nurs 230 part 3
Generalized seizures are different from partial seizures in that generalized seizures arise from multiple foci in both hemispheres of the brain and are often accompanied by what? Seeing spots (aura) or experiencing automatisms Loss of consciousness Lip smacking, chewing, or pulling at clothing Disturbances in hearing, sight, or taste
Loss of consciousness
When assessing your client's past drug history, what information should you record? Select all that apply. Tobacco and alcohol use OTC medications taken Allergic reactions Client's medication questions Adverse/side effects of any drugs
Tobacco and alcohol use OTC medications taken Allergic reactions Adverse/side effects of any drugs
Arrange the steps of the nursing process in the correct sequence. Instructions: Click on the down arrow for each step of the nursing process in the right column and select the correct choice from the list.
1st Assessment 2nd Diagnosis 3rd Planning 4th Implementation 5th Evaluation
The nurse is performing the morning assessment on Frank, a 7-year-old client. Frank stares off into space for a few seconds and does not seem to hear the nurse as she says his name. A few seconds pass, then Frank continues as if nothing happened. Which type of seizure is this child experiencing? Myoclonic seizure Absence seizure Tonic-clonic seizure Atonic seizure
Absence seizure
Thirteen-year-old Ricky Coleman and his family came to your clinic after Ricky fell on the baseball field and twisted his ankle. The ankle is swollen and he cannot put weight on it. Ricky also has scratches and sunburn on his forearms. He complains that he didn't have time to eat much today and is very hungry. Ricky also says he feels a little light-headed. What is your nursing diagnosis of first priority? Activity intolerance related to twisted ankle and acute ankle pain Potential for skin breakdown, related to sunburn Nutrition imbalance less than body requirements, related to overactivity Electrolyte imbalance
Activity intolerance related to twisted ankle and acute ankle pain
Which categories of antiseizure medication have a mechanism of action that enhances the action of GABA in the brain? Select all that apply. Barbiturates Benzodiazepines Succinimides Hydantoins Hydantoin-like medications
Barbiturates Benzodiazepines
The nurse is preparing to administer phenytoin (Dilantin), an antiseizure medication, to the client. Which nursing action is most important in relation to this medication? Keep the phenytoin (Dilantin) in a safe place out of the reach of children. Remind the client not to take the medication with grapefruit juice. Make sure phenytoin (Dilantin) is taken on an empty stomach. Before administering the medication, review lab data for the current blood level.
Before administering the medication, review lab data for the current blood level.
Which categories of antiseizure medication have a mechanism of action that enhances the action of GABA in the brain? Select all that apply. Hydantoin-like medications Benzodiazepines Barbiturates Hydantoins Succinimides
Benzodiazepines Barbiturates
A client tells the nurse that her neurologist said that phenytoin (Dilantin) is the drug of choice for treatment of seizures and asks how this medication works. The nurse explains that phenytoin inhibits seizure activity how? By suppressing the flow of sodium ions in the brain By desensitizing the sodium channels in the brain; this limits rapid firing of brain cells, thereby suppressing seizure activity By slowing neuronal firing rates via increasing gamma aminobutyric acid (GABA) levels in the brain By enhancing the action of gamma aminobutyric acid (GABA) in the brain, which decreases neuronal activity
By desensitizing the sodium channels in the brain; this limits rapid firing of brain cells, thereby suppressing seizure activity
The nurse is reviewing the medication order for a pregnant client. Which category of drugs, established by the U.S. Food and Drug Administration (FDA), is safest for the client to take? Category B Category D Category C Category A
Category A
