Chapter 3: Toxic Effects of Drugs (prep-u)
A client began a new medication 4 days ago and has been reporting increasing malaise for the past 72 hours. The nurse is reviewing the client's most recent laboratory findings. What findings should suggest the possibility of a cytotoxic reaction? (Select all that apply.) decreased hematocrit decreased leukocytes increased liver enzymes decreased potassium increased sodium and chloride
-decreased hematocrit -decreased leukocytes -increased liver enzymes A cytotoxic drug reaction involves several effects that are apparent from laboratory testing. These include decreased hematocrit and white cells as well as increased liver enzyme levels. Electrolyte levels would remain relatively unaffected since these are not cells.
Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply. skeletal and limb abnormalities central nervous system alterations birth at 40 weeks' gestation heart defects
-skeletal and limb abnormalities -central nervous system alterations -heart defects 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. Birth at 40 weeks' gestation is a normal pregnancy outcome.
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? Select all that apply. Ananphylactic reactions involve an antibody that causes the release of histamine. Histamines produce immediate reactions. This allergy involves antibodies that circulate in the blood and cause damage to various tissues by depositing in blood vessels. Anaphylactic reactions can lead to respiratory distress and even respiratory arrest. This reaction occurs several hours after exposure and involves antibodies that are bound to specific white blood cells.
-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. This allergy involves an antibody that reacts with specific sites in the body to cause the release of chemicals, including histamine, that produce immediate reactions (i.e., mucous membrane swelling and constricting bronchi). These reactions can lead to respiratory distress and even respiratory arrest. Serum sickness reaction involves antibodies that cause tissue damage and a delayed allergic reaction can occur several hours after exposure.
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 a paradoxical effect of aspirin The man may be allergic to aspirin The man may be experiencing liver toxicity from the aspirin The man may be experiencing nephrotoxic effects of aspirin
The man may be experiencing nephrotoxic effects of aspirin Damage to the kidneys is called nephrotoxicity. Decreased urinary output, elevated blood urea nitrogen, increased serum creatinine, altered acid-base balance, and electrolyte imbalances can all occur with kidney damage.
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? toxic anaphylactic shock additive synergistic
anaphylactic shock Anaphylactic shock occurs shortly after administration of a drug to which the client is sensitive. It may be life-threatening and must be treated immediately. The client may experience respiratory, cardiovascular, integumentary, and gastrointestinal symptoms.
The nurse would assess a client receiving which medication for possible superinfection? antibiotics antihistamines antihypertensives antineoplastics
antibiotics Superinfection is caused by several kinds of drugs, especially antibiotics (which destroy the normal flora). Antihistamines, antihypertensives, and antineoplastics are not typically associated with superinfection.
The nurse administers chloroquine (Aralen) to a client to treat rheumatoid disease. The client has been taking this medication for several years. What assessment should the nurse prioritize? hearing ability potassium levels assessment for anticholinergic effects assessment of visual acuity
assessment of visual acuity Chloroquine (Aralen), a drug used to treat some rheumatoid diseases, can cause retinal damage and even blindness. The drug is not associated with auditory damage, hyperkalemia, or anticholinergic effects.
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: affect the eighth cranial nerve of the fetus. affect the liver of the fetus. affect the kidneys of the fetus. damage the immature nervous system of the fetus.
damage the immature nervous system of the fetus. Neurotoxicity can occur as a result of exposure to drugs and other chemicals and gases, such as industrial vapors. Immature nervous systems such as those of the fetus and neonate can easily be damaged by drugs that produce neurotoxicity. Hence, the client has been advised not to expose herself to chemical or industrial vapors and specific drugs. The liver and kidney functions and the eighth cranial nerve of the fetus are not directly affected as a result of exposure to neurotoxic substances.
