Cardiac Rate- Peds

Remember: 311
(Fetal HR 120-160)
RR
-30 90-130 Infant 30-60
-10 80-120 Toddler 20-30
-10 70-110 Preschooler 16-22

450,000
Hgb F: 12-16 M: 14-18 Hct F: 37-47% M: 42-52%
Amylase: 53-123 Albumin: 3-4.3 Alk Phosphate: 14-100 NH3 (3565)
Blood Osmol 280-300 Lipase 14-280
Bilirubin (Total: 0.3-1; Indirect: 0.2-0.8; Direct 0.1-0.3)
Phenylalanine: Newborn < 2 Adult < 6

Temperature
F = (1.8 * C) + 32
(Think of them as being ~ 2 apart)
37C = 98.6 F
38C=100.4 F
39C=102.2 F
40C =104 F

Antidotes
Digoxin Digiband
Tylenol Mucomist (17 doses + loading dose)
Heparin Protamine Sulfate
Benzodiazepine Flumzaemil (Romazicon)
CoumadinVit K
DI ADH, u/o, Urine Specific Gr, Na (think Na = urine spec
gr)
SIADH think syndrome of ed diuretic hormone ADH, u/o, urine
spec gr

Labs
BUN/CR = Dehydration
BUN/CR = Overhydration
El: Na (135-145) K (3.5-5) Mg (1.5-2.5) Ca (9-11) Cl (96-106)
Phos (3-4.5)
Endocrine
BUN (7-22 or to remember put the buns in the oven for 10-20 min)
Cr (0.5-1.5)
Urine Spec Gravity (1.005-1.030)
Glucose:
Nml 80-110
Fasting <110
Infant BG 50-90 (<45=hypoglycemia-high pitch cry)
HgbA1c= 4-6% (or <7%)
Thyroid:
T3 (60-180)
T4 (5-11)
TSH (0.5-5) or 0.5-2 for hypothyroid pts
Free T4: 0.8-2.7 ( I remember it .8-2.8 easier to memorize)
Hypothyroid: TSH ; T3 & T4
Hyperthyroid: TSH ; T3 &T4
ABGs:
PH 7.35-7.45
pO2 80-100
pCO2 35-45
HCO3 22-26
ROME:
With Acidosis the PH is always and PH is always in Alkalosis
Respiratory Opposite; Metabolic Equal
RESP OPP:
PH PCO2 = Resp Acidosis
PH PCO2 = Resp Alkalosis
METABOLIC =
PH HCO3 = Metabolic Acidosis
PH HCO3 = Metabolic Alkalosis
Blood:
RBC 4.2-6.1 million WBC 5000-10000 (or 4500-11000) Plt 150,000

Insulins
Rapid Reg Interm Very Long Long Acting
5-15m 30-60m 1-3h 1h 6-8h
1-2h 2-4h 6-12h peakless action 12-16h
4-6h 5-7h 16-20h 18-24h 20-30
Novolog Novolin R NPH Lantus Ultra Lente \
Humalog Humulin R Lente
Vaccines
Hep B 0, 1-2, 6-18mo
Hib 2, 4, 6, 12-15
Pneumo 2, 4, 6,12-15
Dtap 2, 4, 6, 15-18, 4-6yrs; Td q 10 yrs
IPV 2, 4, 6-18, 4-6yr
Varicella 12-15, 4-6yr
MMR 12-15, 4-6yr
Hep A 12-23 mo (2 doses, 6 mo apart)
Mening 9-11 yrs
Rota 2, 4, 6
Influenza at 6 mo and then yearly after
Random Stuff
Thiazides BG
Neupogen = Neutrophil
Epogen = RBC/Erythocyte
Lofenalac Formula = for PKU infants
Ototoxic drugs = loop diuretics (Lasix) and Platinol-AO
TB Meds (RISE)
Rifampin
INH
Streptomycin
Ethambutol
GCS
Eyes (4 points)
Verbal (5 points)
Motor (6 points)
Max = 15 (<8=coma)

