Rx: Meridia

(ANTIOBESITY)
SIBUTRAMINE HCL
(ANTISIBU- ANTI SEBO :)
10 mg OD with or without food
Sideeffects:
...M igraine
E ar pain
R ash
I ncrease appetite
D yspepsia
I increase thirst
A norexia

Adverse effects: (Report to the doctor)
Seizure, ecchymosis and liver damage
Monitor LFT: ALT or SGPT (Hepatotoxic)

Highly Active Antiretroviral Therapy

HAART is the name given to aggressive treatment regimens used to suppress HIV viral replication and the progression of HIV disease. The regimen combines t 3 or more different drugs ...such as 2 nucleoside reverse transcriptase inhibitors (NRTIs) & a protease inhibitor (PI), two NRTIs and a non-nucleoside reverse transcriptase inhibitor (NNRTI)

Addisons Disease

A utoimmune
D ecrease adrenal hormones
D ecrease fluids and sodium
I ncrease pigmentation... See More
S evere weakness
O ral intake of corticosteroids for life
N eed to increase salt and fluids (potato chips)

SOMA

SOMA (CARISOPRODOL)
for muscle pain and spasm :)

S keletaL muscle relaxant
O ral intake with a full glass of water
M edications that causes CNS down must be avoided
A void drinking alcohol

SINUSITIS

SINUSITIS
Sinusitis is a condition consisting of inflammation of the paranasal sinuses, which may or may not be as a result of infection, from bacterial, fungal, viral, allergic or autoimmune

HFQ: DIET FOR SINUSITIS
Patients should take a balanced diet. Most persons with sinus trouble also suffer from acidity. Their diet should, therefore; veer to the alkaline side. The intake of salt should be reduced to the minimum as salt leads to accumulation of water in the tissues and expels calcium from the body.

In the acute stage of the disease, when fever is pre¬sent, the patient should abstain from all solid foods and only drink fresh fruit and vegetable juices diluted with water in the proportion of 50:50. After the fever subsides, he may adopt a low-calorie raw fruit and vegetable diet with plenty of raw juices.

After the acute symptoms are over, the patient may gradually embark upon a well-balanced diet of three basic food groups, namely seeds, nuts and grains; vegetables and fruits. In persistent chronic conditions, repeated short juice fasts may be undertaken for a week or so at intervals of two months.

PERSANTIN STRESS TEST

PERSANTIN STRESS TEST
is a test where pictures are taken of your heart muscle.

This test helps to diagnose a CAD. This test helps caregivers see areas of the heart muscle that do not get enough blood supply. The test can also show areas that have been damaged after a heart attack (PERSANTIN)

P regnancy is a contraindication to this procedure
E ating is restricted 6H PTP
R efrain from caffein
S smoking must be avoided
A ssess allergy to persantin
N o to sports drinks
T hallium is a a radioisotope that will also be injected
I V line must be patent
N uclear medicine department - location of the procedure

IMPETIGO

IMPETIGO (SATA)

I mpetigo contagiosa (highly contagious)
M outh and face - most common site
P ustules & vesicles - appearance of lesion progressing to an
E xudative and crusting stage
T reatment - ABT - antibiotic therapy
I solation precaution is CONTACT (GGG)
G ABHS or staph auresus - agent
O ral ABT, ointment and PHISOHEX are included in the Tx

ZETIA

ZETIA (EZETIMIBE)
♥ ♥ ♥

Z...etia is an anticholesterol drug
E...zetimibe is the generic name
T...ime of effectiveness (2 weeks)
I... nstruct to report muscle pain
....Zetia increases skeletal muscle break down
A...void during pregnancy, kidney failure and allergy to Zetia

report myalgia since zetia increases skeletal muscle breakdown

Laryngitis

L aryngeal inflammation which causes hoarseness of voice
A lcohol, viruses, bacteria (SY) are the causes
R esults from overuse of the vocal cords
Y in (cold) drinks must be avoided
N o alcohol and smoking
G ive warm, soothing liquids
I hale steam from a bowl of hot water
T hroat lozenges and nonprescription pain reliever
I instruct to complete ANTIBIOTIC therapy
S peaking in public must be avoided during recovery ♥

mnemonics

VEAL CHOP about fetal accelerations and decelerations!
Variable - Cord compression
Early - Head compression
Accelerations - OK
Late - Placental insufficiency

