week 9 Pharmacology (ATI) Musculoskeletal System

A health care professional is caring for patient who is beginning raloxifene (Evista) therapy to prevent osteoporosis. The health care professional should tell the patient to moniyor for which of the following?

calf pain Raloxifene can increase the risk of deep-vein thrombosis, which can lead to a pulmonary embolism or cerebrovascular accident. Patients should avoid long periods of inactivity, and report any pain, redness, or swelling in the calf.

A health care professional is administering succinylciline (Anectine) to a patient). Which of the following information is correct regarding depolarizing neuromuscular blocking agents?

causes muscle paralysis by binding with cholinergic receptors at the neuromuscular junction Succinylcholine, a depolarizing muscle relaxant, mimics acetylcholine (Miochol-E) by binding with the cholinergic receptors at the neuromuscular junction.

Prior to administering calcitonin-salmon (Miacalcin) for the first time to patient who i diagnosed with postmenopausal osteoporosis, the health care professional should perform which of the following task?

check for allergies using skin testing

A health care professional is caring for a patient who is taking alendronate (Fosamax) to treat postmenopausal osteoprosis. The health care professional should explain to the patient that alendronate increases bone mass by which of the following actions?

decreases activity osteoclasts Osteoclasts are cells that cause bone resorption or bone loss. Alendronate reduces the activity of osteoclasts, reducing bone loss and increasing bone mass

A health care professional is talking about self-administering methorexate to a patient who has rheumatoid arthritis. The health care professional should tell the patient to:

drink 2-3 L of water per day to promote the drugs excretion Methotrexate can cause kidney damage. Adequate hydration optimizes drug excretion and helps prevent kidney damage. Patients can take sodium bicarbonate tablets to increase urine alkalinity and reduce the drug precipitation that can lead to kidney damage.

A health care professional is carign fro a patient who is taking raloxifene (Evista). Which of the following information should the health care professional include?

increase activity, such as walking use a contraceptive if there is any risk of pregnancy increase intake of calcium and Vitamin D

A health care professional should question the use of etanercept (Enbrel) for a patient who has a history of diabetes mellitus because of which of the following risk?

infection Etanercept increases the risk of developing a serious infection. Primary care providers should not prescribe etanercept for patients who have an existing infection and should use it cautiously with patients who have diabetes mellitus because the disease itself increases infection risk.

A health care professional is caring fro a patient who is about to begin methotrexate therapy for rheumatoid arthritis. The health care professional should include which of the following information?

avoid people who are sick periodic laboratory test are essential Report bruising or perechiae Avoid drinking alcohol Avoid people who are sick is correct. Methotrexate causes bone marrow suppression and increases the risk for infection. Patients taking the drug should avoid contact with large crowds or people who are sick or have a communicable illness. Periodic laboratory tests are essential is correct. Periodic laboratory tests help the primary care provider monitor for kidney and liver damage. It is important to assess for jaundice and abdominal pain because they can indicate liver damage. The drug's effects are immediate is incorrect. It can take 3 to 6 weeks to achieve the drug's therapeutic effects. Report bruising or petechiae is correct. Methotrexate can cause thrombocytopenia. Patients should report bruising or petechiae, because this indicates a low platelet count. Health care professionals should monitor laboratory values for a decrease in platelets and red and white blood cells. Avoid drinking alcohol is correct. Alcohol ingestion can increase the risk of liver damage. Patients taking methotrexate should avoid drinking alcohol.

A health care professional is preparing to administer neostigmine (Prostigmin) to a patient). Which of the following information in teh patient's health history should alert her to use caution when administering neostigmine?

Asthma Neostigmine can cause bronchospasm. It requires cautious use with patients who have asthma. The health care professional should monitor breath sounds, and have atropine (AtroPen) available to reverse the effects of neostigmine.

A health care professional is preparing to administer neostigmine (Prostigmin) to a patient who has myasthenia gravis. Knowing the adverse effects of neostigmine, which of the following drugs should the health care professional have ready to administer?

Atropine (AtroPen) It is important to have atropine, an anticholinergic, available to reverse bradycardia that can result from the administration of neostigmine, a cholinesterase inhibitor.

A health care professional should tell a patient who is taking methotrexate to monitor for which of the following?

