Nsg 2400 Exam 2 Meds

Mannitol

Diuretics, Osmotic Agents Used a lot with head injury pt's Used to treat cerebral edema

Lorazepam (Ativan)

For seizures lasting longer than 30 minutes

Corticosteroids

Treatment for Leukemia Oral steroids are administered daily in divided doses to maintain consistently high blood levels

methotrexate

Treatment for leukemia has breast and head neck and lung cancers interferes with folic acid metabolism as immunosuppressive Properties Only chemo agent that can be administered intrathecally - (CNS) additional side effects pulmonary fibrosis. S/E: hair loss (alopecia)

potassium

When potassium needs to be replaced the priority with replacing potassium by IV is to put the patient on a heart monitor

furosemide

a loop diuretic What is the K level? Could go down.

A toddler is scheduled to receive methotrexate for treatment of leukemia. The mother asks the nurse whether the child should be started on vitamin supplements because the child seems so weak. How will the nurse respond? 1 "That's a fine suggestion, and I'll ask for a prescription." 2 "Vitamin supplements won't help him feel any better right now." 3 "He'll benefit from a vitamin supplement and will be getting it soon." 4 "Supplements that contain folic acid interfere with the effectiveness of chemotherapy."

"Supplements that contain folic acid interfere with the effectiveness of chemotherapy." Vitamins are contraindicated because methotrexate is a folic acid antagonist, and folic acid will counteract the effectiveness of methotrexate. Telling the mother that vitamins won't help her child feel better doesn't answer the question; the parent is asking about improving her child's strength, not well-being.

A nurse teaches the parents of a 7-year-old girl who has been prescribed long-term phenytoin therapy about care pertinent to this medication. Which statement indicates that the teaching has been effective?

"We'll have her massage her gums and floss her teeth frequently." A common side effect of phenytoin is gingival hyperplasia. Meticulous oral hygiene may reduce the risk of this side effect. Phenytoin is strongly alkaline and should be administered with meals to help prevent gastric irritation. Pink urine may be observed during drug excretion; it is expected and does not require treatment. Avoidance of overeating and overhydration may result in better seizure control.

A client who is receiving phenytoin asks why folic acid (Folate) was prescribed. What is the best explanation by the nurse?

Absorption of folate from foods is inhibited. Phenytoin inhibits folic acid absorption and potentiates the effects of folic acid antagonists. Folic acid is helpful in correcting certain anemias that can result from administration of phenytoin. The dosage must be carefully adjusted because folic acid diminishes the effects of phenytoin. Absorption of iron from foods and prevention of neuropathy caused by phenytoin are not effects of folic acid.

A client is taking phenytoin to treat clonic-tonic seizures. The client's phenytoin level is 16 mcg/L. Which action should the nurse take? 1 Hold the medication and notify the healthcare provider. 2 Administer the next dose of the medication as prescribed. 3 Hold the next dose and then resume administration as prescribed. 4 Call the healthcare provider to obtain a prescription with an increased dose.

Administer the next dose of the medication as prescribed.

A child with acute lymphoid leukemia is started on a chemotherapy protocol that includes prednisone. What side effect of this medication does the nurse anticipate?

Anorexia Mood swings may result from steroid therapy. Alopecia does not result from steroid therapy. An increased appetite, not anorexia, results from steroid therapy. Weight gain, not weight loss, results from steroid therapy.

Leucovorin

Antidote for methotrexate toxicity

Nifedipine

Autonomic Dysreflexia treatment 10mg Capsule Bite & swallow method

A client who had a tonic-clonic seizure of unknown etiology is to begin taking phenytoin. What instructions will the nurse give to the client?

Brush the teeth and gums three times daily. Adequate dental hygiene is essential to control or prevent the common side effect of hypertrophy of the gums. The medication should be taken with food or milk to decrease gastrointestinal side effects. The healthcare provider should be consulted before the drug is discontinued or the dosage is adjusted; usually in this situation, a gradual dosage reduction is prescribed. Changes in pulse and respiratory rates are unrelated to phenytoin therapy.

A client is treated with lorazepam for status epilepticus. What effect of lorazepam does the nurse consider therapeutic?

Depresses the central nervous system (CNS) Lorazepam, an anxiolytic and sedative, is used to treat status epilepticus because it depresses the CNS. Slower cardiac contractions are not an effect of lorazepam. Dilating tracheobronchial structures is not an effect of lorazepam. Providing amnesia for the convulsive episode is not an effect of lorazepam.

DDAVP-

Helps to decrease urine output,

Regular insulin

Insulin drip for DKA.

A nurse administers the drug desmopressin acetate (DDAVP) to a client with diabetes insipidus. What should the nurse monitor to evaluate the effectiveness of the drug?

Intake and output DDAVP replaces antidiuretic hormone, facilitating reabsorption of water and consequent return of a balanced fluid intake and urinary output. The mechanisms that regulate pH are not affected. DDAVP does not alter serum glucose levels; diabetes mellitus, not diabetes insipidus, results in hyperglycemia. Although correction of tachycardia is consistent with correction of dehydration, the client is not dehydrated if the fluid intake is adequate; respirations are unaffected.

Antiemetics: Ondansetron

Management for nausea and vomiting chronic in cancer patients

Anticonvulsants :

To raise the seizure threshold & prevent seizure High enough dosing to maintain therapeutic drug levels Adjustments need to be made during puberty & growth spurts Always gradually wean off antiepileptic drug therapy

preventative vaccines

are recommended for Chronic Lymphocytic Leukemia

Phenytoin

seizure treatment. S/E: gum hyperplasia, increased hair growth therapeutic range of 10 to 20 mcg/L, folic acid diminishes the effects of phenytoin.

Declomycin

used in SIADH decrease urine output, Don't give with calcium it affects the absorption