CHAPTER 8 CENTRAL NERVOUS SYSTEM
2. The nurse plans to implement additional fall precautions for this patient. Why are additional fall precautions needed?
2.Gabapentin is a CNS depressant and can cause sedation, dizziness, and ataxia that increase a patient's risk for falls.
QUIZ 7 2. The nurse knows that there is a risk of lithium toxicity. What are the symptoms of lithium toxicity, and how will it be prevented? ANS. diarrhea
2.Symptoms of lithium toxicity include diarrhea, vomiting, drowsiness, muscular weakness, and a lack of coordination. At higher lithium levels, giddiness, ataxia, blurred vision, tinnitus, and a large output of dilute urine may be seen. Lithium toxicity is prevented by regularly monitoring serum lithium levels to maintain a therapeutic range between 0.8 to 1.2 mEq/L.
3. What potential common side effects should the nurse discuss with the patient?
3.Common side effects of SSRIs that the nurse should discuss with the patient include sedation, low blood pressure that can cause dizziness, suicidal thoughts, heart palpitations, sexual dysfunction, and anticholinergic side effects such as dry mouth. Patients should be advised to avoid drinking alcohol when taking an SSRI.
3. The patient's partner asks, "How quickly will the lithium work?" What is the nurse's best response?
3.The nurse should advise the patient that lithium reaches therapeutic range within 1 to 3 weeks.
The patient states, "I can't wait to feel better again. How soon will this medication work?" 4. What is the nurse's best response?
4.The nurse should advise the patient that it may take up to 12 weeks to reach therapeutic levels of this medication where they feel better.
Which of the following is the most serious side effect of the mood stabilizing drug lithium?
A) fatigue B) headache C)seizures* D)abdominal pain C
Which of the following are common side effects when taking the drug Phenytoin. Select all that apply.
A. Drowsiness B. Increased suicidal thoughts C. Ataxia D. Dry mouth B C
When administering Phenytoin you should monitor?
A. behavior B. therapeutic blood levels C. for Steven Johnson syndrome D. all of the above D
10. You are instructing a school-age child and his parent about the use of amphetamine-dextroamphetamine (Adderall) to manage the child's attention-deficit hyperactivity disorder. You should tell the child and parent to watch for which of the following? (Select all that apply.
A.Weight loss B. Insomnia C. Hallucinations D. Orthostatic hypotension E. Flu-like symptoms A B C Rationale: Amphetamine-dextroamphetamine, a central nervous system stimulant, can lead to weight loss. Patients should take drug right before meals and maintain healthful eating habits. Amphetamine- dextroamphetamine can cause insomnia and restlessness, so patients should take the drug in the morning. It can cause paranoid psychosis, thus patients should report delusions, hallucinations, and changes in mood. Risperidone (Risperdal), an atypical antipsychotic drug, is likely to cause orthostatic hypotension. Atomoxetine (Strattera) may cause liver injury. Patients taking atomoxetine should report signs of liver injury such as flu-like symptoms, yellowing skin, and abdominal pain
Critical Thinking Activity 8.5 A patient who has been experiencing panic attacks is prescribed lorazepam. Upon further discussion with the patient, the nurse discovers that the patient is planning to go on a cruise with her husband next week and plans to use a scopolamine patch to control the nausea. The patient states, "I can't wait to relax on the cruise ship and have a margarita as we leave port!" What important patient education should the nurse provide to the patient about the new prescription for lorazepam?
Lorazepam is a benzodiazepine, which is a CNS depressant. The riskiest side effects associated with the use of lorazepam are respiratory depression and oversedation. Other central nervous system depressants, such as scopolamine and alcohol, can cause additive effects and should be avoided when taking lorazepam. Sedation, drowsiness, respiratory depression, hypotension, and unsteadiness may occur when taking lorazepam, so these side effects should be considered when participating in activities on the cruise.
A nurse is providing teaching for a client who is to begin taking risperidone. Which of the following instructions should the nurse include? Risperidone oral tablet is used to treat schizophrenia, bipolar I disorder, and irritability associated with autistic disorder.
a. "Add extra snacks to your diet to prevent weight loss." b. "Notify the provider if you have trouble sleeping." c. "You may begin to have mild seizures while taking this medication." d. "This medication is likely to increase your libido." B may experience difficulty sleeping, agitation, or irritability.
ATI PROCTORE A nurse is providing teaching to a client who has a new prescription for Clozapine. Which of the following statements should the nurse include in the teaching? Clozapine is an FDA-approved atypical antipsychotic medication for treatment-resistant schizophrenia.
a. "Diarrhea is a common adverse effect of this medication." b. "Ringing in the ears is an expected adverse effect of this medication." c. "Notify your provider if you develop a fever while taking this medication." d. "You might experience weight loss while taking this medication." C
A nurse is teaching a client who has tobacco use disorder about nicotine replacement therapy. Which of the following statements by the client indicates understanding of the teaching?
a. "I should avoid eating right before I chew a piece of nicotine gum." b. "I will need to stop using the nicotine gum after 1 year." c. "I know that nicotine gum is a safe alternative to smoking if I become pregnant." d. "I must chew the nicotine gum quickly for about 15 minutes." A avoid eating and drinking 15 minutes prior to and while chewing the nicotine gum.
A nurse is teaching a client who has a new prescription for escitalopram for treatment of generalized anxiety disorder. Which of the following statements by the client indicated understanding of the teaching?
a. "I should take the medication on an empty stomach." b. "I will follow a low-sodium diet while taking this medication." c. "I need to discontinue this medication slowly." d. "I should not crush this medication before swallowing." C The client should taper the medication slowly to reduce the risk of withdrawal syndrome.
A nurse is providing instructions to a client who has a new prescription for zolpidem. Which of the following instructions should the nurse include?
a. "Notify the provider if you plan to become pregnant." b. "Take the medication 1 hr before you plan to go to sleep." c. "Allow at least 6 hr for sleep when taking zolpidem." d. "To increase the effectiveness of zolpidem, take it with a bedtime snack." A
A nurse is providing discharge teaching to a client who has a new prescription for clozapine. Which of the following statements should the nurse include in the teaching? Clozapine- is an atypical antipsychotic medication used to treat schizophrenia and other mental disorders.
a. "You should have a high-carbohydrate snack between meals and at bedtime." b. "You are likely to develop hand tremors if you take this medication for a long period of time." c. "You may experience temporary numbness of your mouth after each dose." d. "You should have your (WBC) white blood cell count monitored every week." D Monitor WBC due to the risk of fatal agranulocytosis.
