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PHARMA: -ase = thrombolytic -azepam = benzodiazepine -azine = antiemetic; phenothiazide -azole = proton pump inhibitor, antifungal -barbital = barbiturate

-coxib = cox 2 enzyme blockers -cep/-cef = anti-infectives -caine = anesthetics -cillin = penicillin -cycline = antibiotic -dine= antiulcer -dipine = calcium channel blocker -done= opiod analgesics -floxacin = antibiotic -iam= antianxiety agents -ide= oral hypoglycemics -ipramine = Tricyclic antidepressant -ine = reverse transcriptase inhibitors, antihistamines -kinase = thrombolytics -lone, pred- = corticosteroid -mab = monoclonal antibiotics -micin = antibiotic, aminoglycoside -navir = protease inhibitor nitr-, -nitr- = nitrate/vasodilator -nium= neuromuscular blocking agents -ole= anti-fungal -olol = beta antagonist, beta blocker -oxacin= antibiotics -oxin = cardiac glycoside -osin = Alpha blocker -pam= antianxiety agents -parin = anticoagulant -prazole = PPI s -phylline = bronchodilator -pril = ACE inhibitor -statin = cholesterol lowering agent, antihyperlipidemics -sartan = angiotensin II blocker -sone = glucocorticoid, corticosteroid -stigmine = cholinergics -terol = Beta 2 Agonist -thiazide = diuretic -tidine = antiulcer -trophin = Pituitary Hormone -vir = anti-viral, protease inhibitors -zosin = Alpha 1 Antagonist -zolam = benzo/sedative -zide= diuretics -zine = antihistamine

Try to look at the suffixes: ace inhibitors end with 'pril (eg: captopril) *note that this drug increases potassium in the blood, angiotensinogen 2 inhibitors end in 'sartan (eg: losartan), beta blockers end with 'olol (eg: metoprolol) *caution with patients who are diabetic or who are asthmatic, cholesterol reducing drugs usually end with 'statin (eg: atorvastatin) * note that if the patient experiences muscular pain, stop immediately and report it to the doctor, also not to consume grapefruit juice, impotence drugs end with "defil (eg: sildenefil-hope I spelled it correctly...if not please excuse the typo) *note that you cannot take this drug if you are taking nitrates such as nitroglycerin or isosorbide and go to the doctor if an erection last longer than 4 hours, accutane is an acne drug, where a pregnancy test must be done on females before prescribing them actonel (again, this may be a typo) cannot be taken unless a person is able to sit up for at least 1/2 hour to an hour after adminstration. Know the acting times of insulin, which is fast acting, long acting or the lente. They may ask when will a person become hypoglycemic, and that would be during peak hours. penicillin: if a person has an allergy to penicillin, they may be at risk for an allergy to a cephalosporin, in that case suggest a macrolide such as clarithromycin. Macrolides are known to cause severe stomach pain for some people. Also, if a nurse administers penicillin or cephalosporin, that the patient should remain with the nurse for 1/2 hour afterwards to intervene with allergic reactions. Most drugs that end with 'mycin may cause nephrotoxicity or ototoxicity Parameters for digitalis administration, and also that if potassium is low and calcium and magnesium is high, there is a inc chance for digitalis tox corticosteriods usually end with 'sone (eg: predinsone), may cause medication related diabetes, increase chances of infection, cause Cushoid symptoms (buffalo hump in back, thin skin, easy to bruise, etc...) Aspirin should not be consumed with alcohol, increases bleeding, causes ulcers, should be taken with food to diminish gastric distress dont forget your diuretics ... esp. those are imp. also I have some for now meds that end in -sartan=decrease blood pressure, increase cardiac load (Used for those who side effect is cough with ACE ANGIOTENSIN II RECEPTOR BLOCKERS- side effects 2nd degree AV block, angina, muscle cramps monitor BUN,BP and PR -vastatin(Lovastatin)=decrease cholesterol, lower tricycerides (NOTE*Lipitor at night only do not take with grapefruit juice) ANTIHYPERLIPIDEMICS-side effects muscle weakness, alopecia monitor liver/renal profile cox=osteoarthritis, rheumatoid arthritis(relieve pain by reducing inflammation) NSAID/CO2 ENZYME BLOCKER-side effects tinnitus, dizziness monitor bowel habits (could cause GI bleed, platlet count) Increase risk of strokes, heart attacks*** tidine=GERD, HISTAMINE 2 ANTAGONIST(inhibit gastric acids) side effects agranulocytosis, brady/tachycardia monitor gastric PH/BUN ***If taking antacids take one hour after or before taking these drugs*** -prazole=ulcers, indigestion, GERD (Take before meals better absorption) PROTON PUMP INHIBITORS- side effects gas, diarrhea, hyperglycemia monitor LFTs -parin=thin blood, DVT, M.I.,post surgeries (Antidote Protamine sulfate-check PTT should be 1.5-2.0x) anticoag. decread vit. K levels side effects hematuria, bleeding, fever monitor PTT, hematocrit and occult testing q 3mths