You are the school nurse working with Eva Lim, a teen who has suffered a mild, one-time seizure during a two-hour metalworking class. Eva's temperature is 98.8°F (37.1°C). Four other students in her class report nausea and headaches. What is the most likely cause of Eva's seizure? Chemical or toxin exposure Fever or infection Family history of cardiac disease Past head injury
Chemical or toxin exposure
You are the school nurse working with Eva Lim, a teen who has suffered a mild, one-time seizure during a two-hour metalworking class. Eva's temperature is 98.8°F (37.1°C). Four other students in her class report nausea and headaches. What is the most likely cause of Eva's seizure? Fever or infection Family history of cardiac disease Past head injury Chemical or toxin exposure
Chemical or toxin exposure
What factors help determine the health care provider's choice of anticonvulsant for a client with seizures? Select all that apply. Clinical manifestations of seizure activity Current diet Other diseases currently present Type of seizure Medical history
Clinical manifestations of seizure activity Other diseases currently present Type of seizure Medical history
The nurse is preparing to administer medications to a group of adult clients. What must the nurse consider when planning to administer the medications? Select all that apply. Compatibility of each drug with others to be administered Expected client response to the taste of each drug Time of day each drug should be administered Need to hold other drugs or foods before or after administration Proper route of administration for each drug
Compatibility of each drug with others to be administered Time of day each drug should be administered Need to hold other drugs or foods before or after administration Proper route of administration for each drug
What characteristics are associated with status epilepticus? Select all that apply. Continued seizure activity for 30 minutes or more Serious condition that may occur during seizure activity Repetitive seizure activity with no return to consciousness between seizures A class of seizures that can result in brain damage Repetitive seizure activity without loss of consciousness
Continued seizure activity for 30 minutes or more Serious condition that may occur during seizure activity Repetitive seizure activity with no return to consciousness between seizures
Which medications become less effective when taken with phenytoin (Dilantin)? Select all that apply. Corticosteroids Oral contraceptives Ibuprofen (Advil) Warfarin sodium (Coumadin Sodium) Aspirin (Bayer)
Corticosteroids Oral contraceptives Warfarin sodium (Coumadin Sodium)
A nurse is preparing to administer medication to an 80-year-old male client with a diagnosis of congestive heart failure. Which lab test result raises concern about the potential for drug toxicity? White blood cells 6,000 mcL (normal: 4,500dash-10,000 mcL) Brain natriuretic peptide (BNP) 120 pg/mL (normal: less than 100 pg/mL) Creatinine clearance 75 mL/min (normal: 97dash-137 mL/min) Hemoglobin (Hgb) 13.6 g/dL (normal: 13.5dash-18 g/dL)
Creatinine clearance 75 mL/min (normal: 97dash-137 mL/min)
The nurse is caring for a pregnant client who has asthma. Which possible change would the nurse expect the health care provider to make to this client's treatment regimen? Discontinue the inhalant. Decrease the inhalant dose. Change the inhalant to a drug administered intravenously. Increase in the inhalant dose.
Decrease the inhalant dose.
What are reasons for changes in a pregnant client's pharmacokinetic response to drugs? Select all that apply. Blood flow through the kidneys decreases. Decreased gastric emptying may occur. The drug metabolism rate increases with physiological changes. Increased estrogen levels affect the stomach's hydrochloric acid production. Plasma proteins are diluted and less able to bind with a drug.
Decreased gastric emptying may occur. The drug metabolism rate increases with physiological changes. Increased estrogen levels affect the stomach's hydrochloric acid production. Plasma proteins are diluted and less able to bind with a drug.
