NUR 283 COMP 1-3 MEDS LATEST UPDATE GRADED A+

NUR 283 COMP 1-3 MEDS LATEST UPDATE GRADED A+ BP meds (lisinopril, metoprolol, valsartan, etc.) Encourage the patient to sit on the side of the bed before standing and to change positions slowly to prevent orthostatic hypotension. Epoetin Alfa stimulates RBC production; used to treat anemia and in patients undergoing chemotherapy. **Increases Hgb as an expected result. **MONITOR for signs of hypertension, stroke, blood clots, and myocardial infarction (stroke). Neupogen (filgrastim): bone marrow stimulant that produces WBCs. WATCH for an INCREASE in WBCs, for example, from 2.6 to 6. Lithium discharge instructions: lithium levels can decrease due to dehydration from long runs or strenuous exercise. Monitor for lithium toxicity (2.0 or greater). MAINTAIN adequate sodium levels (normal range 135-145) and fluids (2-3L daily). If a patient requires 12 weeks of antibiotic therapy, they will need a PICC line for infusions. DO NOT send an? IV drug user home with a PICC line! MDROs (multi-drug resistant organisms): MRSA: drugs to treat: vancomycin, rifampin VRE: drugs to treat: penicillin, amoxicillin ESBL: drugs to treat: Meropenem 1. Resistance occurs when a patient on two medications (first-line and second-line) stops one of them. 2. The patient briefly responds to the single medication, then resistant organisms start to grow. 3. The patient, now infectious again, spreads the drug-resistant organism to others. 4. Repeating this process leads to organisms resistant to many first-line tuberculosis medications. Transdermal patch patient teaching: NEVER throw it away in a trash can! It does not need covering in the shower, and DO NOT place over an abrasion or bruise. Nitroglycerin should be replaced after 3 months of storage. If the nitro reduces chest pain to 3, take another pill. Take at the first sign of chest pain. You may use nitroglycerin sublingual 5 to 10 minutes before an activity that might cause chest pain. Try to rest or stay seated when taking nitroglycerin (may cause dizziness or fainting). Headache is a common side effect. Hydrochlorothiazide (thiazide diuretic) potassium depleting NOT for diabetics, hypotension, syncope, SLE, Gout, or any of THESE electrolyte imbalances: hypercalcemia, hypochloremia, hypokalemia, hypomagnesemia, hyponatremia, or metabolic alkalosis. WATCH for muscle cramps, may need to hold the medication. Desmopressin for DI/diabetes insipidus, expected outcome with medication would be decreased urine output from 500ml/hr down to 125 ml/hr. Gentamicin peak and trough: PEAK 30 minutes after infusion; TROUGH right before the next dose. Tobramycin: Adverse reactions: ototoxicity (hearing damage and loss of balance); nephrotoxicity (cloudy/bloody urine). Allopurinol: treats Gout; patient teaching: you should increase fluid intake;alsoigvenintumorlysissyndrome Pyridostigmine: (anticholinesterase drug) treats Myasthenia Gravis; prevents breakdown of acetylcholine by enzymes in the neuromuscular junction which increases muscle response improving strength; Give with food to minimize GI upset MUST EAT 45 minutes to an hour AFTER taking!! Phenytoin: treats seizures, bipolar disorder or other mood disorders and trigeminal neuralgia; patient teaching: should perform good oral hygiene to prevent gingival hyperplasia Digoxin: toxicity above 2.0 (normal levels: 0.5-2.0) patient WILL eat foods that are potassium rich such as: potatoes, tomatoes, oranges, melon