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Adenosine 6 mg
Atropine sulfate 0.5 – 1 mg.q 3-5 Bradycardia
min
Epinephrine 1 mg.q 3-5 min Cardiac arrest
Lasix 0.5-1 mg/kg Pulmonary edema
Lidocaine 1-1.5 mg/kg Ventricular fibrillation, Ventricular
tachycardia
Magnesium sulfate 1-2 g Ventricular tachycardia r/t hypomagnesemia
Morphine Sulfate 1-3 mg Chest pain, pulmonary edema
Narcan 0.02-2mg Narcotic – respiratory depression
Nitroglycerine 0.4 mg SL Chest pain, pulmonary edema
Vasopressin 40 units Cardiac arrest
Commonly Asked Emergency Drugs
Antidotes
Agents Antidotes
Acetaminophen Acetylcysteine (Mucomyst)
Anticholinesterase Atropine So4
Anticholinergics Physostigmine
Benzodiazepines Flumazenil
Coumadine Vitamin K
Cyanide Sodium nitrate
Digoxin Digoxin immune fab (Digibind)
Dopamine Phentolamine
Heparin Protamine sulfate
Iron Deferoxamine
Lead Dimercaprol, edetate disodium and succimer
Magnesium Calcium gluconate
Sulfate
Narcotics Naloxone
Drug Name Endings: What they can suggest you!!!
Endings class
*cain Local anesthetics
*cillin Antibiotics
*dine Antiulcer agent
*done Opiod analgesics
*ide Oral hypoglycemics
*lam/
*pam Antianxiety
*micin/
*mycin Antibiotics
*mine/
*zide Diuretics
*olol Beta blockers
*pril ACE inhibitors
*sone Steroids
FREQUENTLY ASKED MEDICATIONS
Drugs Trade /(generics) Classification Desired Effects Best Time to be Other Considerations
Taken
1 Aminophylline Bronchodilator To case breathing AM / empty stomach No smoking
(theophylline) No caffeine
Check heart rate
2 Amphogel Antacid phosphate level Between meals and HS Give with glass of water
(aluminum hydroxide) Report melena
3 Antabuse Antialcoholic agent Avoidance of alcohol After 12 hrs. stoppage No alcohol in any means
(disulfiram) from alcohol
4 Aspirin (ASA) Anti-inflammatory temperature Full stomach Check for bleeding tendencies
Anti-pyretic pain and Syrup of inpecae in case of
Analgesic inflammation overdose
5 Atropine SO4 Anticholinergic and heart rate and 30 PC Observe facial flushing
Vagolytic decrease secretion s Avoid hot environment
6 Bacterium Antibiotic (-) infection PC Reddish urine
(cotrimoxazole) Rashes
Assess for signs of
nephrotoxicity
7 Benadryl Antihistamine (-) allergy Best taken with food Avoid alcohol
(diphenhydramine hcl) Anti – EPS (-) movement
syndrome
8 Celestone Steroids respiratory distress Best taken with food Monitor weight
(betamethazone) in newborn
9 Cytoxan Antineoplastic size of tumor AM Increase fluids
(cyclophosphamide) Monitor CBC
10 Diabinase Antidiabetic agent Normal glucose range AM Monitor for hypoglycemia
(chlorpropaminde)
11 Diamox Antiglaucoma urine output AM with meals Photosensitivity
(acetazolamide) antidiuretics vertigo
12 Digoxin (lanoxin) Cardiac glycoside Normal heart rate AM Assess pulse rate
Monitor serum K
13 Dilantin (phenytoin) Anti-convulsant (-) seizure Best taken with food Taper dosage
14 Diuril (chlorothiazide) Diuretics urine output Best taken with food Report weakness in the
extremities
Increase K in the diet
15 Epinephrine Bronchodilator heart rate AM Don’t operate machineries and
drive automobile
Assess for increase pulse
16 Flagyl (metronidazole) Antihelmintic (-) helminth Best taken with food Avoid alcohol
Not to give with antabuse
Tetratogenic
17 Haldol (haloperidol) Antipsychotic (+) symptoms of AC Assess BP
psychosis Photosensitivity
18 Kayexalate Promote excretions serum K May cause constipation
of K Monitor serum potassium
19 Lasix (furosemide) Diuretic urine output AM Increase intake of food rich in
K
20 Lithane (LiCO3) Antimanic hyperactivity PC Monitor lithium toxicity
Decrease activity
21 Lovenox (mevacor) Antithrombotic (-) thrombosis Soft bristle toothbrush
No razor
Keep protamine SO4
22 Magnesium SO4 Anticonvulsant (-) convulsion Assess DTR and PR
Antidote is Calcium gluconate
23 Mastinon Cholinesterase muscle strength PC Monitor for muscle weakness
(pyridostigmine) inhibitor Antidote is atropine SO4
24 Mathergine Oxytocic for post Firmly contracted Monitor BP
(methylergonovine partum atony uterus Report dyspnea