The nurse is administering medications to older adult clients in a long-term care facility. Which does the nurse identify as a physiologic change affecting drug therapy? Select all that apply. Decreased gastric mobility Increased amount of body fat Loss of muscle cells Loss of skin tone and elasticity Less efficient blooddash-brain barrier
Decreased gastric mobility Increased amount of body fat Loss of muscle cells Less efficient blooddash-brain barrier
Identify the drugs class. Instructions: Use the dropdown menus in the left column to select the correct class for each drug in the right column. Valproic acid (Depakene) Clonazepam (Klonopin) Lamotrigine (Lamictal) Ethosuximide (Zarontin) Carbamazepine (Tegretol) Methsuximide (Celontin) Levetiracetam (Keppra) Mephobarbital (Mebaral) Lorazepam (Ativan) Primidone (Mysoline) Diazepam (Valium) Phenobarbital (Luminal)
Hydantoin-Like Medications Benzodiazepines Hydantoin-Like Medications Succinimides Hydantoin-Like Medications Succinimides Hydantoin-Like Medications Barbiturates Benzodiazepines Barbiturates Benzodiazepines Barbiturates
The client tells the nurse that her neurologist recently weaned her off of her antiseizure medication, phenobarbital (Luminal), and prescribed phenytoin (Dilantin). The client indicated that she had been taking phenobarbital for almost 4 years, and her neurologist said the side effects were the reason for this medication switch. The nurse explains that the major side effects of barbiturates include what? Select all that apply. Gingival hyperplasia (swelling of the gums) Blurred vision and rashes Dependence and increased tolerance of drug with continued use, requiring higher doses over time Drowsiness and sedation Slowed heart rate and respirations, and decreased blood pressure
Dependence and increased tolerance of drug with continued use, requiring higher doses over time Drowsiness and sedation Slowed heart rate and respirations, and decreased blood pressure
Which antiseizure drugs, when administered by IV, can be very irritating to veins? Select all that apply. Diazepam (Valium) Methsuximide (Celontin) Ethosuximide (Zarontin) Carbamazepine (Tegretol) Lorazepam (Ativan)
Diazepam (Valium) Lorazepam (Ativan)
The neurologist diagnosed a 23-year-old male client with epilepsy several days ago. At age 20, this client was diagnosed with viral meningitis, which precipitated his seizures. The client tells the nurse that his older sister had one single seizure that lasted for one minute, several years ago, when she was in treatment for alcohol withdrawal. She was given one dose of diazepam (Valium), which stopped the seizure. She has not had any subsequent seizures. The client asks the nurse why his neurologist ordered phenytoin (Dilantin) for his epilepsy instead of diazepam. Which response by the nurse is least complex and still answers the client's question? Diazepam (Valium) is a benzodiazepine that enhances or improves the effects of gamma aminobutyric acid (GABA) in the brain, thereby inhibiting further seizures. Diazepam (Valium) is a benzodiazepine. Benzodiazepines are used to gain short term control of seizure activity rather than long-term treatment of seizures. Phenytoin (Dilantin) acts by desensitizing neurologic channels that are responsible for the seizure activity and disrupting or suppressing that seizure activity. Phenytoin does not have the addictive potential associated with diazepam. Diazepam (Valium) is often ordered to control a one-time seizure event, whereas phenytoin (Dilantin) is one of the most commonly prescribed antiseizure medications for epilepsy.
Diazepam (Valium) is often ordered to control a one-time seizure event, whereas phenytoin (Dilantin) is one of the most commonly prescribed antiseizure medications for epilepsy.
Drugs may pass from the mother to the fetus through various mechanisms. What is the term for a substance moving from an area of higher concentration to one of lower concentration? Active transport Solubility Binding Diffusion
Diffusion
Which instruction should the nurse give to a client who is prescribed carbamazepine (Tegretol) for seizures? The medication should be taken on an empty stomach. Ginkgo will enhance the drug's effect. Alcohol consumption should be limited. Do not take with grapefruit juice or St. John's wort.
Do not take with grapefruit juice or St. John's wort.
