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:

http://www.amazon.com/dp/B00EMLFF0S/ref=rdr_kindle_ext_tmb to get the Top Medications on NCLEX RN exam

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.

http://www.amazon.com/dp/B00EMLFF0S/ref=rdr_kindle_ext_tmb to get the Top Medications on NCLEX RN exam

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.

http://www.amazon.com/dp/B00EMLFF0S/ref=rdr_kindle_ext_tmb to get the Top Medications on NCLEX RN exam

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

 

Score High in Your NCLEX: MAOI Inhibitors Must-Knows

MAOI Inhibitors Must-Knows

According to studies, depression affects more than 120 million individuals around the world. This mental disorder, unfortunately, disturbs one’s quality of life, relationships and social skills. Worst of all, it has led to approximately 850,000 cases of suicide worldwide.

Because of the prevalence of this disease, it is your responsibility as a nurse to familiarize yourself – as well as your clients – with anti-depressant medications, such as MAOI Inhibitors.

http://www.amazon.com/dp/B00EMLFF0S/ref=rdr_kindle_ext_tmb to get the Top Medications on NCLEX RN exam

Indications for Use

MAOI inhibitors are anti-depressants that affect neurotransmitters that serve as linkages between neurons. It addresses depression symptoms by altering the levels of such brain chemicals.

MAOI inhibitors prevent the synthesis of monoamine oxidase, which eliminates dopamine, serotonin and epinephrine from the brain. With higher levels of the aforementioned neurotransmitters, enhanced mood is experienced.

Examples of MAOI inhibitors are Phenelzine (Nardil), Selegilin (Emsam), Isocarboxazid (Marplan) and Tranylcypromine (Parnate.)

Nursing Considerations

Before administering MAOI inhibitors, the nurse should take the history of the patient. Pertinent information that should be noted are hypersensitivity to MAOI inhibitors, seizure disorders and cerebrovascular defects. Disorders such as cardiovascular disease, hypertension and hyperthyroidism should be documented as well.

As for physical examination, the nurse should obtain the client’s vital signs, reflexes, affect, orientation and urine output. Skin color and the presence of skin lesions should be checked as well. Laboratory tests that should be obtained include CBC, urinalysis, thyroid function tests, ECG and EEG.

NCLEX Nursing Interventions

The most important nursing intervention for patients taking MAOI inhibitors is to ensure that they limit the intake of tyramine-rich foods. Tyramine, whose breakdown is impeded by MAOI inhibitors, can lead to a hypertensive crisis. Symptoms include elevated BP and severe headache. At the sign of this, immediately discontinue the drug and inform the doctor.

Consequently, make sure to control the patient’s intake of cheese, alcohol, banana, liver and fermented/smoked food products. In anticipation of a hypertensive crisis, keep alpha-adrenergic blocking drugs and phentolamine at bay.

Apart from the symptoms of hypertensive crisis, MAOI inhibitors should also be discontinued at the first sign of hepatic dysfunction (jaundice.)

Important NCLEX Teaching Points

Nurses are health educators, so when teaching patients taking MAOI inhibitors, remind them to take the drug as prescribed.  Advise them not to discontinue use abruptly.

As it has been emphasized, instruct your patients to avoid tyramine-rich foods while taking MAOI inhibitors, up to 2 weeks after therapy. Alcohol, appetite suppressants and over-the-counter drugs should be averted as well.

Additionally, make sure to educate your patients about the expected side effects of MAOI inhibitors, which are:

  • Dizziness
  • Weakness/fainting resulting from an abrupt positional change
  • Drowsiness
  • Blurred vision (reversible)
  • Nausea and vomiting
  • Loss of appetite
  • Emotional or mental changes
  • Irritability/ nervousness

Patients should be informed about the warning signs that warrant immediate physician/nurse attention as well. They include:

  • Headache
  • Rashes
  • Darkened urine
  • Pale stools
  • Eye/skin yellowing
  • Chills and fever
  • Sore throat

Your patient’s recovery depends on your knowledge, skills and passion as a nurse. Enhance your mind and become an excellent nurse with the practice NCLEX questions at nclexpreceptor.com.

References:

http://www.mayoclinic.org/diseases-conditions/depression/in-depth/maois/art-20043992

http://web.squ.edu.om/med-Lib/MED_CD/E_CDs/Psychiatric%20Nursing%20Care%20Plans/monographs/phenelzine%20sulfate.htm

http://assistednursingcare.net/monoamine-oxidase-inhibitors-maois-an-antidepressant-and-its-contraindications/