ATI review

Methiamazole (Tapazole)

Antithyroid drugs Blocks iodine uptake Inhibits thyroid productions for clients with hyperthyroidism. WEIGHT GAIN & DECREASED HR ARE INDICATIONS OF THE DEVELOPMENT OF HYPOTHYROIDISM

Enalapril (Vasotec) Ace inhibitor

Block renin-angiotensin-aldosterone system in kidney to decrease BP ACE inhibitors

A nurse is caring for an older adult client who has a new prescription for amitriptyline to treat depression. Which of the following diagnostic tests should the nurse plan to perform prior to starting the client on this medication?

Electrocardiogram Amitriptyline can cause tachycardia and ECG changes. An older adult client is at risk for cardiovascular effects of amitriptyline; therefore, an ECG should be performed prior to the start of therapy to obtain a baseline of the client's cardiovascular status.

The nurse is caring for a client who has a new prescription for enalapril. The nurse should monitor the client for which of the following adverse effects of this medication?

Hypotension enalapril=ACE inhibitor, can cause hypotension and postural hypotension, especially during first 3 hr. following initial dose.

A nurse is providing teaching to a parent of a child who has asthma and a new prescription for cromolyn sodium metered dose inhaler. Which of the following statements by the parents indicates the need to further teaching?

I will give my child a dose as soon as wheezing starts. Cromolyn is a mast cell inhibitors that has a slow onset and is given for prophylactic tx of asthma. It is not a rescue inhaler.

Propylthiouracil (PTU)

block thyroid production and is a second-line medication for hyperthyroidism.

Filgrastim (Neupogen) increases

neutrophil production. Its given to treat neutropenia and reduce the risk of infection for clients who are receiving chemotherapy for cancer or who have undergone bone marrow transplant.

Metoclopramide (Reglan)

*class*: antiemetic *Indication*: prevention of nausea, vomiting, hiccups, migraines, gastric stasis *Action*: accelerates gastric emptying by stimulating motility

Amantadine (Symmetrel)

- Blocks dopamine reuptake into presynaptic neurons, increases dopamine release from presynaptic fibers=antiparkinsonian medication used to tx extrapyramidal manifestation that occur with chlorpromazine thearpy.

A nurse is preparing to administer an enteral tube feeding through an NG tube at 250 mL over 4 hr. The nurse should set the pump to deliver how many mL/hr? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.)

62.5=63ml/hr

A nurse is assessing a client who has a new prescription for chlorpromazine to treat schizophrenia. The client has a mask-like facial expression and is experiencing involuntary movements and tremors. Which of the following medications should the nurse anticipate administering? Amantadine Bupropion Phenelzine Hydroxyzine

Amantadine The client is experiencing parkinsonism, which is an adverse effect of the antipsychotic medication chlorpromazine. Amantadine is an antiparkinsonian medication used to treat the extrapyramidal manifestations that can occur with chlorpromazine therapy.

A nurse is caring for a client who has a new prescription for tamoxifen. The nurse should recognize that tamoxifen has which of the following therapeutic effects?

Antiestrogenic Tamoxifen is an antiestrogen med used to tx of cancer of the breast.

Gemfibrozil (Lopid)

Can decrease WBC; hyperglycemia; myopathy

A nurse is caring for an older adult client who has a prescription for zolpidem at bedtime to promote sleep. The nurse should plan to monitor the client for which of the following adverse effects?

Dizziness= Zolpidem can cause dizziness and daytime drowsiness. It can cause confusion in the older adult client.

A nurse providing teaching to a client who has ulcerative colitis and a new prescription for sulfasalazine. Which adverse effect should you monitor for.

Jaundice Sulfasalazine can cause a yellow discoloration of the urine. The nurse should instruct the client to notify the provider if these occur. Bloody diarrhea, stomatitis, headache, peripheral neuropathy.

A nurse is providing teaching to a newly licensed nurse about caring for a client who has a prescription for gemfibrozil. The nurse should instruct the newly licensed nurse to monitor which of the following laboratory tests?

Liver function Gemfibrozil reduces triglycerides by decreasing the liver's uptake of fatty acids. It can cause liver toxicity; the nurse should moniter clients liver function.

A nurse is caring for a client who has a new prescription for ergotamine. The nurse should recognize that ergotamine is administered to treat which of the following conditions?

Migraine headaches-prevents or stops a migraine headache by blocking alpha-adrenergic receptors in the cranial peripheral vascular smooth muscle, which causes vasoconstriction of dilated cerebral blood vessels.

Misoprostol (Cytotec)

Misoprostol is a prostaglandin used to promote cervical ripening and induce labor.

A nurse is caring for a client who has a prescription for chlorothiazide to treat hypertension. The nurse should plan to monitor the client for which of the following adverse effects?

Muscle weakness Chlorothiazide is a thiazide diuretic used to tx HTN and congestive HF. It promotes excretion of water, Na+ and K+. Manifestation of Hypokalemia include muscle weakness, muscle cramps and dysrhythmias.

A nurse is caring for a client who is at 28 weeks of gestation and is experiencing preterm labor. Which of the following medications should the nurse plan to administer?

