STAT Stitch Deep Dive Podcast Beyond The Bedside

STAT Stitch Deep Dive Podcast Beyond The Bedside

by Regular Guy

Courses Life Sciences

Season 2

MEDSURG | Lower GI Primer

🔥 Med-Surg Crash Review: Lower GI Problems 1️⃣ Acute Infectious Diarrhea Main cause: Infectious agents (bacteria/viruses/parasites), often from contaminated food/water 🌎🍲. Big danger: Severe dehydration + electrolyte loss → hypovolemia & metabolic acidosis. C. diff = HIGH priority (hospital-acquired, spore-forming). Nursing Must-Knows Assess: I&O, electrolytes, H&H, skin turgor, VS, stool frequency. Intervene: IV fluids (NS/LR), oral electrolytes (Pedialyte). Infection control: Soap + water only, contact precautions, bleach cleaning. Avoid antidiarrheals ❌ (except certain traveler’s diarrhea). Red Flags: Sunken eyes, hypotension, tachycardia. 2️⃣ Acute Abdominal Pain & Peritonitis Often caused by inflammation, perforation, obstruction, or bleeding. Peritonitis = life-threatening! Priority Signs 🚨 Shock: Low BP, tachycardia, cool skin, ↓ urine. Peritonitis: Board-like rigidity, rebound tenderness, fever. Nursing Actions ABCs + high-flow O₂ Two large-bore IVs + rapid fluids NPO Pain control after MD eval Prepare for imaging or surgery Quick Cue: Don’t apply heat to the abdomen (may worsen inflammation). 3️⃣ Inflammatory Bowel Disease (UC & Crohn’s) Chronic, autoimmune, inflammatory flares. UC vs Crohn’s 🔍 UC: Continuous colon inflammation → bleeding risk + toxic megacolon Crohn’s: “Skip lesions,” transmural → fistulas, strictures, malabsorption Medications 5-ASAs: reduce inflammation (best for UC) Steroids: for flares only Immunomodulators/Biologics: maintain remission; test for TB/Hep B/C first Nursing Focus Monitor stool, H&H, electrolytes NPO + IV fluids during severe flares Skin care for diarrhea Diet: high-calorie, high-protein, low-residue B12 deficiency common in Crohn’s Emergency: Toxic megacolon → fever, tachycardia, abdominal distention. 4️⃣ Bowel Obstruction (SBO & LBO) Contents can’t pass → fluid backs up → massive fluid loss → hypovolemic shock ⚡ Mechanical vs Paralytic Ileus Mechanical: adhesions, tumors, hernias Non-mechanical: post-op, inflammation, meds (opioids) Priority Signs Strangulation: sudden severe pain, fever, rigidity SBO: rapid vomiting (bile/projectile) → metabolic alkalosis LBO: distention, constipation → metabolic acidosis

MEDSURG | Lower GI

🔥 Med-Surg Crash Review: Lower GI Problems 1️⃣ Acute Infectious Diarrhea Main cause: Infectious agents (bacteria/viruses/parasites), often from contaminated food/water 🌎🍲. Big danger: Severe dehydration + electrolyte loss → hypovolemia & metabolic acidosis. C. diff = HIGH priority (hospital-acquired, spore-forming). Nursing Must-Knows Assess: I&O, electrolytes, H&H, skin turgor, VS, stool frequency. Intervene: IV fluids (NS/LR), oral electrolytes (Pedialyte). Infection control: Soap + water only, contact precautions, bleach cleaning. Avoid antidiarrheals ❌ (except certain traveler’s diarrhea). Red Flags: Sunken eyes, hypotension, tachycardia. 2️⃣ Acute Abdominal Pain & Peritonitis Often caused by inflammation, perforation, obstruction, or bleeding. Peritonitis = life-threatening! Priority Signs 🚨 Shock: Low BP, tachycardia, cool skin, ↓ urine. Peritonitis: Board-like rigidity, rebound tenderness, fever. Nursing Actions ABCs + high-flow O₂ Two large-bore IVs + rapid fluids NPO Pain control after MD eval Prepare for imaging or surgery Quick Cue: Don’t apply heat to the abdomen (may worsen inflammation). 3️⃣ Inflammatory Bowel Disease (UC & Crohn’s) Chronic, autoimmune, inflammatory flares. UC vs Crohn’s 🔍 UC: Continuous colon inflammation → bleeding risk + toxic megacolon Crohn’s: “Skip lesions,” transmural → fistulas, strictures, malabsorption Medications 5-ASAs: reduce inflammation (best for UC) Steroids: for flares only Immunomodulators/Biologics: maintain remission; test for TB/Hep B/C first Nursing Focus Monitor stool, H&H, electrolytes NPO + IV fluids during severe flares Skin care for diarrhea Diet: high-calorie, high-protein, low-residue B12 deficiency common in Crohn’s Emergency: Toxic megacolon → fever, tachycardia, abdominal distention. 4️⃣ Bowel Obstruction (SBO & LBO) Contents can’t pass → fluid backs up → massive fluid loss → hypovolemic shock ⚡ Mechanical vs Paralytic Ileus Mechanical: adhesions, tumors, hernias Non-mechanical: post-op, inflammation, meds (opioids) Priority Signs Strangulation: sudden severe pain, fever, rigidity SBO: rapid vomiting (bile/projectile) → metabolic alkalosis LBO: distention, constipation → metabolic acidosis

