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RESPIRATORY
| Term | Definition |
|---|---|
| SABA (Short-Acting Beta Agonists) — Albuterol (Ventolin, ProAir), Levalbuterol (Xopenex) | Mechanism: Stimulates beta-2 receptors → bronchodilation Use: Rescue inhaler for asthma & COPD exacerbations Side Effects: Tremor, tachycardia, nervousness, hypokalemia Nursing Teaching: Use before exercise if needed; carry at all times; if using |
| LABA (Long-Acting Beta Agonists) — Salmeterol (Serevent), Formoterol (Perforomist) | Mechanism: Long-acting beta-2 agonist → sustained bronchodilation Use: Maintenance therapy — asthma (ONLY with ICS) & COPD Side Effects: Tremor, tachycardia, headache Nursing Teaching: NEVER use alone in asthma — must combine with inhaled cortico |
| SAMA (Short-Acting Muscarinic Antagonists) — Ipratropium (Atrovent) | Mechanism: Blocks muscarinic receptors → bronchodilation Use: Rescue adjunct in COPD; alternative for patients who can’t tolerate SABA Side Effects: Dry mouth, bitter taste, blurred vision if sprayed in eyes Nursing Teaching: Avoid spraying near |
| LAMA (Long-Acting Muscarinic Antagonists) — Tiotropium (Spiriva), Umeclidinium (Incruse Ellipta) | Mechanism: Anticholinergic → long-acting bronchodilation Use: Maintenance therapy for COPD (sometimes asthma in combo inhalers) Side Effects: Dry mouth, constipation, urinary retention, blurred vision Nursing Teaching: Capsule is inhaled, NOT swa |
| ICS (Inhaled Corticosteroids) — Fluticasone (Flovent), Budesonide (Pulmicort), Beclomethasone (QVAR) | Mechanism: Reduces airway inflammation by suppressing immune response Use: Maintenance therapy for Asthma & COPD (prevents flare-ups) Side Effects: Oral thrush (candidiasis), hoarseness, sore throat Nursing Teaching: Rinse mouth and spit after ea |
| Leukotriene Modifiers — Montelukast (Singulair), Zafirlukast | Mechanism: Blocks leukotriene receptors → ↓ inflammation & bronchoconstriction Use: Asthma maintenance & allergic rhinitis — NOT for COPD Side Effects: Mood changes, depression, nightmares, suicidal ideation Nursing Teaching: Take at night; monit |
| ICS + LABA (Inhaled Corticosteroid + Long-Acting Beta Agonist) Advair (Fluticasone/Salmeterol), Symbicort (Budesonide/Formoterol), Dulera (Mometasone/Formoterol), Breo Ellipta (Fluticasone/Vilanterol) | Mechanism: Reduces inflammation (ICS) + bronchodilation (LABA) Use: ✅ Asthma maintenance / ✅ COPD (depending on formulation) Side Effects: Thrush, tachycardia, headache Nursing Teaching: Rinse mouth after use; still carry rescue inhaler; never st |
| LAMA + LABA (Long-Acting Muscarinic Antagonist + Long-Acting Beta Agonist) Anoro Ellipta (Umeclidinium/Vilanterol), Stiolto Respimat (Tiotropium/Olodaterol), Bevespi (Glycopyrrolate/Formoterol) | Mechanism: Dual bronchodilation via anticholinergic + beta-2 stimulation Use: ✅ COPD ONLY — NOT for asthma Side Effects: Dry mouth, tachycardia, urinary retention Nursing Teaching: Not a rescue inhaler; monitor for glaucoma or BPH symptoms |
| Quick Memory Hack | Asthma loves ICS + LABA COPD loves LAMA + LABA And very severe COPD gets all three → ICS + LAMA + LABA |
| Mucolytics — Acetylcysteine (Mucomyst) | Mechanism: Breaks disulfide bonds in mucus → thins secretions Use: Thick mucus in COPD / Cystic Fibrosis; also Tylenol overdose antidote Side Effects: Rotten egg smell, bronchospasm, nausea Nursing Teaching: Give bronchodilator before to open air |
| Expectorants — Guaifenesin (Mucinex) | Mechanism: Increases respiratory tract fluid → loosens mucus Use: Productive cough in Asthma/COPD or URI Side Effects: Mild GI upset, nausea Nursing Teaching: Increase fluids; avoid combining with cough suppressants unless directed |
| Methylxanthines — Theophylline | Mechanism: Relaxes smooth muscle → bronchodilation; CNS stimulation Use: Rarely used — last-line for severe asthma/COPD Side Effects: Toxicity signs: tachycardia, insomnia, restlessness → seizures, arrhythmias Nursing Teaching: Monitor serum leve |
| POTASSIUM | 3.5 - 5.0 |
| CALCIUM | 9 - 11 |
| SODIUM | 135 - 145 |
| MAGNESIUM | 1.5 -2.5 |
| BLOOD UREA NITROGEN (BUN) | 10 - 20 |
| WBC | 5000 - 10,000 |
| RBC | 4.5 - 5.5 |
| HEMATOCRIT | 37-47 FEMALE 42 - 52 MALE |
| HEMOGLOBIN | 12 - 16 FEMALE 14 -18 MALE |
| Antitussives (Cough Suppressants) — Dextromethorphan (DM), Codeine, Benzonatate (Tessalon Pearls) | Mechanism: Suppress cough reflex by acting on the cough center in the brain (medulla) or numbing stretch receptors in the airways Use: Dry, nonproductive cough Side Effects: Dextromethorphan: dizziness, drowsiness, risk of abuse (robotripping) |
| CREATININE | 0.6 -1.2 |
| What is the primary use of Amiodarone (Arrythmia) | To treat ventricular tachycardia (VT), ventricular fibrillation (VF), and atrial fibrillation with rapid ventricular response (AFib w/ RVR) |