The nurse is reviewing the client's chart for information obtained during an initial nursing interview. Which is the most important information for the nurse to report to the health care provider prescribing medications? Health history Vital signs Drug history Nurses' notes
Drug History
The nurse identifies several problems in a client admitted with a diagnosis of pneumonia. Which problem should have top priority? Dysuria Dyspnea Insomnia Nutritional deficiencies
Dyspnea
Identify the drugs class. Instructions: Use the dropdown menus in the left column to select the correct class for each drug in the right column. Valproic acid (Depakene) Clonazepam (Klonopin) Lamotrigine (Lamictal) Ethosuximide (Zarontin) Carbamazepine (Tegretol) Methsuximide (Celontin) Levetiracetam (Keppra) Mephobarbital (Mebaral) Lorazepam (Ativan) Primidone (Mysoline) Diazepam (Valium) Phenobarbital (Luminal)
Hydantoin-Like Medications Benzodiazepines Hydantoin-Like Medications Succinimides Hydantoin-Like Medications Succinimides Hydantoin-Like Medications Barbiturates Benzodiazepines Barbiturates Benzodiazepines Barbiturates
The emergency department (ED) nurse is busy assessing a newly admitted 27-year-old client who was involved in a motor vehicle accident. While in the ED, the client had seizure activity that lasted continuously for 47 minutes, during which she did not regain consciousness. The nurse is aware that this client is in a medical emergency situation and needs what? Click the three Exhibit links below for additional information about the client. EXHIBIT Lab Results LOADING... Admission Note LOADING... EKG LOADING... Emergency management of airway, breathing, and circulation; measurement of glucose, oxygen, and other blood gases Medication for possible head and neck injuries and severe pain Application of a cervical collar to prevent brain and spinal cord injuries and dysfunction Information from any witness who was at the scene of the motor vehicle accident that offers clues to the cause of the seizure activity
Emergency management of airway, breathing, and circulation; measurement of glucose, oxygen, and other blood gases
During which phase of the nursing process is the client's current health status compared with the desired outcome? Diagnosis Planning Implementation Evaluation
Evaluation
The nurse on a medical-surgical unit is busy assessing newly admitted clients. Which client conditions or medical diagnoses indicate that a client may experience a seizure? Select all that apply. Abdominal pain, diarrhea, fever of 100degrees°F (38.1degrees°C), nausea, vomiting, and reduced appetite in an otherwise healthy 24-year-old female Fever of undetermined origin (FUO), 103.5degrees°F (rectal) (40degrees°C), for past 2 hours in a toddler Multiple trauma and a closed head injury as a result of a motor vehicle crash (MVC) Abnormally high glucose level and a 33-year history of type 1 diabetes Meningitis in a 4-year-old child
Fever of undetermined origin (FUO), 103.5degrees°F (rectal) (40degrees°C), for past 2 hours in a toddler Multiple trauma and a closed head injury as a result of a motor vehicle crash (MVC) Abnormally high glucose level and a 33-year history of type 1 diabetes Meningitis in a 4-year-old child
The nurse is reviewing therapeutic options for a client with a seizure disorder who just learned she is pregnant. Teratogenic drugs pose the greatest risk to the fetus during which phase of pregnancy? First and second trimesters Second trimester Second and third trimesters First trimester
First trimester
When educating clients about antiseizure medications, which activities will the nurse teach that will help decrease seizure activity? Select all that apply. Following up with lab work Taking medication at specified times Taking medication consistently Receiving a flu shot Staying with the same drug brand
Following up with lab work Taking medication at specified times Taking medication consistently Staying with the same drug brand
What are possible contraindications for taking herbal supplements? Select all that apply. Food or drug allergies Acupuncture treatment Pregnancy Breastfeeding Prescribed medications
Food or drug allergies Pregnancy Breastfeeding Prescribed medications
The nurse is reviewing the medical records for an older adult woman who has just been admitted to the long-term care facility. Which of the client's over-the-counter medications should be classified as herbal supplements? Select all that apply. Glucosamine Ginkgo biloba Valerian root St. John's wort Feverfew
Ginkgo biloba Valerian root St. John's wort Feverfew
The nurse teaches the client and his wife the adverse effects of and most common problems associated with taking phenytoin (Dilantin) to treat epilepsy. These two common problems are gingival hyperplasia (swelling of the gums) and maintaining therapeutic levels rather than toxic levels of the drug. Which responses include actions that the client needs to take to counteract these problems? Select all that apply. Do not take phenytoin (Dilantin) with grapefruit juice. Have serum phenytoin (Dilantin) levels monitored routinely. Monitor vital signs before and after each dose of phenytoin (Dilantin). Medication must be taken with food. Schedule and keep routine dental examinations and practice good oral hygiene and gum care.
Have serum phenytoin (Dilantin) levels monitored routinely. Schedule and keep routine dental examinations and practice good oral hygiene and gum care.
