WGU D444 Adult Health 1 Complete with 100% accurate solutions + rationales

Ototoxic Drugs

Vancomycin (antibiotics), aminoglycosides, loop diuretics, cisplatin

Also: NSAIDs, acetaminophen, quinine, chemo drugs (ex. cisplatin), antimalarials

hepatoxic drugs

Acetaminophen (most common)

anti-fungals

Nephrotoxic drugs

aminoglycosides. amphotericin B. ACE inhibitors. cicplatin. cyclosporin. NSAIDS. Radiographic I V contrasts.

Vancomycin

Glaucoma meds: Prostaglandin agonists (end in -prost)

lowers IOP by allowing more outflow of aqueous humor

Glaucoma meds: Adrenergic Agonists (apraclonidine, brimonidine tartrate, dipivefrin hydrochloride)

reduces amount of aqueous humor produced by ciliary bodies, lowering IOP

Glaucoma meds: Beta-Adrenergic Blockers (betaxolol hydrochloride, carteolol, levobunolol, timolol)

decreased IOP by blocking beta-adrenergic receptors so less aqueous humor is produced

Glaucoma meds: cholinergic agonists (pilocarpine, echothiophate, carbachol)

lower IOP by decreasing amount of aqueous humor produced

Glaucoma meds: carbonic anhydrase inhibitors (brinzolamide, dorzolamide)

reduce IOP by inhibiting production of aqueous humor

What's important to monitor for glaucoma patients when on meds?

monitor I&O

Emphysema Acronym

PINK Puffer

Pink skin, pursed lip breathing

Increased chest (barrel chest)

No chronic cough (minimal)

Keep tripoding

Chronic Bronchitis Acronym

BLUE Bloater

Blue color (cyanosis)

Long chronic cough

Unusual breath sounds (wheezing and crackles)

Edema

Low Oxygen s/s (hypoxia)

restlessness, agitation, decreased LOC

Celiac disease

- no gluten

- give fat soluble vitamins (ADEK)

- S/S: abdominal pain, steatorrhea, diarrhea, (stunted growth and slowed puberty in children) wt. loss

Chron's disease

- auto-immune (exacerbations and remissions)

- causes: Stress, Smoking, Sepsis (infection)

- can include all GI tract

- "skip lesions"- don't bleed

- granulomas (bumps and lumps in bowel wall)

- s/s: 5 loose stools/day (mucus/pus) and steatorrhea

Ulceritive Colitis

chronic inflammatory disease of the colon

- s/s: 15-20 bloody stools/day

- decreased H/H (anemia)

- Rebound tenderness- REPORT

Care for UC and Chrons

- strict I&O monitoring

- daily multivit's with calcium

DIET: HIGH protein and calories; LOW fiber; keeping food journal

- small frequent meals

- Pain- administer analgesics; AVOID alcohol. Reduce CAFFEINE; stress reduction, discuss feelings

COPD care

- pursed lip breathing

- huff coughing

- oral care BEFORE meals

- small frequent meals

- HIGH calories, high protein (avoid high carbs)

- avoid exercise 1 hour before and after meals

- avoid gassy foods

- increase fluids (2/3 L/day)

- avoid fluid w/meals

- REPORT: increased sputum, fever, worsening symptoms

UC and Chron's Complications

- REPORT: peritonitis signs (Fever over 100.3; REBOUND TENDERNESS, Rigid/board-like abdomen, increasing pain & tenderness, Restless tachycardia & tachypnea

UC and Chron's medications

- Sulfasalazine- Stops body from attacking itself (yellow/orange discoloration to urine and skin is normal) (reactions: Sun- photosensitivity, urine crystals, Low urine output (elevated specific gravity), Fluid and folic acid)

- Steroids (- sone) "soothe the swelling"

- Antidiarrheals (Loperamide; dicyclomine- CONTRAINDICATED for paralytic ileus and NOT for glaucoma, NOT for urinary retention)

Tinea Pedis treatment

- Topical antifungals (creams, powder, sprays)

- wash and dry feet esp. between toes

- wear cotton socks and change after sweating

- wear flip-flops to public pools/showers

Pneumonia Patient care

- can give pain meds

- can give O2

- increase fluids (2-3 L/day), elevated HOB to high fowlers; TCDB; Chest physio; HUFF coughing

Pneumonia Post-op

- Early ambulation

- Cough with splinting

- Handwashing

- Mouth care q12h (chlorhexidine)

- Incentive Spirometer every hour!

- Give pain meds

Pneumonia discharge teaching

- avoid cough suppressants

- Cool mist humidifier

- Increase fluids

- Incentive Spirometer

- Prevent reinfection (finish antibiotics, pneumonia vaccine ev. 5 yrs, smoking cessation, handwashing, F/U chest x-rays

*REPORT: increased or worsening FEVER, CONFUSION, SOB, Cough, Sputum

What can be give to help with flu symptoms?

Oseltamivir

What eye condition can you use ketorolac for?

corneal abrasions

Ipratropium

anticholinergic bronchodilator

used with asthma

DO NOT use for glaucoma, BPH, bowel obstruction, urinary retention

If a pt is showing signs of anaphylactic shock, what antibody will be present?

IgE (immunoglobulin E)

What cells do HIV destroy within the body?

CD4 and T cells

What are the s/s of TB?

Night sweats

low-grade fever

malaise

weight loss (anorexia)

SOB/Dyspnea

Cough and hemoptysis

If TB is suspected, what do you do first?

Place pt in isolation (airborne precaution)

What are you worried about with a myasthenic crisis?

Airway protection

Myasthenia gravis

a chronic autoimmune disease that affects the neuromuscular junction and produces serious weakness of voluntary muscles

- "DRYasthania gravis"

- muscle weakness, ptosis, double vision, impaired speech, dysphagia, trouble breathing

MS

- muscle stiffness and spasms; ataxia, urinary retention, hyperreflexia, decreased concentration, fatigue & paralysis, double vision, blurry, or dark

- PT ED: balance exercise and rest, AVOID 4 S's (stress, smoking, sun, sickness); PROMOTE self-care ADL's, gait training

MS meds

- IVIG

- Interferon

- Steroids (Prednisone)

- muscle relaxants (Baclofen)

- immunosuppressants (cyclosporine)- report signs of infection & bleeding, not for pregnant clients

GERD s/s and risk factors

S/S: Dyspepsia (heartburn)

Worse pain when lying down

RF: stress, obesity, hiatal hernia

GERD CAUSES and avoidances

- Avoid eating fried food, chocolate, spearmint/peppermint, fatty foods, citrus, dairy,

- NO caffeine, smoking, alcohol

- AVOID eating before bed (approx. 3 hours); sit up after meals, elevate HOB at night, eat small meals

REPORT s/s of PERITONITIS

Hepatitis

A- fecal oral (contaminated food) is self-limiting

B- blood & body fluids (unprotected sex, IV drug use, sharing razors)- treated w/antivirals

C- blood & body fluids (most IV drug use)- treated w/antivirals

D- only occurs w/B

E- fecal/oral route- contaminated water

*Complications: think Liver issues

Huntington's

- passed on by genetics

- only need 1 parent

- Genetic counseling!

- causes dementia

Lactulose

Osmotic laxative

- lactu"lose" can cause diarrhea

- helps with hepatic encephalopathy by lowering ammonia levels

*Mental status change is the only way to ensure ammonia levels are lowering

What are risky meds with H. Pylori infection?

- Aspirin

- NSAIDS

What lab levels are associated with the liver?

ALT and AST

What lab levels are associated with the pancreas?

Amylase and Lipase

What lab levels are associated with kidneys?

BUN and creatinine