A nurse working in an emergency department is caring for a client who has benzodiazepine toxicity. Which of the following actions is the nurse's priority?
a. Administer flumazenil. b. Identify the client's level of orientation. c. Infuse IV fluids. d. Prepare the client for gastric lavage B
A nurse in an acute mental health facility is caring for a client who is experiencing withdrawal from opioid use and has a new prescription for clonidine. Which of the following actions should the nurse identify as the priority?
a. Administer the clonidine on the prescribed schedule b. Provide ice chips at the client's bedside. c. Educate the client on the effects of clonidine. d. Obtain baseline vital signs. D
What is the classification for the drug valproate?
a. Anti-diabetic b. Anti-convulsants c. Anti-ulcer agent d. Anti-hypertensives B
A nurse is caring for a client who has a new prescription for lithium carbonate. When teaching the client about ways to prevent lithium toxicity, the nurse should advise the client to do which of the following?
a. Avoid the use of acetaminophen for headaches. b. Restrict intake of foods rich in sodium. c. Decrease fluid intake to less than 1,500 mL daily. d. Limit aerobic activity in hot weather. D Avoid activity that potential to cause sodium/water/deletion. which increases the risk of toxicity.
A nurse is caring for a client who takes paroxetine to treat posttraumatic stress disorder and reports that they grind their teeth during the night. The nurse should identify which of the following interventions to manage bruxism? (Select all that apply.) Bruxism is a condition where a person grinds, clenches, or gnashes his or her teeth; it can occur when awake or asleep
a. Concurrent administration of buspirone b. Administration of different SSRI c. Use of mouth guard d. Changing to a different class of antidepressant medication e. Increasing the dose of paroxetine C D Paroxetine is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). It's often used to treat depression, and sometimes obsessive compulsive disorder (OCD), panic attacks, anxiety or post-traumatic stress disorder (PTSD).
Your patient is on the medication Lithium for bipolar I disorder. What major side effect should you monitor the patient for?
a. Cough b. hypothermia c. Seizures d. Pulmonary edema C
A nurse is following up with a client who takes chlorpromazine for the treatment of schizophrenia. The nurse should expect to find the greatest improvement in which of the following manifestations? (Select all that apply.)
a. Disorganized speech b. Bizarre behavior c. Impaired social interactions d. Hallucinations e. Decreased motivation A B D Disorganized speech typically arises from abnormal thought processes. Bizarre behavior behavior that is odd, strange, or unexpected, particularly if it is out of the ordinary for a given person.
A nurse is assessing a client who has a prescription for bethanechol for urinary retention. The nurse should identify that which of the following findings is a manifestation of muscarinic stimulation?
a. Dry mouth b. Hypertension c. Excessive perspiration d. Fecal impaction C
What are the drug natural interactions for phenytoin?
a. Echinacea b. St.Johns Wort c. Valerian d. Jeff Salernos War B
When giving a patient Lithium what is a life threatening side effect?
a. Erythema b. Pancreatitis c. Seizures d. Headache C
A nurse is caring for a client who is taking Lithium and reports starting a new exercise program. The nurse should assess the client for which of the following electrolyte imbalances?
a. Hypocalcemia b. Hypokalemia c. Hyponatremia d. Hypomagnesemia C Hyponatremia- LOW SODIUM
A nurse is assessing a client after administering Phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication?
a. Hypoglycemia b. Bradycardia c. Red man syndrome d. Hypotension B
A nurse is assessing a client after administering Phenytoin IV bolus for a seizure. Which of the following should the nurse identify as an adverse effect of this medication?
a. Hypoglycemia b. Bradycardia c. Red man syndrome d. Hypotension B CNS effects: drowsiness sedation, depression , confusion, anxiety, double vision, ataxia, cognitive impairment, nystagmusii. Gingival hyperplasia, skin rash, dysrhythmias, hypotension
A nurse is reviewing the medications of a client is experiencing orthostatic hypotension. The nurse should identify this finding as an adverse effect of which of the following medications?
a. Imipramine b. Levothyroxine c. Montelukast d. Omeprazole A IMIPRAMINE (im IP ra meen) treats depression. It increases the amount of serotonin and norepinephrine in the brain, substances that help regulate mood.
A nurse is providing teaching for a client who is withdrawing from alcohol and has a new prescription for propranolol. Which of the following information should the nurse include in the teaching?
a. Increases the risk for seizure activity. b. Provides a for of aversion therapy. c. Decreases cravings. d. Can increase blood pressure. C
A nurse is providing teaching to a client who has a new prescription for Carbamazepine for the treatment of seizures. The nurse should instruct the client to monitor for which of the following adverse effects?
a. Insomnia b. Blurred vision c. Tachypnea d. Metallic taste B
A nurse is caring for a client who has major depression and a new prescription for Citalopram. Which of the following adverse effects is the priority for the nurse to report to the provider?
a. Insomnia b. Bruxism c. confusion d. weight loss C
A nurse is caring for a client who has major depression and a new prescription for Citalopram. Which of the following adverse effects is the priority for the nurse to report to the provider? Citalopram is used to treat depression, including major depressive disorder (MDD)
a. Insomnia b. Bruxism c. confusion d. weight loss C
When administering a Serotonin Antagonist it is important to monitor for
a. Intake and output b. Mental status changes c. Respiratory rate d. Anorexia B
When administering a Serotonin Antagonist it is important to monitor for?
a. Intake and output b. Mental status changes c. Respiratory rate d. Anorexia B
A nurse is caring for a client who is receiving moderate sedations with diazepam IV. The client is oversedated. Which of the following medications should the nurse expect to administer to this client?
a. Ketamine b. Naltrexone c. Flumazenil d. Fluvoxamine C
A charge nurse is planning a staff education session to discuss medications used during the care of a client experiencing alcohol withdrawal. Which of the following medications should the charge nurse include in the discussion? (Select all that apply.)
a. Lorazepam b. Diazepam c. Disulfiram d. Naltrexone e. Acamprosate A B Lorazepam Diazepam are benzodiazepines are used for alcohol withdrawal to decrease anxiety and reduce the risk of seizures.
Which drug is the antidote of Alprazolam?
a. Physostigmine b. Protamine sulfate c. Flumazenil d. Acetylcysteine C
2. A patient is taking risperidone (Risperdal) for schizophrenia. Recognizing the adverse effects of risperidone, you advise the patient to monitor for and report which of the following?
a. Tremor b. Weight loss c. Oral ulcers d. Bronchospasm A TremorRisperidone, an atypical antipsychotic, may cause Parkinson-like extrapyramidal effects, such as tremor and shuffling gait. You should instruct patients and caregivers to monitor for these effects. Risperidone may cause weight gain and new onset diabetes. It is unlikely to cause weight loss. Risperidone may cause dry mouth and nausea. It is unlikely to cause oral ulcers. Risperidone may cause photosensitivity. Advise patient to wear sunscreen and protective clothing. Risperidone may cause blurred vision. It is unlikely to cause bronchospasm.
