Mark Lecture 6

drug toxicity, abdominal dumping syndrome vs hiatal hernia, electrolytes

the main drug toxicities on nclex

• lithium -digoxin - aminophyline - dilatin (phenytoin) - bilirubi

Lithium Action and Therapeutic Levels

Action: Treats mania of bi-polar Therapeutic Levels: 0.8 - 1.2 for maintenance and initial is 1-1.5

Lithium AE and NC

AE: Dizziness, headache, impaired vision, fine hand tremors, reversible leukocytosis

NC: Adequate fluid and salt intake - avoid caffiene and no diuretics Look for N/V, ataxia, blurred vision, slurred speech

Digoxin Action and Therapeutic Levels

Action: treats a-fb and CHF Therapeutic levels: 0.5 - 2 toxic is >2

Digoxin AE and NC

AE: Anorexia, N, bradycardia, visual disturbance, confusion, abdominal pain

NC: Asses Apical before administration, monitor renal function, instruct to eat high potassium foods

Kalemia and Calcemia + Magnesia considerations

1. Does same as prefix besides HR + Urine output 2. Opposite of prefix also mag is a drag

Hyperkalemia s/s

irritable, agitation, restlessness, aggression, loud, tachypnea, low HR but peaked T and ST waves, diarrhea, muscle spasticity, increased muscle tone, hyper reflexive, low urine output

Hypokalemia s/s

lethargy, obtunded, stupor, bradypnea, increase HR, ileus constipation, flaccid low reflexes, high urine output

Hypercalcemia s/s

body goes low, bradycardia, bradypnea, flaccidity, lethargy, constipation

Hypocalcemia s/s

body goes high, agitation, clonus, hyperreflexive, seizure, tachycardia, trousseau’s sign, chvosteks sign

Trousseaus sign

BP cuff on arm hand tremors

Chvosteks sign

tap cheek and face spasms

Sodium s/s

dEhydration = hypErnatremia Overload = hypOnatremia

earliest sign of electrolyte disorder

numbness and tingling