To assess the postpartum pt. think BUBBLE

B-breast
U-uterus
B-Bowels
B-bonding
L-lochia
E-episiotomy

S/E of Pitocin

P= pressure is elevated
I= intake and output
T= tetanic contractions
O=O2 decreases in fetus
C=cardiac arrhythmia
I=Irregularity in fetal heart rate
N=N/V

INTRAUTERINE DEVICES (IUD) - complications

P - Period late; abnormal spotting or bleeding
A - Abdominal pain; pain with coitus
I - Infection exposure, abnormal vaginal discharge
N - Not feeling well, fever or chills
S - String missing, shorter or longer

POSPARTUM COMPLICATIONS: Ms.PITCH
M=mastitis
S=subinvolution

P=pulmonary embolism
I=infection
T=thrombophlebitis
C=cystitis
H=hematoma

SPECIAL assessment for Mastitis, pospartum complication
S=swelling
P=pain
E=elevated temperature
C=complain of flu like symptoms
I=infxn
A=and
L=localized heat

mnemonics

For glaucoma:
C- close angle glaucoma
H- halo vision
O- open angle glaucoma
P- peripheral vision loss/ tunnel vision


S/S that may be associated with child 'CANCER'

C=continued unexplained wt. loss
H=headaches,often with vomiting at night or early morning
I=increased swelling, persistent pain in bones,joints back,legs
L=lump or mass, ( abdomen,neck,chest,pelvic,armpits)
D=development of excessive bruising,bleeding and rash

C=constant infxn.
A=a whitish color behind the pupil
N=nausea wich persist or vomiting w/o nausea
C=constant tiredness or noticeable paleness
E=eye or vision changes
R=recurrent fever of unknown origin

Muscuskletal Tx. prices/rice

P= pressure
R=rest
I=ice
C=compression
E=elevation
S=support

R=rest
I=ice
C=compression
E=elevation


Assistive devices -- Canes:

C Cane
O Opposite
A Affected
L Leg

CHOLECYCTITIS/CHOLELITHIASIS, remember 5 F's

F - female
F - forty (40 yr olds)
F - Fat (obesity)
F - Fried foods
F - Fertile (with increased risk in pregnancy)

Pulmonary Edema tx= MAD DOG:

M=Morphine
A=aminophylline
D=digoxin

D=diuretic
O=O2
G=Gases (ABG's)


REMEMBER: PNEUMONIA

P - Position for Comfort
N - Nutritional Support
E - Ensure Proper Sputum Disposal
U - Use Isolation Technique
M - Many Cultures
O - Omit Going to Public Places
N - No Smoking
I - Inverse Oral Fluids
A - Antibiotics

Care Management for MYASTHENIA GRAVIS

G - Go check muscle Strength
R - Respiratory monitoring
A - Anticholinesterase drugs
V - Ventilatory Support
I - Instruct to avoid stress
S - See for crisis
a.) Myasthenic Crisis
b.) Cholinergic Crisis
C.) Brittle Crisis

Signs of a Cholinergic Crisis, think SLUD:

S Salivation
L Lacrimation
U Urination
D Defication


Common causes for increased levels of bilirubin: HOT LIVER

H=hemolysis
O= obstruction
T=tumor
L=liver dse.

