Pharm Exam 2

A nurse is caring for a patient diagnosed with type 2 diabetes. What should the nurse inform the patient are risk factors associated with type 2 diabetes?

obesity

The school nurse identifies more children with type 2 diabetes each year and recognizes that this trend is mainly attributed to what issue?

obesity and inadequate exercise

goal of antibiotics

provide maximal antimicrobial effects while causing minimal harm to the host.

Damage to heart tissue may feel pain in neck or jaw

referred pain

A nurse is providing client education to a 13-year-old girl who was just diagnosed with type 1 diabetes mellitus. Which statement by the client will alert the nurse that special instructions regarding insulin are necessary? - "I walk two blocks to school every day." - "I am on the middle school track team." - "We live in a two-story house." - "My mother is going to give me my insulin."

"I am on the middle school track team."

The nurse is reinforcing teaching about acarbose (Precose) to a client with newly diagnosed type 2 diabetes. Which statement by the client indicates a need for further understanding? -"I will take this medication three times a day." - "I may experience some gas with this medication." - "I must take this medication one hour before I eat." - "I will check my blood sugar at least three times a day while I am getting used to the medication."

"I must take this medication one hour before I eat."

During a teaching session on the care of the client with diabetes, the nurse should make which statement to explain the differences in insulin?

"Insulins have different onsets and durations of action."

A female client is a newly diagnosed diabetic. She is a stay-at-home mother and responsible for meal planning and management of the home. What will the home care nurse teach this client? (Select all that apply.) - Instruct the client to go to the emergency department immediately if she develops a cold or upper respiratory infection. - Assist the client in making menus that will meet the needs of both the client and the family. - Watch the client draw up and administer her insulin. - Reinforce instructions on dealing with hypoglycemia. - Encourage the client to check her blood glucose every hour.

- Assist the client in making menus that will meet the needs of both the client and the family. - Watch the client draw up and administer her insulin. - Reinforce instructions on dealing with hypoglycemia.

Actions of narcotics

- act at specific opioid receptor sites - used for surgical pain, trauma, analgesia during anesthesia, palliative pain, severe/chronic pain, antitussives (codeine) - Select the drug most effective in each situation

three ways to prevent antibiotic resistance

- limit use to treatment - make sure doses are high enough and make sure duration is long enough - be cautious of indiscriminate use

fibers that respond quickly to acute pain

A-delta fibers

transmit sensations associated with touch, temp

A-fibers

The nurse is caring for a client who has been prescribed glyburide. Which factor, if identified in the client history, would cause the nurse to inform the health care provider of a contraindication to use?

Allergy to sulfonamides

A client receives a dose of insulin lispro at 8 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

Between 8:30 AM and 9:30 AM

The nurse is educating a client who is beginning therapy with acarbose and tells the client to take the medication with the first bite of each main meal to help prevent what adverse effect?

Bloating and diarrhea

fibers that send impulse to spinal to horn of spinal cord, form synapses that send impulses to brain

C-fibers

pain receptors are found in

CNS peripheral nerves cells in GI tract Brainstem Spinal Cord and thalamus Hypothalamus Limbic system Peripheral nerve sites

goal of abx therapy

Decrease the population of the invading bacteria to a point where the human immune system can effectively deal with the invader

Which would a nurse identify as an example of a sulfonylurea? - Glyburide - Metformin - Acarbose - Miglitol

Glyburide

The nurse is interviewing a client who was diagnosed with type 2 diabetes four months ago. The client does not records glucometer readings but reports no concerns. What laboratory test does the nurse anticipate the health care provider will order for this client?

HbA1C

nonpharmacological pain management

Heat, massage, positioning, acupuncture, meditation

t/f: you can stop taking abx when feeling better

false-- must take all medication as prescribed

critical to effectively treat infections, protect patients from harms caused by unnecessary antibiotic use, and combat antibiotic resistance.

Improving antibiotic prescribing and use

A client is receiving acarbose. What would the nurse incorporate into the teaching plan for this client about the action of the drug?

Inhibits an enzyme to delay glucose absorption

receptors that narcotics react with

Mu Kappa

pharmacological pain management

Narcotics, anti-migraines, NSAIDS

A nurse is caring for a patient with diabetes mellitus who is receiving an oral antidiabetic drug. Which of following ongoing assessments should the nurse perform when caring for this patient? - Assess the skin for ulcers, cuts, and sores. - Observe the patient for hypoglycemic episodes. - Monitor the patient for lipodystrophy. - Document family medical history.

Observe the patient for hypoglycemic episodes.

Which agent would a nurse expect to administer as a single oral dose in the morning? - Repaglinide - Rosiglitazone - Exenatide - Miglitol

Rosiglitazone

The nurse is providing care for several clients who have diabetes. Which client should the nurse monitor most closely for signs and symptoms of hypoglycemia? - a client who received 12 units of Humulin R 45 minutes ago - a client who received 12 units of metformin minutes ago - a client whose most recent blood glucose level was 150 mg/dL - a client whose type 2 diabetes was diagnosed one week ago

a client who received 12 units of Humulin R 45 minutes ago

pain is transmitted through

a-delta fibers c-fibers a-fibers

Kappa (k) receptors are related to

analgesia pupil constriction sedation dysphoria

NSAIDS are

anti-inflammatory

Directly lethal to bacteria

bactericidal

Slows bacterial growth, does NOT cause cell death. Elimination of bacteria by host defenses

bacteriostatic

antibiotic consideration in older adults

comorbidities such as cardiac, renal or liver problems - abx can cause toxicity to those organs

what should be obtined prior to beginning antibiotics?