Drugs can produce a wide variety of effects in addition to the desired pharmacological effect. Sometimes the drug dose can be adjusted so that the desired effect is achieved without producing undesired secondary reactions. Which are examples of this secondary action? Select all that apply. spontaneous bleeding after taking an anticoagulant dizziness after starting an antihypertensive drowsiness after taking an antihistamine diarrhea after taking an antibiotic
drowsiness after taking an antihistamine diarrhea after taking an antibiotic Secondary action is when drugs produce a wide variety of effects in addition to the desired pharmacological effect. Sometimes the drug dose can be adjusted so that the desired effect is achieved without producing undesired secondary reactions. Sometimes this is not possible, however, and the adverse effects are almost inevitable. For example, many antihistamines are very effective in drying up secretions and helping breathing, but they also cause drowsiness. A client taking an oral antibiotic needs to know that frequently the effects of the antibiotic on the gastrointestinal tract result in diarrhea, nausea, and sometimes vomiting. The other two are primary actions and that is when the client suffers from effects that are merely an extension of the desired effect.
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. cheese. chicken. corn.
grapefruit. Grapefruit contains a substance that strongly inhibits the metabolism of drugs normally metabolized by the cytochrome P450 CYP3A4 enzyme. This effect greatly increases the blood levels of some drugs (e.g., the widely used "statin" group of cholesterol-lowering drugs), and the effect lasts for several days. Clients who take medications metabolized by the CYP3A4 enzyme should be advised against eating grapefruit or drinking grapefruit juice.
A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety? a list of pharmacies where the drug can be obtained measures to alleviate any discomfort associated with adverse effects the cost of the brand-name drug compared with the generic form statistics related to phase III of testing for the prescribed drug
measures to alleviate any discomfort associated with adverse effects If clients are aware of certain adverse effects and how to alleviate or decrease the discomfort, they are more likely to continue taking the medication and providing for safe administration. A list of pharmacies can be useful information, but will not improve safety or compliance. Knowing the cost of the brand versus the generic could also be helpful to the client. However, a substitution may not be allowed, and the cost of a drug does not improve client safety. Most clients are not concerned with statistics regarding drug testing, and the testing is usually not discussed with clients.
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 immunotoxicity from the ibuprofen allergic reaction to the ibuprofen anaphylactic reaction to the ibuprofen
ototoxicity from the ibuprofen Ototoxicity is damage to the eighth cranial nerve. It may or may not be reversible. Signs and symptoms of ototoxicity include tinnitus, which is a buzzing or ringing sound in the ear, and sensorineural hearing loss. Other signs and symptoms, particularly of vestibular toxicity, include light-headedness, vertigo, a spinning sensation from a seated position, and nausea and vomiting.
A client comes to the clinic reporting vaginal discharge with itching. Which statement would alert the nurse to the possibility that the client's reports are related to a superinfection? "For the last 2 months I have been taking a water pill that the doctor prescribed." "I just completed a course of antibiotics prescribed by my dentist to treat a tooth abscess." "I've been taking aspirin several times a day for the past few months for my back pain." "I've been exhausted and overworked for the past several weeks."
"I just completed a course of antibiotics prescribed by my dentist to treat a tooth abscess." Antibiotics are commonly associated with superinfections because they destroy the normal flora. Diuretics or water pills would be associated with electrolyte imbalances. Aspirin is often linked to tinnitus and eighth cranial nerve function. In addition, its antiplatelet activity increases the risk for bleeding problems. Stress and fatigue suppress the immune system, but do not cause superinfections.
What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects? Try to stay as warm as possible to prevent chilling. Be sure to drink plenty of fluids to prevent dehydration. Avoid strenuous exercise to minimize calorie loss Eat a low-fiber diet to prevent constipation.
Be sure to drink plenty of fluids to prevent dehydration. Drugs with anticholinergic effects often cause dry mouth, constipation, dehydration, and decreased sweating. The client should be instructed to drink fluids to prevent dehydration and to avoid overly warm or hot environments. Avoiding exercise to affect calorie intake is not necessary. A high-fiber diet would be indicated to prevent constipation. Diarrhea is an anticholinergic effect.
An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect? toxicity increased absorption delayed gastric emptying idiosyncratic effects
toxicity An elevated creatinine level is indicative of diminished kidney function, which will result in serum drug toxicity. The creatinine level indicates kidney function, does not affect absorption, and has no effect on gastric emptying. Idiosyncratic effects are reactions that occur rarely and unpredictably among the population.