MEDSURG | GU

Renal/urologic disorders involve infection, inflammation, obstruction, and immune-mediated damage to the urinary system. UTIs (cystitis, urethritis, pyelonephritis) occur when bacteria—mainly E. coli—enter the urinary tract. Risk factors include female anatomy, obstruction (BPH, stones), retention, catheter use, pregnancy, diabetes, and immunosuppression. Symptoms include dysuria, frequency, urgency, suprapubic pain, foul/cloudy urine, and hematuria. Older adults may only show confusion 🧠. Diagnosis uses UA + culture; treatment uses antibiotics like TMP-SMX, nitrofurantoin, fosfomycin. Teaching: hydration, wipe front-to-back, void after sex, complete antibiotics 🌊. Pyelonephritis is infection of the renal parenchyma. Acute cases present with fever, chills, CVA tenderness, N/V, systemic toxicity 🤒. Labs show WBCs, bacteria, possible casts. Treat with broad-spectrum IV or PO antibiotics and hydration. Chronic pyelonephritis leads to fibrosis, CKD, and renal scarring. Urethritis often arises from bacterial or STI causes, presenting with dysuria and discharge. Treat based on organism. Interstitial cystitis/painful bladder syndrome causes chronic pelvic pain, urinary frequency, and urgency without infection. No cure—management includes diet changes (avoid citrus, caffeine, alcohol), stress reduction, and bladder analgesics. 🧬 Glomerular Disorders Glomerulonephritis (GN) results from immunologic inflammation of the glomeruli. Triggers include infections (post-strep GN), autoimmune diseases (SLE), hypertension, diabetes, drugs, and toxins. S/S: hematuria (tea-colored urine), proteinuria, edema, hypertension, flank pain. APSGN follows strep infection; treat with rest, sodium/fluid restriction, antihypertensives, and sometimes diuretics or antibiotics 🎯. Nephrotic syndrome results from massive protein loss (≥3.5 g/day). Causes: diabetes, SLE, infections, drugs. Symptoms: severe edema, ascites, foamy urine, hyperlipidemia, hypoalbuminemia. Treatment: ACEIs/ARBs, corticosteroids, statins, diuretics, low-sodium diet. Risk for DVT/PE due to hypercoagulability ⚠️. 🪨 Urinary Tract Calculi Stones form when solutes supersaturate urine. Types: • Calcium oxalate 🧊 • Calcium phosphate • Uric acid • Struvite (infection) • Cystine (genetic) Risk factors: dehydration, high sodium, high animal protein, hyperparathyroidism, immobility, UTIs. Symptoms: sudden severe flank pain radiating to groin, N/V, hematuria, restlessness. Diagnosis: CT, ultrasound. Management: fluids, tamsulosin, pain control, strain urine. Procedures: lithotripsy, ureteroscopy, stent placement. 🚑 Renal Trauma & Vascular Disorders Renal trauma occurs from blunt injuries (MVCs, falls). Assess flank bruising, hematuria. Management ranges from observation to surgery. Vascular conditions include nephrosclerosis, renal artery stenosis, and thromboembolism—may require antihypertensives or revascularization. 🧬 Polycystic Kidney Disease (PKD) Autosomal dominant disorder → multiple renal cysts → enlarged kidneys, flank pain, hematuria, HTN, progressive renal failure. No cure; manage BP, treat infections, prepare for dialysis/transplant. Tolvaptan may slow progression. Counseling is essential due to hereditary risk. 🧬