Which of the following drugs can suppress seizure activity and decrease the frequency of migraine headache?
a. glipizide b. hydrochlorothiazide c. atropine d. valproate D
Critical Thinking Activity 8.7 A 32-year-old female visits the nurse practitioner with concerns about "feeling tired all the time," "having difficulty concentrating," "problems sleeping," and "just generally feeling down." The nurse practitioner prescribed fluoxetine.- Fluoxetine is a selective serotonin reuptake inhibitor (SSRI) antidepressant. The patient tells the nurse, "One of my friends told me I have to be careful or I might get serotonin syndrome if I take medication." 1.What places a patient at risk for serotonin syndrome, and what symptoms
1.A patient taking an SSRI medication like fluoxetine is at risk for developing serotonin syndrome if they have liver dysfunction or are taking other CNS medications. SSRIs are contraindicated with MAOIs due to the risk of developing serotonin syndrome. Symptoms of serotonin syndrome include confusion, elevated temperature, and rapidly changing levels of blood pressure. (MAOIs)-Monoamine oxidase inhibitors= An enzyme called monoamine oxidase is involved in removing the neurotransmitters norepinephrine, serotonin and dopamine from the brain.
Critical Thinking Activity 8.10 A 70-year-patient in a long-term care center has diabetes and has been prescribed gabapentin for neuropathic pain. 1. The patient states, "I have never had a seizure. Why has the doctor prescribed an antiseizure medication for me?" What is the nurse's best response?
1.Gabapentin is classified as an anti-seizure medication, but it is also used to help relieve neuropathic pain that patients with diabetes often describe as a "burning" or "tingling" sensation in their lower extremities.
Critical Thinking Activity 8.11 A 76-year-old patient in a long-term care center has developed a shuffling gait with a stooped posture, along with a hand tremor at rest. The nurse practitioner prescribed carbidopa/levodopa. 1. The nurse knows that Parkinson's disease is related to dopamine, but dopamine can't cross the blood-brain barrier. How will carbidopa/levodopa assist with dopamine levels? Levodopa -is the main drug of Parkinson's treatment - Dopamine precursor low dopamine- low movement More dopamine- more movement
1.Levodopa, the metabolic precursor of dopamine, crosses the blood-brain barrier and is then converted to dopamine in the brain. Carbidopa is combined with levodopa to help prevent the breakdown of levodopa before it is able to cross the blood-brain barrier. ans. This combination inhibits the breakdown of levodopa. Levodopa is the most effective drug for the treatment of symptoms of Parkinson disease. It is particularly effective for helping people who have slowness of movements caused by Parkinson disease, a problem called bradykinesia. Adverse affect Hallucination , key points sign toxicity- dyskinesia slow onset 2-6 weeks become effective slow position No high protein Not elimination only decreases of tremors or rigidity. Taken life long Never stop abruptly Levodopa/carbidopa - contraindicated MAOIs this medication is effective- Improvement in spontaneous movement. Effectiveness -Client more ambulatory This medication does not help memory
Critical Thinking Activity 8.8 A 42-year-old male was recently diagnosed with bipolar disorder after his partner became concerned about his extreme highs and lows in moods. His high mood swings were often associated with grandiose ideas, gambling, risky sexual behavior, and shopping sprees that were causing the couple to go bankrupt. The physician prescribed lithium. 1. The patient states, "The doctor told me I am having manic episodes. What does that mean?" What is the nurse's best resp
1.The nurse should explain symptoms of manic episodes include rapid speech, hyperactivity, reduced need for sleep, poor judgment, hostility, aggression, decreased impulse control, and risky behaviors. For more information about mania and bipolar disorder, review the "Disorders of the CNS System" section.
2. The patient states, "I am looking forward to spending next weekend with my grandson. He even said he would let me drive his new Mustang!" What teaching should the nurse provide the patient and his grandson (with the patient's permission) regarding the new medication and his weekend plans?
2.Patients taking carbidopa and levodopa have reported suddenly falling asleep without prior warning of sleepiness while engaged in activities of daily living, including operation of motor vehicles. Patients should be advised to exercise caution while driving or operating machines during treatment with carbidopa and levodopa.
2. The nurse knows that anyone starting an antidepressant is at risk for suicidal thoughts. How should the nurse therapeutically discuss this potential adverse effect with the patient?
2.The nurse should advise the patient of the potential for suicidal thoughts with this medication and advise her to notify her provider if she has any thoughts of self-harm.
3. The nurse reads that the most common side effect of carbidopa-levodopa is dyskinesia. What is dyskinesia? If it occurs, what is the likely treatment?
3.Dyskinesia is involuntary muscle movements including tics. If a patient develops dyskinesia while taking carbidopa-levodopa, dosing adjustment or alternate drug therapy is required.
3. What potential adverse effects should the nurse plan to monitor? What adverse effects would require immediate notification of the provider?
3.The nurse should plan to monitor for worsening depression, suicidal ideation, fever, rash, lymphadenopathy, dizziness, sleepiness, stumbling, and a lack of coordination. Development of any of these signs should be reported to the provider; suicidal ideation requires urgent notification.
8. During an assessment of a patient taking chlorpromazine, the provider notes a slow shuffling gait, rigid facial expression, and fine tremors. The provider recognizes this as which of the following?
A. Acute dystonia B. Tardive dyskinesia C. Parkinsonism D. Akathisia C Parkinsonism, an adverse effect of antipsychotic drugs, is characterized by a shuffling gait, drooling, and tremors. Acute dystonia is characterized by acute muscle spasms of the face, neck, and back. Tardive dyskinesia is characterized by involuntary movements that include smacking the lips and flicking the tongue. Akathisia is characterized by constant uncontrolled movement
9. You are instructing a patient about taking phenelzine (Nardil) to treat depression. Which of the following foods should you tell the patient avoid?
A. Aged cheese B. Milk C. Potato chips D. Candy A yramine-enriched foods, such as aged cheese and red wine, may trigger severe hypertension in patients taking phenelzine. Manifestations include hypertension, headache, and nausea. Health care providers should give patients taking this drug a list of foods to avoid. Fatty foods, dairy products, and foods high in sodium and sugar are not contraindicated for patients taking phenelzine. However, foods like potato chips and candy have little nutritive value and are not good choices for a healthy lifestyle. It might help to recall that risperidone (Risperdal) may cause and onset or worsening of diabetes. Patients taking that drug should reduce their sugar intake.
