Drug Classifications The following is a list of the major drug classifications. "Memory tricks" are included where applicable.

A Antianemics: prevention and treatment of anemias Antianginals nitrates: used to treat and prevent attacks of angina; acute treatment calcium channel blockers and beta blockers are used prophylactically for longerterm management Antianxiety agents benzodiazepines: better for intermittent or short-term use in the management of anxiety buspirone, paroxetine, venlafaxine: better for long-term use Antiarrhythmics: suppression of cardiac arrhythmias generally classified by their effects on cardiac conduction tissue (Class IA, IB, IC, II, III & IV) atropine and digoxin: also used as antiarrhymics Antiasthmatics: management of acute and chronic episodes of reversible bronchoconstriction Anticholinergics atropine: bradyarrhythmias ipratropium: bronchospasm atropine: also used as ophthalmic mydriatic benztropine: management of Parkinson's disease Anticoagulants: prevention and treatment of thromboembolic disorders Anticonvulsants: decrease the incidence and severity of seizures due to different etiologies Antidepressants Antidiabetics insulin: type 1 diabetes mellitus oral agents used primarily in type 2 diabetes mellitus Antidiarrheals: for control and symptomatic relief of acute and chronic nonspecific diarrhea Antiemetics: used to manage nausea and vomiting due to many causes, including surgery, anesthesia, and antineoplastic and radiation therapies Antifungals: memory trick - most end with "AZOLE" Antihistamines used for relief of symptoms associated with allergies and as adjunctive therapy in anaphylactic reactions some are used to treat insomnia and Parkinson-like reactions Antihypertensives: including, but not limited to, the following ACE inhibitors: treatment of choice for hypertension; memory trick - most end with "PRIL" angiotension receptor blockers: memory trick - most end with "SARTAN", including losartan (Cozaar), valsartan (Diovan) beta blockers (see below) calcium channel blockers (see below) Anti-infectives: treatment and prophylaxis of various bacterial infections Antineoplastics: used in the treatment of various solid tumors, lymphomas, and leukemias Antiplatelet agents: used to treat and prevent thromboembolic events, e.g., stroke, myocardial infarction Antipsychotics

Antipyretics: used to lower fever of many causes, including infection, inflammation, and neoplasms Antirheumatics: used to manage symptoms of rheumatoid arthritis and slow down joint destruction and preserve joint function Antituberculars: used in the treatment and prevention of tuberculosis Antiulcer agents used in the treatment and prophylaxis of peptic ulcer and gastric hypersecretory conditions, e.g., Zollinger-Ellison syndrome memory trick - most end with "PRAZOLE", including omeprazole (Prilosec), pantoprazole (Protonix), esomeprazole (Nexium) Antivirals: memory trick - many end with "CY[I]CLOVIR", including acyclovir (Zovirax), valacyclovir (Valtrex) Beta blockers: used in the management of hypertension, angina pectoris, tachyarrhythmias, migraine headache (prophylaxis), MI (prevention), glaucoma (opthlalmic use), CHF (carvedilol and sustained-release metoprolol only), hyperthyroidism (management of symptoms only) memory trick - most end with 'OLOL", "ALOL" or "ILOL" Bone resorption inhibitors used to treat and prevent osteoporosis in postmenopausal women also used to treat osteoporosis due to corticosteriod therapy, treatment of Paget's disease of the bone, and management of hypercalcemia Calcium channel blockers used in the treatment of hypertension (amlodipine, diltiazem, felodipine, isradipine, nicardipine, nifedipine, nisoldipine, verapamil) also used in the treatment and prophylaxis of angina pectoris or coronary artery spasm (amlodipine, diltiazem, felodipine, nicardipine, verapamil) memory trick - most end with "DIPINE" Corticosteriods: used in replacement doses (20 mg of hydrocortisone or equivalent) systematically to treat adrenocortical insufficiency larger doses are usually used for their antiiinflammatory, immunosuppressive, or antineoplastic activity Diuretics thiazide diuretics and loop diuretics are used alone or in combination in the treatment of hypertension or edema due to CHF or other causes potassium-sparing diuretics have weak diuretic and antihypertensive properties and are used to conserve potassium in clients receiving thiazide or loop diuretics osmotic diuretics are often used in the management of cerebral edema Hormones used in the treatment of deficiency states including diabetes (insulin), diabetes insipidus (desmopressin), hypothyroidism (thyroid hormones), and menopause (estrogens or estrogens/progestins) hormones may be used to treat hormonally sensitive tumors (androgens, estrogens) Immunosuppressants: most are used in the prevention of transplantation rejection reactions others are used in the management of selected autoimmune diseases (nephrotic syndrome of childhood and sever rheumatoid arthritis)