APGAR Score
At 1 and 5 min after birth
(1st score is the transitional score and 2nd is planning care of
newborn)
8-10 = ok
210
Appearance [All pink, pink&blue, blue/pale]
Pulse [> 100, < 100, No Response]
Grimace [cough, grimace, no response]
Activity [flexed, flaccid, limp]
Resp [strong cry, weak cry, no cry]
INFECTION CONTROL
Airborne (My Chicken Hez TB)
Measles (Rubeola)
Chicken pox (Varicella)
Herpes Zoster (shingles in (immuno compromised ind, or
disseminated)
Tuberculosis
Management:
-private room
-negative airflow pressure, minimum of 6-12 air exchanges per hour
-UV germicide irradiation/ high efficiency air filter is used, mask,
N95 mask for TB
Droplet (SPIDERMAn)
Sars
Scarlet fever
Sepsis
Streptococcal pharyngitis
Pertussis
Parvovirus B19
Pneumonia
Influenza
Diphtheria
Epiglottitis
Rubella
Mumps
Mycoplasmal/Meningeal Pneumonia
AdeNovirus
Management:
-private room
-mask (within 3 ft)
Contact (MRS.WEE)
Multi-resistant organism
Respiratory Syncitial Virus (RSV)
Skin Infections VCHIPS (e.g:
Varicella zoster
Cutaneous Diphtheria,
Herpes Simplex
Impetigo
Pediculosis
Staph infection
Scabies)

Alex = AIDS
Hez= Herpes Zoster
5=5th Dx
Coins=Croup
HeRe= Hepatitis and RSV
Wound Infection
Enteric Infection (Clostridium Difficile)
Eye Infection (Conjunctivitis)
Croup
Management:
-MRSA: gloves, gown, goggles, face shield
-patients should be in a private room
Donning
1 Gown
2 Mask
3 Goggle
4 Gloves
Removing
1 Gloves
2 Goggle
3 Gown
4 Mask
Addisons - hyponatremia, hyperkalemia
Cushings - hypernatremia, hypokalemia
REMEMBER: VEAL CHOP
Variable is Cord compression
Early is Head compression
Acceleration is Ok
Late is Placental Insufficiency

Sickle Cell Dx,

Alpha Anti-Trypsin Deficiency,
Galactetsemia

o Cytotax, Imuran (Immunosupressants)

o NSAIDs
o Plaquinil (also an anit-malarial drug)

Autosomal Dominant:
Huntingtons Disease,
Marfans,
Polydactly,
Achandrophic Dwarfism,
Polycystic Kidney Disease

More Maternity
Fundal Height
o Top of Symphis Pubis to top of fundus
o Gross estimate of dates
o Use a non-stretchable tape measure
o 12-14 wks (at level of symphis)
o show after week 14 (can tell preg)
o 20 wks (~ 20cm) at level of umbilicus
o rises 1 cm/wk till 36 weeks then varies
Quickening = fetal movement; 16-20 weeks
Fetal Heartbeat = 8-12 weeks (by Doppler) and 18-20 weeks by
auscultating with stethoscope
Preterm: 20-37 weeks
Term: 38-42 weeks
Post-term: 42 weeks plus
Total preg weight gain: 11-14 kg (25-35 lb)
300 cal during preg (DAILY) and 200-500 cal during
breastfeeding (DAILY)
Caffeine < 300 mg/day (500-750 mL/day => risk of spontaneous
abortion or fetal intrauterine growth restriction
Uterine contractions can be felt after 4th month = Braxton Hicks
Contractions facilitate uterine blood flow through placenta and
promote O2 delivery to fetus

X-Linked Recessive:
Duchennes Muscle Dystrophy,
Hemophilia A (Females are carriers in these diseases and males are
affected by the disease)
Newborn At Term:
Nml = wt: 6-9lbs, head circumference: body length, 13-14 in,
chest: 12-13in
Umbilical cord falls off in 1-2 weeks
Stool:
1st stool (Mecconium) black + tarry (passes w/in 12-24 hrs),
thin/green/brown day 3,
formula feedings (1-2 pale yellow/light brown stools) or
breast feeding (loose golden yellow stools with sour milk odor)
Hypokalemia:
Flat T wave,
Depressed ST, and
Prominent U wave
Hyperkalemia:
Tall T wave,
Wide QRS,
Long PR Wave