What is the category class of Lithium?
A. Antidiabetics, biguanides B. Mood stabilizers C. Antiarrhythmics, anticonvulsants D. Vascular headache suppressants B
8. You are instructing a patient who has multiple sclerosis about how dantrolene (Dantrium) will help control spasticity. Through which of the following pharmacologic actions is this drug effective in treating this manifestation?
A. Blocks acetylcholine at the neuromuscular junction B. Interrupts nerve signals from the spinal cord to the muscles C. Inhibits destruction of acetylcholine by acetylcholinesterase D. Alters intracellular calcium exchange at the muscles D Rationale: Dantrolene, a peripherally acting muscle relaxant, acts directly on spastic muscles and inhibits muscle contraction by preventing the release of calcium in skeletal muscles. Anticholinergic drugs or muscarinic antagonist block acetylcholine at the neuromuscular junction. Baclofen, a centrally acting muscle relaxant, relieves spasticity by interrupting nerve signals from the spinal cord. Most drugs used to treat myasthenia gravis act by preventing the destruction of acetylcholine at the neuromuscular junction
4. You continue to instruct the patient about using pilocarpine (Isopto Carpine). You tell the patient to watch for and report which of the following adverse effects of this drug? (Select all that apply.)
A. Blurred vision B. Headache C. Visual floaters D. Dilated pupils E. Tachycardia A B C Blurred visionHeadacheVisual floatersPilocarpine, a direct-acting cholinergic agonist, can cause constriction (not dilation) of the pupil, blurred vision, and headache. It can also cause floaters or spots in the visual field, manifestations patients must report because they might indicate retinal detachment. Bradycardia (not tachycardia), bronchospasm, and hypotension may occur with systemic absorption.
6. A patient is to start taking amitriptyline. For which of the following should the health care provider instruct the patient to monitor and report? (Select all that apply.)
A. Blurred vision B. Urinary hesitancy C. Diarrhea D. Joint pain E. Tachycardia A B E Blurred visionUrinary hesitancyTachycardiaCORRECT!Correct answer submitted. Rationale now showing.Amitriptyline, a tricyclic antidepressant, can cause anticholinergic effects such as blurred vision, urinary hesitancy, dry mouth, constipation, sedation, and tachycardia. It is more likely to cause constipation than diarrhea, and it is more likely to cause headache than joint pain.
6. While obtaining a client medical history, you find that client is taking levodopa/carbidopa for Parkinson's disease. which information in the client's health history alerts you to take further action?
A. Bradycardia B. pancreatic disease c. glaucoma D. impaired hearing C
A nurse is teaching a client who is taking levodopa/carbidopa to treat Parkinson's disease. Which of the following instructions should the nurse include?
A. Change position slowly to prevent orthostatic hypotension. B. Eat a protein snack to increase absorption. C. Take the drug at bedtime to avoid daytime drowsiness. D. Expect eye twitching to develop with long-term therapy. A Rationale: Levodopa/carbidopa can cause orthostatic hypotension.
12. You are instructing a patient about taking buspirone. You inform the patient to monitor and report a paradoxical reaction to buspirone. Which of the following is a paradoxical effect of buspirone?
A. Chest pain B. Insomnia C. Diaphoresis D. Fever InsomniaBuspirone is a non-benzodiazepine that reduces anxiety. A paradoxical effect is one that is the opposite of what is expected. Insomnia, nervousness, and anxiety are paradoxical effects of anti-anxiety drugs. Chest pain, diaphoresis, and fever are not paradoxical effects of buspirone and are unlikely with this drug. Adverse effects of buspirone include dry skin, flushing, and palpitations.
1. A nurse in the emergency department is caring for a client who has benzodiazepine toxicity. Which of the following medications should the nurse expect to administer? benzodiazepine OR LORAZEPAM- ativan Benzodiazepines are depressants that produce sedation and hypnosis, relieve anxiety and muscle spasms, and reduce seizures. alprazolam- xanax
A. Clordiazepoxide B. Citalopram C. Flumazenil D. Fluoxetine C Flumazenil- used for overdose Benzodiazepine toxicity- sedation, lightheadedness, drowsiness, bradycardia, altered mental status, ataxia, decreased respiration, experience hallucination or memory loss. decrease cognitive function.
12. A patient receives spinal anesthesia with lidocaine (Xylocaine) and epinephrine (Adrenalin). You explain that epinephrine is used with lidocaine for which of the following reasons?
A. Decreases the risk for a spinal headache B. Reduces the risk for infection C. Prolongs the anesthetic effects D. Prevents respiratory depression C Rationale: Injecting epinephrine with lidocaine for local or regional anesthesia extends the duration of the regional anesthesia. Epinephrine will not reduce the risk for a spinal headache. Instead, positioning patients supine can reduce headache. Epinephrine has no effect on infection risk. It is essential for the anesthetist to confirm correct drug concentration and correct spinal placement to prevent drug toxicity and to monitor for paresthesia, confusion, agitation, which can lead to seizures and respiratory arrest. Injecting epinephrine into the subarachnoid space will not prevent respiratory depression. A spinal anesthetic that involves the intercostal muscles can cause respiratory depression. Should this occur, it is critical to monitor spinal level, administer supplemental oxygen, and provide respiratory support as needed.
11. A patient is taking venlafaxine to treat major depression. Which of the following information should you include when instructing the patient and family about the use of venlafaxine? (Select all that apply.)
A. Discontinue it immediately for increased depression. B. Take it with food to reduce gastric disturbances. C. Monitor and report insomnia. D. Have blood pressure checked regularly. E. Check with the provider before taking any herbal supplements. B C D E Venlafaxine, a serotonin norepinephrine reuptake inhibitor antidepressant, may cause withdrawal symptoms if discontinued abruptly. You should instruct the patient and family to monitor and report increased depression or thoughts of suicide and not to stop taking the drug. Instead, they should taper the dosage over a period of 2 to 4 weeks to reduce the intensity and duration of withdrawal symptoms. Patients should take venlafaxine with food to reduce its common side effects of nausea and vomiting. Venlafaxine may cause tachycardia and hypertension, so patients taking it should have regular blood pressure checks. Some herbal supplements, such as St John's wort, may cause serotonin syndrome when patients take it concurrently with venlafaxine.
