Term
Mr. Jones is a 70 y/o in ED w/ epigastric pain, n/v, & decrease appetite. Smokes 1 pack/day, drinks 3-4 beers a night. Admits to chewing enteric coated acid to relieve a severe head ache.
What's important? |
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Definition
- Crushed EC
- History of smoking |
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Term
| Why does it matter if he chews an EC tablet? |
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Definition
| They are not meant to be digested in the stomach, but rather in the alkaline environment of the small intestine. Because he chewed it, the digestion in the tummy can cause gastritis. |
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Term
| Why does it matter if he smokes or drinks? |
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Definition
| Alcohol and smoking aggravate his gastritis. |
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Term
68 y/o has annorexia, diarrhea, n/v, a HR of 48, cardiac dysrhythmias, heart attack, malaise, confusion, and is seeing yellow halos. Has not had his dig levels checked because he is not feeling well.
The man takes lanoxin, furosemide, ASA, and ibuprofen.
Blood tests reveal potassium level is 2.9 and digoxin is 2.1
What is important? |
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Definition
- HR = 48
- No lab work done recently
- Digoxin = 2.1
- Potassium = 2.9 |
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Term
| Why are normal blood levels for potassium & digoxin? Is he abnormal? What does this mean? |
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Definition
Digoxin = 0.8-2.0 ng/ml
Potassium 3.7 - 5.2 ng/ml
HIGH DIGOXIN, LOW POTASSIUM
LOW THERPEUTIC WINDOW = MONITOR CLOSELY |
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Term
| What leads us to believe his is dig toxic? |
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Definition
- Seeing yellow halos
- Bradycardia
- Has not had levels drawn recently
- Hypokalemia |
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Term
| What does potassium have to do with dig toxicity? |
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Definition
| K and Dig fight for binding spots on the Na+/K pump so a lessened amount of potassium leads to more availability of dig which leads to toxicity. |
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Term
58 y/o admitted with streptococcus pneumonia pneumonia. Is prescribed IV of Vancomycin (1 g/every 12 hours)
What is important? |
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Definition
- Prescribed vancomycin. Has narrow therapeutic index so his levels should be monitored very closely.
- Peak and trough should be drawn before he gets the medication again. |
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Term
| When the peak/trough is too high _______ occurs. |
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Definition
|
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Term
| When the peak/trough are too low _______ occurs. |
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Definition
|
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Term
| When are peak levels drawn? |
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Definition
|
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Term
| When are trough levels drawn? |
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Definition
| B4 medicine is administered again |
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Term
A client is prescribed a cholinergist AGONIST to treat urinary retention.
What is relevant? |
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Definition
- Baseline vital signs
- Urinary output
- Health history
(peptic ulcer, urinary obstruction asthma) |
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Term
A client is prescribed an adrenergic AGONIST to treat broncho-spasms related to asthma.
What is relevant? |
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Definition
- Baseline vitals
- Monitor for tremors, dizziness, nervousness, restlessness
- Urinary output
- Elevated blood glucose |
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