LNN ACADEMY 🦠🩺💊

7 pm Youtube class

Vancomycin – Key Points 🔹 Drug Class Glycopeptide antibiotic Bactericidal Works by inhibiting bacterial cell wall synthesis 🔹 Main Use (VERY IMPORTANT ) Serious Gram-positive infections Especially MRSA Endocarditis Osteomyelitis Sepsis Pneumonia (hospital-acquired) 👉 PO (oral) vancomycin is used for: C. difficile infection (acts locally in gut) 🔹 Route Trick for NORCET IV → systemic infections PO → C. diff only IM route ❌ (causes tissue necrosis) ⚠️ Major Side Effects (HIGH-YIELD) Nephrotoxicity Monitor serum creatinine Risk ↑ with aminoglycosides Ototoxicity Tinnitus Hearing loss Red Man Syndrome (VERY COMMON QUESTION) Flushing Red rash on face/neck/chest Hypotension Caused by rapid IV infusion 👉 Prevention: Infuse over at least 60 minutes (very imp) Slow infusion rate 🔬 Monitoring Monitor trough levels Normal trough: 10–20 mcg/mL Check kidney function Monitor I/O 🚨 Nursing Interventions Infuse slowly Assess hearing changes Monitor urine output Encourage fluids (if not contraindicated) Do NOT mix with other drugs in same IV line

NORCET-10 Important Dates* 📰 Notification Released: 24-02-2026 📝 Online Application Starts: 24-02-2026 ⏰ Last Date to Apply: 16-03-2026 (till 5:00 PM) NORCET Preliminary (Stage-I CBT): 11 April 2026 (Saturday) NORCET Mains (Stage-II CBT): 30 April 2026 (Thursday) Age Cut-off Date: 16-03-2026 (last date of application)

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LITHIUM (Mood Stabilizer) 🔹 Drug Class Mood stabilizer Used mainly for Bipolar disorder (acute mania & maintenance) 🎯 Therapeutic Range (VERY IMPORTANT ⚠️) 0.6 – 1.2 mEq/L → Therapeutic >1.5 mEq/L → Toxicity begins >2.0 mEq/L → Severe toxicity (medical emergency) 👉 NCLEX tip: Always check serum lithium level before giving dose. Mechanism (Simple) Alters sodium transport in nerve cells Affects serotonin & norepinephrine ⚠️ Signs of Toxicity (MOST TESTED) 🔸 Early Toxicity (1.5–2.0) Nausea, vomiting, diarrhea Tremors (coarse tremors) Muscle weakness Drowsiness 🔸 Moderate–Severe (>2.0) Confusion Ataxia Slurred speech Seizures Coma 🚨 If toxicity suspected → Hold drug & notify provider immediately 🧂 Sodium & Fluid = KEY CONCEPT (Exam favorite) Lithium acts like sodium in body. ❗ Low sodium = Lithium toxicity Because kidneys reabsorb more lithium when sodium is low. Nursing Teaching: Maintain normal salt intake Drink 2–3 liters water daily Avoid dehydration Avoid excessive sweating 💊 Drug Interactions (Common NCLEX Trap) Increase Lithium Level: Diuretics (especially Thiazides) NSAIDs (Ibuprofen) ACE inhibitors 👉 If patient on lithium + starts diuretic → monitor closely! 🩺 Nursing Responsibilities ✔ Monitor lithium levels regularly ✔ Monitor kidney function (BUN, Creatinine) ✔ Monitor thyroid (can cause hypothyroidism) ✔ Give with food (to prevent GI upset) 🤰 Pregnancy Warning Category D Causes Ebstein anomaly (cardiac defect) Avoid in pregnancy 🧠 Scenario Trick If question says: Patient has vomiting + diarrhea + tremors On lithium Sodium low Think Lithium toxicity 📝 One-Line Memory Trick “Low Sodium = High Lithium = Toxic

Photo from AKASH YELMULE