5 Ps of Fracture: Pain, pallor, pulseless, paresthesia, paralysis

Hypoventilation => Resp Acidosis ( CO2) Retain CO2
Hyperventilation=> Resp Alkalosis ( CO2) Blow off CO2 (think Cushings Triad: (Indicates ed ICP) HR, RR, BP
of preg breathing)
Lasix/Bumex = K+ Wasting (can cause hypokalemia)
Aldactone = K+ Sparing (can cause hyperkalemia)
Tx of DIC = Heparin (safe during preg)
Post Masectomy Care: BREAST
BP NOT on affected side
Reach Recovery
Elevate affected side
Abduction and external rotation no initial exercise (initial is
extension/flexion)
Self Breast Exam (1x month 7 day after period)
Try to promote a (+) self-image
Autosomal Recessive:
Cystic Fibrosis,
PKU,
Tay-Sachs,
Albinism,

CONVERSIONS:
1 lb = 16 oz ; 1 T = 3 tsp = 15 mL 1 t = 5 mL
1c = 8 oz = 240 mL 1 lb = 454 g = 16 oz
2 c = 1 pt = 16 oz
1 oz = 30 mL= 8 drams 1 mg = 1000 mcg
2 pt = 1 qt= 32 oz 1 g = 15 gr
4 qt =1 gal = 128 oz 1 gr = 60 mg
Med Trivia
Talwan and Stadol=> Avoid (opoid agonist antagonists) much
less effective than opoid agonists
No Tagamet with Warfarin
Erogostat => For Migraine
No Quinolones/Tetracyclines with pregnancy
No ASA/NSAIDS in Hemophilia A patients
Lipitor = PM ONLY, no grapefruit juice
tPA= dissolves clots (heparin does not)
SLE Tx

Amniotic Fluid:
o Nml: 800-1200 mL (transparent/clear, no odor)
o <300 mL = Olighydrimanos (low amniotic fluid) = Kidney
problems
o Polyhydrimanos (too much amniotic fluid)
Umbilical Cord: 2 arteries and 1 vein
Placenta: Fetal lungs in utero
Alcohol, caffeine, nicotine, meds = easily cross placenta (viruses
can cross, bacteria cannot; exs of viruses (HIV, AIDS, Herpes,
Measles, Toxoplasmosis, Hep)
AFP Test: measured at 16-18 weeks
o ed Levels = risk of neural tube/abd wall defects (ex. spina bifida)
o ed Levels: risk of Down Syndrome
Fetal Distress
o HR < 110 or > 160
o Fetal hyperactivity or no activity
o Fetal Blood pH < 7.2
Other Stuff
Immed after put pt on a Mech Vent check BP (hypotension)
Lesions of midbrain = decerebrate positioning
Morphine Toxicity = Pinpoint pupils
Corticosteroid Effects: Acne, Hirituism, Mood Swings, ostoporosis
and adrenal suppression (in kids = delayed growth)
No Paxil with MAOI)
Beta Blockers = Mask Effect Of Hypoglycemia
SOMogyi Effect = BG sometimes up and sometimes down
Dawn Phenomenon = high BG in DAWN hrs (5-8am)
AFTER
o Post tracheostomy: keep O2 and Suction at bedside

o Post pleural biopsy: chest tube and drainage system at bedside

o Post parathyroidectomy: tracheostomy at bedside
o Tonic Clonic Seizures: Suction apparatus at bedside
o Paracentesis: BP Cuff at Bedside
RACE-Priority in a fire
o R-Rescue
o A-Alarm
o C-Confine
o E-Extinguish
PASS To use a fire extinguisher
o P-Pull Pin
o A-Aim at Base Fire
o S-Squeeze Handle
o S-Sweep fire from side to side
Folic Acid Rich Foods (FOL)
o F= Fish
o O=Organ Meats, Oranges
o L=Leafy green veggies
K+ Foods (ROYGBIV-Rainbow colors)
o Red= Strawberries, Tomatoes (not apples)
o Orange= Oranges
o Yellow=Banana
o Green= Avocado, green veggies
o Blue= Fish from the BLUE sea
o Indigo/Violet= Raisins