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. Administer prescribed epinephrine subcutaneously Encourage the use of a MedicAlert identification. Administer topical corticosteroids.
Discontinue the drug immediately as ordered. If serum sickness occurs, the prescriber is notified and the drug is discontinued. Epinephrine is given for an anaphylactic reaction and requires a physician's order. A MedicAlert identification may be indicated, but is not the nurse's first concern. Topical corticosteroids may be used to treat dermatological symptoms such as rash, but would not be the nurse's first concern.
An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include? Many drugs are potentially harmless if used correctly. Any effect results from the alteration of several chemical factors. Most reactions occurring with present-day therapy are less severe than before. Drugs cause unexpected or unacceptable reactions despite screening and testing.
Drugs cause unexpected or unacceptable reactions despite screening and testing. All drugs are potentially dangerous. Even though chemicals are carefully screened and tested in animals and in people before they are released as drugs, drug products often cause unexpected or unacceptable reactions when they are administered. Drugs are chemicals, and the human body operates by a vast series of chemical reactions. Consequently, many effects can be seen when just one chemical factor is altered. Today's potent drugs can cause a great variety of reactions, many of which are more severe than ever seen before.
A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do? Monitor laboratory blood values. Place the client on protective isolation. Facilitate cardiac monitoring. Prepare the client for dialysis.
Monitor laboratory blood values. Monitoring blood counts would be most important for the client with bone marrow suppression. Protective isolation would be appropriate if the client were immunocompromised. Bone marrow suppression does not pose an immediate threat to cardiovascular status. Frequent mouth care would be appropriate if the client develops stomatitis. Dialysis would be indicated if the client develops renal injury due to drug therapy.
A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize? Provide supportive care to manage fever and inflammation. Administer subcutaneous epinephrine as prescribed. Initiate emergency resuscitation measures. Administer naloxone as prescribed.
Provide supportive care to manage fever and inflammation. This client's presentation and history are suggestive of a serum sickness reaction. Interventions include discontinuing the drug and providing supportive care. Resuscitation is not justified by this client's presentation. Epinephrine is prescribed to clients experiencing anaphylaxis. Naloxone is used to treat narcotic overdoses, not serum sickness reactions.
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 Stomatitis Blood dyscrasia Cytotoxic reactions
Teratogenicity Teratogenicity is when drugs that reach the developing fetus or embryo cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. Stomatitis and blood dyscasia are examples of tissue and organ damage. Cytotoxic reaction is an example of an allergic reaction to a drug.
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? The nurse should not be concerned. Medication is not the cause of the client's confusion. The client probably has the onset of Alzheimer disease. This may be coincidental, and the memory loss may be attributed to changes with aging. All elderly clients have dementia at some point in life, and the medication is making it worse.
This may be coincidental, and the memory loss may be attributed to changes with aging. It is important for nurses and other health care professionals to be alert for adverse effects from drug therapy. Sometimes, determining whether an adverse effect has occurred as a result of drug therapy is difficult. Adverse effects may be mistaken for changes associated with aging or disease pathology.
A client is prescribed a combination of medications to treat the disease process. The client is exhibiting signs of toxicity related to the new drug regimen. A possible cause of the change in the absorption of the medications may be enzyme inhibition. What is true of enzyme inhibition? (Select all that apply.) current administration of two or more drugs that compete for the same metabolizing enzymes. It may occur with concurrent administration of two or more drugs that compete for different metabolizing enzymes. It may necessitate the administration of larger doses of the medication. It may necessitate the administration of smaller doses of the medication. e. It occurs within seconds or minutes of starting an inhibiting agent. It occurs within seconds or minutes of starting an inhibiting agent.
