Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Practical Nurse (LPN) School Study Aid
Vitamin C (Ascorbic Acid)
- Antioxidant
- Collagen Formation
- Steroid Synthesis
- Dietary Deficiency
- Scurvy
- GI Distress
- Citrus Fruits
- May Improve Healing
Vitamin B3 - Niacin (Nicotinic Acid)
- Decreases Triglycerides
- Decreases LDL
- Increases HDL
- Dyslipidemia
- Pellagra
- Diarrhea
- Dermatitis
- Dementia
- Flushing
- GI Distress
- Hepatotoxicity
Iron (Ferrous Sulfate)
- Ferrous Salts
- Anemia
- GI Distress
- Nausea and Vomiting
- Dark Stools
- Take Between Meals
- Liquid can Stain Teeth
- Keep out of Reach from Children
- Caution with GI Disorders
- Avoid Antacids
Cobalamin (Vitamin B12)
- Vitamin B12
- Vitamin Deficiency
- Pernicious Anemia
- Hypokalemia
- Arthralgia
- Dizziness
- IM Injection for Pernicious Anemia
- Never Give IV
Vitamin B6 (Pyridoxine)
- Amino Acid and Protein Metabolism
- Heme Synthesis
- Neurotransmitters
- Adjunct to Isoniazid
- Dietary Deficiency
- Premenstrual Syndrome (PMS)
- Ataxia
- Peripheral Neuropathy
- Levodopa
- Cereals and Meats
Vitamin E (Alpha-tocopherol)
- Antioxidant
- Fat Malabsorption Syndrome
- Alpha-TTP Deficiency
- Bleeding
- Increased Risk Hemorrhagic Stroke
- Limit Doses < 200 IU per Day
- Nuts and Whole Grains
- Vegetable Oils
Sickle Cell Anemia Assessment
- Hemoglobin S (Genetic Defect)
- Sickle Shaped RBCs
- Jaundice
- Vaso Occlusive Crisis
- Fever
- Priapism
- Severe Pain
- Prominent in African Americans
- May be Asymptomatic
- Increased Risk of Infection
Sickle Cell Anemia Interventions
- Increase Hydration
- Analgesics
- Oxygen
- Warm Compress
- Bone Marrow Transplant
- Hydroxyurea
- Avoid High Altitudes
- Prophylactic Antibiotics
- Avoid Strenuous Exercise
- Vaccines
Polycythemia Vera Disease
- JAK2 Mutation leading to increased red blood cells
- Tyrosine Kinase
- Erythromelalgia
- Pruritus
- Often After Hot Shower
- Headache
- Phlebotomy
- Aspirin
Heparin (Unfractionated)
- Suppresses Coagulation
- Deep Vein Thrombosis (DVT)
- Pulmonary Embolism
- Hemorrhage
- Heparin-Induced Thrombocytopenia (HIT)
- Monitor aPTT
- Preferred (Safe) During Pregnancy
- Protamine Sulfate
Bleeding Precautions
- Hard Foods
- Aspirin Products
- Blowing Nose Forcefully
- Straining During BMs
- Enemas or Rectal Suppositories
- Pads and Monitor Menstruation
- Soft-bristled Toothbrush
- Electric Razor
- Limit Needle Sticks
- Smaller Needle Size
Prednisone (Glucocorticoids)
- Glucocorticoid
- Inflammatory Conditions
- Organ Transplant Rejection
- Cataracts and Glaucoma
- Cushing's Syndrome
- Osteoporosis
- Immunosuppression
- Hyperglycemia
- Ulcers
- Adrenal Insufficiency
- Taper Gradually
Warfarin (Coumadin)
- Inhibits Clotting Factors
- Atrial Fibrillation
- Venous Thrombosis
- Pulmonary Embolism
- PT/INR Levels
- Observe for Bleeding
- Pregnancy
- Vitamin K and Fresh Frozen Plasma
- Prolonged Therapeutic Onset
- Maintain Same Diet
Hemophilia
- Genetic Mutation
- Prolonged Bleeding
- Pain
- Hemarthrosis
- Clotting Factor Replacement Therapy
- DDAVP (Desmopressin Acetate)
- Antifibrinolytic Therapy
- Analgesics
- Genetic Counseling
- Prevent Injury
Disseminated Intravascular Coagulation (DIC) Assessment
- Improper Initiation of Clotting Cascade
- Systemic Bleeding
- Petechiae, Purpura, Ecchymosis
- Change in LOC
- Increased PT and PTT
- Cyanosis
- Increased Fibrin Degradation Products (FDP)
- Decreased Platelets and Fibrinogen
Disseminated Intravascular Coagulation (DIC) Interventions