| What baseline assessments are required before starting Amiodarone? | ECG, chest X-ray, thyroid function tests, liver function tests, and pulmonary assessment. |
| What serious long-term complication can occur with Amiodarone therapy? | Pulmonary fibrosis (watch for cough or shortness of breath) |
| What vital signs must be closely monitored when giving Amiodarone IV | Heart rate and blood pressure — risk of bradycardia and hypotension. |
| What is Lidocaine (IV) used for in cardiac care | Ventricular arrhythmias, especially PVCs and ventricular tachycardia. |
| What is a major toxicity sign of Lidocaine? | Neurological changes such as confusion, dizziness, tremors, or seizures. |
| What arrhythmia is Adenosine specifically used to treat? | Supraventricular tachycardia (SVT / PSVT). |
| How must Adenosine be administered? | Rapid IV push followed immediately by a saline flush. |
| What should the nurse warn the patient about when giving Adenosine? | hey may feel chest pressure or experience a brief pause in the heartbeat (asystole). |
| What is the primary action of Digoxin? | It increases myocardial contractility (positive inotrope) and decreases heart rate by slowing AV node conduction. |
| What are the main clinical uses of Digoxin? | Heart failure and atrial fibrillation (to control ventricular rate). |
| What is the therapeutic serum range for Digoxin | 0.5–2.0 ng/mL. |
| What vital sign must be assessed before giving Digoxin? | Apical heart rate for one full minute — hold if HR < 60 bpm. |
| What electrolyte imbalance increases the risk of Digoxin toxicity? | Hypokalemia (low potassium). |
| What are common early signs of Digoxin toxicity? | Nausea, vomiting, anorexia, and fatigue. |
| What is a classic visual symptom of Digoxin toxicity? | Yellow or green vision, or seeing halos around lights. |
| What other lab should be monitored with Digoxin due to renal excretion? | Creatinine or GFR — impaired kidneys increase toxicity risk. |
| What should the nurse instruct the patient to do if they miss a dose of Digoxin? | Do not double the dose — take the next scheduled dose. |
| What is the primary purpose of Nitroglycerin? | To relieve angina by dilating coronary and systemic veins, reducing preload and myocardial oxygen demand. |
| How should sublingual nitroglycerin be taken during chest pain? | One tablet under the tongue every 5 minutes, up to 3 doses — call EMS if pain persists after the first dose. |
| What position should a patient be in when taking Nitroglycerin? | Sitting or lying down to prevent dizziness or fainting due to hypotension. |
| What is a common and expected side effect of Nitroglycerin? | Headache due to vasodilation. |
| What serious drug interaction must be avoided with Nitroglycerin? | PDE-5 inhibitors such as sildenafil (Viagra) — can cause life-threatening hypotension. |
| What is important about storing sublingual nitroglycerin tablets? | Keep them in the original dark glass bottle, tightly capped — light and air reduce effectiveness. |
| Why must Nitroglycerin patches be removed at night? | To prevent tolerance — patients should have a 10–12 hour nitrate-free interval. |
| What vital sign must be assessed before giving Nitroglycerin? | Blood pressure — hold if systolic BP is too low (commonly < 90 mmHg or per provider parameters). |
| What is the primary action of furosemide (Lasix)? | It is a potent loop diuretic that causes rapid excretion of sodium and water, reducing fluid overload. |
| What is the biggest electrolyte concern with loop diuretics? | Hypokalemia (low potassium), which can lead to dysrhythmias |
| What assessments are essential before giving furosemide? | Blood pressure, potassium level, daily weight, lung sounds, and I&O |
| When is the best time of day to give loop or thiazide diuretics? | Morning — to prevent nocturia. |
| What is the main difference between loop diuretics and thiazide diuretics? | Thiazides are milder and are often used for long-term blood pressure control rather than acute fluid overload. |
| What electrolyte imbalance is also common with thiazide diuretics? | : Hypokalemia — same as loops. |
| What is the key benefit of spironolactone compared to other diuretics? | : It retains potassium, preventing hypokalemia. |
| What is the major safety concern with spironolactone? | Hyperkalemia, especially when combined with ACE inhibitors or potassium supplements. |
| What unusual side effect can spironolactone cause in males? | Gynecomastia (breast enlargement or tenderness). |
| What teaching should be given regarding diet and diuretics? | Loop/Thiazide: Encourage potassium-rich foods (bananas, oranges, potatoes). K⁺-sparing: Avoid potassium supplements and salt substitutes. |
| What is the main action of ACE inhibitors? | They block the conversion of angiotensin I to angiotensin II, causing vasodilation and lowering blood pressure. |