Laxatives: used to treat or prevent constipation or to prepare the bowel for radiologic or endoscopic procedures Lipid-lowering agents: used as a part of a total plan, including diet and exercise, to reduce blood lipids in an effort to reduce the morbidity and mortality of atherosclerotic cardiovascular disease and its sequelae memory trick - many end with "STATIN", e.g., atorvastatin (Lipitor), simvastatin (Zocor), rosuvastatin (Crestor) Minerals/electrolytes/pH modifiers used in the prevention and treatment of deficiencies or excesses of electrolytes and maintenance of optimal acid/base balance for homeostasis acidifiers and alkalinizers are also used to promote urinary excretion of substances that accumulate in some disease states, e.g., kidney stones Nonopioid analgesics: used to control mild to moderate pain and/or fever Nonsteroidal anti-inflammatory agents: used to control mild to moderate pain, fever, and various inflammatory conditions, e.g., rheumatoid arthritis and osteoarthritis Opioid analgesics: used in the management of moderate to severe pain Sedative/hypnotics used to provide sedation, usually prior to procedures selected agents are useful as anticonvulsants, skeletal muscle relaxants, adjuncts in general surgery and adjuncts for the treatment of alcohol withdrawal syndrome Skeletal muscle relaxants used to treat spasticity (associated with spinal cord diseases or lesions) used as adjunctive therapy in the symptomatic relief of acute painful musculoskeletal conditions IV dantrolene is also used to treat and prevent malignant hyperthermia Thrombolytics: used for the acute management of coronary thrombosis (MI), massive pulmonary emboli, deep vein thrombosis, and arterial thromboembolism Vascular headache suppressants used for the treatment of vascular headaches, e.g., migraine and cluster headaches; memory trick - many end with "TRIPTAN", including sumatriptan (Imitrex) other agents are used for suppression of frequently occurring vascular headaches, e.g., some beta blockers and calcium channel blockers

O S

T V

Erikson's Theory of Psychosocial Development Erik Erikson's theory extends Freudian psychosexual theory Personality develops in a series of eight predetermined stages across the lifespan Each stage in Erikson's theory involves an identify crisis or conflict; the conflict is either resolved, which leads to personal growth, or there are feelings of inadequacy and failure

Erikson's Eight Stages of Psychosocial Development

Psychosocial Stage 1

Name of Stage Trust vs. Mistrust

Age*

Major Characteristic(s)

Birth to 18 months

The development of trust is based on the dependability and quality of the child's caregivers, i.e., feeding Children develop a greater sense of personal control, i.e., toilet training

Autonomy vs. Shame and Doubt Initiative vs. Guilt

Toddlers (2 to 3 years-old)

Preschool (3 Children begin to assert to 5 years-old) their power and control over the world through directly play and other social interaction, i.e., independence School age (6 to 11 yearsold) Through social interactions, children begin to develop a sense of pride in the accomplishments Exploring independence and developing a sense of self Exploring personal relationships is important, especially love relationships Building careers and family

Industry vs. Inferiority

Identity vs. Role Confusion Intimacy vs. Isolation

Adolescence (12 to 18 years-old) Early adulthood (19 to 40 yearsold) Adulthood (40 to 64 yearsold) Older adult (65 years to death)

