chapter 3
A patient is taking chloroquine (Aralen) for rheumatoid arthritis. What problem reported by the patient would the nurse suspect may be an adverse reaction of the medication?
"Sometimes I have blurred vision."
The patient with diabetes is also taking ephedrine to treat asthma that causes her blood sugar to increase. The patient asks the nurse, "Why does this medication make my blood sugar go up?" What is the nurse's best response?
"Stored glycogen is broken down by ephedrine, which is causing higher blood sugar levels."
Before administering a macrolide antibiotic the nurse would question the order for what patient
A 12-year-old boy with hearing loss
Which client is experiencing an adverse effect that is a result of a primary action
A client taking anticoagulants who develops a gastrointestinal bleed
A patient with Parkinson's disease is taking an anticholinergic drug to decrease the tremors and drooling caused by the disease process. The patient complains that he is having trouble voiding. The nurse would explain that this is what?
A secondary action of the drug
A patient presents at the clinic complaining of vaginal itching and a clear discharge. The patient reports to the nurse that she has been taking an oral antibiotic for 10 days. The nurse is aware that the patient is experiencing what?
A superinfection caused by the antibiotic
A patient with seasonal allergies is taking an antihistamine to relieve itchy, watery eyes, and a runny nose. When planning teaching for this patient, the nurse would include what teaching point?
Advise the patient to avoid driving or operating machinery
The nurse administers erythromycin, a drug that is known to irritate mucosa in the stomach lining. When the patient reports abdominal discomfort after taking the medication, the nurse would classify this discomfort as what type of adverse effect?
Allergic reaction
What cardiac effect would the nurse be prepared to see in the patient with an extremely high potassium level?
Arrhtmia
The nurse is assessing a client for anticholinergic effects of a prescribed drug, What assessments should the nurse perform ? select all that apply
Asses the clients visual acuity ,Asses the moisture level of clients skin,Asses the clients recent bowel pattern
The nurse administers chloroquine to a client to treat rheumatoid disease . The client has been taking this medication for several years . What assessment should the nurse prioritize
Assessment of visual acuity
A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to Mexico. The nurse will encourage the patient to do what?
Avoid sightseeing during the hottest part of the day.
An example of a drug allergy is
Breathing difficulty after an injection
what is a drug used that is used to treat some rheumatoid diseases and can cause rectal damage even blindness ?
Chloroquine
Oral antidiabetic drugs can cause alterations in glucose metabolism. Patients who are taking these drugs would need to be observed for what?
Confusion and lack of coordination
5. Outline the important factors to consider when applying the nursing process to selected situations of drug toxicity
Discontinue the drug and notify the prescriber ,Offer small frequent meals , skin care, a cool environment and frequent rest periods
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 nurses primary action
Discontinue the drug immediately as ordered
A recent nurse graduate is preparing to enter the workforce. What principle should guide the the nurses administration of medications
Drugs can cause unexpected reactions even after thorough screening and testing
A client is suspected to have a live injury as a result of a drug therapy .What laboratory finding would best support this diagnosis
Elevated aspartate aminotransferase (AST) level
The home health nurse is caring for an elderly patient with benign prostatic hypertrophy. An anticholinergic drug has been prescribed. What would be the nurse's priority teaching point for this patient?
Empty the bladder before taking the drug.
A client presents to the clinic reporting ringing in the ears and difficulty hearing . what medication in the client's current regimen should the nurse expect
Erythromycin
what antibiotics can cause severe auditory nerve damage manifested by ringing in the ears and hearing loss?
Macrolide antibiotics
A nurse is planning to teach a patient teaching about a newly prescribed drug. What is a priority teaching point included by the nurse to improve compliance and safety?
Measures to alleviate any discomfort associated with adverse effects
.Define the term poison.
Occurs when an overdose of drug damages multiple body systems, leading to potential for fatal reactions
A client with a long standing diagnosis of schizophrenia has taken antipsychotic drugs for several decades . What adverse effects would the nurse assess for
Parkinson's symptoms
A client reports to the office with vaginal discharge and itching , which statement would lead the nurse to believe the patient is experiencing a superinfection
Patient states i just completed a course of antibiotics from my dentist for a tooth infection
The pharmacology instructor is talking to the nursing students about potassium-sparing diuretics and how they can lead to hyperkalemia, indicated by what assessment finding?
Potassium level of 5.9 mEq/L
An 80-year-old patient presents at the clinic for a follow-up appointment. She is taking a macrolide antibiotic and is experiencing tinnitus. The nurse is talking with family members about home care for the patient. What should the nurse include in her instructions regarding home care?
Provide protective measures to prevent falling or injury.
A 77-year-old man is brought to the clinic by his daughter for a routine follow-up appointment. The daughter tells the nurse that her father is only taking half the prescribed dosage of several of his medications. What effect would the nurse explain could result from this behavior?
Reduced therapeutic effect
A patient with a severe infection is given gentamicin , the only antibiotic shown to be effective in culture and sensitivity test. A few hours after the drug is started intravenously the patient becomes very restless and develops edema . Blood tests reveal abnormal electrolytes and elevated blood urea nitrogen. This reaction was most likely caused by
Renal toxicity associated with gentamicin
A client who is receiving drug therapy starts experiencing numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform
Review the clients most recent potassium level
A client is experiencing central nervous system effects related to drug therapy . What is the nurse's priority teaching point to emphasize in the teaching plan
Safety measures
A nurse is providing teaching to a group of patients who are beginning drug therapy for acquired immunodeficiency syndrome (AIDS). What should be included in her instructions to the group
Take your medications as directed. Poisoning occurs with over dosage causing damage to more than one body system."
The nurse at a campus medical clinic is administering a new medication to a 22 year old female client . the nurse should educate the client about what potential risk of drug therapy ?