-It may occur with concurrent administration of two or more drugs that compete for the same metabolizing enzymes. -It may necessitate the administration of smaller doses of the medication. e. It occurs within seconds or minutes of starting an inhibiting agent. Metabolism may be decreased or delayed in a process called enzyme inhibition, which most often occurs with concurrent administration of two or more drugs that compete for the same metabolizing enzymes. In this case, smaller doses of the slowly metabolized drug may be needed to avoid adverse effects and toxicity from drug accumulation. Enzyme inhibition occurs within hours or days of starting an inhibiting agent. Cimetidine, a gastric acid suppressor, inhibits several CYP enzymes (e.g., CYP1A, CYP2C, CYP2D, CYP3A) and can greatly decrease drug metabolism.
The nurse is caring for a client who appears to be developing anaphylactic shock. What drug does the nurse anticipate the health care practitioner will order to treat this condition? Epinephrine (Adrenalin) Furosemide (Lasix) Acetaminophen (Tylenol) Acetylsalicylic acid (Aspirin)
Epinephrine (Adrenalin) Anaphylactic shock can be fatal if the symptoms are not identified and treated immediately. Epinephrine (Adrenalin) is the first drug to be adminstered to assist in reversing the physical effects of the anaphylactic shock.
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? visual disturbances yellowing of the skin a decrease in urine output ringing noise in the ears
a decrease in urine output Decreased urinary output, elevated blood urea nitrogen, increased serum creatinine, altered acid-base balance, and electrolyte imbalances can occur with nephrotoxicity. Ringing noise in the ears (tinnitus) is an indication of possible ototoxicity. Visual disturbances can suggest neurotoxicity, and yellowing of the skin (jaundice) is a sign of hepatotoxicity.
What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body? decreased activity. decreased gastric motility. decreased cognition. decreased glomerular filtration rate.
decreased glomerular filtration rate. In older adults (65 years and older), physiologic changes may alter all pharmacokinetic processes. Changes in the gastrointestinal tract include decreased gastric acidity, decreased blood flow, and decreased motility. Despite these changes, however, there is little difference in drug absorption. Changes in the cardiovascular system include decreased cardiac output, and therefore slower distribution of drug molecules to their sites of action, metabolism, and excretion. In the liver, blood flow and metabolizing enzymes are decreased. Therefore, many drugs are metabolized more slowly, have a longer action, and are more likely to accumulate with chronic administration. In the kidneys, there is decreased blood flow, decreased glomerular filtration rate, and decreased tubular secretion of drugs; all of these changes tend to slow excretion and promote accumulation of drugs in the body. Impaired kidney and liver function greatly increases the risks of adverse drug effects. In addition, older adults are more likely to have acute and chronic illnesses that require the use of multiple drugs or long-term drug therapy. Therefore, possibilities for interactions among drugs and between drugs and diseased organs are greatly multiplied.
The nurse is assessing a community-dwelling client with a history of rheumatoid arthritis. During the interview, the client states, "The last few months, I have this ringing in my ears that I just cannot seem to get away from." What assessment question should the nurse ask? "Have you been taking aspirin on a regular basis?" "Have you ever had any steroid injection to treat your arthritis?" "Do you ever check your blood pressure when you're at home?" "Are you taking any herbal remedies or vitamin supplements?"
"Have you been taking aspirin on a regular basis?" Aspirin is a relatively common cause of tinnitus and auditory nerve damage. As well, the fact that the client has an inflammatory disease makes it possible that the client is self-medicating with aspirin. Corticosteroids are not as commonly associated with tinnitus. Similarly, hypertension and hypotension do not normally cause this problem. Herbs and supplements have widely varying effects, but aspirin is a more likely cause due to the client's diagnosis and the wide availability and use of aspirin.
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? "The sexual dysfunction is caused by an allergic reaction to the medication. We need to stop this drug immediately." "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." "This is an idiosyncratic response to the medication, not an expected result. Such responses are genetically predetermined so you will not be able to take this medication." "This is a toxic reaction to the medication and can cause permanent damage. We need to take you off this medication immediately."
"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." An adverse effect of drug therapy is a usually undesirable effect other than the intended therapeutic effect. It may occur even with normal drug dosing. Adverse effects may also occur independently of the dose and be unpredictable. The term adverse effect encompasses all nontherapeutic responses to drug therapy.