Generativity vs. Stagnation Integrity vs. Despair

Focused on reflecting back on life

*Note: ages are approximate

Common Antidotes
Medication-Medication TypePoison acetaminophen Antidote

N-acetylcysteine (Mucomyst, Acetadote) - most effective given within 8 hours of ingesting acetaminophen physostigmine chelation therapy 1) dimercaprol 2) penicillamine 3) calcium disodium edetate 4) succimer (DMSA) flumazenil (Romazicon, Anexate) (high dose) glucagon glucagon, calcium chloride, calcium gluconate (10%) atropine, pralidoxime (2-PAM) amyl nitrate sodium thiosulfate hyperbaric oxygen chamber digoxin antibodies: digoxin immune fab, DigiFab, Digibind protamine sulfate ethanol fomepizole (Antizol) pyridoxine hydrochloride (vitamin B6) protamine sulfate glucagon octreotide (Sandostatin) deferoxamine mesylate chelation therapy: 1) dimercaprol (BAL) 2) penicillamine 3) calcium disodium edetate (CaNa2EDTA) 4) succimer (DMSA) calcium gluconate chelation therapy: 1) dimercaprol (BAL) 2) penicillamine 3) calcium disodium edetate (CaNa2EDTA) 4) succimer (DMSA) folinic acid (Leucovorin) and then folic acid fomepizole (Antizol) atropine sulfate

anticholinergics arsenic

benzodiazepines beta blockers calcium channel blockers cholinergics cyanide

digitalis/digoxin dnoxaparin (Lovenox) ethylene glycol

heparin hypoglycemic agents

iron lead

magnesium sulfate mercury

methanol

mushrooms, muscarinic

Medication-Medication TypePoison nerve gas (Sarin, soman and VX)

Antidote

atropine sulfate pralidoxime chloride (2-PAM Cl, Protopam) naloxone, nalmefene Antivenin (Crotalidae) Polyvalent (equine origin) Crotalidae Polyvalent Immune Fab (Ovine) Antivenin (Latrodectus mactans), equine sodium bicarbonate phentolamine mesylate (Regitine)

opioids (codeine, morphine) snakes (rattlesnakes, copperheads, cottonmouths) spiders (black widow) tricyclic antidepressants vasopressor infiltration and extravasation warfarin

phytonadione (vitamin K)

Heart Failure symptoms listed in order of earliest to later findings

Right Nocturia Bulging neck veins (JVD) Ankle & foot edema Liver enlargement (hepatomegaly with abdominal pain, anorexia, and nausea) Bilateral Fatigue in adults and decreased play activity in children Tachycardia Hypotension Left Restlessness, irritability, hostility, agitation, anxiety Cough (often dry initially) Weight gain Shortness of breath/orthopnea Tachypnea Crackles S3 heart sound Pulmonary edema Frothy, sputum (may be blood-tinged) Diaphoresis Cyanosis

Pernicious anemia 1. Definition: anemia caused when tissues fail to absorb enough vitamin B12

sore tongue(beefy red), anorexia, nausea, vomiting, diarrhea, abdominal pain

A ventricular gallop, S3 is caused by blood flowing rapidly into a distended non-compliant ventricle. This is the most common sound with left-sided heart failure.

This labor is a precipitous labor (defined as active labor lasting less than 3 hours). Since the contractions are coming rapidly, with little time in between contractions, fetal hypoxia would be expected. Maternal episiotomy is incorrect since there is no time (lacerations would be anticipated). Due to the potential for fetal hypoxia, the APGAR score would certainly be lower than 9.

Extremely rapid delivery can be anxiety-provoking for the client (and partner). When the actual birth event is not what is expected, other reactions may include hostility, fear and disappointment.

Meningococcal meningitis is a bacterial infection that can be communicated to others. The initial therapeutic management of acute bacterial meningitis includes droplet precautions, initiation of antimicrobial therapy, monitoring neurological status along with vital signs, instituting seizure precautions and, lastly, maintaining optimum hydration. The first action is to initiate any necessary precautions to protect themselves and others from the potential infection. Viral meningitis usually does not require protective measures of isolation and these clients often return home to recover.