Pylori treatment regimen: TOMB

T=tetracycline
O=omeprazole
M=metronidazole
B=bismuth

Symptoms of Hyperthyroidism: STING

S=sweating
T= tremors/tachycardia
I=intolerance to heat
N=nervousness
G=goiter and gastrointestinal ( loose stool /diarrhea)

A way to remember the eyes is:
You look OUt with Both eyes.
Take the Right dose so you won't OD [overdose].
The only one that is Left is OS.
Both eyes=OU, Right eye=OD, Left eye=OS


Diabetes

Hot and Dry : sugar high
Cold and clammy : need some candy

To remember side effects & adverse reactions to immunizations:

F- Fever
I- Itching
S- Stiffness
H- Headache
E- Edema
R- Redness
F- Fussy
L- Localized Tenderness
A- Appetite decrease
G- General Aches Pains

W- Wheezing
H- Hypotension
U- Uticaria
N- Nasal Decongestion
T- Tachycardia

mnemonics

12 cranial nerves:

Oh -olfactory
Oh -optic
Oh -ocuomotor
to -trochlear
touch -trigeminal
and -abducens
feel a -facial
very -vestibulocochlear
good -glossopharyngeal
victory -vagus
seems -spinal accessory
heaven -hypoglossal

S - SENSORY, M-MOTOR, B-BOTH S&M.

so.. the 12 CN will be..

O - SOME
O - SAYS
O - MAKE
T - MONEY
T - BUT
A - MY
F - BROTHER
A - SAYS
G - BIG
V - BOOBS
S - MAKES
H - MONEY

mnemonics

Mag Sulfate
( Sung to the tune of "Achy,Breaky Heart")

Decreased BP,
Decreased Pee Pee,
These are toxic signs of Mag Sulfate.
Drop in respiratory rate,
Patellar reflex there ain't,
Give antidote calcium gluconate!

Antidotes:

In Heaven, there is Peace (Heparin - Protamine sulfate)
In War, there is Killing (Warfarin - Vit. K)


Spinal Meds: Little Boys Prefers Toys

Little - Lidocaine,
Boys - Bupivicaine,
Prefer - Procaine,
Toys - Tetracaine

Side effects of steroids. The 5 S's:
Sick- easier to get sick
Sad-causes depression
Sex-increases libido
Salt-retains more and causes weight gain
Sugar-raises blood sugar

Narcan is a NARCotic ANtagonist

mnemonics

To remember the clinical findings associated w/UTI think urinary tract is FULL of infection:

F-frequent urge to void
U-urine that is foul smelling and cloudy
L-low grade fever
L-lethargy


No P No K.

If the patient isn't peeing, they are probably retaining potassium, therefore they shouldn't be getting it.

Nursing Considerations for renal failure --KIDNEY:

K - Keeping fluid balance
I - Inspecting the skin for Pruritus
D - Dietary Instructions
N - No to Acidosis
E - Electrolyte imbalance maintainance
Y - Your blood counts

ASSESSMENT on dehydration

D=dry skin & mucous membrane
E=eyeball/fontannel sunken
H=hypotension
Y= you feel coolness/mottling of the extremeties
D=delayed capillary filling time
R= response to stimuli/LOC changes
A= absence of tears
T=tachycardia
I=increase urine specific gravity
O=oliguria
N=no/loss skin turgor and elasticity

mnemonics

ASSESSTMENT FOR:

HYPOCALCEMIA = CATS

C=convulsion
A=arythmias
T=tetany
S=spasm and stridor

HYPERNATREMIA = SALT FRIED

S=skin flushed ( fever)
A=agitation
L=low grade fever
T=thirst

also,
F=fever (low grade) flushed skin
R=restless ,irritable
I= increased fluid retention,increased BP
E= edema
D= decreased urinary output

HYPONATREMIA = SALT LOSS

S=stupor/coma
A=anorexia,n/v
L=lethargy
T=tendon reflex decreased

also,
L= limp muscle(weakness)
O=orthostatic hypotension
S=seizure/headache
S=stomach cramping