o M-Morphine
o A-Aminophylline
o D-Digitalis
o D-Diuretics
o O-O2
o G-Gasses in blood (ABGs)
Cholecystisis: Gallbladder inflammation (RUQ pain)
Cholelithiasis: Gall Stones
Pancreatitis
o TURNERS SIGN: Flank echymosis
o CULLANs SIGN: Bluish periumbical (around the belly button)
Who needs Dialysis?
Vowels: AEIOU
A: Acid/Base Problems
E: Electrolyte Problems
I: Intoxications
O: Overload of fluids
U: Uremic Symptoms

o 4 point gait
Both legs and both crutches touch the ground
Weight bearing
o Swing through gait
Advancing both crutches, then both legs, and requires weight
bearing
Not as stable as other gaits
Laminectomy = removal of 1 or more vertebral laminae need
straight back after = LOGROLL and
KEEP BACK STRAIGHT (so flat bed)
Intussceptation
o Seen in Non-Hodgkins Lymphoma
o Hot dog mass in RUQ
o Red Currant Jelly Like mucous and bloody stool
Sweat Chol
o > 60 = CF
o 40-60 = Borderline CF
Ostomy = pouch opening 1/8 in larger than stoma
Macule = flat and round
Papule = rounded and red
Vesicle = filled with fluid
Impetigo = 1:20 Burrows Soln, honey colored crusts
Permethrin [NIX] => 10% for lice tx and 5% for Scabies tx
o (Scabies = mites bury under skin)

Cushings Dx
o (Cushion too much Cortisone)
o (3 Ss = high Steriods, high Sugars (hyperglycemia), high Sodium
o Moon Face, Buffalo Hump, Trunkal obesity, thin skinny
extremities, slow wound healing, osteoporosis, HTN, muscle wasting RUQ: Right upper quadrant
o K+
Cholelithiasis (gallstones)
Cholecystitis (inflamm of gallbladder)
Cretenism = Congential Hypothyroidism (appears 3-6 mo in
Addisons Dx
Hepatitis
bottlefed infants and later in breastfed infants)
o Need to ADD steroids
Pancreatitis (severe knifelike pain; worse with eating/lying down;
Hepatitis: low fat, high cal/carbs/protein, no alcohol
o (3 Ss = Low Steroids, Low Sugars, Low Sodium)
some relief with fetal position)
Hypothryoid: High Protein, low cal diet
o Low vascular volume (Not holding salt and H20 like in Cushings),
Cystic Fibrosis: High Protein Diet and Pancr enzyme replacement low BP
RLQ:
Hital Hernia: Fundopliction (tighten cardiac sphincter on stomach) o Hyperkalemia ( K+)
Crohns Dx (Ileum, Rt Colon; pain after meals)
dont lie down for 1 hr after meals, HOB 4-8 in when sleepy, no
o Bronze Skin, Hyperpigmentation
Appendicitis
food before bed
o Pain at McBurneys Point
Papable olive shaped tumor in epigastrim = pyloric stenosis
ALLEN TEST
(1/2 b/w umbilicus and right iliac crest)
(projectile vomiting)
o B4 drawing ABGs do an Allens Test
o In adults from peptic ulcers; in infants from hypertrophy of
o Compress both radial and ulnar arties (wrist) at same time on 1
LLQ:
pylorous (symp 2nd-4th wk after birth)
hand
Ulcerative Colitis (Rectum, left colon; pain pre-defecation)
o Release the ULNAR side (pinky side) and hand should turn
Diverticulitis
PEDS
discolored and should be able to see blood flow back into it
o Relieved by passage of stool/flatulus
Toddler: Fear of separation (give simple directions)
(Radial is located on the thumb side and ulnar is on the pinky
Preschooler: Fear mutilation (Allow to play with equipment)
side)
Duodenal Ulcer: Pain 2-3 hrs after meals and nighttime (relieve pain
School Agers: Fear loss of control (allow to play with equipment) o Minutes of press on the ABG site after drawing blood?
with FOOD INTAKE)
Adol: Fear loss of independence
5-10 min or 15-20 min if on anti-coagulants
Gastric Ulcer: Pain 1 hr after meal/when fasting; relieve pain with
After a liver biopsy place patient on the RIGHT Side
vomiting, not with food intake
Pneumothorax Symp (P-Thorax)
(Starve the gastric ulcer and feed the duodenal)
o P-Pleurtic Pain
Mobility
o T-Trachea Deviation
o Cane
Diverticular Dx: Cramping in LLQ relived by passage of stool and
o H-Hyperresonance
COAL = Cane Opp Affected Leg
flatus (constipation alternates with diarrhea (from def in diet fiber)
o O-Onset Sudden
o 2 point gait
high fiber diet
o R-Reduced breath sounds (dyspnea)
One leg and 1 crutch touch ground at same time
Meckels Diverticulum: congen sac or pouch in ileum, symp seen by
o A-Absent Fremitus
Weight bearing
age 2; painless rectal bleeding, abd, hematechezia, (currant jelly like
o X-X-Rays show collapse
o 3 point gait
stool), s/s of appendicitis (tx = remove diverticulum)
Both crutches and 1 foot are on the ground
Pul Edema Tx (MAD DOG)
Non-weight bearing
Cirrhosis:

 Biliary obstruction, alcohol, Hepatitis

Early stage: high protein/carbs and Vit B
Adv stage: low fiber/salt/fat/protein, high cal, fluid restriction
Esophageal Varices
o Sengstaken Blakemore Tube or Minnesota Tube
Balloon on Esophagus and stomach to apply direct press on
bleeding veins
o TIPS (transesophegal intrahepatic post systemic shunt)
Balloon Catheter inserted via jugular vein with angiography to
create a metal stent b.w portal vein to vena cava channel (provides a
pathway for blood b/w portal vein and hepatic vein = bypasses
cirrhotic liver) and relieves press on esoph varicies
Jaundice (Icterus)
Hemolytic
o RBCs are destroyed (release bilirubin)
Hemolytic transfusion rxn
Hemolytic Anemia
Sickle Cell Crisis
Hepatocellular
o The impaired liver cell (hepatocyte) doesnt allow bilirubin to
convert from the unconjugated to the conjugated form
Obstructive
o Bile flow is obstructed
Tumors
EKGS
Nml Sinus
o 60-100
o PQRST nml EKG Strip
Sinus Brady
o < 60
o Tx: Atropine
o (can be nml in physically fit/trainer person = then no tx needed)
1st degree AV Block
o Prolonged PR interval
o Nml PR interval: 0.12-0.20
o Conduction Problem
o Drugs (Dig, Beta Blockers, Ca Channel Blockers) can cause by
slowing conduction system (slows conduction from SA node to AV
node to Purnjee Fibers = see slowed PR (Atrial Response)
o Usu dont see symp, so usu not treated
Atrial Flutter
o Saw Tooth Appearance
o Atrium racing away, blood pools and can throw a clot => stroke
o Treat with Cardioversion 20-50 Jules (NURSE must hit
Synchronize button)
o Ventricle beats are regular
Atrial Fib
o Ventricle beats are irregular
o Atrium quivers, not good pump
o Cardiovert 50-100 Jules
o If in hospital and were stable b4 going into a fib = give cardizem