MEDSURG | GU Primer

Renal/urologic disorders involve infection, inflammation, obstruction, and immune-mediated damage to the urinary system. UTIs (cystitis, urethritis, pyelonephritis) occur when bacteria—mainly E. coli—enter the urinary tract. Risk factors include female anatomy, obstruction (BPH, stones), retention, catheter use, pregnancy, diabetes, and immunosuppression. Symptoms include dysuria, frequency, urgency, suprapubic pain, foul/cloudy urine, and hematuria. Older adults may only show confusion 🧠. Diagnosis uses UA + culture; treatment uses antibiotics like TMP-SMX, nitrofurantoin, fosfomycin. Teaching: hydration, wipe front-to-back, void after sex, complete antibiotics 🌊. Pyelonephritis is infection of the renal parenchyma. Acute cases present with fever, chills, CVA tenderness, N/V, systemic toxicity 🤒. Labs show WBCs, bacteria, possible casts. Treat with broad-spectrum IV or PO antibiotics and hydration. Chronic pyelonephritis leads to fibrosis, CKD, and renal scarring. Urethritis often arises from bacterial or STI causes, presenting with dysuria and discharge. Treat based on organism. Interstitial cystitis/painful bladder syndrome causes chronic pelvic pain, urinary frequency, and urgency without infection. No cure—management includes diet changes (avoid citrus, caffeine, alcohol), stress reduction, and bladder analgesics. 🧬 Glomerular Disorders Glomerulonephritis (GN) results from immunologic inflammation of the glomeruli. Triggers include infections (post-strep GN), autoimmune diseases (SLE), hypertension, diabetes, drugs, and toxins. S/S: hematuria (tea-colored urine), proteinuria, edema, hypertension, flank pain. APSGN follows strep infection; treat with rest, sodium/fluid restriction, antihypertensives, and sometimes diuretics or antibiotics 🎯. Nephrotic syndrome results from massive protein loss (≥3.5 g/day). Causes: diabetes, SLE, infections, drugs. Symptoms: severe edema, ascites, foamy urine, hyperlipidemia, hypoalbuminemia. Treatment: ACEIs/ARBs, corticosteroids, statins, diuretics, low-sodium diet. Risk for DVT/PE due to hypercoagulability ⚠️. 🪨 Urinary Tract Calculi Stones form when solutes supersaturate urine. Types: • Calcium oxalate 🧊 • Calcium phosphate • Uric acid • Struvite (infection) • Cystine (genetic) Risk factors: dehydration, high sodium, high animal protein, hyperparathyroidism, immobility, UTIs. Symptoms: sudden severe flank pain radiating to groin, N/V, hematuria, restlessness. Diagnosis: CT, ultrasound. Management: fluids, tamsulosin, pain control, strain urine. Procedures: lithotripsy, ureteroscopy, stent placement. 🚑 Renal Trauma & Vascular Disorders Renal trauma occurs from blunt injuries (MVCs, falls). Assess flank bruising, hematuria. Management ranges from observation to surgery. Vascular conditions include nephrosclerosis, renal artery stenosis, and thromboembolism—may require antihypertensives or revascularization. 🧬 Polycystic Kidney Disease (PKD) Autosomal dominant disorder → multiple renal cysts → enlarged kidneys, flank pain, hematuria, HTN, progressive renal failure. No cure; manage BP, treat infections, prepare for dialysis/transplant. Tolvaptan may slow progression. Counseling is essential due to hereditary risk. 🧬

Season 3

PHARM Amoxicillin

PHARM Amox” is an audio lesson zeroing in on amoxicillin pharmacology. It delivers a structured, no-nonsense review of therapeutic uses, contraindications, side effects, administration, and nursing management. Designed for nursing students and clinicians, this fast-paced, high-yield refresher sharpens the essentials you need for safe patient care and exam success.

