Notes in L04 Guerrero Compatability, Stability, Clinical Application

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Published	10/18/2023	Compatibility and Stability (Slide 2)IncompatibilityDrug modified as a result of {{c1::combining with other medications or solutions}}InstabilityDrug …
Published	10/18/2023	Compatibility and Stability (Slide 3) Incompatibilities/Instabilities can lead to (5):{{c1::Precipitation}}{{c1::Color change}} (this one is usually o…
Published	10/18/2023	Factors Affecting Compatibility (Slide 4)Chemical ComplexationTwo drugs forming a {{c1::new chemical}}Minerals and Salts (Calcium, Magnesium, Phosphat…
Published	10/18/2023	Factors Affecting Compatibility (slide 5)pHCertain medications will {{c1::precipitate}} if in low or high pH solutionsMedications can {{c1::alter}} th…
Published	10/18/2023	Factors Affecting Compatibility (Slide 6)Concentration{{c1::Stability}} of certain products can change depending on their concentration in solution. (…
Published	10/18/2023	Examples Of Incompatibility (Slide 7)PhenytoinIncompatible with {{c1::D5W}}LevofloxacinIncompatible with {{c1::Furosemide}}, {{c1::Acyclovir}}, {{c1::…
Published	10/18/2023	Factors Affecting Stability (Slide 9)TemperatureMost medications stable longer when {{c1::refrigerated}}Some meds should avoid {{c1::refrigeration}}Ti…
Published	10/18/2023	Example #2 Incompatibility (Slide 8)In general, max {{c1::15}} mEq {{c2::calcium}} can be combined with {{c1::30}} mEq of {{c3::phosphate}}*
Published	10/18/2023	Factors Affecting Stability (Slide 10)ContainerSome meds can bind with {{c1::polyvinyl chloride}} (PVC) plastics or {{c1::aluminum}} from administrati…
Published	10/18/2023	Factors Affecting Stability (Slide 11)LightSome products must be protected from lightMay need to cover with a {{c1::light protective wrap}}
Published	10/18/2023	Storage and Handling (Slide 12)Dry, clean, ventilated area, and limited accessStorage temperatures (see specific product recommendations)Freezing: {{c…
Published	10/18/2023	Examples of Instabilities (Slide 13)Insulin potency reduced by at least {{c1::20}}% when stored in a {{c1::plastic container}}Paclitaxel forms {{c1::p…
Published	10/18/2023	Examples of Instabilities (Slide 14)Nitroglycerin and amiodarone {{c1::adsorb}} to the plastic, leads to decrease amount of drugDoses may need to be {…
Published	10/18/2023	Other Considerations (Slide 15)Dilution/Concentration requirementsExample: Bactrim Specific dilution requirements to avoid {{c1::precipitation}}Recomm…
Published	10/18/2023	Minimizing Incompatibilities (Slide 17)Use {{c1::freshly prepared}} solutionsFollow {{c1::manufacturer's instructions}} for reconstitutionKeep additiv…
Published	10/18/2023	Minimizing Incompatibilities (Slide 18)If an incompatibility cannot be avoided, consider:Administering meds at {{c1::different times}}Using a {{c1::di…
Published	10/18/2023	Intravenous Fluids (Slide 20){{c1::Dextrose}} (D5W){{c1::0.9% Sodium Chloride}} (Normal Saline)0.45% Sodium Chloride (1/2 NS)D5/0.2% Sodium ChlorideD5…
Published	10/18/2023	Clinical Application of IV Fluids (Slide 21)As a {{c1::vehicle}} for the administration of intravenous antibiotics or other intravenous medications{{c…
Published	10/18/2023	Clinical Application of IV Fluids (Slide 22)Replacement Fluid TherapyGoal is to correct {{c1::abnormalities}} in fluid status and/or serum electrolyte…
Published	10/18/2023	Replacement of Daily Losses (Slide 23)Give enough fluid to replace {{c1::urine}} outputabout {{c1::1500}} mL/day lostGive enough fluid to replace {{c1…
Published	10/18/2023	Give Extra Fluid If... (Slide 24){{c1::Fever}}Increase fluid administration by {{c1::100-200}} ml for each {{c1::degree C increase in temperature abov…
