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NUR 203 wk 7 meds

NUR 203 wk 7 meds

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Published by Kenneth Smith II
drug cards
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Published by: Kenneth Smith II on Jul 07, 2012
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Faulkner State Community College/Division of NursingClinical Medication Sheet Nursing 203Student __Kenneth Smith II_ Client’s Initials __RG____ Clinical Week __7______ Class __NUR 203__________ 
Drug Classification &Mechanism of ActionMajor Side Effects &ContraindicationsNursingConsiderations
Drug:
potassium chloride
Dose:
20 mEq
1.
For K+ = 3.7-3.9: 20 mEqKCI in 100 mL SWFI over 1 hr 
2.
For K+ = 3.6 or less: 40mEq KCI in 100 mL SWFI,over 2 hrs and repeat K+level 2 hours post-completion
3.
For K+ = less than 3 or greater than 5.5: notify physician
Route:
IV
Max 24rh dose:
480 mEq
Frequency:
PRN/ see Dose
Rationale for client:
Fluid andElectrolyte imbalance/
 
 
restorenormal potassium levels
Functional class:
Dietarysupplement
Chemical class:
potassiumchloride, Inorganic Ions
Action:
K+ works to maintainintracellular tonicity; it isnecessary for the transmissionof nerve impulses, thecontraction of cardiac, skeletaland smooth muscle, and themaintenance of normal renalfunction. It also works as anacid/base buffer [in the case of acidosis chloride is not theappropriate salt; consider: potassium bicarbonate, potassium citrate, potassiumacetate, or potassiumgluconate.
Normal Range:
3.5-5
Critical Values:
<2.5; >6.5
Side-Effects:CNS:
Weakness
CV:
Bradycardia
Hema:
Hyperkalemia
GI:
Diarrhea, nausea, stomach pain, flatulence, vomiting
EENT:
Dyspnea
Contraindications:
Severerenal impairment, untreatedAddison's disease, heat cramps,hyperkalemia, severe tissuetrauma
Overdose s/s:
Nausea, Fatigue,weakness, tingling sensation,Peak T waves, small P waves,Widened QRS complex, andsinusoidal rhythm
Hypokalemia s/s:
muscular weakness, myalgia, musclecramps, flaccid paralysis,hyporeflexia, flattened or inverted T waves, a U wave,ST depression and a wide PR interval.1. Administer with plenty of fluid and/or food because of stomach irritation anddiscomfort2. Labs – BUN, Creatinine,Chemistry, UA3. Antidote:
1
st
- Cardiac Membranestabilization
– Give Cagluconate 10 mL of a 10%calcium gluconate solutioninfused over 2 to 3 minutes;repeat in 1-2 mins if needed
2
nd
- Promotion of PotassiumInflux into Cells
– Dextrose 50ml over 5 min then 5-10 unitsof reg insulin IVP
3
rd
- Potassium Removal fromthe Body
- Sodium PolystyreneSulfonate [Kayexalate] 15g PO[preferred] in water or sorbital;or 30-50g enema deep intosigmoid colon.
 
