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Therapeutic and adverse effects may be potentiated by complementary and alternative therapies (CAT), including ginseng, sage, nightshade, celery, coriander, and saw palmetto extract. Additionally, alcohol and OTC medications (especially NSAIDs) affect drug actions and potentiate adverse effects. Be sure to specifically ask your clients if they are using any alternative or complementary therapies. Pharm Fri! BONE RESORPTION INHIBITORS - Take oral bisphosphonates in the morning, on an empty stomach. If a question asks what the client needs, use Maslow's hierarchy to help determine which need to address first. Use this mnemonic device to remember lead placement for a 3lead EKG: (White) on the right, smoke (Black) over fire (Red). This week's NCLEX question of the week Of all the age-appropriate nursing diagnoses for older adults listed below, which one would indicate that the client is at greatest risk for falling? 1. Sensory perceptual alterations related to decreased vision 2. Alteration in mobility related to fatigue 3. Impaired gas exchange related to retained secretions 4. Altered patterns of urinary elimination related to nocturia This week's NCLEX question The nurse is reviewing the list of medications for a client who is scheduled for electroconvulsive therapy (ECT). Which medication does the nurse recognize as the one that will promote skeletal muscle relaxation? 1. Propofol (Diprivan) 2. Atropine 3. Succinylcholine (Anectine) 4. Thiopental (Pentothal) NCLEX Study Tip Make a chart of the various electrolyte imbalances with the states of excess in one column and the deficiencies in the second column. List only those features of each electrolyte imbalance common to another

electrolyte imbalance. For example: positive Chvosteks sign is common to both hypocalcemia and hypomagnesemia.

It's Pharm Friday! Antiulcer agents: Cimetidine can cause confusion in older clients. This week's NCLEX Question of the Week A nurse administered intravenous immune globulin (IVIG) to an 18 month-old child with immune deficiency disorder. The parents asks why this medication is being given. How should the nurse respond? 1. "It will slow down the replication of the virus." 2. "This medication will improve your child's overall health status." 3. "This medication is used to prevent bacterial infections." 4. "It will increase the effectiveness of the other medications your child receives." Pharm Friday! Antituberculars Rifampin will stain tears a reddish-orange color; clients should not wear soft contact lenses. Pharm Fri! Anti-infectives - Tetracylines Tetracyclines should be taken on an empty stomach. Anti-infectives - Sulfonamides Silver sulfadiazine (Silvadene) is a topical sulfonamide used to treat burns. Don't confuse these three! Ileum = most distal part of the small intestine Ileus = an obstruction (often in an intestine) Ilium = part of the hipbone A nurse is assessing an infant with developmental dysplasia of the hip. Which finding should a nurse anticipate? 1. Unequal leg length 2. Limited adduction 3. Diminished femoral pulses 4. Symmetrical gluteal folds Adverse effects of anticholinergic agents include dry mouth, constipation, and blurred vision, which are similar to the effects of anticholinergic agents

(like atropine or scopolamine). Learn anticholinergic effects and apply the findings to all anticholinergic agents. Remember... AMPLE (used to asses client injury/trauma)Allergies, Medication, Past Illness, Last meal, Event preceding injury. This week's NCLEX question... A nurse is caring for a post myocardial infarction client in an intensive care unit. It is noted that urinary output has dropped from 60 to 70 mL per hour to 30 mL per hour. This change is most likely due to which of the following issues? 1. Dehydration 2. Diminished blood volume 3. Decreased cardiac output 4. Renal failure In major mental illnesses, the nursing care has four goals: protection, medication, reality, and hygiene or "Popcorn Makes Rick Happy" Protection - protect client and others from harm; establish trust Medication - administer medications; teach about side effects and need for compliance; monitor for extrapyramidal symptoms Reality - reality orientation, realistic goals, safe successes; encourage control Hygiene - assist with hygiene, feeding; encourage self-care" ACE inhibitors: used to control BP, treat heart failure & help prevent strokes. Look for meds that end with pril like ramipril (Altace). Emergency Trauma Assessment, ABCDEFGHI A-Airway B-Breathing C-Circulation D- Disability E- Examine/Expose F- Fahrenheit (temperature) G- Get vitals H- head to toe assessment or history I- Inspect the back TIP: If there is a fire, remember RACE: R=Rescue or remove clients

A=Activate fire alarm system C=Contain fire by closing windows and doors E=Extinguish flames (with fire extinguishers) When the stem of the question asks what is essential for the nurse to do, think safety(especially if there isn't an urgent physiologic need) TIP: Documentation has six key components:CO-ACTS: Confidential Organized(chronologically) Accurate Complete Timely Subjective and objective data Dont forget! The 1st step of the nursing process is assessment; when the stem of a question asks for the initial nursing action, always look to see if there is a relevant assessment answer. When reading the stem of the question, give special attention to words such as: BEST, MOST, LEAST, FIRST, PRIORITY, INITIAL