HYPERKALEMIA = MACHINE

M=medication(ACE inhibitors,NSAIDS)
A=acidosis(metabolic,respiratory)
C=cellular destruction(burns,traumatic injury)
H=hypoaldosteron,hemolysis
I= intake -excessive
N=nephrons,renal failure
E=excretion impaired

mnemonics

When a child has a cyanotic heart defect,check for the
"4'C's"

C-cyanosis,especially increasing with crying
C-crabbiness or irritability
C-clubbing of digits
C-crouching or squating,which increase systemic venous return,shunt blood from extremeties to the head and trunk and decrease cyanosis

S/S OF MI(myocardial infarction)- think of DANCE PAD....

D-dyspnea
A-anxiety
N-nausea/vomiting
C-crushing substernal chestpain
E-elevated temp.

P-pallor
A-arrythmias
D-diaporesis

Immediate tx for MI remember MOAN (like when patient has that crushing chestpain, he'll moan!):
Morphine, Oxygen, ASA, Nitroglycerine

Mnemonic for remembering "antiarrhythmics" DRUGS

CLASS IA
procainamide = professor
quinidine = quackers
disopyramide= dissed/dismiss

CLASS IB
lidocaine = lydia's
phenytoin = penny
mexiletine = mexican
tocainide = tacos

CLASS IC
flecainide = feeling
propafenone= profaned

CLASS II
propanolol = proper
beta blockers = bertha butt

CLASS III
amiodarone = amiable
bretylium = british
solatol = socialite

CLASS IV
verapamil = virtually
diltiazem = dismembered 'im

READ AS: Pofessor Quackers"dissed" - Lydia's penny Mexican tacos. Feeling profaned,proper Bertha butt,(amiable British socialite), virtually dismembered 'im!

"Cardio selective"( A BEAM)

A= acebutolol
B=betaxolol
E=esmolol
A=atenolol
M=metoprolol

"Beta receptor activity"

one- heart two - lungs

Beta 1= primarily on heart

airway is Beta 2 receptors

Treatment of CHF, think UNLOAD FAST:

U sit Upright
N Nitro
L Lasix
O Oxygen
A Aminophylline
D Digoxin

F Fluids- decrease
A Afterload - decrease
S Sodium - decrease
T Tests: dig level, ABG, K+

5 T's of early Cyanosis

T= tetralogy,transposition,truncus,total anomalous,triscuspid atresia.

REMEMBER...for HYPERTENSION:

H - Health Education
Y - Your diet is concern (low caloric & low fat diet)
P - Pressure Monitoring
E - Exercise
R - Rest and Relaxation
T - Take Medication
E - Eliminate Salt
N - No Smoking
S - Stress Reducing Technique
I - Inhibit Coffee & Stimulants
O - Observe for Complications
N - Never Forget to Take Medication

Foods high in sodium:

P-processed foods
M-moo foods (dairy)
S- salty tasting

NCLEX sample q's 103

1. A nurse is reviewing a patient’s medication during shift change. Which of the following medication would be contraindicated if the patient were pregnant? Note: More than one answer may be correct.

A: Coumadin

B: Finasteride

C: Celebrex

D: Catapress

E: Habitrol

F: Clofazimine

2. A nurse is reviewing a patient’s PMH. The history indicates photosensitive reactions to medications. Which of the following drugs has not been associated with photosensitive reactions? Note: More than one answer may be correct.

A: Cipro

B: Sulfonamide

C: Noroxin

D: Bactrim

E: Accutane

F: Nitrodur

3. A patient tells you that her urine is starting to look discolored. If you believe this change is due to medication, which of the following patient’s medication does not cause urine discoloration?

A: Sulfasalazine

B: Levodopa

C: Phenolphthalein

D: Aspirin

4. You are responsible for reviewing the nursing unit’s refrigerator. If you found the following drug in the refrigerator it should be removed from the refrigerator’s contents?

