Nephrotoxic Drugs – NCLEX Review (Nursing)

00:00 Now, nephrotoxicity. Hey, there's our signal again. The 60 second overview.

00:05 Look at the bold there: antibiotics, ACE inhibitors, NSAIDs, radiocontrast media, lithium salts and chemotherapy.

00:13 Okay, that would be the first pass through that you would take a look at that.

00:17 So, we got the names listed for you there, but you're gonna have to come back and really review this.

00:24 You make sure that you have those names rock solid.

00:27 Now, how will I evaluate kidney function? Take a look at this, you're learning way more than just pharmacology here.

00:34 We're gonna teach you how to keep patients safe in different body systems.

00:38 So, you know whether you're in a patho question, whether you're in a physiological adaptation question, whatever you're in, you need to know how to evaluate kidneys.

00:47 So, watch down there, it says "watch for".

00:50 You see that red box, that's another clue to you.

00:53 We're gonna be looking for elevated serum creatinine.

00:56 That's a sign that the kidneys are struggling.

00:58 Elevated BUN, that's a sign that kidneys are struggling.

01:03 So, you've got the normal levels there for you.

01:05 And you're welcome. Just kidding.

01:08 I know it's so frustrating in nursing school because every text book, every class, and sometimes, it felts like every faculty looks at a different range as being normal.

01:19 Okay, that's true. So, you gotta Elsa that, you know what the means? Let it go.

01:25 I've put a nice general range in here but if you already have a very specific one memorized, go with that.

01:32 Because it's hard to relearn simple numbers like that.

01:35 But I also wanna give you a heads up for practice.

01:38 When you are in practice, every laboratory has different exact results.

01:44 Now, they'll post them with your patients results, but keep that mind, whatever you're looking in evaluating lab work, you need to know what that particular lab sees as normal.

01:55 So, I've put some ranges up there.

01:56 If you don't have these memorized yet, make sure you come back and do that.

02:01 If you do, and your memorized values are a little different, run with it.

02:05 You just stick with that.

02:07 In fact, you can even write them in if it's a little different just to remind yourself, this is the one my brain is going to remember.

02:19 Okay. So far, we've looked at bad for ears, ototoxicity; bad for kidneys, nephrotoxicity.

02:26 So, make sure you have these, that you're looking at.

02:30 I just wanna say one thing about the middle column. Okay, I lied.

02:33 I wanna say a couple things about the middle column.

02:36 NSAIDs, are particularly challenging for the elderly because they take a lot of them and their kidneys really can suffer.

02:46 So, you know for any patient that's had some renal problems in the past, and these medications, bad combo.

02:52 But really, write yourself a note about NSAIDs and the elderly, and then radiocontrast media for any patient who's on metformin.

03:01 Very common oral medication for type II diabetics.

03:05 So, if they're gonna take radiocontrast media, they need a two-day window before and after they receive the metformin.

03:12 So, they have to stop it two days before they get the media and then they can't start taking it again for an additional two days after they've received it.

03:21 So, keep those things in mind.

03:23 Also, look for drugs that are bad for multiple organs.

03:27 I think you've seen one already.

03:28 Based on ototoxicity and nephrotoxicity, which drug name have you seen come up on both lists? Yeah, I'm not gonna tell you.

03:37 It's your job to make sure you look back at that because your brain will remember much more effectively if you've done the work of sorting through that.