maleate)
25 Monoamine oxidase Antidepressant Improved sleeping PC No tyramine rich food
inhibitor pattern Assess for hypertensive crisis
Monitor BP
26 Nitroglycerin Antiangina (-) chest pain Best taken before any Taken SL; don’t chew
strenuous activity Keep tablets in dark container
27 Pancrease (pancreatin) Pancreatic enzyme (-) fat in the stool Between meal and Preparation is enteric coated,
snacks don’t show
Observe for diarrhea
28 Phenergan Antihistamine (-) allergy Empty stomach Antidote is epinephrine
(promethazine
hyrochloride)
29 Reserpine (serpasil) Antihypertensive BP Best taken with meals No sudden change of position
Monitor BP and PR
30 Ritalin Stimulant hyperactivity AM / PC Monitor growth and
(methylphenidate) development
31 Robaxin Skeletal muscle (-) muscle spasm AM No alcohol
(methocarbamol) relaxant Antidote : Epinephrine
32 Synthroid Thyroid hormone Normal T4 level AM Monitor BP and PR
(levothyroxine sodium) supplement
33 Tagamet (cimetidine) Antiacidity (-) heartburn Best taken with food Avoid smoking
34 Thorazine Antipsychotic (-) positive signs of PC Photosensitivity
(chlorpromazine hcl) psychosis Monitor BP
35 Valium (diazepam) Antianxiety (-) anxiety AC No alcohol, caffeine
36 Xylocaine (lidocaine) Antiarrythmic Normal heart rate Monitor for toxicity –
convulsion
S / E : tinnitus
37 Zyloprim (allopurinol) Antigout uric acid Best taken with food Increase fluid intake, restrict
vit. C
Common Tubes
Characteristics:
1. it provides an indirect assessment of organ size, shape, and / or function
2. it is safe
3. it is easily reproducible
4. it requires less complex equipment for recording
5. it does not require the written consent of patient or guardian
1. Chest – used to determine size, contour of the heart; size, location, and nature of pulmonary
lesions: pleural thickening and effusions: pulmonary vasculature: disorder of thoracic ones
and soft tissues.
- used lead shield to protect pregnant woman
2. Kidney, Ureter, and Bladder (KUB) – used to determine size, shape, and position of
kidney, ureter and bladder
- No special consideration
3. Breast (Mammography) – examination of the breast with or without the injection of the
radiopaque substance into the duct of mammary gland.
- used to determined the presence of tumor or cyst (best done a week after
menstruation)
- no deodorant, perfume, powder, or ointment in underarm area on the day of X-ray
(contains Calcium oxalate)
- May be uncomfortable due to the pressure on the breast. (uses two x-ray plates)
Patients preparations:
- no food after evening meal the evening before the test
- stool softener laxatives and enema suppositories to cleanse the bowel before the test
- NPO after midnight before the test
After care:
- increased fluid intake, food and rest
- laxatives for at least two days or until stools are normal in color and consistency
3. Cholecystogram – ingestion of organic iodine contrast medium (Telepaque) followed in
12 hour by x-ray visualization
- gallbladder disease is indicated with poor or no visualization of the bladder
- accurate only if GI and liver function is intact
- perform before barium swallow and barium enema
Patients preparations:
- administer large amount of water with contrast capsule
- low-fat meal before evening before x-ray
- oral laxative of stool softener after meal
- no food allowed after contrast capsule
After care:
- increased fluid intake, food and rest
- observe for any untoward reactions
Patients preparations:
- Laxative in the evening before the examination
- NPO for 12 hours
- Cleaning enema morning of the procedure
After care:
- increased fluid intake, food and rest;
- observe for any untoward reactions
D. Computed Tomography (CT) – an x-ray beam sweeps around the body, allowing measuring
of various tissue densities. Provides clear radiographic deficition of structures that are not
visible by other techniques.
- initial scan may be followed by “contrast enhancement” using an injection of
contrast agent iodine via vein, followed by a repeat scan.