drip and beta blockers b4 cardioversion

B9 - For Pregnant Patients

B12 - Pernicious anemia, Vegetarians.
V-Tach
Complications of Coumadin - 3Hs - Hemorrhage, hematuria &
o Wide QRS complexes
hepatitis
o V Tach and awake drugs I must take (Amiodarone or Lidocaine)
FFP is administered to DIC(disseminated intervascular coagulation)
o V Tach and a nap (unconscious) zap zap zap (defibrillate)
b/c of the clotting Fx
o Can only stay in for 2-3 min (can die)
Mannitol (osmotic diuretic [Head injury]) crystallizes at room temp
use a filter needle
V Fib
Antianxiety medication is pharmacologically similar to alcohol
o Irreg makes no sense
used for weaning Tx
o Only way to tx = defribillate start at 360 Jules
Administrate Glucagon when pt is hypoglycemia and unresponsive
o Epi (to HR)
Phenazopyridine ( Pyridium)--Urine will appear orange
Stroke
Rifampicin -- Red-urine, tears, sweat)
Right Sided: Impatient, easily distracted, impulsive, less concerned Hot and Dry = sugar high (hyperglycemia)
about life events, safety is a big issue (impulse)
Cold and clammy = need some candy (hypoglycemia)
Med of choice for V-tach is = lidocaine
Left Sided: Slow, cautious, particular, very aware of deficits, greater Med of choice for SVT = adenosine or adenocard
depression/anxiety
Med of choice for Asystole = atropine
Med of choice for CHF is = Ace inhibitor.
(Think rt brain = creative, left brain = logical, math, science)
Med of choice for anaphylactic shock= is Epinephrine
Med of choice for Status Epilepticus = is Valium.
Pharm Facts
Med of choice for bipolar is =lithium.
Dont give non-selective beta-blockers NSBB to patients
Give ACE inhibitors w/food to prevent stomach upset
w/respiratory problems
Administer diuretics in the morning
Vitamin C can cause false +ive occult blood
Give Lipitor at 1700 since the enzymes work best during the evening
Avoid the G herbs (ginsing, ginger, ginko, garlic) when on antiCommon Tricyclic Meds - 3 syllabes (pamelor, elavil)
clotting drugs (coumadin, ASA, Plavix, etc)
Common MAOIs - 2 syllables (Parnate, marplan, emsan, nardil, ,)
ASA toxicity can cause ringing of the ears Ototoxicity
TPN has a dedicated line & cannot be mixed ahead of time
No narcotics to any head-injury victims
RHoGAM -- Given at 28 weeks & 72 hrs postpartum
Mg2+ toxicity is treated with Calcium Gluconate
Do not administer erythromycin to Multiple Sclerosis pt
Do not give Calcium-Channel Blockers with Grapefruit Juice
Benadryl and Xanax taken together will cause additive effects.
Oxytocin is never administered through the primary IV
Can't take Lasix if allergic to Sulfa drugs.
Lithium (Mood) patients must consume Na extra sodium to prevent Acetaminophen can be used for headache when the client is using
toxicity
nitroglycerin.
MAOI Patients should avoid thyramine: (Aacados, bananas,
Dilantin - can not give with dextrose. Only give with NS.
beef/chicken liver, caffeine, red wine, beer, cheese (except cottage
cheese), raisins, sausages, pepperoni, yogurt, sour cream)
Dont give atropine for glaucoma it increases IOP
Addison is skinny ( hypoglycemic, you get weight loss, you got
Dont give ant-acids with food -- b/c it delays gastric emptying.
weakness, and you get postural hypotonic)
Dont give Stadol to Methadone/Heroin Preggos -- cause instant
Cushing is fat ( hyperglycemic, you get moon face, big cheeks, and
withdrawal symptoms
you retain a lot of Na and fluid, weight)
Insulin clear before cloudy
Never Give via IVP:
Dont give Meperidine (Demerol) to pancreatitis patients
oKCL
Always verify bowel sounds when giving Kayexelate
oHeparin
Hypercalcemia Ca = Phos hypophosphatemia
oIbuprofen
Radioactive Dye urine excretion
oInsulin
Signs of toxic ammonia levels is Asterixis (hands flapping)
oDobutamine
D10W can be substituted for TPN (temporary use)
oASA
Dopamine and Lasix are incompatible
oAlbumin
Hypoglycemic shivers can be stopped by holding the limb, seizures oAcetaminophen
cannot (infants)
Common symptom of Aluminum hydroxide constipation
Insulin:
Thiazide diuretics may induce hyperglycemia
oRapid: (lispro/humalg) onset <15 min. Peak: 1hr. Dur 3hr
Take Iron with Vit C it enhances absorbtion Do not take with
oShort: Reg (humulin/novolin) onset - 1hr. Pk: 2-3hr. D:4-6
milk
oInt: (NPH/Lente)onset: 2hr. Peak 6-12 hr. Duration: 16-24hr
B1 - For Alcoholic Patients (to prevent Wernickes encephalopathy oLong: (Ultralente ) onset 4-6 hr. Peak: 12-16 hr. Dura: >24hr
& Korsakoffs syndrome)
oV.Long: (Lantus/glargine) onset 1hr. Peak: None. Dur: 24hr
B6 - For TB Patients

