Lithium Carbonate: What You Need to Know

Lithium Carbonate Must-Knows

The NCLEX consists of four core topics, with Physiological Integrity as one of them. Under this section is ‘pharmacological and parenteral therapies,’ undoubtedly one of the hardest subjects in the exam.

As such, it is important that you familiarize yourself with the common medications found in the NCLEX, one of which is Lithium Carbonate. Here are some important facts you need to know about this drug:

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Indication for Use

Lithium Carbonate is an anti-manic drug, used in the treatment of manic episodes in individuals with bipolar disorder. It is also used as a maintenance drug, in order to decrease the intensity and frequency of ensuing manic outbreaks.

Lithium Carbonate, also known by the names Eskalith, Eskalith CR, Lithobid, Lithonate and Lithotabs, works by inhibiting dopamine and norepinephrine release. Placed under Pregnancy Category D, this drug is known to cross the placenta and the milk ducts.

Nursing Considerations

As a nurse, you need to know that Lithium Carbonate interacts with a lot of drugs and supplements. Toxicity can occur if it is taken in conjunction with Thiazide diuretics such as Hydrochlorothiazide and Indapamide. CNS toxicity can also occur if it is taken with Carbamazepine.

Plasma Lithium Carbonate levels, on the other hand, can increase and become toxic if it taken in conjunction with NSAIDs (i.e. Ibuprofen and Meloxicam) and Indomethacin.

Prior to administering Lithium Carbonate, make sure to take the patient’s history. Note if the patient has a severe heart or kidney problem. Assess if the patient takes diuretics, or if he suffers from tartrazine hypersensitivity.

Also remember to monitor the patient’s vital signs, weight, orientation and affect prior to administering Lithium Carbonate. Check his fluid intake and output as well. Do not forget to evaluate the baseline results of the following exams: CBC, Urinalysis, ECG, Thyroid and Renal function tests.

Nursing Interventions

Because of this risk of toxicity associated with Lithium Carbonate, religiously check the serum levels of the patient, especially if he is dehydrated, debilitated, or diagnosed with heart or kidney diseases. Remember that the therapeutic level for this drug is 0.6 to 1.2 mEq/L.

The efficacy or toxicity of Lithium Carbonate depends on the patient’s salt and fluid intake. As such, instruct your client to maintain adequate salt and fluid intake, which is 2.5 to 3 liters per day.

Important Teaching Points

Nurses are patient educators, so you need to remind them of essential drug pointers, especially if they will be taking Lithium Carbonate at home.

Make sure to advise your patient to take Lithium Carbonate after meals with food or milk. Remind him about maintaining a normal salt and fluid intake for optimum effectiveness.

Inform your patient about the expected side effects of Lithium Carbonate, which are drowsiness, dizziness, GI upset, mild thirst, increased urine volume and fine hand tremor.

Most importantly, instruct your patient to coordinate with you or another healthcare provider if he experiences the signs of toxicity, which include tremor, vomiting, diarrhea, drowsiness, muscular weakness and lack of coordination.

 

Lithium is just one of the many medications you can expect in your forthcoming NCLEX exam. Master this drug – among many others – at NCLEXpreceptor.com’s practice NCLEX questions.

 

Resources:

http://web.squ.edu.om/med-lib/med_cd/e_cds/Nursing%20Drug%20Guide/mg/lithium.htm

http://www.mayoclinic.org/drugs-supplements/lithium-oral-route/description/drg-20064603

 

 

Vitamin K – Pass the NCLEX on your First Time by Mastering this Drug

Master Vitamin K

Vitamins are essential for everybody’s health. So if you are an aspiring nurse, you definitely have to master these vital substances.

Now that you are about to take your NCLEX, remember that you need to be familiar with the common drugs, such as Vitamin K. Often found in NCLEX tests, you can memorize its important points by reading through the rest of this article.

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Indications for Use

Also known as Phytomenadione, Vitamin K is a medication that works similar to the natural vitamin found in green leafy vegetables and fish. It is needed for the synthesis of clotting factors that prevent excessive bleeding.