Your client, Mr. Dan Lee, is a retired older adult who takes multiple medications for multiple health issues, including onset of dementia. He lives with his son and daughter-in-law, who are very supportive. As his nurse, what do you recognize about Mr. Lee? He is a likely candidate for drug noncompliance. He needs to create a daily administration schedule. He should ask his family to monitor his drug compliance. He should be taught the various benefits of drug therapy.
He is a likely candidate for drug noncompliance.
The client tells the nurse that his medication bottle indicates that he is to avoid drinking grapefruit juice with his antiseizure medication, but he does not really understand why. He asks the nurse to explain. Which response by the nurse will best help the client understand why grapefruit juice must be avoided with his antiseizure medication? The grapefruit juicedash-drug interaction can lead to unpredictable and hazardous levels of certain important drugs. If carbamazepine (Tegretol) is taken with grapefruit juice, this combination leads to a significant increase in the concentration of the medication in the bloodstream, which can be toxic and life-threatening. When some medications are taken with grapefruit juice, this combination can cause excessive sedation, low blood pressure, and EKG changes. Taking carbamazepine (Tegretol) with grapefruit juice is contraindicated.
If carbamazepine (Tegretol) is taken with grapefruit juice, this combination leads to a significant increase in the concentration of the medication in the bloodstream, which can be toxic and life-threatening.
What characteristics put infants and young children at a higher risk for drug toxicity? Select all that apply. Immature liver function Immature kidney function Slower rate of gastric emptying A higher proportion of fat to water Strong gastric acids
Immature liver function Immature kidney function Slower rate of gastric emptying
A client being evaluated for an infection informs the nurse that she is concerned about taking any medications because she is in the 18th week of pregnancy. Which physiologic changes must be considered when prescribing medications to this client? Increased levels of hydrochloric acid in the stomach Decreased blood flow to the kidneys Decreased total body water Accelerated gastric emptying
Increased levels of hydrochloric acid in the stomach
A client at your clinic, Jamilla Johnson, has been taking phenobarbitol (Luminal) for her seizure disorder for many years. Which adverse effect(s) should you monitor Ms. Johnson for when she visits the clinic? Cerebrovascular accident and anemia Increased tolerance of drug over time Gingival hyperplasia and plaque buildup Problems falling asleep and sleep apnea
Increased tolerance of drug over time
A client at your clinic, Jamilla Johnson, has been taking phenobarbitol (Luminal) for her seizure disorder for many years. Which adverse effect(s) should you monitor Ms. Johnson for when she visits the clinic? Gingival hyperplasia and plaque buildup Increased tolerance of drug over time Problems falling asleep and sleep apnea Cerebrovascular accident and anemia
Increased tolerance of drug over time
For what condition does a client take the dietary supplements glucosamine and chondroitin? Vision improvement Hypertension Joint pain from arthritis Hyperglycemia
Joint pain from arthritis
Which antiseizure drugs, when administered by IV, can be very irritating to veins? Select all that apply. Lorazepam (Ativan) Methsuximide (Celontin) Carbamazepine (Tegretol) Ethosuximide (Zarontin) Diazepam (Valium)
Lorazepam (Ativan) Diazepam (Valium)
The nurse at a clinic has been asked to review complementary and alternative medicine (CAM) therapies to incorporate into client care. Which is considered CAM? Select all that apply. Massage Aromatherapy Aerobic exercise Yoga Meditation practices
Massage Aromatherapy Yoga Meditation practices
What is the body weight method of pediatric dose calculation based on? A nomogram that plots height and weight Height, weight, and age of the child Milligrams per kilogram of weight, plus a unit of time The child's body surface area (BSA)
Milligrams per kilogram of weight, plus a unit of time
Your client, Ms. Joelle Brewster, is a new mother with a diagnosis of rheumatoid arthritis (RA), who is beginning to breastfeed her son. Her health care provider took her off methotrexate sodium (MTX) during pregnancy and lactation because that drug is in pregnancy category X. For joint swelling and pain, she is currently prescribed small doses of prednisone (Orasone), in pregnancy category C, and acetaminophen (Tylenol), in pregnancy category B. What is the most important thing for you to teach Ms. Brewster to do? Use nipple cream to decrease possible side effects to her son Weigh herself daily at the same time Increase her prednisone (Orasone) incrementally, as needed Observe her son for adverse affects such as diarrhea or constipation