Faulkner State Community College/Division of NursingClinical Medication Sheet Nursing 203Student __Kenneth Smith II_ Client’s Initials __RG____ Clinical Week __7______ Class __NUR 203__________ 
Drug:
Magnesium Sulfate
Dose:1.
For Mg++
=
1.8-1.9 : 16 mEq(2g) Magnesium Sulfate in 50mL D5W over 1 hr 
2.
For Mg++ = 1.6-1.7: 24 mEq(3g) Magnesium Sulfate in 100mL D5W over 1.5 hrs
3.
For Mg++ = 1.4-1.5: 32 mEq(4g) Magnesium Sulfate in 100mL D5W over 2 hrs.
4.
For Mg++ = 1.3 or less: 32mEq (4g) Magnesium Sulfatein 100 mL D5W over 2 hrsand notify physician.
Route:
PO
Max 24rh dose:
30-40 g
Frequency:
PRN
Rationale for client:
Fluidand Electrolyte imbalance/restore normal Mag+ levels
Functional Class:
Electrolytereplacement
Chemical Class:
Mag
+
Action:
Stabilizes excitablemembranes, Essential role incardiac, skeletal, and smoothmuscle contraction, Blood-clotting cascade cofactor,Cofactor for the synthesis of DNA and proteins
Major
Side-Effects:CNS:
flaccid paralysis
CV:
circulatory collapse
GI:
n/v, cramps, diarrhea,anorexia
Contraindications:
hypersensitivity, abd pain, n/v,obstruction, acute surgical abd,rectal bleeding, heart block,myocardial damage
Overdose s/s:
Weakness, n/v,Impaired breathing, Decreasedrespirations, Hypotension,Hypercalcemia,Decreased/absent deep tendonreflexes, Bradycardia
Hypomagnesemia s/s:
weakness, cramps, tremors,spasms, nystagmus and anextensor plantar reflex,confusion, disorientation,hallucinations, depression,epileptic fits, hypertension,tachycardia and tetany
1.
Assess: I&O ratio, cause of constipation
2.
Assess: Cramping, rectal bleed, n/v
 
3.
Mag Levels:
Normal Range:
1.2-2.1
Critical Values:
<1.3; >5.1
4.
See s/s of overdose incolumn to the left
5.
Antidote – 10% Cagluconate 5 to 10 mEq IV x1
Over Tx:
1. D/C Mag2. Ambu bag w/ O2 if needed3. 5 to 10 mEq of 10% Cagluconate
 
Faulkner State Community College/Division of NursingClinical Medication Sheet Nursing 203Student __Kenneth Smith II_ Client’s Initials __RG____ Clinical Week __7______ Class __NUR 203__________ 
Drug:
Calcium Chl
Dose:
1.
For Ionized Ca++ 1 - 1.13 :1 gm CaCl in 50 mL 05W over 1 hr 
2.
For Ionized Ca++ less than 1: 2 gms CaCl in 100 mL D5Wover 1 hr 
Route:
IV 100ml/hr 
Max 24rh dose:
2000mg
Frequency:
PRN
Rationale for client:
 
Fluid and Electrolyteimbalance/
 
restore normal Ca++ levels
Functional Class:
Electrolytereplacement- calcium product
Chemical Class:
Ca
++
Action:
Cation needed for maintenance of nervous,muscular, skeletal function;enzyme reactions; normal cardiaccontractility; coagulation of  blood; affects secretory activityof endocrine, exocrine glands.
Total Norm Range:
8.5-10
Total Crit Value:
<1.5; >3.25
Ionzd Norm Range:
4.5-5.6
Ionzd Crit Values:
<2.2; >71 g/dL ↓albumin = ↓0.8 mg/dLserum Ca
Major Side-Effects:CV:
 bradycardia,
short QTinterval, wide T wave and STelevation
, cardiac arrest,hypotension
GI:
constipation, anorexia, n/v, polyuria, thirst
Contraindications:
hypersensitivity todrug/class/components,Hypercalcemia
Overdose Tx:
1. D/C Ca++2. Lasix – 40 80 mg IV/1-2 mins3.
 
Calcitonin – 4 I.U./kg Q12hr  by SC or IM1. Labs: CMP, Albumin, IonzdCa, Ca2. Monitor VS and ECG carefullyfor bradycardia and hypotension 
Overdose s/s:
Hypotension,syncope, short QT interval,wide T wave and ST elevation,
drowsiness, lethargy, muscleweakness, headache,constipation, coma, anorexia, n/v, polyuria, thirst.
Hypocalcemia s/s:
Petechiae,Oral, perioral, acral paresthesia,tetany, Trousseau sign,Chvostek's sign, Hyperreflexia,Laryngospasm, IntermittentQT prolongation, TdP, and V-Fib

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