Published	10/18/2023	Dehydration (Slide 25)Dehydration is defined as a {{c1::loss of water from the body}}Water loss comes from both {{c1::ECF}} and {{c1::ICF}}Mild Dehydr…
Published	10/18/2023	Signs and Symptoms of Moderate Dehydration (Slide 26)Dry, leafy {{c1::tongue}}Dry {{c1::mouth}}, {{c1::skin}} and {{c1::mucous membranes}}Lack of {{c1…
Published	10/18/2023	Signs and Symptoms of Severe Dehydration (Slide 27)Low {{c1::blood pressure}}{{c1::Sinus Tachycardia}}Sunken {{c1::eyeballs}}{{c2::Tenting}}Signs of d…
Published	10/18/2023	Maintenance Electrolytes (Slide 29)All patients on maintenance IV’s must receive {{c1::sodium}}, {{c1::potassium}}, and {{c1::chloride}}
Published	10/18/2023	Normal Serum Electrolyte Concentrations (Slide 30)Na         {{c1::140}} mEq/LK     &…
Published	10/18/2023	Sodium Requirement (Slide 31)The {{c1::kidney}} can adapt to a wide range for sodium intakeCan conserve or excrete sodiumIn states of sodium depletion…
Published	10/18/2023	Sodium Requirement (Slide 32)Primary extracellular cationImportant for maintaining {{c1::normal extracellular fluids}}Requirement is about {{c1::80-10…
Published	10/18/2023	Potassium Requirement (Slide 33)The normal kidney can adapt to wide changes in potassium intakeIn states of potassium deficiency, renal potassium excr…
Published	10/18/2023	Potassium Requirement (Slide 34)Primary {{c1::intracellular}} cationImportant for {{c1::normal cardiac and skeletal muscle}} functionRequirement is ab…
Published	10/18/2023	Major Fluid Compartments (Slide 36)Intracellular Fluid Compartment or ICFFluid found {{c1::inside}} of the cellsAbout {{c1::40}}% of the patient’s wei…
Published	10/18/2023	Transcellular Fluid Compartment (Slide 37)Consists of fluid found in the {{c1::CNS}}, {{c1::eyes}}, {{c1::pleura}}, {{c1::GI tract}} and {{c1::periton…
Published	10/18/2023	When Calculating Fluid Compartment Shifts Remember (Slide 41)Sodium stays {{c1::outside}} the cell and thus is usually found only in the {{c1::ECF}}Wh…
Published	10/18/2023	Conclusion (Slide 45)Knowing to {{c1::which compartment}} an administered fluid goes can help you determine the {{c1::purpose}} of that solution
Published	10/18/2023	General Uses (Slide 46)Dextrose (D5W)Solution for {{c1::medication delivery}}0.9% Sodium Chloride (Normal Saline){{c1::Hypotension secondary to dehydr…
Published	10/18/2023	General Uses Cont. (Slide 47)D5/0.45% Sodium Chloride{{c1::Maintenance fluid}}If NPO, will provide some {{c1::calories}} as well and help {{c1::mainta…
Published	10/18/2023	Parenteral Nutrition (Slide 48)TPN Total Parenteral NutritionIntravenous nutritional support for patients {{c1::unable to take in nutrients}} through …
Published	10/18/2023	Parenteral Nutrition (Slide 49)Compounded based on patient’s needsMust determine patient’s:{{c1::Fluid}} needs{{c1::Electrolyte}} needs{{c1::Caloric}}…
Published	10/18/2023	Parenteral Nutrition (Slide 52)Typical volume is {{c1::2-3 liters}}Administered over {{c1::8-24 hours}}
Published	10/18/2023	Parenteral Nutrition (Slide 53)Monitor Daily:{{c1::Vital Signs}}{{c1::Body Weight}}{{c1::Temperature}}{{c2::Blood work}} (CBC, Chem Panel){{c2::Nutrit…
Published	10/18/2023	Parenteral Nutrition: Peripheral Administration (Slide 58)Low {{c1::energy}} and {{c1::protein}} needsPeripheral Parenteral NutritionLow concentration…
Published	10/18/2023	Parenteral Nutrition: Central Venous Administration (Slide 59)Used if {{c1::GI tract}} non-functional or needed to rest {{c1::>7 days}}Energy and p…
Published	10/18/2023	Parenteral Nutrition - Terminology (Slide 60)PN{{c1::Parenteral Nutrition}}PPN{{c1::Peripheral Parenteral Nutrition}}TNA{{c2::Total Nutrient Admixture…
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