The nurse administers penicillin to a client and monitors the client for an adverse reaction despite the fact that the client claimed not to be allergic to penicillin. What is the rationale for checking for adverse reactions? {Select all that apply.} A person can be allergic to any medication at any time. Medications can react with over-the-counter medications to cause toxicity. Certain medications react with orange juice to cause toxicity. If medications are not taken on an empty stomach, adverse reactions may occur. Medications can react with herbal supplements to cause adverse reactions. Medications can react with other medications prescribed for the client.
-A person can be allergic to any medication at any time. -Medications can react with over-the-counter medications to cause toxicity. -Medications can react with herbal supplements to cause adverse reactions. -Medications can react with other medications prescribed for the client. A person can be allergic to any medication at any time. Over-the-counter medications and herbal supplements, in combination with prescribed drugs, can cause serious undesired effects. Also, certain medications, if taken with grapefruit juice, can cause toxicity. Some medications should always be taken with food, whereas others should be taken on an empty stomach.
Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs? Select all that apply. a pregnant woman who takes tamoxifen (Nolvadex) and delivers a baby with birth defects a postoperative client with extrapyramidal symptoms, hyperthermia, and autonomic disturbances a client taking an antipsychotic who exhibits akinesia, muscular tremors, drooling, changes in gait, jitters (akathisia), or spasms (dyskinesia) a postoperative client who had atropine and exhibits dry mouth, altered taste perception, dysphagia, heartburn, constipation, and bloating
-a postoperative client with extrapyramidal symptoms, hyperthermia, and autonomic disturbances -a client taking an antipsychotic who exhibits akinesia, muscular tremors, drooling, changes in gait, jitters (akathisia), or spasms (dyskinesia) -a postoperative client who had atropine and exhibits dry mouth, altered taste perception, dysphagia, heartburn, constipation, and bloating Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Nerves function by using a constant source of energy to maintain the resting membrane potential and allow excitation. Neuroleptic malignant syndrome, Parkinson-like syndrome, and atropine-like (anticholinergic) effects are all examples. Teratogenicity is when a drug causes birth defects.
The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects? 20-year-old female client who has been diagnosed with a chlamydial infection 40-year-old male client who has a history of intravenous drug use and who has endocarditis 60-year-old female client who is tetraplegic and who has developed a sacral pressure ulcer 6-year-old girl who has a urinary tract infection and who is accompanied by her parents
20-year-old female client who has been diagnosed with a chlamydial infection The risk of teratogenicity is a priority consideration for female clients of child-bearing age, not for males or prepubescent girls.
The nurse is conducting an admission assessment of a new client. When asked about any food or drug allergies, the client states that the client is allergic to tetracycline. What action should the nurse next perform? Ask the client, "What happens when you take a dose of tetracycline?" Ask the client, "Are you allergic to any other antibiotics, or just tetracycline?" Document an allergy to tetracycline in the client's health record Educate the client about antibiotics that are alternatives to tetracycline.
Ask the client, "What happens when you take a dose of tetracycline?" Clients often characterize a wide variety of medication reactions as "allergies." The nurse should assess further, not because of mistrust for the client but because there is a need for further detail. Documentation of the client's allergy status should occur at the completion of assessment. Education about alternatives would be premature.
When administering drug therapy for a client, how can the nurse ensure beneficial outcomes? (Select all that apply.) Make sure the client can explain about the drug classifications. Maximize therapeutic effects. Minimize adverse effects and drug interactions. Order laboratory studies to determine effectiveness of drug therapy. Provide appropriate drug education for the client and family.
Maximize therapeutic effects. Minimize adverse effects and drug interactions. Provide appropriate drug education for the client and family. When administering drug therapy, the nurse's main focus is ensuring a beneficial outcome by maximizing therapeutic effects, minimizing adverse effects and drug interactions, and providing appropriate drug education for the client and family.