Vitamin K is prescribed in patients who suffer from an overdose of oral anti-coagulants, such as Coumadin and Inandione. It is also used in individuals who suffer from hypoprothrombinemia resulting from the intake of oral antibiotics and Vitamin A.

Those with disorders resulting to the malabsorption and inadequacy of Vitamin K, such as ulcerative colitis and obstructive jaundice, are also treated with the said drug.

Vitamin K is also an essential medication for newborns, as it is used in the treatment of neonatal hemorrhagic disease.

Nursing Considerations

As a nurse, you are responsible for monitoring the patient who will receive Vitamin K. You should take a comprehensive history, specifically noting if he has allergies. For female patients, establish if they are pregnant, planning to be pregnant or lactating, as it can cause jaundice and other conditions to the fetus/neonate.

Since Vitamin K helps in the synthesis of clotting factors, you should check the patient’s PT and INR tests every so often.

NCLEX Nursing Interventions

As it has been established, you should religiously monitor your patient’s PT/INR response. After all, the result will dictate the duration, frequency and dose of Vitamin K.

The effectiveness of the drug is evidenced by the following responses:

  • Shortened PT/INR, bleeding and clotting times
  • Decreased bleeding tendencies

Important NCLEX Teaching Points

When dealing with patients taking Vitamin K, it is vital to remind them to maintain a normal diet. Remind them to avoid increasing the intake of Vitamin K-rich foods (i.e. green leafy vegetables, fish, meat and eggs,) especially if the treatment regimen has already been stabilized.

It is also important to inform patients taking Vitamin K that they might develop temporary resistance to anticoagulants similar to Coumadin. Should this oral medication be needed, a larger dose – or heparin even – might be prescribed instead.

Vitamin K is an essential drug, commonly seen in many hospital floors. Boost your nursing knowledge and obtain that most-awaited license by going through the practice NCLEX questions here at nclexpreceptor.com.

Resources:

http://www.mayoclinic.org/drugs-supplements/vitamin-k-oral-route-parenteral-route/description/drg-20069592

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/P045.html

Epogen Pointers: What You Need to Become an Excellent Nurse

Epogen Pointers for Excellent Nursing

Anemia is a condition characterized by the inadequacy of red blood cells, components that deliver oxygen to various parts of the body. This disorder is hallmarked by symptoms such as fatigue, dizziness, shortness of breath, tachycardia and pallor.

To cure this illness, doctors usually prescribe Epogen. As such, this medication is commonly found in the NCLEX.

Indications for Use

Generically known as Epoietin Alfa, Epogen is categorized as a recombinant human erythropoietin. It boosts the production of glycoproteins in the kidneys, which then increases the synthesis of red blood cells in the bone marrow.

Epogen is prescribed in patients with anemia related to the following:

  • Chronic renal failure, especially those on dialysis
  • Renal failure in ages 1-16 years old, requiring dialysis
  • Zidovudine therapy for HIV-AIDS
  • Chemotherapy

Apart from anemia treatment, Epogen is also used to reduce allogenic blood transfusions in patients undergoing surgery. Other indications included pruritus secondary to renal failure, myelodysplastic syndrome and chronic inflammation due to rheumatoid arthritis.

Nursing Considerations

Assessment is an integral part of Epogen therapy. As such, make sure to take the patient’s history and note for hypersensitivity to mammalian cell-derived products/human albumin, uncontrolled hypertension and lactation.

As for physical examination, obtain pertinent information such as the patient’s vital signs, affect, reflexes and urinary output prior to administration. Ensure that lab exams such as CBC, Hematocrit, Serum iron, electrolytes and renal function tests are extracted accordingly.

NCLEX Nursing Interventions

When preparing Epogen, remember to gently mix the solution. Do not shake the vial, as it might denature the glycoprotein. Additionally, use only one dose per vial and avoid re-entering it. Discard the vial after use, even if there is still something remaining in the container.

Avoid giving Epogen with any other drug or medication.

Epogen should be administered thrice weekly. Intravenous or subcutaneous are the preferred routes, though it can be given directly to the venous access line of dialysis patients. Prior and after administration, evaluate the access line for signs of clotting.