A: Corgard

B: Humulin (injection)

C: Urokinase

D: Epogen (injection)

5. A 34 year old female has recently been diagnosed with an autoimmune disease. She has also recently discovered that she is pregnant. Which of the following is the only immunoglobulin that will provide protection to the fetus in the womb?

A: IgA

B: IgD

C: IgE

D: IgG

6. A second year nursing student has just suffered a needlestick while working with a patient that is positive for AIDS. Which of the following is the most important action that nursing student should take?

A: Immediately see a social worker

B: Start prophylactic AZT treatment

C: Start prophylactic Pentamide treatment

D: Seek counseling

7. A thirty five year old male has been an insulin-dependent diabetic for five years and now is unable to urinate. Which of the following would you most likely suspect?

A: Atherosclerosis

B: Diabetic nephropathy

C: Autonomic neuropathy

D: Somatic neuropathy

8. You are taking the history of a 14 year old girl who has a (BMI) of 18. The girl reports inability to eat, induced vomiting and severe constipation. Which of the following would you most likely suspect?

A: Multiple sclerosis

B: Anorexia nervosa

C: Bulimia

D: Systemic sclerosis

9. A 24 year old female is admitted to the ER for confusion. This patient has a history of a myeloma diagnosis, constipation, intense abdominal pain, and polyuria. Which of the following would you most likely suspect?

A: Diverticulosis

B: Hypercalcaemia

C: Hypocalcaemia

D: Irritable bowel syndrome

10. Rho gam is most often used to treat____ mothers that have a ____ infant.

A: RH positive, RH positive

B: RH positive, RH negative

C: RH negative, RH positive

D: RH negative, RH negative

Answer Key

1. (A) and (B) are both contraindicated with pregnancy.

2. (F) All of the others have can cause photosensitivity reactions.

3. (D) All of the others can cause urine discoloration.

4. (A) Corgard could be removed from the refigerator.

5. (D) IgG is the only immunoglobulin that can cross the placental barrier.

6. (B) AZT treatment is the most critical innervention.

7. (C) Autonomic neuropathy can cause inability to urinate.

8. (B) All of the clinical signs and systems point to a condition of anorexia nervosa.

9. (B) Hypercalcaemia can cause polyuria, severe abdominal pain, and confusion.

10. (C) Rho gam prevents the production of anti-RH antibodies in the mother that has a Rh positive fetus.

NCLEX Pharma

1. Muscarinic Agonists

A. Bethanecol (URECHOLINE) – increase GI motility

B. Carbachol (ISOPTO, MIOSTAT, CARBACHOL) – various types of glaucoma

C. Methacholine (PROVOCHOLINE) – test hyperactivity of airways

D. Pilocarpine – used for glaucoma

2. Anticholinesterases

A. Pysostigmine (ANTILIRIUM) – treat glaucoma, crosses BBB, reverse anticholinergic toxicity.

B. Neostigmine (PROSTIGMIN) – synthetic form of Pysostigmine

(Anticholinesterases) – used for Myasthenia gravis, glaucoma, and to increase tone in bladder

Symptoms of Anticholinesterase toxicity:

1. Miosis
2. Rhinitis
3. Bradycardia
4. GI spasms
5. brochoconstriction
6. involuntary voiding of urine

Mnemonics 01

MI management: MONA
Morphine
O2
Nitroglycerine
Aspirin

HYPOGLYCEMIA: TIRED
T Tired
I Irritability
R Restless
E Excessive hunger
D Diaphoresis-Depression

HEART MURMURS: SPASM
S Stenosis
P Partial obstruction
A Aneurysms
S Septal defect
M Mitral regurgitation

Hyperthyroidism (s/s)
THYROIDISM
Tremor
Heart rate up
Yawning (fatigueability)
Restlessness
Oligomenorrhea & amenorrhea
Intolerance to heat
Diarrhea
Irritability
Sweating
Muscle wasting & weight loss

Miotic: Little word=Little pupil
Mydriatic: Big word=Big pupil

Anticholingergics Side Effects:
Can't see
Can't pee
Can't spit
Can't sh*t

5W's of common causes of post-op fever

Wind (think pneumonia, splinting, incentive spirometer exercises not done, DB+ coughing not done)
Water (dehydration...)
Wound (infection, dehiscence...)
Walking (PE...)
Wonder drug (approriate antibiotic...)

