1 oz - ✔✔ 30 mL
1 tsp - ✔✔ 5mL
1 tbsp - ✔✔ 15 mL
1 tbsp - ✔✔ 3 tsp
1 kg - ✔✔ 2.2 lbs
Dosages by weight -
... [Show More] ✔✔ a nurse is preparing 8 mg/kg/day to divide equally every 12 hours to a toddler that weighs 22 lb. Available is 100mg/5mL. How many mL should the nurse administer per dose?
2.2 lb/1 kg = client's desired weight in lb/X kg
so for example, a 22 lb toddler would weigh 10 kg.
mg*kg/day= X
8 mg* 10 kg/1 day = 80 mg/day or 40 mg every 12hr
have/quanity = desired/X
100mg/5mL = 40 mg/xmL
x= 2
so 2 mL PO every 12 hours (Page 20)
Tetracyclines - ✔✔ Antibiotics
Doxycycline
Minocycline
Demeclocycline
Expected Action Tetracyclines - ✔✔ inhibit micro-organism growth by preventing protein synthesis (bacteriostatic)
Tetracyclines complications - ✔✔ 1. GI discomfort: cramping, NV, diarrhea, esophageal ulceration
-Monitor I&O, suggest taking with meal (doxy./mino.), avoid at bedtime
2. Yellow or brown tooth discoloration, hypoplasia of tooth enamel
-avoid to children and pregnant women
3. Hepatoxicity: lethargy, jaundice
-avoid administration of high daily doses
4. Photosensitivity (intense sunburn)
5. Suprainfection: pseudomembranous colitis (diarrhea), yeast infections of mouth pharynx vagina bowels
-notify if any of these manifest
6. Dizziness, lightheadedness (*mino.)
-take care with ambulation & report
Tetracyclines contraindications - ✔✔ Pregnancy Risk D. Stain teeth of pregnant and children. Use cautiously in liver/kidney disease.
Tetracyclines interactions - ✔✔ milk products, calcium, and iron supplements, laxatives containing magnesium, and antacids cause formation of non absorbable chelates, thus reducing the absorption of tetracyclines. (take on empty stomach with 8 oz water (1 hr before or 2 hr after meals).
Decrease the efficacy of oral contraceptives
Mino and doxy increase risk of digoxin toxicity
Tetracyclines nursing admnistration - ✔✔ -take on empty stomach (Except mino.) with 8 oz of water. It may be taken with food if gastric distress occurs.
-Do not take before lying down because increased risk of esophageal ulceration.
-Maintain 2hr interval between ingestion of chelating agents and tetracyclines
-complete entire course of therapy
-additional contraception
Tetracyclines evaluation of effectiveness - ✔✔ decrease in manifestations of infection such as fever, pain, inflammation, and adventitious breath sounds. Resolutions of yeast infections of mouth, vagina, and bowels. Resolution of acne vulgaris.
Identifying a causative agent to select antimicrobials - ✔✔ lab testing of body fluids, such as blood, urine, sputum, and wound drainage to identify the micro-organism causing the infection.
1. Gram Stain: technicians examine an aspirate of body fluid under a microscope
2. Culture: colonies of microorganisms grow under several days
Varicella (Chicken Pox) mild adverse effects - ✔✔ tenderness and swelling at injection site
fever
rash for up to 1 month after immunization
Varicella (Chicken Pox) moderate adverse effects - ✔✔ seizures
Varicella (Chicken Pox) severe adverse effects - ✔✔ pneumonia, low BC, severe brain reactions
Varicella (Chicken Pox) contraindications - ✔✔ pregnancy, anaphylactic section to gelatin or neomycin
Varicella (Chicken Pox) precautions - ✔✔ transfusion with blood product containing antibodies within the prior 11 months, tx with antiviral med within 24 hr prior to immunization (avoid taking antivirals for 14 days following immunization), extended use (2 weeks or longer) of corticosteroids or other meds that can affect IS, cancer
ANTIDIURETIC HORMONE - ✔✔ vasopressin, desmopressin
ANTIDIURETIC HORMONE
vasopressin, desmopressin
purpose - ✔✔ reabsorption of water within the kidney.
-Vasopressin stimulates the potent action of ADH (vasoconstriction due to contraction of smooth muscle)
-Desmopressin causes much less vasoconstriction
ANTIDIURETIC HORMONE
vasopressin, desmopressin
complications - ✔✔ 1. Reabsorption of too much water:
-monitor for indications of over hydration (Sleepiness, pounding ha). Notify
-Reduce fluid intake
-Smallest effective dose
2. Myocardial Ischemia
-from excessive vasoconstriction (vasopressin)
-monitor ECG and blood pressure. notify of chest pain, tightness, or diaphoresis.
ANTIDIURETIC HORMONE
vasopressin, desmopressin
contraindications - ✔✔ -CAD (risk for angina, MI) decreased peripheral circulation or chronic nephritis
-renal impairment use with caution . If creatinine clearance is less than 50mL/min do not administer.
ANTIDIURETIC HORMONE
vasopressin, desmopressin
interactions - ✔✔ carbamazepine & tricyclic antidepressants can increase action
concurrent use of alcohol, heparin, lithium, and phenytoin can decrease ADH effects
ANTIDIURETIC HORMONE
vasopressin, desmopressin
admin - ✔✔ monitor VS, central venous pressure, I&O, specific gravity, and lab studies (K, Na, BUN, creatinine, specific gravity, osmolality)
monitor BP/heart rate
monitor for headache, confusion, etc.. (water intox)
for IV vasopressin watch for extravasation which can lead to gangrene
intranasal desmopressin starts at bedtime and I&O is monitored and when nocturne is controlled doses are given twice daily
ANTIDIURETIC HORMONE
vasopressin, desmopressin
effectiveness - ✔✔ reduction in large volumes of urine output associated with DI to normal levels of urine output (1.5 to 2L/24 hr) OR cardiac arrest survival
ANTIDIURETIC HORMONE
vasopressin, desmopressin
use/routes - ✔✔ treat diabetes insidious (mainly desmopressin), vasopressin is sometimes used during CPR to temporarily decrease blood flow to the periphery and increase flow to brain and heart
D: oral, intranasal, SQ, IV
V: SQ, IM, IV
Thyroid Hormone - ✔✔ Levothyroxine (T4)
Levothyroxine (T4) Expected - ✔✔ increase metabolic rate, protein synthesis, cardiac output, renal perfusion, oxygen use, body temperature, blood volume, and growth processes
Levothyroxine (T4) uses - ✔✔ tx of hypothyroidism
emergency tx of myxedema coma (IV) a severe deficiency of thyroid hormone
-give either PO or IV
Complications of Levothyroxine (T4) - ✔✔ 1. Overmedication
-hyperthyroidism (anxiety tachycardia, palpitations, altered appetite, abdominal cramping, heat intolerance, fever, diaphoresis, weight loss, menstrual irregularities.. REPORT)
2. Chronic Overtreatment
-Atrial Fibrillation and an increased risk of fractures from bone loss especially in older adults (TSH levels should be monitored at least once a year) [Show Less]