Nifedipine is a tocolytic medication that is administered to stop preterm labor.

A nurse is planning care for a client who has a seizure disorder and a new prescription for valproic acid. Which of the following laboratory values should the nurse plan to monitor? (Select all that apply.)

PTT valproic acid can alter coagulation; PT and PTT should be monitored; AST/AST valproic acid causes hepatotoxicity, Pt needs baseline LFT b/f starting Rx and repeat w/ reg. intervals during therapy. Levels of liver enzyme identify liver damage.

A nurse is teaching a newly licensed nurse about contraindications to ceftriaxone. The nurse should include a severe allergy to which of the following medications as a contraindication to ceftriaxone?

Piperacillin Clients who have a severe allergy to piperacillin, which is a penicillin, can have a cross sensitivity to ceftriaxone, a third-generation cephalosporin. Ceftriaxone is contraindicated for the client who has an allergy to cephalosporins or a severe allergy to penicillin.

A nurse is providing teaching to a client who has chronic kidney failure with and AV fistula for hemodialysis and a new prescription for epoetin alfa. Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching?

Promotes RBC production Epoetin alfa stimulates erythropoiesis in the bone marrow to increase RBC production and reduce anemia. Anemia is common in clients who have CKF, since erythropoietin is produced by the kidney.

A nurse is assessing a client who is receiving IV gentamicin three times daily. Which of the following findings indicates that the client is experiencing an adverse effect of this medication?

Proteinuria= Proteinuria is a manifestation of nephrotoxicity, and adverse effect of gentamicin. The nurse should monitor for oliguria and hematuria.

A nurse is providing teaching to a client who has cirrhosis and a new prescription for lactulose. The nurse should instruct the client that lactulose has which of the following therapeutic effects? Increases blood pressure Prevents esophageal bleeding Decreases heart rate Reduces ammonia levels

Reduces ammonia levels Lactulose is a laxative that promotes the excretion of ammonia in a client who has hepatic encephalopathy from cirrhosis of the liver.

The nurse is providing teaching to a new licensed nurse about administering morphine via IV bolus to a client. Which of the following information should the nurse include in the teaching?

Respiratory depression can occur within 7 min following the administration of IV bolus morphine. The nurse should monitor the clients

A nurse is caring for a client who has been taking isoniazid and rifampin for 3 weeks for the treatment of active pulmonary tuberculosis (TB). The client reports his urine is an orange color. Which of the following statements should the nurse make?

Rifampin can turn body fluids orange; hematuria as well

Conditions that is contraindicated to metoclopramide (Reglan)

Seizure disorders, GI obstructions, drug hypersensitivity

A nurse is providing teaching to a client who has rhematoid arthritis and a prescription for long-term prednisone therapy. The nurse should instruct the client to monitor for which of the following adverse effects?

Stress fractures Prednisone can cause demineralization of the bones and can lead to osteoporosis and stress fractures.

A nurse caring for a client with a new dx of oral candidiasis after taking tetracycline for 7 days. The nurse should recongnize that candidiasis is a manifestation of which of the following adverse effects?

Super-infections develop from the overgrowth of fungus due to antibacterial effect of tetracycline. The nurse should monitor the client for manifestations of a super-infection, such as soreness of the mouth and a swollen tongue.

A nurse is providing teaching to a client who has a new prescription for hydrochlorothiazide 50 mg PO daily to treat hypertension. Which of the following instructions should the nurse include in the teaching?

T Take the hydrochlorothiazide in the morning The client should take hydrochlorothiazide in the morning to allow for diuresis during the day and prevent nocturia.

Hydrochlorothiazide (HCTZ)

THIAZIDE DIURETIC promotes sodium, chloride, and water excretion (diuresis) TREAT: HTN and peripheral edema does not treat immediate emergency diuresis FIRST DRUG OF CHOICE FOR PERIPHERAL EDEMA spares calcium= hypercalcemia affect glucose tolerance = hyperglycemia ONLY USE IN PATIENTS WITH NORMAL RENAL FUNCTION ***monitor for leg cramps, causes hypokalemia

A nurse is administering subcutaneous epinephrine for a client who is experiencing anaphylaxis. The nurse should monitor the client for which of the following adverse effects?

Tachycardia Adverse effects of epinephrine, an adrenergic agonist, can include tachycardia and dysrhythmias as the result of cardiac stimulation.

Cromolyn

administered by inhaler can cause mouth/throat irritation. Rinse or gargle with water after each use.

Chlorothiazide (Diuril)

can cause hypoglycemia, hypoactive reflexes, hypercalemia

Enalapril, Lisinopril, Captopril

can cause kidney failure; can decrease Hgb/Hct but does not alter platelets.

Ergotamine

contraindicated for clients who have anemia or malnutrition. It can cause peripheral vasoconstriction and cyanosis of digits.

Dinoprostone (Cervidil)

dinprostone is a oxytocic medication used to stimulate uterine contractions for clients who are at term and to control post partum hemorrhage.

Clients who take prednisone are at risk for....

hypertension=sodium and fluid retention; weight gain due to water retention