Observe her son for adverse affects such as diarrhea or constipation
The nurse, seeking the fastest and most consistent absorption, would administer drugs by which route to the infant client? Select all that apply. Subcutaneous Oral Intramuscular Transdermal Intravenous (IV)
Oral Transdermal Intravenous (IV)
What factors help determine the health care provider's choice of anticonvulsant for a client with seizures? Select all that apply. Other diseases currently present Clinical manifestations of seizure activity Type of seizure Medical history Current diet
Other diseases currently present Clinical manifestations of seizure activity Type of seizure Medical history
The nurse is preparing to perform discharge teaching to a client being discharged after an appendectomy. Which factor should be considered for the timing of the teaching session? Pain level Cognitive level Client age Language barriers
Pain Level
You are assessing your client, Stuart Silkowski, before administering an antiseizure medication. Mr. Silkowski does not take any other drugs or herbals; however, he does have chronic gingivitis. Which medication should Mr. Silkowski avoid, if possible? Phenobarbital (Luminal) Carbamazepine (Tegretol) Diazepam (Valium) Phenytoin (Dilantin)
Phenytoin (Dilantin)
You are assessing your client, Stuart Silkowski, before administering an antiseizure medication. Mr. Silkowski does not take any other drugs or herbals; however, he does have chronic gingivitis. Which medication should Mr. Silkowski avoid, if possible? Phenytoin (Dilantin) Phenobarbital (Luminal) Carbamazepine (Tegretol) Diazepam (Valium)
Phenytoin (Dilantin)
What type of community health nurse would most likely teach about contraception and sexually transmitted diseases? Select all that apply. Public health nurse Assisted living facility nurse Hospice nurse Home care nurse School nurse
Public health nurse School nurse
What characteristics are associated with status epilepticus? Select all that apply. Repetitive seizure activity with no return to consciousness between seizures Continued seizure activity for 30 minutes or more Serious condition that may occur during seizure activity Repetitive seizure activity without loss of consciousness A class of seizures that can result in brain damage
Repetitive seizure activity with no return to consciousness between seizures Continued seizure activity for 30 minutes or more Serious condition that may occur during seizure activity
The nurse is admitting a new 7-year-old male client with a diagnosis of epilepsy. Which actions by the nurse would be contraindicated? Select all that apply. Protect the child's head during a seizure. Position the client on his side. Restrain the child's arms and legs. Pad the side rails and remove clutter from the bedside. If the child has a seizure, slide a tongue blade or spoon into the child's mouth between the teeth.
Restrain the child's arm and legs. If the child has a seizure, slide a tongue blade or spoon into the child's mouth between the teeth.
The nurse is admitting a new 7-year-old male client with a diagnosis of epilepsy. Which actions by the nurse would be contraindicated? Select all that apply. Protect the child's head during a seizure. Position the client on his side. Restrain the child's arms and legs. Pad the side rails and remove clutter from the bedside. If the child has a seizure, slide a tongue blade or spoon into the child's mouth between the teeth.
Restrain the child's arms and legs. If the child has a seizure, slide a tongue blade or spoon into the child's mouth between the teeth.
The nurse is providing care to a 27-year-old client admitted with epilepsy. A student nurse is also working with this nurse and client. The student nurse is assessing the client prior to administering an antiseizure medication. Which nursing actions are appropriate for this client? Select all that apply. Give all medications via intravenous access (IV). Review the medication orders and clarify any orders that are not clear. Correctly identify the client using at least two sources of identification. Assess for any drug allergies. Teach the client to ask for help with ambulation to prevent a fall or injury.
Review the medication orders and clarify any orders that are not clear. Correctly identify the client using at least two sources of identification. Assess for any drug allergies. Teach the client to ask for help with ambulation to prevent a fall or injury.
