Medical-Surgical Nursing, 10th Ed., Lewis, Dirksen, Heitkemper & Bucher | Registered Nurse (RN) School Study Aid
Metabolic Alkalosis Assessment
- Increased pH > 7.45
- Increased HCO3 > 26
- Excitable State
- Arrhythmias
- Paresthesias
- Muscle Cramps
- Muscle Weakness
- Decreased Respiratory Effort
Metabolic Acidosis Assessment
- Decreased pH < 7.35
- Decreased HCO3 < 22
- Abdominal Pain
- CNS Depression
- Coma
- Hypotension
- Arrhythmias
- Increased Respirations
- Kussmaul Respirations
- Flushed, Warm, Dry Skin
- Muscle Weakness
Mallory-Weiss
- Bleeding From Tears in Mucosa
- Forceful Vomiting
- Alcoholism
- Eating Disorders (Bulimia)
- Painful Hematemesis
- Endoscopy
- Observation
Promethazine (Phenergan)
- Histamine H1 Receptor Antagonist
- Weak Dopamine Antagonist
- Nausea and Vomiting
- Motion Sickness
- Respiratory Depression
- Sedation
- Anticholinergic Effects
- Extrapyramidal Symptoms
- Use Large Bore IV
- Monitor for Tissue Necrosis
Chlorpromazine (Thorazine)
- Low Potency Antipsychotic
- Schizophrenia
- Hiccups
- Sedation
- Weight Gain
- Orthostatic Hypotension
- Anticholinergic Effects
- QT Prolongation
- Neuroendocrine Effects
- Caution in Seizure Patients
- Corneal Deposits
Mumps (Parotitis)
- Paramyxovirus
- Fever
- Headache
- Earache
- Orchitis
- Pain and Swelling of Parotid Glands
- MMR Vaccination
Gastroesophageal Reflux Disease (GERD) Assessment
- Relaxed Lower Esophageal Sphincter
- Dyspepsia (Indigestion)
- Belching
- Nighttime Coughing
- Dysphagia
- Epigastric Pain
- Regurgitation
- Heartburn (Pyrosis)
- Globus
Cimetidine and Famotidine (H2 Receptor Blockers)
- -tidine Suffix
- H2 Receptor Blocker
- Suppress Gastric Acid Secretion
- Pneumonia
- Anti-androgen Effects
- CNS Changes
Omeprazole (Prilosec)
- "-prazole" Suffix
- Zollinger-Ellison Syndrome
- Gastritis
- Peptic Ulcer
- Gastroesophageal Reflux Disease (GERD)
- Proton Pump Inhibitor (PPI)
- Inhibit H+/K+/ATPase
- Hip Fracture
- Pneumonia
Dinoprostone and Misoprostol
- Prostaglandins
- Promote Cervical Ripening
- Prevent GI Ulcers
- Medical Abortion
- Fetal Distress
- Hyperstimulation of Uterus
- Vaginal Insertion
- Give Before Induction of Labor
Sucralfate (Carafate)
- Creates Protective Barrier
- GI Ulcers
- Constipation
- Require Acidic Environment
- Give on Empty Stomach
- Oral Suspension Available
- May Decrease Absorption of Other Meds
Types of Hernias
- Hiatal
- Gastroesophageal Reflux Disease (GERD)
- Inguinal
- Men
- Femoral
- Women
- Incisional
- Umbilical
- Strangulation
NSAIDs
- Anti-inflammatory
- Analgesic
- Fever
- Closure of Patent Ductus Arteriosus
- Reversible Inhibition of COX-1 and COX-2
- Block Prostaglandin Synthesis
- Interstitial Nephritis
- Gastric Ulcer
- Renal Ischemia
Peptic Ulcer Disease Assessment
- Helicobacter Pylori
- NSAIDs
- Increased Stomach Acid
- Abdominal Pain
- Heartburn (Pyrosis)
- Melena
- Weight Changes
- GI Distress
- Most Commonly in Duodenum
- Duodenal: Pain Relieved by Eating
- Gastric: Pain Caused by Eating
Hypertrophic Pyloric Stenosis (HPS) Assessment
- Hypertrophied Pylorus
- Macrolide Use
- 3-6 Weeks of Age
- Projectile Vomiting After Feeding
- No Pain or Discomfort
- Weight Loss
- Dehydration
- Hungry Baby
- Olive Mass
Hypertrophic Pyloric Stenosis (HPS) Interventions
- Pyloromyotomy
- Stabilize Fluid and Electrolyte Balance
- Nasogastric Tube
- Monitor Feeding
- Start Formula or Breastfeeding Within 24 Hours
- Feedings Every 4-6 hours
- Full Feeding Within 2 days
Peptic Ulcer Disease Interventions
- Combination Drug Therapy
- Two Antibiotics
- Proton Pump Inhibitor (PPI)
- Decrease Acid Secretion
- Avoid NSAIDs
- Diet and Lifestyle Changes
Tricyclic Antidepressants (TCAs)
- Inhibits Reuptake of Norepinephrine and Serotonin
- Depression
- Bipolar Disorder
- Fibromyalgia
- Sedation
- Orthostatic Hypotension
- Anticholinergic Effects
- Cardiac Toxicity
- Delayed Effect
- Do Not Stop Abruptly