Pharm-- Ch. 3 PrepU

The nurse is administering medications to a client who says, "About 30 minutes after you gave me that medication yesterday, I felt funny." What is the nurse's best response to this client?

"I'm going to call your health care provider before I give you this medication today."

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

- Fever - Glossitis (swollen tongue) - Joint pain

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

All drugs can cause adverse reactions. What is an example of an adverse reaction?

tissue and organ damage

An 85-year-old has a creatinine level of 25. When the client is administered a medication, the client is at risk for which medication-related effect?

toxicity

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

- skeletal and limb abnormalities - central nervous system alterations - heart defects

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

A client taking anticoagulants who develops a gastrointestinal bleed

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

A recent nursing graduate is preparing to enter the workforce. What principle should guide the nurse's administration of medications?

Drugs can cause unexpected reactions even after thorough screening and testing

A client is suspected of having a liver injury as a result of drug therapy. What laboratory finding would best support this diagnosis?

Elevated aspartate aminotransferase (AST) level

A client in the ambulatory care clinic is experiencing shortness of breath and facial and throat edema while receiving a pegloticase infusion. What is the nurse's best action?

Notify emergency personnel

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 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 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 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."

Drugs can affect the special senses, including the eyes and ears. Alterations in seeing and hearing can pose safety problems for clients. What are examples of sensory effects of drugs?

- A drug used to treat some rheumatoid diseases can cause retinal damage and even blindness. - Aspirin, one of the most commonly used drugs, is often linked to auditory ringing and eighth cranial nerve effects.

One of the most common occurrences in drug therapy is the development of adverse effects from simple overdose. In such cases, the client suffers from effects that are merely an extension of the desired effect. Which are examples of this primary action?

- spontaneous bleeding after taking warfarin (Coumadin) - dizziness after starting amlodipine (Norvasc)

A client with a recent history of peripheral edema has been taking hydrochlorothiazide 75 mg PO daily. The client reports increased appetite and restlessness to the nurse and inspection reveals warm, flushed skin. What is the nurse's best action?

Assess the client's blood glucose level

A client comes to the clinic with ringing in the ears and difficulty hearing. What medication in the client's current regimen should the nurse suspect?

Erythromycin

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?

a decrease in urine output

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

A client is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the client develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is:

an allergic response

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

Atropine, which is used preoperatively, is considered which drug classification?

anticholinergic

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

Changes due to aging in the geriatric client that may affect excretion and promote accumulation of drugs in the body include:

decreased glomerular filtration rate (GFR)

Which drug allergy involves antibodies bound to specific white blood cells?

delayed allergic reaction

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

epinephrine

A client is diagnosed with atrial fibrillation and prescribed the drug Coumadin (warfarin). The nurse would instruct the client to avoid what foods?

foods with vitamin K

A client is diagnosed with hypercholesterolemia and is prescribed a statin by the physician. As part of client education, the nurse should teach the client to avoid eating:

grapefruit

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

hypertension

A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client?

ototoxicity from the ibuprofen

The nurse is reviewing the laboratory test results of a client receiving drug therapy. What would the nurse suspect if the results reveal an elevation in the blood urea nitrogen level and creatinine concentration?

renal injury

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

A client is being discharged from the emergency department (ED) after being treated for an anaphylactic reaction to shrimp the client ate for dinner. The client asks the nurse to explain food reactions. Which would be correct responses?

- Ananphylactic reactions involve an antibody that causes the release of histamine. - Histamines produce immediate reactions. - Anaphylactic reactions can lead to respiratory distress and even respiratory arrest.

Which client is experiencing a secondary action of a medication?

A client who is drowsy after taking antihistamine

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

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

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

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 client develops stomatitis from drug therapy. Which measure would be most appropriate for the nurse to suggest?

frequent rinsing with cool liquids

A client develops a cytotoxic reaction to a drug. What would the nurse expect to do?

Discontinue the drug immediately as ordered

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

Mrs. Armin is taking several medications. Part of evaluating her response to this therapy is to monitor her blood and urine for adverse reactions. Upon reviewing laboratory test results, the nurse notes that the liver enzyme levels are elevated. The nurse reviews the medications that Mrs. Armin is taking and determines that an adverse effect of one of the medications is hepatotoxicity. What is the most likely explanation for Mrs. Armin's liver damage?

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

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

Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. What is the name of the adverse reaction that can cause birth defects?

Teratogenicity

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

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

A female client has a 12-year history of ETOH abuse. The client is injured in a motor vehicle accident and requires surgery with general anesthesia. What would the nurse expect for this client?

a larger-than-normal dose of the general anesthetic