PHARM | Anti-Diabetics and Insulins

This episode is everything Anti-Diabetic and Insulins. All of this material is being pulled from PDR (Physician's Desk Reference) PHARMACOLOGY STUDY GUIDE: ANTIDIABETIC AGENTS Covers Insulin, Glipizide (Sulfonylurea), Metformin (Biguanide), and Glucagon — focusing on MOA, red-flag effects, nursing priorities, and top NCLEX points. I. INSULIN (Lispro, Aspart, Humulin R, Novolin N) MOA: Promotes glucose uptake → stored as glycogen. Use: Type 1 DM, sometimes Type 2. Major Risk: Hypoglycemia — trembling, sweating, confusion, tachycardia. Priority: If conscious, give 4 oz OJ; if mild, check glucose first. Other Concerns: Somogyi (night hypoglycemia → AM rebound), Dawn Phenomenon (AM hyperglycemia), Lipodystrophy (rotate sites). Teach: Recognize hypo/hyper signs, store insulin refrigerated, avoid heat/light. Interactions: ↑BG—steroids, thiazides. ↓BG—MAOIs, aspirin, TCAs. NCLEX Tips: 1️⃣ Hypoglycemia = Priority. 2️⃣ Somogyi vs Dawn. 3️⃣ Store properly. II. SULFONYLUREAS (GLIPIZIDE) MOA: Stimulates pancreas → ↑ insulin. Use: Type 2 DM with functioning β-cells. Risk: Hypoglycemia (especially if no meal), weight gain, GI upset. Teach: Take 30 min before meals; always eat right after. Avoid: Renal/hepatic impairment. NCLEX Tips: 1️⃣ Take before meal. 2️⃣ Never skip eating. 3️⃣ Watch for hypoglycemia. III. BIGUANIDES (METFORMIN) MOA: ↓ hepatic glucose production, ↑ insulin sensitivity. Use: Type 2 DM (normal renal/hepatic function). Risk: Metallic taste; lactic acidosis in renal/hepatic impairment. Priority: Monitor renal/hepatic labs; hold before contrast dye studies. NCLEX Tips: 1️⃣ Liver = Target. 2️⃣ Monitor kidney. 3️⃣ Hold before procedures. IV. HYPERGLYCEMIC AGENT (GLUCAGON) MOA: ↑ BG via glycogenolysis (liver). Use: Severe hypoglycemia when oral glucose unavailable. Priority: Emergency only—administer IM/IV; follow with carbs when awake. NCLEX Tips: 1️⃣ Use when patient can’t take PO. 2️⃣ Fast-acting, life-saving. Rapid Recall: 💉 Insulin: Pushes glucose in. 💊 Glipizide: Squeezes pancreas. ⚙️ Metformin: Stops liver sugar dump. 🚨 Glucagon: Brings glucose out.

Pharm | Aminoglycosides

This is everything Aminoglycosides. PHARMACOLOGY STUDY GUIDE: AMINOGLYCOSIDES Drugs: Amikacin, Gentamicin, Tobramycin, Neomycin, Streptomycin Class: Anti-infective; bactericidal via 30S ribosomal inhibition. Key Mechanism & Uses MOA: Inhibits bacterial protein synthesis (30S ribosome) → kills bacteria. Use: Serious gram-negative infections (Pseudomonas, E. coli, Klebsiella, Proteus, Serratia). Often combined with penicillins or other agents for staph, endocarditis, or TB. Special Uses: Neomycin: Pre-op bowel prep, hepatic encephalopathy. Tobramycin (Inhaled): CF with Pseudomonas. PK: Well absorbed IM, full bioavailability IV. Poor PO absorption (except Neomycin). >90% excreted by kidneys. Half-life: 2–4 hr; prolonged in renal impairment → dose adjust. Contraindications & Major Interactions Avoid: Hypersensitivity, pregnancy (fetal nephro/ototoxicity), known ototoxicity, severe renal impairment. Deadly Combos: Loop diuretics (Furosemide): ↑ ototoxicity Nephrotoxic drugs (Vancomycin, NSAIDs): ↑ kidney injury Neuromuscular blockers: Respiratory paralysis risk Penicillins/Cephalosporins: Inactivation in renal insufficiency Warfarin + Neomycin: ↑ anticoagulant effect Red-Flag Adverse Effects 🚨 Nephrotoxicity — ↓ urine, ↑ BUN/Cr. → Priority: Monitor renal labs + output, ensure hydration (1.5–2L/day). 🚨 Ototoxicity — tinnitus, hearing loss, vertigo. → Priority: Assess hearing pre- and during therapy. Report ringing, dizziness, or balance issues immediately. 🚨 Respiratory Paralysis — esp. w/ rapid IV or neuromuscular blockers. → Priority: Stop infusion, support airway if apnea develops. Other Common: Headache, ataxia, nausea, vomiting, rash, hypersensitivity. Nursing Priorities & Monitoring Therapeutic Drug Monitoring (TDM):Peak: 30–90 min post-dose. Trough: Just before next dose (most critical to avoid toxicity). Maintain hydration, monitor renal & auditory function. Avoid in pregnancy unless life-threatening infection. Teach patients to report ringing in ears, decreased urine, or dizziness. Top 5 NCLEX Points 1️⃣ MOA: Bactericidal → inhibits protein synthesis (30S). 2️⃣ Toxicities: Ototoxicity + Nephrotoxicity (dose-related). 3️⃣ Monitor Peaks/Troughs: Narrow therapeutic window—mandatory. 4️⃣ Renal Caution: Half-life ↑ drastically in renal impairment → adjust dose. 5️⃣ Major DDI: Loop diuretics = hearing loss, nephrotoxics = kidney damage. Rapid Recall: 💊 Gentamicin & friends kill bacteria hard—but kill kidneys & ears faster if you’re not watching. 🩺 Monitor labs, monitor hearing, hydrate, and never skip those trough levels.