5. The patient returns to the provider's office after 1 week. The patient is sweating and reports urinary urgency. The provider suspects systemic effects from the pilocarpine. Which of the following drugs can reverse systemic toxicity from pilocarpine?
A. Flumazenil B. Protamine C. sulfateNaloxone D. Atropine sulfate D Atropine sulfateSystemic effects of pilocarpine, a direct-acting cholinergic agonist, include bradycardia, bronchospasm, hypotension, sweating, and urinary urgency. An anticholinergic drug, such as atropine, reverses it. Flumazenil reverses the effects of benzodiazepines. Protamine sulfate reverses the effects of heparin. Naloxone reverses the effects of opioid narcotics.
9. You are caring for a patient who is preoperative and is NPO. The patient takes carbamazepine (Tegretol), 200 mg PO BID for a seizure disorder. Which of the following actions should you take?
A. Give the oral dose of carbamazepine with a sip of water. B. Give carbamazepine IV. C. Withhold the carbamazepine. D. Administer half the usual morning dose of carbamazepine. Rationale: It is important to continue the oral carbamazepine to maintain therapeutic blood levels and to prevent seizure activity. You should notify the anesthesiologist and should give the patient the carbamazepine with a sip of water. Carbamazepine is not available IV. Withholding the carbamazepine may reduce the therapeutic blood level and cause seizure activity. Administering a reduced dose of carbamazepine may reduce the therapeutic blood level and cause seizure activity.
A nurse is reviewing the medical record of a client who has a newly diagnosed seizure disorder and a new prescription for valproic acid and phenytoin. The nurse should identify that which of the following can occur as a result of an interaction between these drugs.
A. Hyperammonemia B. Phenytoin toxicity C. Hypertension D. Peptic ulcer disease B. Phenytoin toxicity B Rationale: Valproic acid can cause an increase in phenytoin blood levels, causing phenytoin toxicity. The primary care provider should monitor serum phenytoin levels and reduce the dosage if levels begin to exceed the therapeutic range
A nurse is caring for a client who has a alcohol use disorder and is experiencing withdrawals. Which of the following interventions is a priority at this time?
A. Implement seizure precautions B. Administer naltrexone C. encourage participation in a 12-step program D. assist the client to identity triggers for alcohol use A
4. A client is taking oral contraceptives for birth control. Which of the following instructions should the healthcare professional include?
A. It is safe to discontinue birth control while taking phenytoin B. Additional birth control method may be needed. C. Oral contraceptive may increase the risk for phenytoin toxicity. D. Oral contraceptive may reduce the effectivemess of phenytoin. B Phenytoin is teratogenic and can cause serious birth defect, so women taking it should prevent pregnancy.
Lithium is used to?
A. Lower blood glucose B. slow the heart rate C. stabilize mood D. heal ulcers C
Select all the early manifestations of lithium toxicity
A. Nausea B. Hypotension C. Renal Failure D. Muscle Weakness A D
A patient states he experiences anxiety and has panic attacks at least once a week. What might be helpful for this patient?
A. Phenytoin (Dilantin) B. Lithium C. Alprazolam (Xanax) D. Spironolactone C
A patient states he experiences anxiety and has panic attacks at least once a week. What might be helpful for this patient
A. Phenytoin (Dilantin) B. Lithium C. Alprazolam (Xanax) D. Spironolactone C
PHARMACOLOGY MADE EASY 1. The healthcare professional is about to administer a loading dose of phenytoin IV. Which of the following is essential for the health care professional to do before administering phenytoin IV?
A. Protect the phenytoin solution from light B. Make sure the phenytoin solution is cloudy C. Mix phenytoin with a dextrose solution D. Infuse phenytoin slowly. D Health care professional should administer IV. phenytoin slowly, no faster than 50 mg/min. because rapid infusion may cause hypotension, bradycardia, and cardiovascular collapse.
What is the therapeutic use of Phenytoin?
A. Replacement in hypothyroidism to restore normal hormonal balance B. Diminished accumulation of acid in the gastric lumen with lessened gastroesophageal reflux C. Diminished seizure activity, termination of ventricular arrhythmias D. Prevention of thrombus formation, prevention of extension of existing thrombi C
7. Early clinical manifestations of lithium (Lithobid) toxicity include which of the following? (Select all that apply.)
A. Seizures B. Nausea C. Hypotension D. Ataxia E. Muscle weakness B E Rationale now showing.Nausea and muscle weakness are early indications of lithium toxicity. Other early findings include thirst, vomiting, and fine muscle tremors. Patients should report these manifestations to the provider immediately. Also, serum lithium levels should be evaluated periodically. Seizure activity, hypotension, and ataxia are signs of advanced lithium toxicity.
5. Which laboratory test should you monitor for a client who is taking unterferon beta-1B to treat multiple sclerosis? select all apply
A. Serum osmolality B. Blood glucose C. Thyroid hormones D. Liver function E. CBC C D E interferon beta- 1B, an immunosuppressant, may cause hepatotoxicity and myelosuppression. Monitor liver studies and complete blood counts.
What do you assess for in a patient who is on Valproate? Select all that apply.
A. Suicidal thoughts B. Monitor for seizures. C. Bipolar disorder. D. Migraines. A B C D
What do you assess for in a patient who is on Valproate? Select all that apply.
A. Suicidal thoughts B. Monitor for seizures. C. Bipolar disorder. D. Migraines. E. Anorexia A B C D
11. A primary care provider prescribes sumatriptan (Imitrex) to treat a patient's migraine headaches. Which of the following instructions should you include when telling the patient how to take sumatriptan. selects all apply
A. Take the drug after onset of the migraine. B. Administer one nasal spray into each nostril. C. Take it once per day to prevent migraine. D. Repeat the dose once if the headache is not relieved. E. Allow the tablet to dissolve under the tongue. A D Rationale: Patients should only take sumatriptan, a serotonin agonist, after the onset of a migraine or a cluster headache. They should spray the drug once into one nostril. They may repeat the dose once, 1 to 2 hours after the initial dose, depending on the route. They should not use sumatriptan sublingually; only oral, subcutaneous, and intranasal routes are appropriate
7. At a visit to the provider office, an older adult clients partner report that the client has nausea, diarrhea, and a loss of appetite. He has a history of Alzheimer's disease and is taking donepezil. Which information should be provided by the nurse?