ganciclovir sodium causes neutropenia and thrombocytopenia and nurse should monitor for s/s of bleeding just as equiv. to a pt. on anticoag. T SSRIs and MAOIs used together potentially fatal

PHARMA FACTS:
Don t give non-selective beta-blockers to patients w/respiratory prob Vitamin C can cause false +ive occult blood Avoid the G herbs (ginsing, ginger, ginko, garlic) when on anticlotting drugs (coumadin, ASA, Plavix, etc) ASA toxicity can cause ringing of the ears No narcotics to any head-injury victims Mg2+ toxicity is treated with Calcium Gluconate Do not give Calcium-Channel Blockers with Grapefruit Juice Oxytocin is never administered through the primary IV Lithium patients must consume extra sodium to prevent toxicity MAOI Patients should avoid TYRAMINE: Avocados, bananas, beef/chicken liver, caffeine, red wine, beer, cheese (except cottage cheese), raisins, sausages, pepperoni, yogurt, sour cream. Don t give atropine for glaucoma it increases IOP Don t give ant-acids with food -- b/c it delays gastric emptying. Don t give Stadol to Methadone/Heroin Preggo s -- cause instant withdrawal symptoms Insulin clear before cloudy Don t give meperidine (Demerol) to pancreatitis patients Always verify bowel sounds when giving Kayexelate Hypercalcemia = hypophosphatemia (and vice versa) Radioactive Dye urine excretion Signs of toxic ammonia levels is asterixis (hands flapping) D10W can be substituted for TPN (temporary use) Dopamine and Lasix are incompatible Hypoglycemic shivers can be stopped by holding the limb, seizures cannot (infants) Common symptom of aluminum hydroxide constipation Thiazide diuretics may induce hyperglycemia Take iron with Vit C it enhances absorbtion Do not take with milk B1 - For Alcoholic Patients (to prevent Wernicke s encephalopathy & Korsakoff s synd) B6 - For TB Patients B9 - For Pregnant Patients B12 - Pernicious anemia, Vegetarians. Complications of Coumadin - 3H s - Hemorrhage, hematuria & hepatitis FFP is administered to DIC b/c of the clotting Fx Mannitol (osmtic diuretic [Head injury]) crystallizes at room temp use a filter needle Antianxiety medication is pharmacologically similar to alcohol used for weaning Tx Administrate Glucagon when pt is hypoglycemia and unresponsive Phenazopyridine ( Pyridium)--Urine will appear orange