PHARM | Azithromycin

Everything Azithromycin. 1️⃣ Azithromycin (Zithromax, Zmax) Class: Macrolide antibiotic (50S inhibitor). MOA: Inhibits bacterial protein synthesis → bacteriostatic/cidal by concentration. Use: Respiratory infections (strep pharyngitis, pneumonia), STIs (gonorrhea, chancroid), and MAC prophylaxis in advanced HIV. Contra: Hypersensitivity, prior cholestatic jaundice, QT prolongation, hypokalemia, or bradycardia → risk of Torsades de Pointes. Adverse / Interventions: QT Prolongation / Arrhythmia: Monitor cardiac status; avoid QT-prolonging drugs (quinidine, amiodarone). Hepatotoxicity / Cholestasis: Monitor LFTs (AST, ALT, LDH). SJS / TEN / Anaphylaxis: Stop immediately at first rash or swelling. C. Diff Diarrhea: Monitor stool frequency and hydration. Priority: Stop for severe skin reaction or anaphylaxis; watch for dysrhythmias. 2️⃣ Aztreonam (Azactam, Cayston) Class: Monobactam β-lactam antibiotic. MOA: Bactericidal; binds cell-wall membrane → cell lysis. Use: Serious gram-negative infections (including Pseudomonas and multi-resistant strains). Contra: Hypersensitivity to aztreonam. Adverse / Interventions: Hypersensitivity / Anaphylaxis: Assess rash, wheezing, edema; notify HCP immediately. Superinfection (oral/vaginal candidiasis): Educate patient to report itching or discharge. Drowsiness/Dizziness: Caution with driving or machinery. Priority: Stop drug and treat if anaphylaxis occurs (fever, chills, dyspnea). 3️⃣ Azathioprine Class: Immunosuppressant / DMARD. MOA: Antimetabolite that suppresses T-cell activity → ↓ immune response (prevents graft rejection). Use: Prevention of transplant rejection; treatment of rheumatoid arthritis. Contra: Severe infection or known hypersensitivity (others not specified). Adverse / Interventions: Bone Marrow Suppression: Monitor CBC and platelets; dose ↓ if < 3000 platelets. Hepatotoxicity: Monitor LFTs and bilirubin; report jaundice. GI Upset: Take with food to reduce nausea. Priority: Bone-marrow suppression = life-threatening → monitor labs and infection signs (fever, fatigue, bleeding, chills). 🔥 Rapid Recall Summary Azithromycin: Watch for QT prolongation & liver toxicity. Stop if rash or arrhythmia. Aztreonam: Kills Gram-negatives hard; monitor for anaphylaxis & superinfection. Azathioprine: Suppresses immune system; monitor CBC & LFTs—bone marrow and liver are targets. Mnemonic: 💊 Three A’s — Airway, Allergy, Anemia → Cardiac for Azithro, Anaphylaxis for Aztreo, Anemia for Azathioprine.