A. Take the drug with food. B. Stop taking the drug right away. C. Take a reduced dosage of the drug. D. Undergo liver function tests right away. Rationale: Cholinesterase inhibitors such as donepezil commonly cause nausea, vomiting, anorexia, and other gastrointestinal symptoms. This is due to the increase of acetylcholine in all parts of the body, and its subsequent effect on the gastrointestinal tract and other systems of the body. The provider should explain to the patient and his caregiver that taking the drug with food and at bedtime will help minimize uncomfortable gastrointestinal effects.
10. A patient is taking risperidone (Risperdal) for schizophrenia. Recognizing the adverse effects of risperidone, you advise the patient to monitor for and report which of the following?
A. Tremor B. Weight loss C. Oral ulcers D. Bronchospasm A TremorRisperidone, an atypical antipsychotic, may cause Parkinson-like extrapyramidal effects, such as tremor and shuffling gait. You should instruct patients and caregivers to monitor for these effects. Risperidone may cause weight gain and new onset diabetes. It is unlikely to cause weight loss. Risperidone may cause dry mouth and nausea. It is unlikely to cause oral ulcers. Risperidone may cause photosensitivity. Advise patient to wear sunscreen and protective clothing. Risperidone may cause blurred vision. It is unlikely to cause bronchospasm.
3. The health care professional is taking with a client, who is soon to be discharge to home, about the adverse effect of phenytoin. which of the following instruction may help minimize the adverse effect of phenytoin?
A. Use a good oral hygiene. B. Take the drug on an empty stomach. C. use sun blocks when outdoors. D. Decrease dietary fiber. A The risk of gingival hyperplasia may be reduce with daily flossing and gum massage. and take the drug with food. and increasing fiber intake might help minimize or prevent that effect.
The charge nurse is observing a newly licensed nurse provide care to a group of clients. Which of the following action by the newly licensed nurse requires the charge nurse to complete an incident report?
A. a client who has a lithiu m level of 1.8 mEq/L receives her morning dose of lithium B. A client who has a blood glucose level of 120 mg/dL receives her morning dose of insulin A
Phenytoin is an antiarrhythmic and anticonvulsant that has an unlabeled use for:
A. headaches B. cold remedy C. neuropathic pain D. antianxiety C
2. The health care professional is now assessing the client. which of the following finding can be early indication of phenytoin toxicity?
A. nystagmus B. tachycardia C. tachypnea D. Jaundice A Phenytoin toxicity can develop with serum phenytoin levels greater than 20 mcg/ml. causing nystagmus, ataxia, sedation, and blurred or double vision.
What is the Therapeutic Effects of Lithium?
A.) Prevents/decreases incidence of acute manic episodes B.) Maintenance of blood glucose C.) Control of hyperglycemia in diabetic patients D.) Diminished seizure activity A
What is a side effect for Phenytoin?
A.) Suicidal thoughts b) Dry mouth c) Blood in urine d) Tremor A
3. A provider prescribes pilocarpine (Isopto Carpine) for a patient. Which of the following information should you include when instructing the patient about instilling pilocarpine eye drops?
A.Apply gentle pressure to the nasolacrimal duct after instillation. B. Massage the eyelid after instillation. C. Cover the eye with a patch after instillation. D. Blink rapidly to disperse the eye drops after instillation. A Apply gentle pressure to the nasolacrimal duct after instillation.You should tell the patient to pull down the lower lid gently and place the drop in the lower eyelid in the conjunctival sac. Next, the patient should apply pressure to the nasolacrimal duct for 1 minute after instillation to reduce systemic absorption. The patient should not rub or massage the eye. It is not necessary to cover the eye with an eye patch. A protective patch is appropriate with topical anesthetics to protect the eye from injury. It is not necessary to blink rapidly after instilling pilocarpine eye drops, because doing so might propel the drops out of the conjunctival sac.
QUIZ 7 A nurse is providing teaching to a client who has a new prescription for phenelzine. Which of the following foods should the nurse instruct the client to avoid?
Cheddar cheese
QUIZ 7 2. The nurse knows that there is a risk of lithium toxicity. What are the symptoms of lithium toxicity, and how will it be prevented?
DIARRHEA
QUIZ 7 A nurse is providing teaching to a client who has a new prescription for paroxetine. The nurse should instruct the client to monitor for which of the following adverse effects? to treat depression, and sometimes obsessive compulsive disorder (OCD), panic attacks, anxiety or post-traumatic stress disorder (PTSD).
Drowsiness
QUIZ 7 A nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression. Which of the following indicates that the client has developed and adverse effect of this medication?
Orthostatic hypotension
quiz 7 Which of the following will you monitor to a patient using Amitriptyine ?
Orthostatic hypotension
Critical Thinking Activity 8.6 QUIZ 7 A 12-year-old male child has been diagnosed with ADHD after his parents and teachers became concerned with his inability to concentrate and his poor impulse control in the classroom. The physician has prescribed methylphenidate (Ritalin). What topics should the nurse reinforce while educating the child and his parents about this medication?
Patient and parent education about methylphenidate should include QUIZ 7-takE the medication in the morning and not after 4 p.m. It is important to monitor the child's growth and weight and to provide food and snacks that the child likes if weight loss is a concern. Methylphenidate has a Black Box Warning due to its high abuse potential, and signs of misuse should be reported to the provider. The risks of drinking alcohol while taking this medication should also be discussed.
QUIZ 7 A nurse is teaching a client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?
Take this medication with food
QUIZ 7 What statement from a patient using Lorazepam needs further teaching?
This drug will help me breathe well.
A nurse is teaching a client who has a new prescription for baclofen to treat muscle spasms. Which of the following statements by the client indicates an understanding of the teaching? (Select all that apply.)
a. "I will stop taking this medication right away if I develop dizziness." b. "I know the doctor will gradually increase my dose of this medication for a while." c. "I should increase fiber to prevent constipation from this medication." d. "I won't be able to drink alcohol while I'm taking this medication." e. "I should take this medication on empty stomach each morning." B C D
A nurse is teaching a client who has obsessive-compulsive disorder and has a new prescription for paroxetine. Which of the following instructions should the nurse include? Paroxetine is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI)
a. "It can take several weeks before you feel like the medication is helping." b. "Take the medication just before bedtime to promote sleep." c. "You should take the medication when needed for obsessive urges." d. "Monitor for weight gain while taking this medication." A
A nurse is providing teaching to a client who has a new prescription for buspirone to treat anxiety. Which of the following information should the nurse include?
a. "Take this medication on an empty stomach." b. "Expect optimal therapeutic effects within 24 hr." c. "Take this medication when needed for anxiety." d. "This medication has a low risk for dependency." D buspirone has a low risk for dependency. and needs to be taken on a regular, schedule rather than a PRN basis.