Rifampicin -- Red-urine, tears, sweat) Hot and Dry = sugar high (hyperglycemia) Cold and clammy = need some candy (hypoglycemia) Med of choice for V-tach is lidocaine Med of choice for SVT = adenosine or adenocard Med of choice for Asystole = atropine Med of choice for CHF is Ace inhibitor. Med of choice for anaphylactic shock is Epinephrine Med of choice for Status Epilepticus is Valium. Med of choice for bipolar is lithium. Give ACE inhibitors w/food to prevent stomach upset Administer diuretics in the morning Give Lipitor at 1700 since the enzymes work best during the evenin Common Tricyclic Meds - 3 syllabes (pamelor, elavil) Common MAOI s - 2 syllables (nardil, marplan) TPN has a dedicated line & cannot be mixed ahead of time RHoGAM -- Given at 28 weeks & 72 hrs postpartum Do not administer erythromycin to Multiple Sclerosis pt Benadryl and Xanax taken together will cause additive effects. Can't take Lasix if allergic to Sulfa drugs. Acetaminophen can be used for headache when the client is using nitroglycerin. Dilantin - cannot give with dextrose. Only give with NS. Addison is skinny ( hypoglycemic, you get weight loss, you got weakness, and you get postural hypotn) Cushing is fat ( hyperglycemic, you get moon face big cheeks, and you retain a lot of Na and fluid) Never Give via IVP: o KCL o Heparin o Ibuprofen o Insulin o Dobutamine o ASA o Albumin o Acetaminophen Insulin: o Rapid: lispro onset <15 min. Peak: 1 hr. Duration 3hr o Short: Regular onset - 1 hr. Peak: 2-3hr. D: 4-6 hr o Int: NPH or Lente onset: 2 hr. Peak 6-12 hr. D: 16-24hr o Long: Ultralente onset 4-6 hr. Peak: 12-16 hr. D: >24hr o V.Long: Lantus onset 1 hr. Peak: None. D: 24 hr continuous Anticholergic Side Effects: o Can t See o Can t Pee o Can t Spit o Can t Sh*t Hypocalcemia CATS C -convulsions A -arrythmias T -tetany

-spasms & Stridor

Hyper Kalemia Causes: MACHINE M -medications (ace inhibitors, NSAIDS) A -acidosis (metabolic & repiratory) C -cellular destruction (burns, traumatic injury) H -hypoaldosteronism, Hemolysis N -nephrons, renal failure E -excretion (impaired) Signs of increased K Murder M -muscle weaknes U -urine olyguria, anuria R -respiratory distress D -decreaed cardiac contractility E -ECG Changes R -reflexes hyperreflexia, or flaccid Substance Poisoning and Antidotes o Methanol Ethanol o CO2 Oxygen o Dopamine Phentolamine o Benzo s (Versed) Flumazenil o Lead -- Succimer, Calcium Disodium o Iron Deferoxamine o Coumadin -- Vitamin K o Heparin -- Protamine Sulfate o Thorazine Cogentine o Wild Mushrooms Atropine o Rat Poison - Vit K DROPLET PRECAUTION think of SPIDERMAN! S - Sepsis S - Scarlet fever S - Streptococcal pharyngitis P - Parvovirus B19 P - Pertussis P - Pneumonia I - Influenza D - Diptheria (Pharyngeal) E - Epiglottitis R - Rubella M - Mumps M - Meningitis M - Mycoplasma or meningeal pneumonia An - Adenovirus Private room Mask Parkland Formula: 4cc * Kg * BSA Burned = Total Volume Necessary o 1st 8hrs total volume o 2nd 8hrs total volume o 3rd 8 hrs total volumes Transmission-based Precautions: ADC A - Airborne D - Droplet C - Contact AIRBORNE PRECAUTION My - Measles Chicken - Chickenpox Hez - Herpes Zoster (Disseminated) TB - TB Private room Negative pressure with 6-12 air exchanges per hour UV Mask N95 Mask for TB CONTACT PRECAUTION MRS.WEE M - Multidrug resistant organism R - Respiratory infection - RSV S - Skin infections W - Wound infections E - Enteric infections - clostridium defficile E - Eye infections Skin Infections: V - Varicella zoster C - Cutaneous diptheria H - Herpes simplex I - Impetigo P - Pediculosis S - Scabies, Staphylococcus Private room Gloves Gown

NCLEX WALK-THROUGH
POINTERS Mitral Stenosis Ask: What childhood illness did you had Myasthenia Gravis Ptosis Don t mix long acting insulin with regular insulin Ondansetron decreases nausea and vomiting Cyclosporin Avoid grapefruit juice AV Fistula Take BP on the other arm of the patient Fifth s Disease Sore throat Headache Slapped cheek appearance Rubella Droplet precaution Huntington s Disease Premature Ventricular Contraction Lidocaine Bumex diuretic Check client s potassium level Simvastatin Taken after dinner Paracentesis Check the client s w t 3-4 y/o child able to walk downstairs with alternating feet BPH Increase urination at night Alendronate Sit upright for 30 mins. After taking the drug Ticlid Causes bleeding Meningocele Cover with wet gauze Diabetic Ketoacidosis .9% saline dextrose solution (+) Trousseu paresthesia of hands and feet Asthma Priority: inaudible wheezing Peritoneal yellowish outflow