Acetylcholine Neurotransmitter
(PNS muscle mov CNS Alzheimers)
ACh Receptor Agonists are used to treat myasthenia gravis and
Alzheimer's disease.
Anticholergic S/E: given for Ach S/E
(dicycloverine/atropine)
oCant See (blurred vision)
oCant Pee (anuria)
oCant Spit ( oral secretions)
oCant Sh*t ( peristalsis vagus nerve)

HypoCalcemia Ca+ CATS

oConvulsions
oArrythmias
oTetany
oSpasms & Stridor
Hyper Kalemia Causes K+: MACHINE
oMedicational (ace inhibitors, NSAIDS)
oAcidosis (metabolic & repiratory)
oCellular destruction (burns, traumatic injury)
oHypoaldosteronism, Hemolysis
oNephrons, renal failure
oExcretion (impaired)
Signs of increased K Murder
oMuscle weakness
oUrine olyguria, anuria
oRespiratory distress
oDecreaed cardiac contractility
oECG Changes
oReflexes hyperreflexia, or flaccid
Substance Poisoning and Antidotes
oMethanol -- Ethanol
oCO2 -Oxygen
oDopamine -- Phentolamine
oBenzos (Versed) -- Flumazenil
oLead -- Succimer, Calcium Disodium
oIron -Deferoxamine
oCoumadin -- Vitamin K
oHeparin -Protamine Sulfate
oThorazine -- Cogentine
oWild Mushrooms - Atropine
oRat Poison Vit K
Parkland Formula: 4cc * Kg * BSA Burned = Total Volume
Necessary
o1st 8hrs total volume
o2nd 8hrs total volume
o3rd 8 hrs total volumes
1. Alpha 1-adrenergic Blockers end in zosin and losin.

SE are dizziness, weakness may occur when changing position.

breathing, night cough, swelling of extremities, slow pulse,
Should teach pt to change position slowly and lie down if dizziness confusion, depression, rash and sore throat.
occurs. GI upset may occur, teach pt to eat smaller more frequent
meals. Should tell the pt to report FREQUENT faintness or dizziness.
Mental Health:
2. Aminoglycosides end in mycin and another imp. that they try to
throw in to confuse you is amikacin sulfate..
Clozaril, Cogentin, Dalamane, Dexedrine, Elavil, Eskalith, Haldol,
teach pt to take full course of drugs and drink plenty of fluids,tell
Luminal, Navane, Phenergan, Ritalin, Serax, Sinequan, Surfak,
them they may report these
Thorazine
SE..RINGING IN EARS, headache, dizziness, N/V, loss of appetite.
They should report pain at the injection site and severe headache,
OB:
dizziness, loss of hearing, changes in urine pattern, difficulty
breathing, rash or skin lesions,
Aldomet, Ampicillin, Cortef, Ergometrine, Magnesium sulfate,
Pitocin, Premarin, Primaxin, Yutopar
3. ACE inhibitors end in pril take these drugs 1 hour before or 2
hours after meals, do NOT take w/ food (captopril, moexipril).
Peds:
SE These drugs will give a false pos. for urine acetone, NOT
pregnant women can cause serious fetal effects. patient may
Kewll, Nix, Oncovin (plus the med-surg drugs)
experience GI upset, appetite loss, dizziness fast heart rate, change in
taste. Teach pt to report sore throat, fever, chills swelling of hands
and feet, chest pain and irregular heart beats swelling of face and
eyes lips tongue difficulty breathing
4. ARBS (Angiotensing II receptor blockers) end in SARTAN.
Teach pt they must use an alternate method to birth control while
using these drugs.
SE May experience dizziness, nausea, abdominal pain, symptoms of
URI, cough. Report fever, chills, dizziness and pregnancy
5. Anti migraine Drugs end in triptan. NO take while pregnant
Contact MD IMMED. if you experience chest pain or pressure that
doesnt go away, Report feelings of heat flushing tiredness, sickness
swelling of lips and eyelids.
SE you may experience are: dizziness and drowsiness, numbness
feelings of tightness or pressure