Black, tarry stools Methotrexate can cause gastric intestinal ulceration, which can lead to perforation and bleeding. The patient should watch for blood in stools or emesis and report either to the health care professional immediately.

A health care professional is caring for a [patient who has myasthenia gravis and has been prescribed neostigmine (Prostigmin) it increase muscle strength. The health care professional should tell the patient to watch of the following as an indication of serious adverse reaction to the drug?

Bradycardia Neostigmine causes bradycardia. The health care professional should show the patient how to measure his apical pulse and notify the primary care provider if the rate is below 60/min. It is essential to have atropine (AtroPen) on hand to reverse the effects of neostigmine.

A health care professional is caring for a patient who is taking perednisone and also takes 1,500 mg/day of calcium carbonate (Tums) to reduce the risk of osteoporosis. Which of the following information should the health care professional include?

Drink 8 oz of water with the calcium tablets Chew calcium tablets before swallowing Take the drugs 1 hr apart Divide the daily dose into three 500-mg doses Take the calcium tablets with food is incorrect. It is not necessary to take calcium carbonate tablets with food when using them for calcium supplementation. Drink 8 oz of water with the calcium tablets is correct. Patients should drink 8 oz of water after taking the calcium carbonate to ensure complete passage of the drug and to maintain hydration. Chew calcium tablets before swallowing them is correct. Patients should chew the tablets before swallowing them to increase bioavailability. Patients should not swallow chewable tablets whole. Take the drugs 1 hr apart is correct. Glucocorticoids reduce the absorption of calcium carbonate. Patients should allow 1 hr in between the two to ensure optimal absorption. Divide the daily dose into three 500-mg doses is correct. Patients should not take more than 600 mg of calcium carbonate at one time. Patients should divide the daily dosage into three doses to increase absorption of the calcium carbonate.

A health care professional is careing for a patient who is postoperative and who demonstrates weakness and needs mechanical ventilation. The patient received pancutonium during the surgery. The health care professional should suspect prolonged paralysis from a drug interaction with which of the following?

Gentamicin Gentamicin, an aminoglycoside, can interact with the nondepolarizing neuromuscular blocker and increase the effects of the neuromuscular blockade causing prolonged paralysis.

A health care professional should recognize that depolarizing muscle relaxants, such as succinylcholine (Anectine), require cautious use with patients who have which of the following?

Hyperkalemia Myasthenia gravis Respiratory depression Hyperkalemia is correct. Succinylcholine can cause potassium release, resulting in hyperkalemia. Health care professionals should monitor for cardiac dysrhythmias, and check potassium levels prior to use. Myasthenia gravis is correct. Patients who have myasthenia gravis can have increased neuromuscular blockade when given succinylcholine; therefore, they might need a reduced dosage. Renal calculi is incorrect. Health care professionals may give succinylcholine to patients who have renal calculi without additional precautions. Bowel obstruction is incorrect. Health care professionals may give succinylcholine to patients who have a bowel obstruction without additional precautions. Neostigmine (Prostigmin) requires cautious use in patients who have a mechanical obstruction of the intestine. Respiratory depression is correct. Pancuronium causes respiratory paralysis. Health care professionals should have mechanical ventilation available, especially for patients who have respiratory depression.

A HCP should tell a patient who is taking alendronate (Fosamax) to monitor for which of the following adverse effects?

Jaw pain Blurred vision Muscle pain Jaw pain is correct. Alendronate can cause osteonecrosis of the jaw, and patients who develop it should report it to the health care professional. Drowsiness is incorrect. Alendronate is unlikely to cause drowsiness. It can cause a headache. Blurred vision is correct. Alendronate can cause ocular inflammation. The patient should report any eye pain or blurred vision. Tinnitus is incorrect. Alendronate is unlikely to cause tinnitus. Salicylate toxicity can cause tinnitus. Muscle pain is correct. Alendronate can cause musculoskeletal pain. If analgesics do not help, the patient might have to stop taking alendronate.

A health care professional is preparing to administer alendronate (Fosamax) to a patient who has osteoporosis. The health care professional should recogize which of the following as an adverse effect of alendronate?

Joint Pain Alendronate can cause joint and muscle pain. Patients may treat joint pain with analgesics. Other adverse effects include nausea, visual disturbances, and esophagitis.