ACE inhibitor Needs further teaching if patient says: I will avoid exposure to sun Breast Cancer Caucasian women Had 1st child at 35 y/o Mother died of cancer Kidney rejection Swelling and tenderness at surgical site Coumadin Avoid green leafy vegetables Traction Observe for purulent drainage Hepatitis A Day care center teacher (most at risk) Chest physiotherapy wear light clothing Patient with fracture admitted for casting immobilize the fracture Electroconvulsive Therapy (ECT) common complication: headache SATA Meniere s Disease hearing loss vertigo tinnitus Cast care petal the edges assess the distal pulses use palm of the hand Kawasaki Disease fever desquamation pf palm lymphadenopathy Multiple sclerosis diplopia ataxia decrease sensation muscle weakness Botox needs to be repeated in 3 mos. Causes headache, botulism, muscle paralysis Use warm compress Mycoplasmal pneumonia Nurse wears mask before entering patient s room Patient wears mask when leaving his room Handwashing Private room Type II DM Risk: obesity, family history, history of gestational diabetes, above 40 y/o Lead Poisoning father is a plumber lives in a house built in 50 s

colorful toys Kidney Transplant rejection fever (38oC) red swollen graft CVA tenderness Carbon Monoxide Poisoning teary eyes headache irritability mask-like face Superior Vena Cava Syndrome neck edema peritoneal edema arm edema T6 Injury check bowel & bladder function Fluorinef Effect: normal BP for client with Addison s Cane elbow flexed at 45o Accolate dilates bronchioles Premature rupture of membrane Assess fetal hear rate Deep vein thrombosis leg pain not relieved by rest Pacemaker stand 5 ft away from microwave Kayexalate abdominal cramps (Hypokalemia) Tofu rich in calcium Bacterial Meningitis nucchal rigidity restlessness (+)Kernig s sign Petechial rash over the chest Latex allergy Avoid: avocado, banana, chestnut, kiwi, pineapple, strawberries Fosamax given before meal remain standing for 30 mins, after taking Glaucoma miotics Hypoparathyroidism Diet: high in Calcium; Low in Phosphorous Alport Syndrome tea-colored urine Harlequin Syndrome Priority: check the BP Internal Disaster injured client Priority: patient with GCS=13 Bone Scan increase fluid intake 3-4 glasses Moslem client

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turn head southeast Thyroid crisis tachycardia fever Enalapril - avoid salt substitute Ciprofloxacin check liver function test Ephosphamide increase fluid intake check renal function test Vancomycin check creatinine Depress patient elated after 2 days risk for suicide Simvastatin hepatotoxic Aspirin toxicity respiratory alkalosis Eurax massage:pediculosis Steroid ointment remove the excess before applying the new one Ribavirin administer with oxygen tent fetotoxic MaHuang immune stimulant DiHuang check sugar level

TRIAGE
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1st to visit: client with laryngectomy st Seen 1 : Patient with multiple sclerosis who is drooling st 1 to visit: clent with CHF whoi reports coughing out of frothy sputum st Seen 1 : chest pain with history of angina st Assess 1 : client with subdural hematoma st Seen 1 : OB multipara with 6am dilation Hemorrhagic shock: EMERGENT Feeding client with dementia can be delegated to nsg. Assistant Female patient complaining of sexual assault sent to treatment room from ER

DISCHARGE INSTRUCTION
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MAO avoid cold counter remedies Finasteride instruct client s wife not to touch the tablet Anticoagulant avoid aspirin Hemoglobin level of 8 increase dietary iron 3 y/o with imaginary playmate disappears when older Coumadin avoid aspirin

Heart failure take patient s w t at the same time everyday

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