Kidney failure
restrict dietary phosphorus by reducing intake of chicken, milk, legumes, carbonated drinks

vitamin D preparations facilitate uptake of calcium keep ampule of calcium gluconate and syringe at bedside - administer if client demonstrates signs of tetany, positive Chvostek's or Trousseau's signs post op Mean arterial pressure must be 70-90 mm Hg to adequately perfuse the organs. MAP is calculated as (diastolic BP x 2 + systolic BP), which is divided by 3. ([58 X 2] + 90)/3 = 68.66 or 69 Breath sounds are the critical assessments at this point. The nurse should be alert to crackles or a pleural friction rub which is highly suggestive of a pulmonary embolism. Sudden dyspnea is a classic finding when a clot lodges in the lung from a deep vein thrombosis.
Nursing Care for sprains and strains: RICE R = Rest I = Ice C = Compression E = Elevation

counter traction for pelvic traction is generally achieved by putting the bed in the "William" position, i.e., both knees and hips are flexed at 30 degrees best indicator of fracture risk in bone densitometry: T score of -2.5 or greater indicates high risk for advanced osteoporosis

A nurse is assigned to a client diagnosed with multiple trauma and head injury with a blood pressure on admission of 140/70 mm Hg. Four hours later the blood pressure is 179/68 mm Hg. What is the difference in the pulse widths or pulse pressures that would lead the nurse to suspect the client may be developing increased intracranial pressure? (Answer the question using whole numbers.) .

INCORRECT
Correct response: 41
Click 'NEXT PAGE' below to continue......

The first pulse width is (140 - 70) = 70. The second pulse width is (179 - 68) = 111. The difference between them is 41, which is an increase that is called a widened pulse pressure.

Ethnocentrism is the universal unconscious tendency of human beings to think that their ways of thinking, acting, and believing are the only right, proper, and natural ways. It can be a major barrier to the provision of culturally conscious care. Ethnocentrism perpetuates an attitude that beliefs that differ greatly from one's own are strange, bizarre, or unenlightened, and therefore wrong. At a more complex level, an ethnocentric regards others as inferior or immoral and believes their own ideas are intrinsically good, right, necessary, and desirable, while remaining unaware of their own value judgments. Before surgical closure, the sac is prevented from drying by the application of a sterile, moist, nonadherent dressing over the defect. Dressings are changed frequently to keep them moist. A dry sterile occlusive dressing is placed on a central line insertion site.

diet: two steps:

less than 30 kcal from fat, with less than ten from saturated fat; less than 300 mg/L cholesterol less than 30 kcal from fat, with less than seven from saturated fat; less than 200 mg/L cholestero

Croup Syndrom
i. classic: "barky" harsh cough, stridor, hoarseness, fever, purulent secretions, dyspnea if severe Listen child looks "sicker" with bacterial infection epiglottitis manifests the four "D's" drooling dysphagia (difficulty swallowing) dysphonia (hoarse voice) distressed inspiratory efforts

ii. iii.

never attempt to directly visualize epiglottis with tongue depressor since it could precipitate laryngospasm In RDS (also known as hyaline membrane disease) the lungs lack the surfactant that enables the alveoli to exchange blood gases.

The first phase of the grieving process is shock, denial or disbelief. Then follows anger, bargaining, depression and acceptance. Each stage can take any amount of time to work through. Clients often go back and forth between the stages until acceptance is achieved. Some clients may get stuck in any one or two of the stages to never achieve acceptance. Neuroleptic malignant syndrome (NMS) is a rare disorder that can occur as a side effect of antipsychotic medications. It is characterized by muscular rigidity, tachycardia, hyperthermia, sweating, altered consciousness, autonomic dysfunction, and increased c<span class="ft">reatine phosphokinase (CPK)</span>. This is a life-threatening complication. Fifth disease is also referred to it as parvovirus infection or erythema infectiosum . Some people may call it slapped-cheek disease because of the face rash that develops resembling slap marks. It is also commonly called fifth disease because it was fifth of a group of once-common childhood diseases that all have similar rashes. The other four diseases are measles, rubella, scarlet fever, and Dukes' disease. People will not know that a child has parvovirus infection until the rash appears, and by that time the child is no longer contagious. Koplic spot is Virus and appear in Measels The rate of increase in head circumference slows by the end of infancy, and the head circumference is usually equal to chest circumference at one to two years of age. Risk factors for pressure ulcers include: immobility, absence of sensation (paresthesia), decreased level of consciousness, inadequate nutrition and hydration, absence of skin moisture, incontinence of bowel or bladder, increased age, decreased immune response. This client has the greatest number of risk factors of any of the clients. When highly protein-bound drugs are administered to clients with low serum albumin (protein) levels, excess free (unbound) drug can cause exaggerated and dangerous effects. Aspirin is a protein-bound drug.