A nurse is preparing a teaching plan for a client who has bipolar disorder and a new prescription for carbamazepine. Which of the following instructions should the nurse include in the teaching? (Select all that apply.)
a. "This medication can safely be taken during pregnancy." b. "Eliminate grapefruit juice from your diet." c. "You will need to have a complete blood count and carbamazepine levels drawn periodically." d. "Notify you provider if you develop a rash." ---- QUIZ 7 e. "Avoid driving for the first few days after starting this medication." B C D E
A nurse is reviewing a new prescription for oxcarbazepine with a client who has partial seizures. Which of the following instructions should the nurse include? (Select all that apply.)
a. "Use caution if given a prescription for a diuretic medication." b. "Consider using an alternate form of contraception if you are using oral contraceptives." c. "Chew gum to increase saliva production." d. "Avoid driving until you see how the medication affects you." e. "Notify your provider if you develop skin rash." A B D E
A nurse is providing discharge teaching to a client who has a new prescription for fluoxetine for posttraumatic stress disorder. Which of the following statements should the nurse include in the teaching? Fluoxetine is a type of antidepressant known as a selective serotonin reuptake inhibitor (SSRI). It's often used to treat depression, and sometimes obsessive compulsive disorder and bulimia. It works by increasing the levels of serotonin in the brain. effect slowly up to 12 weeks.
a. "You can have a decreased desire for intimacy while taking this medication." b. "You should take this medication at bedtime to help promote sleep." c. "You will have fewer urinary adverse effects if you urinate just before taking this medication." d. "You'll need to wear sunglasses when outdoors due to the light sensitivity caused by this medication." A book- Instruct client that adverse effects can decrease libido, urinary retention, constipation, and increase photosensitivity. Patient teaching- monitor patient carefully for suicidal book common side effects of SSRI- sedation, low blood pressure, dizziness, suicidal thoughts, heart palpitation, sexual dysfunction, dry mouth, ATI- weight loss, serotonin syndrome, withdrawal syndrome, hyponatremia, rash,
A nurse is teaching a client who has a new prescription for ramelteon. The nurse should instruct the client to avoid which of the following foods at the time of medication administration? Ramelteon is a sedative that works by affecting your sleep-wake cycle. It is used to treat insomnia that is associated with trouble falling asleep
a. Baked potato b. Fried chicken c. Whole-grain bread d. Citrus fruit B
PART 2 1. Which of the following drugs, used to treat open-angle glaucoma, should primary care providers use with caution for a client who is taking propranolol?
a. Betaxolol (Betoptic) b. Pilocarpine c. Latanoprost (Xalatan) d. Acetazolamide (Diamox) A Betaxolol (Betoptic)Betaxolol is a topical cardioselective beta1 blocker that decreases IOP by reducing the amount of aqueous humor produced. Pilocarpine is a muscarinic drug that constricts the pupil and ciliary muscle, which promotes the outflow of aqueous humor to lower IOP. Latanoprost is a topical prostaglandin analog that increases aqueous humor outflow through relaxation of the ciliary muscle. Acetazolamide is a systemic carbonic anhydrase inhibitor that reduces the production of aqueous humor by causing diuresis through renal effects.
A nurse is caring for a client who has been taking sertraline for the past 2 days. Which of the following assessment findings should alert the nurse to the possibility that the client is developing serotonin syndrome?
a. Bruising b. Fever c. Tinnitus d. Rash B
A nurse is reviewing the medical record of a client who reports urinary incontinence ad asks about a prescription for oxybutynin. The nurse should recognize that oxybutynin is contraindicated in the presence of which of the following conditions?
a. Bursitis b. Sinusitis c. Depression d. Glaucoma D
A nurse is providing teaching to a client who has a new prescription for amitriptyline for treatment of depression. Which of the following should the nurse include in the teaching? (Select all that apply.) Amitriptyline is an antidepressant medicine. It's used to treat low mood and depression.
a. Expect therapeutic effects in 24 to 48 hr. b. Discontinue the medication after a week of improved mood. c. Change positions slowly to minimize dizziness. d. Decrease dietary fiber intake to control diarrhea. e. Chew sugarless gum to prevent dry mouth. C E ATI- change position slowly or sudden drop in blood pressure. book- Patient teaching 1. Instruct the patient to report sudden changes mood, behaviors, thoughts, or feelings. adverse effects- constipation, drowsiness, urinary retention, hypotension, QT interval, sedation, sexual dysfunction, risk for arrhythmias. ATI adverse effects- Dry mouth, blurred vision, photophobia, urinary hesitancy, constipation, tachycardia.
A nurse is providing information to a client who has early Parkinson's disease and a new prescription for pramipexole. The nurse should instruct the client to monitor for which of the following adverse effects of this medication?
a. Hallucinations b. Increased salivation c. Diarrhea d. Discoloration of urine A This medication can cause hallucinations within 9 months of the initial dose and might require discontinuation.
chapter 15 ATI 1. A nurse is providing instructions to a client who has been experiencing insomnia and has a new prescription for temazepam. The nurse should inform the client that which of the following manifestations are adverse effects of temazepam? (Select all that apply.) Temazepam is a benzodiazepine that treats insomnia by slowing down the central nervous system.
a. Incoordination b. Hypertension c. Pruritus d. Sleep driving e. Amnesia A D E Temazepam is a benzodiazepine that treats insomnia by slowing down the central nervous system.
QUIZ 7 A nurse is teaching a client who has a new prescription for levodopa/carbidopa for Parkinson's disease. Which of the following instructions should the nurse include?
a. Increase intake of protein-rich foods b. Expect muscle twitching to occur c. Take this medication with food d. Anticipate relief of manifestations in 24 hr C and avoid high-protein snacks. Adverse effect book- DEpression, suicidal ideation, hallucination, intense urges with inability to control.
A nurse is caring for a client who has depression and a new prescription for venlafaxine. The nurse should monitor the client for which of the following manifestation as an adverse effect of this medication? (Select all that apply.) Venlafaxine is used to treat depression. It is also used to treat general anxiety disorder, social anxiety disorder, and panic disorder. Venlafaxine belongs to a group of medicines known as serotonin and norepinephrine reuptake inhibitors (SNRI).
a. Mydriasis b. Dizziness c. Decreased libido d. Alopecia e. Hypotension A B C a. Mydriasis - dilation of pupils b. Dizziness c. Decreased libido - ATI- adverse effect: sexual dysfunction, Decreased orgasm menstrual change, dilation of pupils, dizziness, blurred vision, decreased libido. book adverse effects- serotonin syndrome, insomnia, anxiety, decreased appetite, weight loss, mania, hyponatremia, increased bleeding.
