chapter 3 toxic drugs PrepUs

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression."

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects?

Be sure to drink plenty of fluids to prevent dehydration

A client with urinary urgency and frequency has been prescribed an anticholinergic medication. The nurse should educate the client about what potential adverse effects related to secondary actions?

Decreased bowel motility

What can the tissue damage noted as an adverse effect of antirheumatoid drugs include? (Select all that apply.)

GI motility skin problems hypoglycemia super-infections

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?

It is necessary to ensure that the client's drug levels are therapeutic but not toxic.

All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug?

Stevens-Johnson syndrome

A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client?

Techniques for providing safe and effective mouth care

A client on a multimedication therapy regimen is demonstrating elevated liver enzymes that suggest hepatotoxicity. What is the most likely explanation for the elevation of the client's liver enzymes?

The liver is exposed to relatively large concentrations of ingested drugs or other potentially toxic substances due to the hepatic anatomy.

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?

This may be coincidental, and the memory loss may be attributed to changes with aging

The nurse should consider teratogenic effects when caring for what clients? (Select all that apply.)

a 29-year-old client receiving prenatal care in her first trimester of pregnancy a 37-year-old client who is taking fertility drugs

Upon assessment after giving oral penicillin, the nurse notes that a client has dilated pupils, increased blood pressure, and increased heart rate. The nurse would document these findings as which type of drug allergic reaction?

anaphylactic

The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication?

anaphylactic shock

The nurse is caring for a client with a drug allergy and understands the allergy is the result of the client developing:

antibodies.

A nurse is alert for any adverse effects of a medication on a client. This alertness in assessment is essential in providing for:

client safety.

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity?

decrease in urine output

A client is receiving antibiotics for treatment of infection. The nurse should assess for what potential indications of superinfection? Select all that apply.

fever glossitis

A client exhibiting Parkinson-like syndrome would be expected to have which manifestation upon assessment?

muscular tremors

The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action?

protecting and maintaining the patency of the client's airway Explanation:

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of:

secondary actions.

Which skin condition would be most likely to cause increased systemic absorption of a topical medication?

severe sunburn

Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply.

skeletal and limb abnormalities central nervous system alterations heart defects

What would the nurse expect the prescribing health care provider to order for a client with a delayed allergic reaction?

topical corticosteroid

The nurse is providing for a client who is being treated for a Pseudomonas infection in the intensive care unit. The client's medication regimen includes gentamicin 75 mg IV t.i.d. When monitoring the client for adverse effects, what assessment should the nurse prioritize?

urine output and creatinine clearance

What client is experiencing an adverse effect that is a result of primary action?

A client taking anticoagulants who develops a gastrointestinal bleed

Which client is experiencing a secondary action of a medication?

A client who is drowsy after taking antihistamine

What does the nurse need to do when there is any indication of an allergic reaction in clients?

Maintain the client's safety during drug therapy

A client is receiving an antineoplastic medication for treatment of breast cancer and begins having tonic-clonic seizure activity. What type of toxicity does the nurse recognize that this client is experiencing?

Neurotoxicity

The nurse is assessing a diverse group of clients, all of whom are being treated with medications. Which clients are experiencing adverse effects related to the primary actions of their medications? (Select all that apply.)

a client whose diuretic causes episodes of dizziness a client whose benzodiazepine causes sedation

Which prescribed medications should the nurse administer to an adult having an anaphylactic reaction?

epinephrine

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?

toxicity

A client is receiving a drug to lower blood glucose level. What would lead the nurse to suspect that the client's blood glucose level was too low?

cold, clammy skin

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:

hyperglycemia.

What would the nurse expect to assess if a client develops neuroleptic malignant syndrome?

hypertension

What factors can potentially contribute to a hypersensitivity reaction? (Select all that apply.)

pathological condition unique receptors and cellular responses age-related changes

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of:

poisoning

The pharmacology instructor explains to the students that adverse effects can be extensions of:

primary action of a drug.

Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs? Select all that apply.

a postoperative client with extrapyramidal symptoms, hyperthermia, and autonomic disturbances a client taking an antipsychotic who exhibits akinesia, muscular tremors, drooling, changes in gait, jitters (akathisia), or spasms (dyskinesia) a postoperative client who had atropine and exhibits dry mouth, altered taste perception, dysphagia, heartburn, constipation, and bloating

A client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a:

contraindication for the use of certain medications.

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?

decreased glomerular filtration rate.

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?

review the client's most recent potassium level

A client with recurrent urinary tract infections was prescribed sulfamethoxazole-trimethoprim and experienced an allergic reaction. The client states, "I don't understand. I had a two-day course of the same drug last year with no problems." What is the nurse's best response?

"Allergic reactions happen after your body has been sensitized to a drug in the past."

The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response?

"Do you remember what happened the last time you received penicillin?"

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

20-year-old female client who has been diagnosed with a chlamydial infection

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?

Discontinue the drug immediately as ordered.

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include?

Drugs cause unexpected or unacceptable reactions despite screening and testing.

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

Monitor laboratory blood values.

The nurse is preparing to administer antineoplastic medication to a client with cancer who has been receiving these medications for several days. When monitoring for potential adverse effects of this medication, the nurse should perform what assessments?

Monitor the client's blood cell counts. Monitor the client's potassium levels. Inspect the client's mucous membranes.

A client with a longstanding diagnosis of schizophrenia has taken antipsychotic drugs for several decades. For what adverse effect should the nurse assess?

Parkinsonian symptoms

A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize?

Provide supportive care to manage fever and inflammation.

A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan?

Safety measures

A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?

The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion?

The client's blood urea nitrogen level and creatinine clearance rate

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?

The man may be experiencing nephrotoxic effects of aspirin

A client with cancer is taking the prescribed dose of morphine sulfate and a family member informs the nurse that the client is extremely sedated. What finding by the nurse would indicate the causative factor of the increased sedation experienced by the client?

There is a bottle of St. John's wort the client is taking for depression.

The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration?

adverse effects

The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize?

asking the client what the client's response is to taking NSAIDs

A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize:

blood urea nitrogen and creatinine levels.

A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could:

damage the immature nervous system of the fetus.

A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety?

measures to alleviate any discomfort associated with adverse effects

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of:

poisoning.