Hesi Pharm

A patient is hypokalemic and taking sustained-release oral potassium chloride. What should the nurse teach about taking this drug?

To minimize gastrointestinal effects, the patient should take oral potassium chloride with meals or a full glass of water,

Which action should the nurse take when caring for a patient receiving triamterene?

Triamterene is a potassium-sparing diuretic. The nurse should monitor potassium for potential hyperkalemia.

Initial therapy for hypertonic contraction may consist simply of drinking water.

like the loop diuretics, the thiazides can elevate plasma levels of glucose.

What is pyelonephritis?

A bacterial infection of the kidneys

A construction worker presents to the emergency department with severe dehydration after working outside in 105-degree weather all day. Which intravenous solution should the nurse expect to administer?

A patient who has severe dehydration from working outside in extreme heat likely has experienced excessive sweating and subsequent hypertonic contraction. Volume replacement in hypertonic contraction should be accomplished with hypotonic fluids (eg, 0.45% sodium chloride) or with fluids that contain no solutes at all.

What is gout?

A systemic disease caused by the buildup of uric acid in the blood (hyperuricemia).

The nurse is assessing a patient with acute cystitis. Which symptom would the nurse expect to find in the patient?

Acute cystitis is a lower urinary tract infection. Symptoms of acute cystitis include pain and burning sensation during urination.

Before administering trimethoprim, it is most important for the nurse to assess the patient for a history of which condition?

Alcoholism Trimethoprim inhibits bacterial synthesis of folic acid. It should be avoided in patients when folate deficiency is likely, such as in alcoholism, because bone marrow suppression may occur.

A patient is being treated for syphilis. Which drug would the nurse anticipate to be prescribed?

Benzathine penicillin G

The nurse is responsible for dispensing medications and notes that the patient has a Schedule IV drug. What should the nurse interpret from this?

Controlled drugs are classified into five categories. A Schedule IV drug is a controlled substance whose use is limited. The drug has a high potential for abuse. Schedule IV drugs need to be dispensed via an approved protocol because they have a high potential for causing dependency. The prescription of a Schedule IV drug is valid for only 6 months, with a maximum of five refills during that period. Schedule IV drugs must have a valid prescription before being filled. This helps to prevent drug abuse.

The nurse should monitor for which adverse effect after administering hydrochlorothiazide and digoxin to a patient?

Digoxin levels have an inverse relationship with potassium levels. Because hydrochlorothiazide can lower potassium levels, combined use of hydrochlorothiazide and digoxin poses a risk for elevated digoxin levels and ensuing digoxin toxicity.

The primary health care provider has prescribed fosfomycin tromethamine to a patient for the treatment of a urinary tract infection (UTI). What would the nurse anticipate as the reason for prescribing this drug to the patient?

Fosfomycin tromethamine is a single-dose treatment that is effective for UTIs

The nurse reviews the laboratory values of a patient receiving furosemide. Which lab result indicates to the nurse that an adverse effect is occurring?

Furosemide increases urinary excretion of magnesium, posing a risk of magnesium deficiency.

The nurse is caring for a patient who has congestive heart failure. The patient's medical history indicates that the patient has a history of chronic kidney disease with a low glomerular filtration rate (GFR). Which drug would the nurse anticipate being prescribed for the patient?

Furosemide is especially useful in patients with severe renal impairment, because, unlike the thiazides, the drug can promote diuresis even when renal blood flow and GFR are low.

A patient has hypermagnesemia from overuse of antacids. Which assessment is priority?

Hypermagnesemia affects respiration before the rest of the vital signs. As the magnesium levels increase in the blood, respiratory paralysis is likely.

A patient with chronic alcoholism is admitted to the hospital for severe diarrhea. Which electrolyte should the nurse most closely monitor in this patient?

Hypomagnesemia also may be seen in chronic alcoholics and from diarrhea, hemodialysis, kidney disease, or prolonged intravenous feeding.

The nurse is preparing to administer intravenous (IV) potassium to a patient with hypokalemia. Which prescription is the most appropriate?

IV potassium must be diluted and infused slowly (never given IV push), at a rate no faster than 10 mEq/hr. Faster infusions of potassium can lead to cardiac toxicity.

A patient with hypertension is receiving spironolactone therapy. The nurse notes that the patient's serum potassium level is 6.2 mEq/L. What would the nurse anticipate to be prescribed for the patient?

If serum potassium rises above 5 mEq/L, or if signs of hyperkalemia develop (eg, abnormal heart rhythm), spironolactone should be discontinued and potassium intake restricted. Injection of insulin can help lower potassium levels by promoting potassium uptake into cells.

The nurse administers sodium chloride plus potassium chloride. Which patient should receive this type of treatment?

In most cases, metabolic alkalosis can be corrected through infusion of a solution of sodium chloride plus potassium chloride. This facilitates renal excretion of bicarbonate and thereby promotes normalization of plasma pH.