A nurse in the operating room is caring for a client who received a dose of succinylcholine. During the operation, the client suddenly develops rigidity and a rise in body temperature. The nurse should expect a prescription for which of the following medications? Succinylcholine is a neuromuscular blocking agent that is used to calm muscles during surgery or on a breathing machine.
a. Neostigmine b. Naloxone c. Dantrolene d. Vecuronium C Dantrolene is used to treat spasticity (muscle stiffness and tightness) or muscle spasms associated with spinal cord injuries, stroke, multiple sclerosis, or cerebral palsy
A nurse in the post-anesthesia recovery unit is caring for a client who received a nondepolarizing neuromuscular blocking agent and has muscle weakness. The nurse should expect a prescription for which of the following medications?
a. Neostigmine b. Naloxone c. Dantrolene d. Vecuronium A Neostigmine is used to reverse the effect of nondepolarizing neuromuscular blockers.
A nurse is reviewing the list of current medication for a client who is to start prescription for Carbamazepine. The nurse should identify that which of the following medications interacts with Carbamazepine? Carbamazepine is used to manage and treat epilepsy, trigeminal neuralgia, and acute manic and mixed episodes in bipolar I disorder
a. Nicotine transdermal system b. Diphenhydramine c. Estrogen-progestin combination d. Beclomethasone C
QUIZ 7 A nurse is caring for a client who has a new prescription for phenelzine for the treatment of depression. Which of the following indicates that the client has developed and adverse effect of this medication?
a. Orthostatic hypotension b. Hearing loss c. Gastrointestinal bleeding d. Weight loss A The nurse should report the adverse effect to the provider. Orthostatic hypotension- is a condition in which your blood pressure suddenly drops when you stand up from a seated or lying position. CNS stimulant- anxiety, agitation, mania, hypomania.
A nurse is caring for a client who is undergo a surgical procedure. Which of the following preexisting conditions can be a contraindication for the use of ketamine as an IV anesthetic?
a. Peptic ulcer disease b. Breast cancer c. Diabetes mellitus d. Schizophrenia D effect of hallucination
A nurse is reviewing laboratory findings and notes that a client's lithium level is 2.1 mEq/L. Which of the following is an appropriate action by the nurse? A safe blood level of lithium is 0.6 and 1.2 milliequivalents per liter (mEq/L). Lithium toxicity can happen when this level reaches 1.5 mEq/L or higher.
a. Perform immediate gastric lavage. b. Prepare the client for hemodialysis. C. Administer an additional oral dose of lithium. d. Request a stat repeat of the laboratory test. A
A nurse is preparing to administer a medication to a client who has absence seizures. The nurse should expect to administer which of the following medications to the client? (Select all that apply.)
a. Phenytoin b. Ethosuximide c. Gabapentin d. Carbamazepine e. Valproic acid B D E Ethosuximide is a medication used to treat absence seizures Carbamazepine is an anticonvulsant that treats seizures and nerve pain Valproic acid is used alone or with other medications to treat certain types of seizures
A nurse is the post-anesthesia care unit is caring for a client who is experiencing malignant hyperthermia. Which of the following actions should the nurse take? (Select all that apply.)
a. Place a cooling blanket on the client. b. Administer oxygen at 100%. c. Administer iced 0.9% sodium chloride. d. Administer potassium chloride IV. e. Monitor core body temperature. A B C E
A nurse is assessing a client who takes lithium carbonate for the treatment of bipolar disorder. The nurse should identify which of the following findings is a possible indication of toxicity to this medication?
a. Severe hypertension b. Coarse tremors c. Constipation d. blurred vision E. Increase urine output B D E book- seek emergency assistance 1. fainting 2. lightheadedness 3. abnormal heartbeats 4. shortness of breath highest risk of toxicity- diarrhea and vomiting, abdominal pain.
A nurse is assessing a client who recently began taking haloperidol. Which of the following findings is the priority to report to the provider? Haloperidol is an antipsychotic medicine that is used to treat schizophrenia.
a. Shuffling gait b. Neck spasms or tremors c. High fever or diaphoresis d. change mental status B C D book- life-threatening 1. Neuroleptic malignant syndrome 2. Tardive dyskinesia 3. Extrapyramidal symptoms
A nurse is caring for a client who is taking Sertraline and reports a desire to begin taking supplements. Which of the following supplements should the nurse advise the client to avoid? Sertraline is used to treat depression, panic attacks, obsessive compulsive disorder, post-traumatic stress disorder, social anxiety disorder.
a. St. John's Wort b. Ginger root c. Black cohosh d. Coenzyme Q10
A nurse is teaching a client, who has schizophrenia, strategies to cope with anticholinergic effects of fluphenazine. Which of the following should the nurse suggest to the client to minimize anticholinergic effects?
a. Take the medication in the morning to prevent insomnia. b. Chew sugarless gum to moisten the mouth. c. Use cooling measures to decrease fever. d. Take an antacid to relieve nausea. B provide moisture to the client's mouth and decrease the severity of dry mouth. which anticholinergic effect.
A nurse is caring for a client who has a new prescription for valproic acid. The nurse should instruct the client to have which of the following blood laboratory tests completed periodically? (Select all that apply.)
a. Thrombocyte count b. Glucose c. Amylase d. Liver function tests e. Potassium A C D should be monitor periodically because Can cause hepatotoxicity.
A nurse is reviewing the laboratory results of a client who is taking Amitriptyline which of the following laboratory values should the nurse report to the provider? Amitriptyline is a tricyclic antidepressant that is FDA-approved to treat depression in adults.
a. Total bilirubin 1.5 mg/dL b. Potassium 4.2 mEq/L c. Hct 0.44% d. WBC count 5000/mm3 A Total bilirubin: NORMAL RANGE- 0.1 to 1.2 mg/dL
A nurse is teaching a client who has a new prescription for clonidine to assist with maintenance of abstinence form opioids. The nurse should instruct the client to monitor for which of the following adverse effects? Clonidine is a medication that treats high blood pressure and ADHD by relaxing the blood vessels and reducing the heart rate
a. constipation b. Dry mouth c. Sedation d. Hypotension A B C D
The nurse is administering Lithium to her patient. The nurse knows that Lithium is used to treat which of the following disorders?
a. hypertension b. nausea c. thyroid disorders d. bipolar disorder D
QUIZ 7 What are the characteristics of dyskinesia
involuntary, head bobbing or body swaying. repetitive movements of the face, writhing movements of the face, arms, legs or trunk.