Make sure that the patient’s Hematocrit is checked prior to Epogen therapy. This will determine the accurate dosage for the client. Additionally, check the patient’s serum iron to evaluate if supplemental iron is needed.

Remember to place patients receiving Epogen on seizure precaution, as it can occur with the drug.

Important NCLEX Teaching Points

As Epogen needs to be given three times a week, create an administration schedule for the patient so that he can comply. Additionally, create a schedule of blood extraction tests handy, so the appropriate dosage can be determined.

As for side effects, inform the patient that these are normal:

  • Headache
  • Dizziness
  • Joint pain
  • Fatigue
  • Nausea and vomiting
  • Diarrhea

The following, however, are warning signs that should be reported to the doctor or the nurse:

  • Difficulty of breathing
  • Tingling/numbness
  • Chest pain
  • Severe headache
  • Seizures

Knowing the following facts will definitely make you an effective nurse. Ensure your patient’s health and safety by studying the practice NCLEX questions at nclexpreceptor.com.

References:

http://www.mayoclinic.org/drugs-supplements/epoetin-alfa-injection-route/description/drg-20068065

http://web.squ.edu.om/med-lib/med_cd/e_cds/Nursing%20Drug%20Guide/mg/epoetin_alfa.htm

http://www.mayoclinic.org/diseases-conditions/anemia/basics/definition/con-20026209

Acyclovir Pointers: What You Need to Pass Your NCLEX Quickly

Vital Acyclovir Pointers

The first anti-viral medications were created in the 1960’s, and they were all focused on curing the herpes virus family. Fortunately, through tireless effort and monitoring – Acyclovir – one of the common NCLEX medications – was invented.

Indications for Use

Known with the brand name of Zovirax, Acyclovir is an anti-viral agent that works by inhibiting DNA replication.

Whereas antibiotics are for bacterial infections, anti-virals such as Acyclovir are prescribed for certain viral illnesses. Compared to antibiotics, anti-virals can only inhibit the development of pathogens, and not destroy them.

Acyclovir is primarily prescribed in patients suffering from a Herpes infection. They include:

  • Genital herpes
  • Herpes zoster/ Herpes simplex
  • Herpes simplex encephalitis in babies 6 months and younger
  • Mucosal/cutaneous Herpes Simplex (HSV) 1 or 2 in Immunocompromised patients
  • HSV infection following transplant
  • Disseminated eczema herpeticum

Other indications include Cytomegalovirus infection, infectious mononucleosis and varicella pneumonia.

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Nursing Considerations

As it has been emphasized in nursing school, assessment is the first vital step to the nursing process. Before administering Acyclovir, make sure to evaluate the patient for the presence of allergies, congestive heart failure, seizures, renal disorder and lactation.

Additionally, perform a thorough physical examination of the patient. Check the client’s vital signs, orientation, lung sounds, urinary output, skin color and presence of skin lesions. Lab exams that should be requested are kidney function tests (BUN and Creatinine.)

NCLEX Nursing Interventions

When administering systemic Acyclovir, ensure that the patient is hydrated throughout the course of the therapy. Remember that this drug is nephrotoxic, which means it can have a negative effect on the kidneys.

If administering Acyclovir topically, institute treatment as soon as the first infectious signs and symptoms appear. Additionally, don a finger cot when applying the medication.

Important NCLEX Teaching Points

For patients receiving Acyclovir therapy, instruct them to complete the prescribed dose. Emphasize that they should not go beyond the recommended dose.

Additionally, remind them that it will NOT cure the disease, but it can lessen the severity signs/symptoms. Note that even with the application of the drug during symptom-free periods, prevention of recurrence is not ensured. As such, instruct the patient to wear a rubber glove/finger cot upon topical application to prevent transmission or self-inoculation.

Remember to teach the patient about the expected side effects of the drug (systemic), which include diarrhea, headache, dizziness, loss of appetite, vomiting and nausea.

Side effects for topical Acyclovir, on the other hand, are stinging, burning, itching and rashes. If these signs become more pronounced, inform the nurse/doctor right away.