culture and sensitivity

A man is brought to the emergency department. He is nonresponsive, and his blood glucose level is 32 mg/dL. Which would the nurse expect to be ordered?

glucagon

examples of psychogenic pain

headache, back pain, stomach ache

the invasion and multiplication of microorganisms in body tissues, which may be unapparent or the result of local cellular injury caused by competitive metabolism, toxins, intracellular replication, or antigen-antibody response.

infection

The nurse admits a client with type 2 diabetes who takes metformin (Glucophage).The nursing diagnosis given is ineffective breathing pattern. What complication of the client's current drug therapy does the nurse believe the client is experiencing?

lactic acidosis

culture and sensitivity is important because it allows you to

match the bug with the drug

Block the effects of the narcotics in cases of overdose

narcotic antagonists

opium derivatives used to treat pain

narcotics

what should be used when limiting the use of antimicrobial agents ot treatment of specific pathogens sensitive to the drug?

narrow spectrum abx

active only on a few micro-organisms. Generally preferred

narrow spectrum antibacterials

narcotics bind to ______________________ to relieve pain and promote feelings of well-being or euphoria

opioid receptors

sensory and emotional experience associated with actual or potential tissue damage.

pain

host factors to consider prior to using abx

site and status of host defenses

A client with a diagnosis of diabetes is prescribed pramlintide. How will this drug assist in controlling the client's blood sugar?

slows gastric emptying

pain is objective or subjective?

subjective-- use pain scales

antibiotics are classified by

susceptible organism and MOA

Best way to increase the benefits and decrease the risk of antibiotics

to complete the entire course of antibiotics ordered and to use antibiotics cautiously.

pain pathways

transmission

T/F: The microbe becomes resistant not the patient

true-- Over time, an organism that had once been highly responsive to an antibiotic may becomes less susceptible, or it may lose drug sensitivity entirely.

The nurse is caring for a client who is taking insulin. The nurse suspects the client is experiencing hypoglycemia when the client displays what signs?

weakness, sweating, and decreased mentation.

keys to preventing infections

•Handwashing •Remove foley catheters ASAP •Surgical site infections •Vaccination compliance(Flu, pneumococcal) •Central Line Catheter-sterile technique

The nurse is educating a client who will be adding an injection of pramlintide to his insulin regimen. What information is most important for the nurse to share with this client to ensure safe medication administration?

Do not give pramlintide in the same site where insulin is administered.

Mu (m) receptors are pain blocking receptors related to

analgesia respiratory depression euphoria decreased GI activity pupil constriction physical dependence

susceptible organism antibiotic classifications

antibacterial antiviral antifungal antiprotozoal

nursing responsibility: obtain ______ prior to initiating antibiotic therapy to confirm appropriateness

culture & sensitivity

most common types of nociceptive pain

dental procedure, sports injury, arthritis

antibiotic consideration in children

early exposure can lead to early sensitivity; more resistance as they get older

In children, early usage of antibiotics can lead to

early resistance

The nurse is caring for a client who is taking glyburide as treatment for type 2 diabetes mellitus. The health care provider has added a corticosteroid to this client's medication regimen for treatment of a severe allergic reaction. The nurse knows that this drug combination may cause what adverse effect on this client?

hyperglycemia Corticosteroids increase insulin needs, so the client may develop hyperglycemia.

The nurse is explaining the action of exenatide to a patient. Which would the nurse include?

increase in insulin resistance - Exenatide is an incretin mimetic, which increases insulin release, decreases glucagon release, stimulates the satiety center, and slows GI emptying.

the effort to measure and improve how antibiotics are prescribed by clinicians and used by patients.

antibiotic stewardship

antibiotic and __________ are used interchangeably

antimicrobial

The nurse's assessment of a client who has presented to the emergency department reveals hyperglycemia. Which type of insulin will have the most rapid effect on the client's blood sugar levels? - NPH - Regular - Aspart - 30/70

aspart

A nurse is assigned to administer glargine to a patient at a health care facility. What precaution should the nurse take when administering glargine?

avoid mixing glargine with other insulin

A client receives regular insulin at 8:00 AM. The nurse would be alert for signs and symptoms of hypoglycemia at which time?

between 10:00 - 12:00 PM (peak)

After teaching a class about the various drugs used to control blood glucose, the instructor determines that the teaching was successful when the class identifies what as a biguanide?

biguanide

active against a wide variety of microbes. Leads to more resistance

broad spectrum antibacterials

use of broad spectrum abx until organism is confirmed by culture in the presence of a severe infection

empiric therapy

Which medication would a nurse identify as a noninsulin injectable antidiabetic drug? - exenatide - sitagliptin - glipizide - pioglitazone

exenatide

factors that play a role in pain perception

experience learned response individual tolerance placebo

A nurse is preparing to administer a rapid-acting insulin. Which medication would the nurse most likely administer? - insulin lispro - insulin glargine - insulin detemir isophane - insulin suspension

insulin lispro

why is antibiotic resistance a huge clinical concern?

it can render currently effective drugs useless.

nerve injury (Carpal tunnel, shingles, phantom limb pain)

neuropathic pain

direct stimulus to a pain receptor

nociceptive pain

receptor sites that respond to naturally occurring peptides such as endorphins and enkephalins

opioid receptors

Which of the following has been found to be as important as drug therapy when treating infections in the immunosuppressed? - Maintaining standard precautions - Proper nutrition - Good hand washing - Exercise

proper nutrition

associated with emotional, psychological, or behavioral stimuli

psychogenic pain

A client diagnosed with diabetic ketoacidosis has been admitted to the intensive care unit. The client is prescribed an intravenous insulin drip, so the nurse knows that what type of insulin will be administered?

regular