| What is a common side effect that often leads to stopping ACE inhibitors? | Dry, persistent cough. |
| What dangerous side effect should the nurse monitor for with ACE inhibitors? | Angioedema — swelling of the face, lips, or tongue (medical emergency). |
| What electrolyte imbalance is associated with ACE inhibitors? | Hyperkalemia, especially when taken with potassium-sparing diuretics. |
| How are ARBs different from ACE inhibitors? | They block angiotensin II receptors instead of its production — no dry cough. |
| When is an ARB preferred over an ACE inhibitor? | When a patient develops cough on ACE inhibitors. |
| What is the primary action of beta blockers? | They reduce heart rate and blood pressure by blocking beta-adrenergic receptors. |
| What vital sign must be checked before giving a beta blocker? | Heart rate — hold if < 60 bpm (unless otherwise ordered). |
| Why should beta blockers be used cautiously in asthmatic patients? | They can cause bronchospasm (especially non-selective beta blockers like propranolol). |
| What is the main effect of calcium channel blockers? | They relax blood vessels and may slow heart rate (especially diltiazem/verapamil). |
| What common side effect is associated with amlodipine? | Peripheral edema (swelling in legs/ankles). |
| : What serious consequence can occur from abruptly stopping antihypertensives (especially clonidine or beta blockers)? | Rebound hypertension — blood pressure spikes higher than before. |
| What key patient teaching is required for all antihypertensives? | Change positions slowly to prevent orthostatic hypotension. |
| What lab is monitored to adjust IV heparin therapy? | aPTT (activated partial thromboplastin time). |
| What is the therapeutic goal range for aPTT while on heparin? | Typically 1.5–2.5 times the normal value (depending on protocol). |
| What is the antidote for heparin overdose? | Protamine sulfate. |
| Where is enoxaparin typically administered? | Subcutaneously, usually in the abdomen. |
| What precaution should be taken when giving enoxaparin? | Do not expel the air bubble from the syringe — it ensures full dose delivery. |
| What lab is monitored to adjust warfarin therapy? | INR (International Normalized Ratio). |
| What is the therapeutic INR range for most indications (ex: AFib)? | 2.0–3.0. |
| What is the antidote for warfarin overdose? | Vitamin K (phytonadione). |
| What dietary teaching is essential for patients on warfarin? | Maintain consistent intake of vitamin K foods (leafy greens) — do not drastically increase or decrease. |
| What is the main action of aspirin and clopidogrel? | They prevent platelet aggregation to reduce risk of clot formation |
| What is a major adverse effect to monitor for with antiplatelet drugs? | Bleeding — especially in gums, stool, or urine. |
| What is the main purpose of Thrombolytic tPA (alteplase)? | To dissolve existing blood clots in stroke or MI cases. |
| What is the time window for administering tPA in ischemic stroke? | Within 3–4.5 hours of symptom onset. |
| What must be ruled out before giving tPA? | Hemorrhagic stroke or active bleeding — CT scan required. |
| What is the main purpose of statins (Antilipemic) (e.g., atorvastatin, simvastatin)? | To lower LDL cholesterol and reduce the risk of cardiovascular disease. |
| When is the best time to administer statins? | At bedtime or in the evening, when the liver produces the most cholesterol. |
| What lab tests must be monitored while on statin therapy | Liver function tests (LFTs) — AST/ALT. |
| What serious side effect should be reported immediately while taking statins? | New or unexplained muscle pain or weakness — may indicate rhabdomyolysis. |
| What food or drink should be avoided while taking statins? | Grapefruit or grapefruit juice, as it increases drug levels and toxicity. |
| Can statins be used during pregnancy? | No — they are contraindicated in pregnancy |
| What is the primary action of PDE-5 inhibitors such as sildenafil (Viagra)? | They enhance nitric oxide–mediated vasodilation, increasing blood flow to erectile tissue. |
| How long before sexual activity should sildenafil be taken? | Typically 30–60 minutes before activity |
| What is the most serious drug interaction with PDE-5 inhibitors? | Nitrates (e.g., nitroglycerin) — combining them can cause life-threatening hypotension. |
| What common side effects can occur with sildenafil? | Headache, facial flushing, nasal congestion, dizziness, and visual disturbances (blue/green tinting). |
| What rare but urgent complication should patients report if using PDE-5 inhibitors? | Priapism — an erection lasting longer than 4 hours, requiring emergency medical treatment. |
| Why should patients avoid high-fat meals when taking sildenafil? | They delay absorption and reduce effectiveness. |
Created by:
Kerry12