As the nurse, what advice should you give to older adult clients who have been approved to take herbal or dietary supplements? Start with the smallest possible dose. Start with the recommended dose on the label. Ask the health food store manager about dosage. Increase the dose slowly, every other week.
Start with the smallest possible dose.
When educating clients about antiseizure medications, which activities will the nurse teach that will help decrease seizure activity? Select all that apply. Receiving a flu shot Taking medication consistently Staying with the same drug brand Following up with lab work Taking medication at specified times
Taking medication consistently Staying with the same drug brand Following up with lab work Taking medication at specified times
Identify the category of seizures based on the clinical manifestation. Instructions: Use the dropdown menus in the left column to select the correct category for each manifestation in the right column. Shallow or absent respirations Client may appear clumsy Found most often in children Brief loss of motor control Called grand mal Client may fall for no reason Characterized by staring Loss of consciousness Called petit mal
Tonic-Clonic Seizures Atonic Seizures Absence Seizures Atonic Seizures Tonic-Clonic Seizures Atonic Seizures Absence Seizures Tonic-Clonic Seizures Absence Seizures
Identify the category of seizures based on the clinical manifestation. Instructions: Use the dropdown menus in the left column to select the correct category for each manifestation in the right column. Shallow or absent respirations Client may appear clumsy Found most often in children Brief loss of motor control Called grand mal Client may fall for no reason Characterized by staring Loss of consciousness Called petit mal
Tonic-Clonic Seizures Atonic Seizures Absence Seizures Atonic Seizures Tonic-Clonic Seizures Atonic Seizures Absence Seizures Tonic-Clonic Seizures Absence Seizures
The nurse is reviewing the drugs taken by clients at an extended care facility for combination risks between herbal drugs and prescription medications. Clients taking which drug should have their histories reviewed first? Ibuprofen (Advil) Diphenhydramine (Benadryl) Cephalexin (Keflex) Warfarin (Coumadin)
Warfarin (Coumadin)
Which medications become less effective when taken with phenytoin (Dilantin)? Select all that apply. Aspirin (Bayer) Ibuprofen (Advil) Warfarin sodium (Coumadin Sodium) Corticosteroids Oral contraceptives
Warfarin sodium (Coumadin Sodium) Corticosteroids Oral contraceptives
The pediatric nurse is studying pharmacokinetics of drugs in children. Which factors are recognized as increasing drug toxicity in children? Select all that apply. Weak acids in the gastrointestinal (GI) tract Low water relative to body weight in the newborn Immature kidney function in the child Highly developed blooddash-brain barrier in the newborn Prolonged half-life
Weak acids in the gastrointestinal (GI) tract Immature kidney function in the child Prolonged half-life
Based on FDA guidelines, which category or categories of drugs should be avoided during pregnancy because evidence shows risk of fetal abnormalities and birth defects? Select all that apply. A B C X D
X D
Your client, Dionne Washington, has type 1 diabetes. She is taking insulin and eats a restricted diet. While completing a health history, you learn that Ms. Washington has successfully used meditation to lower her stress/anxiety levels. Now she is interested in trying some herbal supplements. She asks, "They are natural, so they must be okay, right?" How should you best respond to Ms. Washington? "Type 2 diabetics are at greater risk for negative effects from herbals than type 1." "I agree that natural supplements are safer than chemical ones." "Natural does not automatically mean safe, especially when combined with insulin." "You can try herbal products if you have no food or drug allergies."
"Natural does not automatically mean safe, especially when combined with insulin."
The nurse is performing discharge teaching for an older adult client with arteriosclerotic heart disease (ASD), hyperlipidemia, and type 2 diabetes mellitus. The client asks the nurse, "Why do I have to take fish oil?" Which is the nurse's most appropriate response? "The fish oil is prescribed for arthritis." "Fish oil has been shown to prevent the common cold." "The use of fish oil can control your blood sugar." "The fish oil can be used to decrease your cholesterol level."
"The fish oil can be used to decrease your cholesterol level."