Apart from the severity of the following signs, the onset of skin rashes, urination difficulty and recurrence also warrant the notification of healthcare personnel right away.

Those receiving Acyclovir therapy (both systemic and topical) should also be reminded to abstain from sexual intercourse especially if lesions are visibly present.

Anti-virals are commonly used in hospital and home settings, so it is best if you know about this medication. Master this drug – and many other therapeutic agents – with the practice NCLEX questions at nclexpreceptor.com.

References:

http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/Principles%20&%20Practice%20of%20Intravenous%20Therapy/mg/acyclovir.htm

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/V002.html

http://www.mayoclinic.org/drugs-supplements/acyclovir-oral-route-intravenous-route/description/drg-20068393

 

Be a NCLEX Wizard with this Atropine Study Guide

Atropine Study Guide

NCLEX is not an easy exam, yet you can pass it with flying colors. More than just browsing through the major topics such as Medical and Surgical nursing, you need to be well-versed with the commonly-used medications in hospitals, hospices and healthcare centers.

One such example is Atropine Sulfate, a parasympatholytic agent. Also an anti-cholinergic and an anti-muscarinic medication, it is a medication that you might encounter in your forthcoming NCLEX exam.

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Indications for Use

Atropine is a multi-faceted drug known by the brands Atropisol and Isopto Atropine. Apart from the aforementioned uses, this Belladonna Alkaloid is also used as an antidote, an anti-parkinsonian, and a diagnostic agent.

Because of its numerous purposes, Atropine is prescribed for a variety of disorders. It is utilized in the treatment of Parkinson’s-related rigidity and tremor, closed head disorders, pylorospasm, colon hypermotility, biliary spasm, ureteral colic, bronchospasm, urinary tract disorders and peptic ulcer, to name a few.

As an antidote, Atropine is used to reverse mushroom poisoning and cardiovascular collapse secondary to parasympathomimetic drug overdose.

Nursing Considerations

Before giving Tegretol, the nurse should take the patient’s complete history. You should determine the presence of hypersensitivity, glaucoma, gastrointestinal disorders, arrhythmia, COPD, bronchial asthma, myasthenia gravis, brain damage, hypertension and hypothyroidism, among many others.

For physical assessment, you should check the patient’s vital signs, as well as lung sounds, urinary output and bowel sounds. Make sure to assess the client’s affect, orientation, reflexes, skin color/lesions and bilateral hand grip strength as well.

As for lab exams, the nurse should periodically check the results of the patient’s liver/kidney function tests and ECG.

NCLEX Nursing Interventions

Hyperpyrexia can occur with Atropine therapy. As a nurse, it is your responsibility to provide temperature control to circumvent this. Ensuring adequate hydration can also curb the onset of hyperpyrexia.

Urinary retention usually occurs with Atropine, therefore advise the patient to empty his bladder prior to the provision of the drug.

Important NCLEX Teaching Points

As a nurse, make sure to teach your client about what he can expect with regards to taking Atropine. For example, you should advise him to take the medication 30 minutes prior to a meal, in order to avoid overdosage.

As it has been established, hyperpyrexia can occur with Atropine. As such, remind your client to avoid hot environments as the drug might cause heat intolerance.

Educate your patient with the usual side effects of Atropine, which are confusion, dizziness, constipation, blurred vision, dry mouth, light sensitivity, urination difficulties and impotence (reversible.)

Most importantly, teach your client about warning signs – the presence of any should warrant immediate notification. These symptoms are hallucinations, abdominal distention, coordination loss, tremors, irregular heartbeat, eye pain, flushing, rashes, headache and swallowing/urinating difficulties.

Atropine might have many purposes, but you can conquer them all (and other difficult drugs as well) with the help of nclexpreceptor.com practice NCLEX questions.

References:

http://web.squ.edu.om/med-lib/med_cd/e_cds/Nursing%20Drug%20Guide/mg/atropine_sulfate.htm

http://www.robholland.com/Nursing/Drug_Guide/data/monographframes/A084.html