EXAM 4 PHARM
The patient diagnosed with hyperthyroidism is prescribed the antithyroid medication propylthiouracil (PTU). Which statement by the patient warrants immediate intervention by the nurse?
"I have a sore throat and have had a fever."
High Alert Drug acronym
'A PINCH' A: Anti-infective P: Potassium and other electrolytes I: Insulin N: Narcotics (opioids) and other sedatives C: Cancer agents or chemotherapy H: Heparin and anticoagulants
Check before administering Chemotherapy:
-Be sure IV is in a large vein with good blood return -Weigh the patient accurately each day -Check dose and recalculate it based on patient's weight -Take the patient's vitals
Patient Teaching for Chemotherapy:
-Temporary and permanent physical damage possible - Anemia, Neutropenia - avoid infection, Thrombocytopenia - avoid injury -Good handwashing; avoid crowds -Cancer therapy symptom distress: nausea/vomiting, alopecia, mucositis, changes in cognitive function -Management of side effect
The nurse is teaching a patient with hypertension about the use of over-the-counter (OTC) drugs. What does the nurse include in the teaching plan? Select all that apply.
A. "In general, be sure to contact your prescriber before taking any OTC preparations." D. "Avoid cold remedies that contain phenylephrine or pseudoephedrine because they can increase your blood pressure." E. "OTC nonsteroidal anti-inflammatory drugs (NSAIDs) can cause secondary hypertension."
A patient is taking levothyroxine sodium (Synthroid). Which of the following changes should you report to the prescriber as an indication that the dose may be too high? Select all that apply.
A. Nightly insomnia B. Frequent diarrhea
What category of blood pressure medications have the potential to produce a persistent dry cough?
ACE inhibitors
The nurse is scheduled to administer a dose of digoxin (Lanoxin) to an adult client with atrial fibrillation. The client has a potassium level of 4.3 mEq/L. The nurse should perform which of the following activities next?
Administer dose as ordered
Before starting a patient with a testosterone Replacement Drug
Ask about history of prostate/breast cancer Have prostate cancer screening Baseline weight and blood pressure
A client diagnosed with cancer has been receiving chemotherapy and subsequently develops a platelet count of 45,000/mm3. The nurse concludes that the client understands instructions to avoid potential complications when the client states to do which of the following?
Avoid aspirin and aspirin (salicylate) - containing products
Beta I receptors can be found in the ____ and beta 2 receptors can be found in the ___.
Beta 1 in heart and Beta 2 in lungs
What type of diabetic may be prescribed insulin?
Both Type 1 and Type 2 Diabetics
Substances or events that damage a normal cell's DNA, cause cancer are called...
Carcinogens
Describe in your own words the mechanism of action (MOA) of a cardiac glycoside AND how that MOA helps to decrease the workload of the heart and alleviate the symptoms of heart failure.
Cardiac glycosides slow the heart rate (allowing more time for the left ventricle to fill) and also increases contractility (increases force of each heart beat)to improve cardiac output.
A patient with diabetes who takes glucophage (Metformin), a Biguanide insulin sensitizer, has postoperative orders to "resume all pre-operative medications." He had a CT scan with contrast prior to surgery completed. What is the priority action for the nurse?
Contact the prescriber to obtain an order to hold the glucophage for 48 hours.
What category of medication will correct adrenal gland hypofunction and is similar to natural cortisol? Must be spelled correctly to receive credit.
Corticosteroids
Symptoms of low testosterone
Decreased interest in sex and decreased well-being Depression, irritability, difficulty concentrating/remembering Erectile dysfunction, decreased muscle, increased fat Anemia, decreased bone density, decreased body hair
Cancer is an
abnormal, invasive cell growth with no useful purpose.
When mixing two types of insulin, the cloudy insulin needs to be drawn up before the clear insulin.
FALSE The clear insulin needs to be drawn up before the cloudy insulin
Prior to administering a cardiac glycoside, the nurse should assess the patient's radial pulse for at least 10 full minutes.
FALSE The nurse should assess the patient's radial pulse for 1 full minute.
What is the preferred medication to treat diabetes for a pregnant patient?
Insulin
Which assessment is most important for the nurse to perform before administering levothyroxine (Synthroid)?
Measuring the heart rate and rhythm
Chemotherapy side effects
Normal cells most affected by chemotherapy are those that divide rapidly (e.g., skin, hair, intestinal tissue, blood-forming cells)
Before administering nitroglycerin ointment to a patient, what precaution should be taken?
Putting on gloves
Chemotherapy
Refers to medications that kills cells that divide rapidly. Damages normal cells AND cancer cells
Metastasis is
Spread of cancer cells to other body areas; cells grow, invade, damage important organs
Modes of Cancer Treatment:
Surgery, radiation, chemotherapy, biotherapy.
Although there are multiple medications that may be prescribed to treat the symptoms of heart failure, the only genuine cure is a heart transplant since damage to the heart muscle is irreversible.
TRUE
It is appropriate to administer the prescribed blood pressure medications to a patient whose blood pressure is currently "normal" at 120/80.
TRUE
There are different Chemotherapy Drug Categories, and how they work are different but the outcome is the same
TRUE
Thyroid-suppressing medications may initially take as long as 3 weeks to be effective as they do not affect hormones already stored in the thyroid gland.
TRUE
Patient Teaching for HRT
Take exactly as prescribed Annual screenings for breast, cervical, uterine, ovarian cancer Smoking cessation Monitor/report symptoms of jaundice Seek medical attention for: ØChest pain, difficulty breathing ØSwelling in one leg Symptoms of stroke
Male hormone replacement
Testosterone
The nurse is caring for a patient taking propranolol (Inderal). Which assessment finding indicates the patient is experiencing a potential adverse complication?
The development of audible wheezes and cough
A patient receives NPH and regular insulin every morning. The nurse is verifying that the patient understands that there are two different peak times to be aware of for this insulin regimen. Why is this an important concept for the nurse to stress?
The risk for hypoglycemia is greatest around the peak of insulin activity.
Adverse effects of HRT
increased blood clotting hormone-sensitive cancers; liver impairment; gallbladder disease; pancreatitis
Life span considerations for testosterone Replacement Drug
increased risk of prostate hyperplasia, or growth stimulation of occult prostate carcinoma Monitoring for any fluid retentions Use with caution in children Do not use during pregnancy or breastfeeding (For gender transitional)