A hospital client began taking a newly prescribed antihypertensive 12 hours ago and has developed a full body rash with edema and pruritis. What is the nurse's best action? Promptly inform the prescriber of the client's status. Discontinue the medication and document the assessment findings. Establish intravenous access and administer 25 mg diphenhydramine IV. Call an emergency code and monitor the client's respiratory and cardiac status.
Promptly inform the prescriber of the client's status. There is no indication that the client is in acute distress, so it is unnecessary to call an emergency code. However, prompt action is necessary, beginning with informing the client's care provider. The provider is likely to discontinue the medication, but the nurse cannot independently do this. Administration of diphenhydramine should only be done on the basis of a prescription.
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. Check the client's blood glucose level. Assess the client's level of orientation. Check the client's urine output.
Review the client's most recent potassium level. Hypokalemia is suggested by numbness and tingling in the extremities, muscle cramps, weakness, and irregular pulse. Fatigue, drowsiness, hunger, tremulousness, and cold clammy skin would suggest hypoglycemia. Renal injury would be manifested by elevated BUN and creatinine concentration, decreased hematocrit, and electrolyte imbalances, fatigue, malaise, decreased urine output and irritability. Neurologic dysfunction would most likely be manifested by confusion, delirium, insomnia, drowsiness, and changes in deep tendon reflexes.
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 allergic to the penicillin and should stop taking it immediately. The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays. The client had a reaction to something in the environment while working in the yard and should take an antihistamine. This is a normal reaction for anyone who takes antibiotics and is nothing to be concerned about.
The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays. The client's environment may increase the likelihood that a certain adverse effect will occur. Some antibiotics can cause the adverse effect of photosensitivity. Even brief exposure to sunlight or strong ultraviolet light can cause severe sunburn, hives, or a rash.
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? route of administration body system affected adverse effects protocols
adverse effects Becoming familiar with classifications of medications helps the nurse to recognize possible adverse effects clients may experience, providing a basis for implementing appropriate nursing actions should undesirable effects occur. The route of administration, body system involved, and protocols are more important to know before medication administration.
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: a hepatotoxic response. an idiosyncratic response. a paradoxical response. an allergic response.
an allergic response. An allergic response is an immune system response. If the body interprets the drug as a foreign substance (antigen) and forms antibodies against the drug, the antigen-antibody response of the immune system is initiated when the drug is taken again. This response involves the release of histamine, which is responsible for many symptoms of allergy—redness, itching, swelling, rash, and hives. Idiosyncratic responses are related to an individual's unique response to a drug, rather than to the dose of a drug. Idiosyncratic responses are unusual and in fact may be the opposite of what is anticipated, which is sometimes called a paradoxical response.
The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize? asking the client what the client's response is to taking NSAIDs asking if the client has tolerated narcotics and acetaminophen in the past assessing the client for signs and symptoms of inflammation assessing the client's pain tolerance and expectations for pain control
asking the client what the client's response is to taking NSAIDs The nurse should ask additional questions of clients who state that they have a drug allergy to ascertain the exact nature of the response and whether or not it is a true drug allergy. This would be a priority over exploring alternatives or determining the client's pain tolerance.
The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action? protecting and maintaining the patency of the client's airway monitoring the client's vital signs at least every five minutes administering intravenous antihistamines as prescribed providing reassurance to the client
protecting and maintaining the patency of the client's airway This client's presentation is suggestive of anaphylaxis. In the care team's immediate treatment, maintaining the airway is a priority. Epinephrine is administered in the short term, not antihistamines. The nurse should reassure the client, if possible, but the patency of the airway is the highest priority. Similarly, this would supersede the need for vital signs monitoring, even though this should be done.
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: primary actions. secondary actions. drug allergy. hypersensitivity.
secondary actions. Secondary actions are effects that are inevitable and undesired but not related to the desired pharmacologic effects. Nausea and diarrhea are examples of secondary actions due to an antibiotic's effect on the gastrointestinal tract. Primary actions are those associated with the therapeutic effect. Drug allergy involves the formation of antibodies to a particular drug. Hypersensitivity refers to an excessive response to either primary or secondary effects of a drug.