Patients preparations:
- instructions for eating before test vary
- clear liquids up to 2 hours before the procedure are permitted
E. Magnetic resonance imaging (MRI) – noninvasive technique that produces cross sectional
images by exposure to magnetic energy sources. It uses no contrast medium; takes 30-0
minutes to complete. Patient may still for periods of 5-20 minutes at a time.
Patients preparations:
- patient can take food and medications except for low abdominal and pelvic studies
(food and fluid withheld) 4-6 hr to decrease peristalsis)
- Restrictions
a. those who have metal implants
b. those with permanent pacemakers
c. those who are pregnant
F. Ultrasound (sonogram) – uses sound waves to diagnose disorders of the thyroid, kidney,
liver, uterus, gallbladder, fetus and intracranial structures of the neonate.
Patients preparations:
- advise client not to chew gum or smoke before the procedure
- no x-ray
- for gallbladder studies; NPO for 8 hours
- for lower abdomen and uterus ; 32 ounces of water PO 30 minutes before the
procedure
1. Vital capacity (VC) – largest amount of air that can be expelled after maximal
inspiration
2. Forced expiratory volume (FEV) – percentage of vital capacity that can be forcibly
expired in 1, 2, or 3 seconds.
H. Sputum Studies
1. Gastric analysis – aspiration of the contents of the fasting stomach analysis of free and total
acid
1. Fasting blood sugar (FBS) – blood sample is drawn after a 12 fast (usually midnight).
Water is allowed.
Patients preparations:
- offer a high-carbohydrate diet for 2-4 days before testing
- patient fast overnight
- eats a high-carbohydrate breakfast
- blood sample is drawn 2 hr interval
- no cigarette smoking and caffeine for these may increase glucose level
Characteristics:
1. it directly records the size, shape and function of an organ;
2. it requires the written consent of the patient or guardian;
3. it may result in morbidity and occasionally death.
2. After procedure:
a. observe and record vital signs
b. check injection or biopsy sites for bleeding, infection, tenderness, or thrombosis
report untoward reaction to the physician
apply warm compress to ease discomfort, as ordered
c. if tropical anesthesia is used during procedure, do not give food or fluid until gag
reflex returns
d. encourage relaxation by allowing patient to discuss experience and verbalize
feelings.
2. Postprocedure observations:
a. monitor ECG pattern for arrhythmias
b. check extremities for color and temperature, peripheral pulses for quality.
1. Lung scan – injection of radioactive isotope into the body, followed by lung scintiscan,
which produces a graphic record of gamma rays emitted by the isotopes in the tissues.
- used to determine lung perfusion when pulmonary emboli and infarctions are
suspected.
4. Thoracentesis – needle puncture through the chest wall and into the pleura
- used to remove fluid and occasionally air from the pleural space
- nursing considerations
a. position : high fowler’s position or sitting upon edge of the bed, with feet
supported on the chair.
b. If the patient is unable to sit up – turn unto unaffected side
a. Position: high fowler’s position or sitting upon edge of the bed, with feet supported on
the chair.
b. If the patient’ is unable to sit up-turn unto unaffected side
Nursing action:
1. Place patient on right side and position pillow for pressure, to prevent bleeding.
5. Paracentesis – needle aspiration of fluid from the peritoneal cavity used to relieve
excess fluid accumulation or for diagnostic studies.
a. Specific nursing actions before paracentesis:
a. Have patient void - to prevent possible injury to bladder during
procedure
b. Position – sitting up on side of bed, with feet supported by
chair.
c. Check vital signs and peripheral circulation frequently
throughout procedure
d. Observe for signs of hypovolemic shock – may occur due to
fluid shift from vascular compartment following removal of
protein – rich ascitic fluid.
Nursing consideration:
Elevate head of bed = with water soluble contrast
Flat position – with oil contrast
V/s every 4 hr for 24 hr.
Respiratory . . . Slow
Alkalosis Hyperventilatio Lightheadedn breathing
pH>7.45; n ess . Paper bag
PaCO2<35 . Anxiety . Ringing of
. Pain the
. Ventilators ears
. Tingling
Metabolic . DKA . Headache . Administer sodium
Acidosis . Diarrhea . N/V bicarbonate
pH<7.35; . ASA . Kussmaul . Monitor I/O
HCO3,22 poisoning respiration . Use seizure
. Renal failure . precautions
Dysrhythmias