It is used with caution in the elderly as it may cause
hypotension. Haldol may also be used for nausea and other indications in palliative care.
It is also used in patients with schizophrenia.
● Haldol can cause tardive dyskinesia, motor restlessness. In dementia patients it can cause
muscle rigidity, and death. It also can cause anti-cholinergic effects such as dry mouth,
blurred vision, and constipation.
Discuss the symptoms of Serotonin Syndrome.
● Serotonin syndrome will present itself with a variety of symptoms and levels of severity.
From the time patients receive an increase in a serotonergic agent, patient will show mild
symptoms within 6-24 hours including hypertension, tachycardia, diaphoresis, high body
temperature, dilated pupils, increased reflexes, tremors, and hyperreflexia, and more
severe symptoms including hyperthermia, delirium, and muscle rigidity.
If you have a patient taking Depakote, what patient teaching would you provide?
● It will be important to teach a patient taking Depakote that physical dependency may
result from extended use. Avoid driving or other activities that will require alertness until
effects of medications are determined. Take the medication as directed, if a dose is missed
take as soon as remembered. If on a multiple dose schedule, take forgotten dose within 6
hours of scheduled time. Abrupt withdrawal may lead to status epilepticus. Notify health
care provider immediately of any suicidal thoughts or ideation, depression or anxiety.
Notify health care provider of abdominal pain, nausea, vomiting, yellow skin or eyes,
fever, sore throat or loss of seizure control. Female patients should notify health care
provider if pregnant, or planning pregnancy. Swallow tablets or capsules whole; do not
break, crush or chew. Take with food or milk to decrease GI symptoms.
What are the side effects of Atropine, an anticholinergic?
● Anticholinergics, such as Atropine, have side effects that are similar to turning off the
parasympathetic nervous system. Side effects include symptoms-like tachycardia, dry
mouth, urinary retention, and blurred vision
, Of the medications you have read about, what medications may cause urinary retention?
Provide your rationale.
● Cholinergic blockers (cholinergic antagonists) may cause urinary retention. These drugs
include Parkinson’s medications, such as Sinemet (carbidopa-levodopa). Other drugs
include Benadryl, Zyprexa (olanzapine), quetiapine (Seroquel).
● These may cause urinary retention by decreasing the motility of the urinary tract. The
nurse should monitor patient taking an anticholinergic for urinary hesitancy and retention;
palpate bladder is retention occurs.
In contrast, what type of effects would you expect from a cholinesterase inhibitor?
● Cholinesterase inhibitors: physostigmine. Block the normal breakdown of ACh. Used in
the treatment of dementia.
Discuss some antidotes or reversal agents you have learned about in these modules.
● I learned about the opiate antidote of Narcan, or naloxone. Narcan is an opioid blocker
and works by competing with opioids at opioid receptor sites. This is given IV,
subcutaneous or IM. This is given to opioid dependent adult patients at a dose of 0.1-0.2
mg every 2-3 minutes, and to non-opioid dependent adult patients at a dose of 0.4 mg
every 2-3 minutes with a max dose of 10 mg.
● Another antidote is flumazenil for benzodiazepines overdose/toxicity. This works by
antagonizing the actions of benzodiazepines on the CNS, competitively inhibiting the
activity at the benzodiazepines receptor complex. This is given to adult patients through
IV, first injecting 0.2 mg over 15 seconds, wait 45 seconds, then give 0.2 mg. If
consciousness still does not occur, this may be repeated at 60 second intervals as needed
with a max of 3 mg/hr, or 1 mg/5 min.
What are some teaching considerations for patients taking aspirin?
● Some important teaching considerations for patients taking aspirin include taking aspirin
with 8 oz of water and sitting upright for 30 minutes after dose to facilitate product
passing into the stomach. Discard tablets if vinegar-like smell is present. Do not exceed
recommended dosage as acute poisoning may result. Be wary of OTC medications, read
their labels as they may contain aspirin as well. Avoid alcohol consumption as GI bleed
may result. Notify health provider if tinnitus, confusion, diarrhea, sweating or
hyperventilation occur. Inform health care provider if surgery is planned as aspirin may
need to be held prior. Take aspirin at prescribed dose as increasing dose has not been
shown to provide additional benefits.
Dilemmas in Medication Administration