A patient has hypomagnesemia. Which drug should the nurse discuss in a teaching session with the patient?

Magnesium sulfate intramuscularly or intravenously is the preferred treatment for hypomagnesemia.

Which statements about mannitol are correct?

Mannitol can cause edema because it exits the capillary beds in all areas except the brain. In doing so, it draws water with it. Mannitol is not absorbed through the gastrointestinal tract, so it must be given parenterally. Diuresis begins in 30 to 60 minutes and persists for 6 to 8 hours. Mannitol is used in prophylaxis of renal failure. Mannitol is an osmotic diuretic, not a loop diuretic.

What medication is most often associated with treatment of bacterial vaginosis?

Metronidazole is the oral treatment used for bacterial vaginosis

The nurse knows that diuretics mostly affect which function of the kidneys?

Most diuretics block sodium and chloride reabsorption, thus affecting maintenance of extracellular fluid volume.

Which finding should the nurse expect when assessing a male patient with secondary syphilis?

Secondary syphilis develops 2 to 6 weeks after emergence of the primary lesion (a chancre , which is a hard, red, protruding, painless sore at the urethra of the penis). Symptoms of secondary syphilis result from the spread of Treponema pallidum by way of the bloodstream and manifest as skin lesions, along with flu-like symptoms and enlarged lymph nodes

Did you know

Sodium polystyrene sulfonate is given to patients with hyperkalemia.

The nurse is caring for a patient with heart failure who needs a diuretic. Which agent is likely to be chosen because it has been shown to reduce mortality greatly in patients with heart failure?

Spironolactone is a potassium-sparing diuretic used to treat both hypertension and edema. It is a preferred drug in mild heart failure because it has been shown to have a cardioprotective effect, reducing mortality in patients with heart failure.

The nurse is teaching a patient who has a new prescription for spironolactone. Which statement by the patient indicates that the teaching was effective?

Spironolactone is a potassium-sparing, aldosterone-blocking diuretic. As such, it can cause endocrine effects, such as gynecomastia, menstrual irregularities, impotence, hirsutism, and deepening of the voice.

What is Trimethoprim-Sulfamethoxazole used for?

TMP/SMZ is a combination drug and consists of trimethoprim and sulfamethoxazole. It is an antibiotic used for the treatment of urinary tract infections (UTIs). It prevents the occurrence of trimethoprim-resistant organisms.

The nurse teaches the patient taking sulfamethoxazole the importance of which action to reduce crystalluria?

The nurse should teach the patient taking sulfamethoxazole the importance of increasing fluid intake to reduce crystalluria.

The nurse is administering several different diuretics. Which drug will produce the most diuresis in a patient?

Furosemide is the most potent diuretic. Drugs that act early in the nephron have the opportunity to block the greatest amount of solute reabsorption. Furosemide works at the loop of Henle; as a result, furosemide produces the greatest diuresis

The nurse is leading a community support group for recovering drug addicts. One individual has abused heroin. The nurse recognizes that the medication is classified in which schedule?

Heroin, mescaline, and lysergic acid diethylamide (LSD) are classified as Schedule I drugs with a high potential for drug abuse and no accepted medical use in the United States

what is a single blind investigation drug study

In a single-blind investigational drug study, the researcher knows whether the subject belongs to the drug or the placebo group, but the subject does not know to which group he or she belongs

he nurse is preparing to administer the initial treatment for a patient with hypertonic contraction. Which action should the nurse take?

Initial therapy for hypertonic contraction may consist simply of drinking water.

What are the loop diuretics?

furosemide, bumetanide, torsemide, ethacrynic acid

After assessing a patient, the nurse anticipates that the primary health care provider will prescribe silver sulfadiazine to the patient for effective treatment. Which findings would enable the nurse to make such an assumption?

helps to prevent the risk of infection in a patient with burns. the silver has antibacterial effects

Which statements about the Family Smoking Prevention and Tobacco Control Act (2009) should the nurse identify as true? Select all that apply.

According to the Family Smoking Prevention and Tobacco Control Act (2009), all ingredients in tobacco products must be listed on the warning label; a gradual reduction of nicotine to nonaddictive levels is required; marketing to youth is prohibited; and harmful additives are restricted. The Family Smoking Prevention and Tobacco Control Act (2009) prohibits sales to minors; however, this age is determined on a state-by-state basis.

Which statements about medication should the nurse identify as true?

All drugs have the potential to produce undesired effects. Drug therapy often can be enhanced by nonpharmacologic measures, such as physical therapy or dietary changes. The risk of a drug interaction increases with each drug added. PRN medications require a high level of nursing discretion, judgment, and knowledge and are not less important than standing orders. Patient adherence is the extent to which a patient's behavior coincides with medical advice. This is especially important for patients taking medications at home.

A patient has been prescribed hydrochlorothiazide. After reviewing the patient's laboratory report, the nurse informs the provider that the patient has hypokalemia. Which drug would the nurse expect to be included in the patient's prescription?