Teratogenicity
The nurse is caring for a client who is taking an antidiabetic agent , what assessment finding should the nurse attribute to a possible adverse reaction
The clients reports feeling unusually drowsy and fatigued
A student nurse asks her study group how to define a drug allergy. What would be the peer group's best response?
The formation of antibodies to a drug protein causing an immune response when the person is next exposed to that drug.
The Kardex record of a male patient who is prescribed antihistamines for treating an allergy reads as follows:Age: 32; Profession: Carpenter; Lifestyle & diet: Lives alone, average smoker, nonalcoholic, no food preferences, practices yoga; Medical history: Suffers from hay fever, recent urinary tract infection that has been treated successfully. What information from the Kardex is likely to have the greatest implication in educating the patient about antihistamine administration?
The patient's profession
Why does the nurse need to be alert for any indication of an allergic reaction in patients?
To maintain the patient's safety during drug therapy
what is a Black or hairy tongue an indication of
a super infection
The nurse is caring for a client with a drug allergy and understands the allergy is the results of the client developing what ?
antibodies
The nurse is assessing a patient new to the clinic. The patient says she is allergic to penicillin. What would be the nurse's appropriate next action?
ascertain the exact nature of the patients response to the drug
The nurse is caring for a patient receiving an antineoplastic medication who reports fever, chills, sore throat, weakness, and back pain. What type of adverse effect does the nurse suspect this patient is experiencing?
blood dyscrasia
Patients receiving antineoplastic drugs that disrupt cell function have often have adverse effects involving cells that turn over rapidly in the body , These cells include
bone marrow cells
The nurse administers a medication to the patient that induces the secondary action of hypoglycemia. What organ will be most acutely impacted by inadequate circulating glucose?
brain
A patient is admitted to the intensive care unit with hyperkalemia. The nurse caring for the patient knows that the most severe adverse effect of hyperkalemia is what?
cardiac emergency
A client is receiving antibiotics for treatment of infection . THe nurse should assess for what potential indications of superinfections .select all that apply
fever, glossitis ,
An example of a drug allergy is
hives and difficulty breathing after an injection of penicillin.
Polyuria , increased thirst and kussmaul respirations would indicate hyperglycemia or hypoglycemia
hyperglycemia
The pharmacology instructor is discussing the adrenergic drug ephedrine with the nursing students and lists an adverse reaction of this drug as what?
hyperglycemia
A patient is taking glyburide (an antidiabetic drug) has his morning dose and then does not have a chance to eat for several hours . An adverse effect that might be expected from this would be?
hypoglycemia
A client who is experiencing a secondary action of a medication that he or she has taken is a client who
is drowsy after antihistamine
A client develops bone marrow suppression related to drug effects. What is the nurses primary action
monitor lab values
The nurse administers antipsychotic medications to the patient who has taken these same drugs for many years. What signs and symptoms would the nurse attribute to secondary actions of the drug? (Select all that apply.)
muscular tremors , drooling , yellow discoloration of skin and sclera
The nurse administers an anticholinergic medication to the patient. When assessing this patient, what finding will the nurse consider a secondary effect of the drug?
nasal congestion
The post-anesthesia care unit nurse is serving a patient after a right knee arthroscopy. As the patient begins to wake up from anesthesia, the nurse assesses rigidity, involuntary movements, hyperthermia, and tachycardia. What would the nurse suspect is causing these effects?
neuroleptic malignant syndrome
Extreme restless or jitters are associated with what?
parksions like syndrome
The nurse is caring for a client who exhibits an excessive response to a secondary effect of a drug . Which the nurse classifies as a hypersensitivity response . What factors can potentially contribute to a hypersensitivity reaction? Select all that apply
pathological condition , unique receptors , cellular responses , age related changes
The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic .In a response , the client took another dose 30 minutes later and then a double dose 1 hour after that , the nurses assessment should focus on the possibility of
poisioning
The nurse is acting as the triage nurse in the emergency department when a 16-year-old boy is brought in by his friends. The patient is in respiratory distress, he is vomiting, and blood is noted in the vomitus. He is somnolent and his electrocardiogram shows an arrhythmia. The boy's friends tell you he was taking a "bunch of little green pills" he got from the cupboard at his grandparent's house. The nurse suspects what?
poisoning
The nurse is caring for a patient who experienced a severe headache. When the prescribed number of over-the-counter pain relievers did not work the patient said she took double the dosage an hour later. The nurse recognizes this patient is at greatest risk for what?
poisoning
The nurse administers a loop diuretic to the patient. In addition to sodium and water, what other electrolyte would the nurse expect to be excreted in significant amounts?
potassium
Bleeding associated with anticoagulants is an example what kind of action ?
primary
The pharmacology instructor explains to students that adverse effects can be extensions of what?
primary action of the drug
Nursing priority for a patient who is immunocompromised is what ?
protective isolation
The nurse is writing a plan of care for a patient who is exhibiting Parkinson-like syndrome. What would be an appropriate intervention if, on assessing the patient, the nurse finds the patient is having difficulty swallowing
provide small frequent meals
A client taking an antibiotic experiences diarrhea is what action
secondary action
Client taking antihistamine becomes drowsy is what action
secondary action
Swollen lymph nodes are associated with what?
serum sickness
What classification of drug allergy would be described as an immune system reaction to injected proteins used to treat immune conditions?
serum sickness
The nurse is helping a client who is in distress and may be experiencing an anaphylactic reaction. What assessment finding is most consistent with this diagnosis.
shortness of breath , increased b/p , dilated pupils , diaphoresis, panicky feeling
A client is believed to be developing neuroleptic malignant syndrome .What is the nurse's priority assessment
temperature