Cranial Nerves

Oh Olfactory Some
Oh Optic Say
Oh Oculomotor Marry
To Trochlear Money
Touch Trigeminal But
And Abducens My
Feel Facial Brother
Virgin Vestibulocochlear Says
Girl's Glossopharangeal Big
Violins Vagus Breasts
Ah Accessory Mean
Heaven Hypoglossal More

For the third column, S stands for sensory, M for motor, and B is both. Also, you have one nose, so Olfactory is CNI, two eyes, so optic is CNII. To remember which order the As come in, ABducens comes before ACcessory alphabetically.

Acute Pancreatitis: I GET SMASHED

I - idiopathic
G - gallstone
E - EtOH
T - trauma
S - steroids
M - mumps (paramyxovirus) and other viruses (EBV, CMV)
A - autoimmune
S - scorpion sting / snake bite
H - hypercalcemia, hyperlipidemia and hypothermia
E - ERCP
D - drugs, duodenal ulcers

To apply a telemetry monitor:
White over right (top right shoulder)
Black beside the white (Over lt shoulder)
Checkers (red below the black)
Christmas (Green beside the red)
Then ofcourse, the brown will be in the middle!

The HYPERKALEMIA "Machine" - Causes of Increased Serum K+
M - Medications - ACE inhibitors, NSAIDS
A - Acidosis - Metabolic and respiratory
C - Cellular destruction - Burns, traumatic injury
H - Hypoaldosteronism, hemolysis
I - Intake - Excesssive
N - Nephrons, renal failure
E - Excretion - Impaired


Signs and Symptoms of Increased Serum K+: MURDER
M - Muscle weakness
U - Urine, oliguria, anuria
R- Respiratory distress
D - Decreased cardiac contractility
E - ECG changes
R - Reflexes, hyperreflexia, or areflexia (flaccid)

HYPERNATREMIA
"You Are Fried"

F - Fever (low grade), flushed skin
R - Restless (irritable)
I - Increased fluid retention and increased BP
E - Edema (peripheral and pitting)
D - Decreased urinary output, dry mouth


"CATS" of "HYPOCALCEMIA"

C - Convulsions
A- Arrhythmias
T - Tetany
S - Spasms and stridor

CDC ISOLATION

SAFE WORK PRACTICES

• Keep hands away from face
• Work from clean to dirty
• Limit surfaces touched
• Change when torn or heavily contaminated
• Perform hand hygiene

DISEASES THAT NEED DROPLET ISOLATION:

"DROPLETISMM"

• Diptheria
• Rubella
• Oral (mumps, strep, paryngitis)
• Pertussis
• Legionnaire’s
• Erythema infectiousum, Epiglottitis (Hemaphilus influenza type B)
• Tonsillitis
• Influenza
• Scarlet fever
• Meningitis
• Mycoplasma pneumonia

DISEASES THAT NEED CONTACT PRECAUTION:

• Major drainages
• Bronchiolitis C. difficile (gastroenteritis)
• Congenital Rubella
• Cutaneous diphtheria
• Hepa A (diapered or incontinent patient)
• Herpes zoster (+ airborne)
• Herpes simplex
• Impetigo
• Pediculosis
• Multi-drug resistant organism infection ( MRSA, VRE, VISA, ESBL)
• Eczema
• Scabies
• Major pressure ulcer

DISEASES THAT NEED AIRBORNE PRECAUTION:

• Measles
• SARS
• Smallpox
• Tuberculosis
• Varicella zoster
• Pulmonary / laryngeal diseases