Although it can be employed alone as a diuretic, amiloride is used primarily to counteract potassium loss caused by more powerful diuretics

The nurse is caring for a patient receiving intravenous (IV) therapy with a 3% sodium chloride infusion at 75 mL/hr. The nurse should closely monitor for which adverse effect of treatment?

An IV solution of 3% sodium chloride is hypertonic and may cause fluid overload. Signs of volume overload include distended neck veins and ankle edema.

What are the qualities of effective goal setting?

An effective goal is patient-centered because it helps to involve the patient in the decision-making process. The patient goal should be realistic and state the expected change in the patient, which will also later help to evaluate the success of the goal. The goal should be acceptable to the patient so that the patient is willing to make efforts to improve

The nurse is assessing the hearing of a patient receiving furosemide. Which information in the chart would cause the nurse to perform this assessment?

Gentamicin ordered The risk of hearing loss from loop diuretics is increased in the presence of other ototoxic drugs, especially aminoglycosides, such as gentamicin.

Which is a true statement about new drug development? Select all that apply.

Preclinical drug testing is not performed in humans; it is done mostly in animals. Because drug testing occurs in a relatively small number of patients, those patients are carefully selected, the drug is taken for a relatively short time, and not all adverse effects are detected during the drug testing process. During the testing process, randomized controlled trials are used, in which the participants are unaware of which subjects are getting drug, placebo, or control. Kinetics, toxicities, and effectiveness are tested during the preclinical phase of drug testing. Phase I clinical testing is on healthy volunteers to evaluate pharmacokinetics, metabolism, and biologic effects. Patient use occurs in phases II and III.

Which acid-base imbalance is caused by chronic renal failure, loss of bicarbonate during severe diarrhea, or metabolic disorders that result in overproduction of lactic acid?

Principal causes of metabolic acidosis are chronic renal failure, loss of bicarbonate during severe diarrhea, and metabolic disorders that result in overproduction of lactic acid (lactic acidosis) or ketoacids (ketoacidosis).

What is a result of the Prescription Drug User Fee Act (PDUFA) of 1992?

The PDUFA was a response to complaints about the length of time required for approval of new drugs by the U.S. Food and Drug Administration (FDA). Under this act, drug sponsors pay fees to the FDA that are used to fund additional reviewers. The FDA then must adhere to strict turnaround times for drug review processes. There are other acts that address controlled substances, drug safety, and accelerated approval for drugs for AIDS.

The nurse knows that which organ is primarily responsible for maintaining fluid volume and osmolality?

The kidneys are responsible for maintaining and regulating volume and osmolality

What is the mechanism of action for nitrofurantoin?

The mechanism of action for nitrofurantoin is that it injures bacteria by damaging the DNA of the bacteria.

A patient has tall T waves on the electrocardiogram reading, a normal arterial pH, weakness, confusion, and tingling of the hands and feet. Which actions can be added to the plan of care?

The patient is experiencing hyperkalemia. Treatment for hyperkalemia includes glucose and insulin, calcium gluconate, and sodium polystyrene sulfonate.

The nurse is reviewing the home medication list with the patient. The nurse should recognize that hydrochlorothiazide is used primarily for which condition?

The primary indication for hydrochlorothiazide is hypertension, a condition for which thiazides are often the drugs of first choice.

After reviewing the chart, which information would cause the nurse to notify the provider for a patient taking hydrochlorothiazide?

The provider should be notified because the patient has a history of gout. Hydrochlorothiazide is a thiazide diuretic, which can cause an increase in uric acid level, leading to a gout attack.

Did you know

The use of thiazides (metolazone, hydrochlorothiazide, or methyclothiazide) is not effective with a low GFR.

The healthcare provider instructs the nurse to administer mannitol to a patient who has cerebral edema. What should the nurse do before administering the drug to the patient?

When administering mannitol, keep it warm and use a filter needle and in-line filter. Note that mannitol may crystallize out of solution if exposed to a low temperature. Accordingly, preparations should be inspected for crystals before use. Preparations that contain crystals should be warmed (to redissolve the mannitol) and then cooled to body temperature for administration. A filter needle is employed to withdraw mannitol from the vial, and an in-line filter is used to prevent crystals from entering the circulation. Mannitol is administered by intravenous infusion only. Because mannitol is an osmotic, diuretic potassium and sodium are not lost, and supplements are not needed.

A patient with hypertension has been prescribed furosemide. On reviewing the patient's medical history, the nurse learns that the patient is also taking a nonsteroidal anti-inflammatory drug (NSAID) for rheumatoid arthritis. What would the nurse anticipate the healthcare provider would prescribe?

When furosemide is used with NSAIDs, the diuretic activity of the drug is decreased due to the inhibition of prostaglandin synthesis. The nurse should expect the provider to increase the dose of furosemide to produce effective diuresis.