A positive CSF for bacterial meningitis would include the presence of protein, a positive blood culture, decreased glucose, cloudy color with an increased opening pressure, and an elevated white blood cell count. If it was viral meningitis, the difference would be that the CSF glucose would be within normal parameters. Test-taking Tip: Note that the correct answer is the only client centered option that is associated directly with the given situation.</div> Peak flow meter with asthma The steps for correctly using the peak flow meter include: move the indicator to the bottom of the numbered scale, stand up, take a deep breath, place mouthpiece in mouth and close lips around it, blow out hard and fast with a single blow, and record the number achieved on the indicator. The steps should be repeated two more times, for a total of three attempts and the highest peak flow reading of the three is recorded. Auscultation of an S3 heart sound is an early sign of volume overload and heart failure because during the first phase of diastole, when blood enters the ventricles, an extra sound is produced due to the presence of fluid left in the ventricles. A sore throat and fever may be findings of agranulocytosis, a serious side effect of chlorpromazine (Thorazine). Agranulocytosis is where the bone marrow does not make enough white blood cells or neutrophils. Homeopathic medicine treats clients with minute doses of plant, mineral or animal substances which provide a gentle stimulus to the body's own defenses. Most cancers are graded using a number from 1 to 3 or 4; the lower the number, the more the cancer cells look like normal tissue a. b. c. d. e. stage 0: carcinoma in situ stage I: localized with tumor limited to the tissue of origin stage II: limited spread stage III: extensive local and regional spreading stage IV: distant metastasis

Xanax:- The anti-anxiety drugs produce tranquilizing effects and may numb the emotions. Naegele's rule states: Add 7 days and subtract 3 months from the first day of the last regular menstrual period to calculate the estimated date of delivery. Moist and productive cough is a later sign. Noisy respirations and a dry non-productive cough are commonly the first of the respiratory signs to appear in a newly diagnosed client with CF. The other options are the earlier findings. CF is an inherited (genetic) condition affecting the cells that produce mucus, sweat, saliva and digestive juices. Normally, these secretions are thin and slippery, but in CF a defective gene causes the secretions to become thick and sticky. Instead of acting as a lubricant, the secretions plug up tubes, ducts and passageways, especially in the pancreas and lungs. Respiratory failure is the most dangerous consequence of CF. Fifth Disease is a viral illness with an uncertain period of communicability (perhaps one week prior to and one week after onset). Isolation of the child with Fifth Disease is not necessary except in cases of hospitalized children who are immunosuppressed or have aplastic crises. The parents may need written confirmation of this from the health care provider to give to the teacher. Clinical manifestations of otitis media include irritability, rhinorrhea, bulging tympanic membrane, and pulling at ears.

This is the intrinsic rate of the SA node. 60 -100 Suppression is willfully putting an unacceptable thought or feeling out of ones mind. A deliberate exclusion, "voluntary fo rgetting," is generally used to protect ones own self esteem. normal ICP: 10 to 15 mm Hg normal parameters

Parameter

Equation

Normal Range 90-140 mm Hg 60-90 mm Hg

Arterial blood pressure (BP)

Systolic (SBP) Diastolic (DBP)

Mean Arterial Pressure (MAP)

SBP + (2 X DBP)/3

70-105 mm Hg 15-25 mm Hg 0-8 mm Hg 15-25 mm Hg 8-15 mm Hg 10-20 mm Hg

Right Ventricular Pressure (RVP)

Systolic (RVSP) Diastolic (RVDP)

Pulmonary Artery Pressure (PAP)

Systolic (PASP) Diastolic (PADP)

Mean Pulmonary Artery Pressure (MPAP) Pulmonary Artery Wedge Pressure (PAWP)

[PASP + (2 X PADP)]/3 N/A

6-12 mm Hg

Aspirin stimulates the central nervous system which may result in ringing in the ears, which is called tinnitus. And reye syndrom is complication Inderal, a beta-blocking agent that is used to treat hypertension, prohibits the release of epinephrine into the cells. This may result in hypotension which results in decreased libido and/or impotence.