-ase = thrombolytic
-azepam = benzodiazepine
-azine = antiemetic; phenothiazide
-azole = proton pump inhibitor, antifungal
-barbital = barbiturate
-coxib = cox 2 enzyme blockers
6. Antivirals end in VIR.
-cep/-cef = anti-infectives
SE pt may experience are n/v/d, loss of appetite, HA, dizziness.
-caine = anesthetics
REPORT: difficulty urinating, skin rash, or freq. recurrences.
-cillin = penicillin
-cycline = antibiotic
7. Barbituates end in barbital. Teach pt that these drugs make you -dipine = calcium channel blocker
drowsy and less anxious dont try to get up after receiving this drug -floxacin = antibiotic
and they may experience drowsiness, dizziness , impaired thinking, -ipramine = Tricyclic antidepressant
hangover, ...AVOID DRIVING. GI upset, dreams (nightmares) diff. -ine = reverse transcriptase inhibitors, antihistamines
concentrating, fatigue.
-kinase = thrombolytics
SE Report severe dizziness, drowsiness, and weakness and
-lone, pred- = corticosteroid
pregnancy
-mab = monoclonal antibiotics
-micin = antibiotic, aminoglycoside
8. Benzodiazepines end in pam and lam and in the middle have
-navir = protease inhibitor
either azo or aze.
nitr-, -nitr- = nitrate/vasodilator
SE are same as above drowsiness, dizziness etc. REPORT: SEVERE -olol = beta antagonist
drowsiness, dizziness, swelling in extremities, diff. voiding,
-oxin = cardiac glycoside
palpitations
-osin = Alpha blocker
-parin = anticoagulant
-prazole = PPIs
9. Beta Blockers end in LOL.
-phylline = bronchodilator
SE You may experience dizziness, drowsiness, light headed, blurred -pril = ACE inhibitor
vision, n/v, loss of appetite, impotence, depression. REPORT: diff.
-statin = cholesterol lowering agent
-sartan = angiotensin II blocker

-sone = glucocorticoid, corticosteroid

-stigmine = cholinergics
-terol = Beta 2 Agonist
-thiazide = diuretic
-tidine = antiulcer
-trophin = Pituitary Hormone
-vir = anti-viral, protease inhibitors
-zosin = Alpha 1 Antagonist
-zolam = benzo/sedative
-zine = antihistamine

Nasonex
Neulasta
Orencia
Reclast
Requip
Restasis
Rozerem
Singulair
Spiriva
Symbicort

Actonel.
Avodart.
Boniva.
Celebrex.
Cialis.
Coreg.
Crestor.
Detrol.
Ditropan.
Enbrel.
Fosamax.
Humira.
Levitra.
Lunesta.
Nexium.
Paxil.
Plavix.
Premarin.
Prilosec.
Procrit
Strattera.
Valtrex
Vesicare.
Viagra.
Vioxx.
Vytorin.
Wellbutrin.
Zelnorm.
Zocor.
Zyprexa.

Some Other Interesting Facts Likely To Be On The Test

Abilify
Alavert
Amitiza
Aricept
Caduet
Cymbalta
Effexor
Enablex
Evista
Flowmax
Gardasil
Imitrex
Januvia
Lyrica
Mirapex
Mirena

Thiazide Diuretics BS
Diabetics need food K like oranges, bananas and brocholli
Vitamine K is a natural coagulant Foods high in Vitamin K like
green leafy vegatables should be avoided with blood thinners.
Normal potassium levels 3.5 to 5.0 mEq/liter
Potassium levels under 3.5 is Hypokalemia
Vasodilators: (esp nitroglyerine) innitially have orthostatic
hypotension side effect which wears off over time
Diuretic Loop:
Calcium Channel Blocker

All listed treat Hypertension

All Treat Hypretension and Angina

AngioTension II Receptor Antagonist All listed treat HTN

ACE- Inhibitors:
1) Are the primary drug of choice for vasodilation in Heart Failure
2) One side effect of ACE-I is orthostatic hypotension.
3) All ACE-I Listed all treat Hypertension & CHF some, treat MI
Beta Blockers :
1) All listed treat Hypertension & Angina
2) Most Treat CHF & Arrythmia
3) Must be taper slowly when discontinued to avoid Angina.
"Complications of Hypertension are:
1) Angina 2) stroke 3) Renal failure

4) Heart failure"

If digitalis is order "Give digitals if 60 < HR < 120

Hold digitalis if 60 > HR > 120"