A health care professional is caring fro a patient who was given succinylcholine (Anectine), a depolarizin neuromuscular blocker, during a surgical procedure. The patient develops rigid muscles, tachycardia, and a sudden spike in temperature. The heath care professional should immediately suspect which of the following?

Malignant hyperthermia Succinylcholine and inhalation anesthetics can trigger malignant hyperthermia, a potentially fatal condition. It causes muscle rigidity and an increase in body temperature.

Which of the following is a therapeutic action of raloxifene (Evista)?

Mimics the effects of estrogen on bone tissue Increase self-breast examinations to two times per month is incorrect. Completing a self-breast exam once per month is sufficient. Additionally, raloxifene can help reduce the risk of breast cancer. Increase activity, such as walking is correct. Patients taking raloxifene should avoid long periods of inactivity to prevent deep-vein thrombosis. Also, walking or other weight-bearing exercise can help increase bone density. Use a contraceptive if there is any risk of pregnancy is correct. Raloxifene is a pregnancy category X drug and can cause severe fetal harm. Women who are pregnant, breastfeeding, or might become pregnant should not take the drug. Take the drug on an empty stomach is incorrect. Patients may take raloxifene with or without food. Increase intake of calcium and vitamin D is correct. Increasing calcium and vitamin D helps improve the effectiveness of raloxifene and increases bone mass.

A health care professional is caring for a patient who is taking a calcium supplement and reports flank pain. The health care professional should suspect the patient has which of the following?

Renal Calculi Calcium supplements can cause renal calculi. Patients should increase water intake while taking calcium supplements to hydrate the kidneys and report any blood in the urine or flank pain

A HCP is caring for a patient who is to begin taking calcitonin-salmon (Miaclcin) intranasal spray to treat osteoprosis. Which of the following information should the health care professional include?

Report rash or itching Prime the pump Report nasal irrigation Report rash or itching is correct. The health care professional should tell the patient to stop using the drug and seek medical attention if any swelling or rash develops. Deliver two sprays to each nostril is incorrect. The patient should spray calcitonin-salmon once in one nostril each day. The patient should use alternate nostrils to avoid irritation. Prime the pump is correct. The patient should prime the pump before use the first time to ensure proper dosage. Report nasal irritation is correct. The patient should report any nasal irritation or bleeding. The patient might need parenteral administration if there is severe nasal irritation. Hold the pump horizontally is incorrect. The patient should hold the nasal pump upright to deliver the spray intranasally.

A health care professional is caring fro a patient who is taking etanercept (Enbrel), a DMARD (2) that treats rheumatoid arthritis. The health care professional should monitor the patient for which o the following indication of a serious reaction to the drugs?

Shortness of breath Etanercept can cause heart failure, manifesting as shortness of breath, cough, elevated blood pressure and heart rate, and pink-tinged sputum.

A health care professional should tell a patient who is taking etanercept (Enbrel) for rheumatoid arthritis to report which of the following?

Skin Rash Etanercept can cause serious skin infections, such as Stevens-Johnson syndrome and toxic epidermal necrolysis. Patients should report any skin rashes or blisters immediately.

When treating a patient who has malignant hyerthermia, the health care professional should do which of the following?

provide cooling measures administer dantrolene (Dantrium) Discontinue anesthesia Administer a depolarizing neuromuscular blocking agent is incorrect. A depolarizing neuromuscular blocking agent, such as succinylcholine (Anectine), can cause or worsen malignant hypertension. Provide cooling measures is correct. The patient requires immediate cooling with a cold saline infusion, ice packs, and a cooling blanket. Temperature and vital signs require continuous monitoring. Administer dantrolene (Dantrium) is correct. Dantrolene reduces the metabolic activity of skeletal muscles and helps reverse malignant hyperthermia. Discontinue anesthesia is correct. Health care professionals should stop succinylcholine and anesthesia immediately, and abort the procedure until the patient is stabilized. Reduce the IV fluid infusion rate is incorrect. Malignant hyperthermia causes hyperthermia, tachycardia, and hypotension. Increasing IV infusion rates helps maintain kidney perfusion.

Alendronate (Fosamax) is contraindicated for patients who?

should remain flat on bed rest Alendronate is inappropriate for a patient who is unable to sit or stand for 30 min. Patients should drink 8 oz of water after taking the drug and sit or stand upright for at least 30 min to prevent esophagitis.