- Risk for Shock
- Renal Failure
- Treat Underlying Cause
- Manage Bleeding
- Maintain Fluid and Hemodynamic Balance
- Transfusion
- Oxygenation
- Heparin Drip
Types of Blood Products
- Whole Blood
- Packed Red Blood Cells
- Fresh Frozen Plasma
- Immunoglobulins
- Clotting Factors
- Albumin
- Platelets
- Use within 24 Hours
- Washing Removes Antibodies
- Irradiation Destroys WBCs
Leukemia Assessment
- Immature WBCs
- Recurrent Infections
- Easy Bruising
- Bleeding
- Anemia
- Fatigue
- Weight Loss
- Bone Pain
- May Have Normal or High WBC Count
Leukemia Interventions
- Bone Marrow Aspiration
- X-Rays
- Chemotherapy
- Bleeding Precautions
- Neutropenic Precautions
- Strict Asepsis
- Bone Marrow Transplant
- Blood Transfusions
- Monitor Temperature Elevations
- Adequate Nutrition
- Imatinib (Gleevec) for Chronic Myelogenous Leukemia (CML)
Busulfan
- CML
- Bone Marrow Ablation
- Cross-Links DNA
- Myelosuppression
- Pulmonary Fibrosis
- Hyperpigmentation
Vincristine (Oncovin)
- Vinca Alkaloid
- Inhibits Microtubules
- Leukemias
- Lymphomas
- Peripheral Neuropathy
- Paralytic Ileus
- Vesicant
Hodgkin's Lymphoma Assessment
- Lymph Node Cancer
- Contiguous Spread
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Bimodal Age Distribution
- Reed-Sternberg Cells
Hodgkin's Lymphoma Interventions
- Biopsy
- Staging
- Radiation
- Chemotherapy
- Treat Side Effects of Therapy
- Secondary Cancer Screening
Bleomycin
- Testicular Cancer
- Hodgkin's Lymphoma
- Induces Free Radical Formation
- Breaks in DNA Strands
- Pulmonary Fibrosis
- Skin Changes
- Mucositis
Non-Hodgkin's Lymphoma Assessment
- Lymphatic Cancer
- Non-Contiguous Spread
- B or T Cells
- Painless Lymphadenopathy
- Constitutional B Signs
- Night Sweats
- Fever
- Weight Loss
- Mediastinal or Abdominal Mass
- Older Adults
- > 60 Subtypes
Blood Transfusion Administration
- Proper Patient Identification
- Large Bore Needle
- Y Tubing
- Baseline Vital Signs
- Slow IV Infusion
- Monitor During First 15 Minutes or 50 mL of Blood
- Monitor for Reactions
- Do Not Add Anything To Same IV Line
- No Dextrose or Lactated Ringers
- Jehovah's Witnesses, No Transfusions
Blood Types and Compatibilities
- No Antigens (Type O Blood)
- Universal Donor
- A Antigen (Type A Blood)
- B Antigen (Type B Blood)
- AB Antigen (Type AB Blood)
- Universal Recipient
- Rh (Rhesus) Antigen
- Never Rh+ to Rh-
- Blood Transfusion
- Obstetric Patient
Blood Types
- Allele A is Dominant
- Allele B is Dominant
- Allele O is Recessive
- Genotypes AA and AO have Type A Blood
- Genotypes BB and BO have Type B Blood
- Genotype AB is co-dominant and has Type AB Blood
- Genotype OO Results in Type O Blood
Transfusion Reactions
- Acute Hemolytic
- Febrile, Non-Hemolytic
- Mild Allergic
- Anaphylactic
- Circulatory Overload
- Sepsis Reaction
- Transfusion-Related Acute Lung Injury (TRALI)
- Massive Blood Transfusion
Cytomegalovirus (CMV) TORCH
- Nonspecific TORCH symptoms
- Intrauterine Growth Restriction (Retardation)
- Deafness
- Microcephaly
- Seizures
- Periventricular Calcifications
- Petechial Rash
- Blueberry Muffin Rash
- Chorioretinitis
- Urine Viral Culture or PCR
Hepatitis B (HBV) Assessment
- Bodily Fluids
- Blood Transmission
- People Who Use IV Drugs
- Variable 1-6 Months
- Fever
- Nausea and Vomiting
- Hepatomegaly
- Cirrhosis
- Hepatocellular Carcinoma
- Vaccination
Hepatitis C (HCV) Assessment
- Blood Transmission
- High Risk Sex (rare)
- IV Drug Users
- 7 Weeks
- Cirrhosis
- Barrier Protection