Pharm Capstone questions

2. A nurse is preparing to administer a topoisonmerase inhibitor to a client with ovarian cancer. What are adverse effects the nurse should monitor when administering this medication?

• Bone Marrow Suppression: low WBC count or neutropenia, bleeding caused by thrombocytopenia, or low platelet count. This can happen up to 6 weeks after infusion. • Nausea and vomiting: The pt can be given ondasetron with dexamethasone, grainsetron or metoclopramide prior to starting chemotherapy. • Alopecia/ hair loss: this can occur 7-10 days after beginning TX and will last for up to 2 months after last administration.

1. A nurse is administering vancomycin to a client who develops an infusion reaction (red man syndrome). What action by the nurse could have prevented this reaction?

• First, this medication should be administered over 60 minutes or 1 hour. • If the Pt begins to get a reaction the infusion should be stopped immediately. If it is a mild reaction the pt can be given supportive care with Diphenhydramine and H2 antihistamines. Usually the reaction will resolve in 30 min and then the Vancomycin can be started again. If the reaction is moderate too severe as noted by clinical symptoms. Then the pt will need the above med's with a NS bolus for hypotension. When the pt is given Vancomycin again they will be premedicated and the infusion will be given over 4 hours. For a severe anaphylactic reaction the pt will need epinephrine and receive advanced emergency care. • Pt.'s can be pretreated with diphhydramine and Zantac. It's also best practice for the pt not to receive vancomycin at an infusion rate > 10mg/min.

3. A nurse is preparing to administer codeine cough syrup to a client. What are three (3) contraindications for this medication?

• Respiratory depression. • Acute asthma • Head trauma. • Liver Dysfunction • Renal Dysfunction • Acute alcohol use disorder.