PHARM | Ceftriaxone

This is everything Ceftriaxone. Third-Generation Cephalosporins Examples: Cefdinir, Cefditoren, Cefixime, Cefotaxime, Cefpodoxime, Ceftazidime, Ceftriaxone (Rocephin) MOA: Bactericidal—Inhibits bacterial cell wall synthesis. Spectrum: Stronger gram-negative coverage (E. coli, H. influenzae, K. pneumoniae, N. gonorrhoeae). Indications Respiratory, skin, GU, bone/joint, abdominal infections; meningitis; septicemia; otitis media. Major Contraindications Allergy: Cephalosporin or serious penicillin hypersensitivity. Neonates: Ceftriaxone contraindicated (<28 days, jaundiced, or on Ca²⁺ IV). Caution: Renal impairment, GI disease, urolithiasis (Ceftriaxone). Red-Flag Adverse Effects 🚨 Anaphylaxis: Stop drug, treat immediately. 🚨 C. diff Diarrhea: Report fever, bloody stool; avoid antidiarrheals. ⚡ Seizures: High doses or renal failure → monitor neuro status, adjust dose. 🩸 Bleeding: Ceftriaxone + Warfarin = ↑ INR; monitor. 💧 Nephrotoxicity: Watch BUN/Cr, ensure hydration. 🧬 Hematologic: Agranulocytosis, thrombocytopenia → monitor CBC. Common: N/V, cramps, rash, IM pain, phlebitis. Interactions Probenecid: ↑ levels/toxicity. Loop diuretics/Aminoglycosides/NSAIDs: ↑ renal risk. Antacids/H2 blockers: ↓ absorption (Cefdinir, Cefpodoxime). Warfarin: ↑ bleeding. OCPs: ↓ efficacy (Cefixime). Alcohol: Disulfiram-like reaction → avoid. PK Highlights Mostly renally excreted; dose-adjust in renal impairment. Half-life: Cefotaxime 1–1.5 hr ⟶ Ceftriaxone 5–9 hr (once daily). Top 5 NCLEX Pearls 1️⃣ Anaphylaxis & CDAD = life-threatening. 2️⃣ Ceftriaxone = no neonates or Ca²⁺ IV. 3️⃣ Adjust dose if Cr ↓. 4️⃣ Monitor INR w/ Warfarin. 5️⃣ Bactericidal cell-wall inhibitor → great Gram-negative coverage. 💊 Quick Recap: “Ceph-3 = Caution: CNS, C. diff, CrCl ↓.” 🩺 Watch for allergy, renal toxicity, and bleeding.

PHARM | 1st Gen Cephalosporins (Cephalexin)

This is everything 1st Gen Ceph Drugs. For my RN Program this class includes Cephalexin. First-Generation Cephalosporins Examples: Cefadroxil, Cefazolin, Cephalexin Class: Anti-infective | Pharmacologic: Cephalosporin (1st Gen) MOA: Binds to bacterial cell-wall membrane → cell death (bactericidal). Top Indications 1️⃣ Skin & soft-tissue infections. 2️⃣ UTIs. 💉 Cefazolin: peri-operative surgical prophylaxis. Therapeutic Effect Resolution of infection — ↓ redness, swelling, discharge, pain, fever. Contraindications / Cautions Allergy: Cephalosporin or serious PCN reaction → risk of anaphylaxis. Renal impairment: Drug is renally cleared → dose-adjust to avoid toxicity. GI disease / Colitis: ↑ risk for C. diff-associated diarrhea (CDAD). Red-Flag Adverse Effects 🚨 Anaphylaxis / Severe Allergy: Stop drug → maintain airway → notify provider → prepare for epi/O₂/resus. 🚨 C. diff Diarrhea: Watery, foul stool (can occur weeks later) → discontinue, report immediately. ⚠️ Stevens-Johnson / TEN: Blistering rash ± fever → stop drug → seek emergency care. Common: Nausea, vomiting, diarrhea → give with food/milk. IV: Phlebitis → monitor site; rotate every 48–72 h. Nursing Priorities 1️⃣ Always check allergy history (ceph ↔ PCN cross-sensitivity). 2️⃣ Monitor renal function (BUN/Cr). 3️⃣ Watch bowel pattern for CDAD. 4️⃣ Observe for rash or respiratory distress during first doses. 5️⃣ Teach: report rash, diarrhea, or SOB immediately. 💊 Quick Recall: “1st Gen = 1st Line for Skin & Surgery.” Kills by breaking the wall; watch for Allergy, Abdomen, and Airway.

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