Pharm Cards

Bone marrow suppression results in

reduced number of circulating white and red blood cells, as well as platelets (thrombocytopenia)

A child with nephrotic syndrome has been receiving prednisone for 1 week. Which information in the child's record indicates to the nurse that the medication has been effective? Select all that apply. One, some, or all responses may be correct. Increased urine output Weight loss Lower blood pH Reduction of lethargy Decreased blood pressure Elevated activity level Normalized lipids Enhanced appetite

Increased urine output Weight loss Reduction of lethargy Elevated activity level Normalized lipids Enhanced appetite Children with nephrotic syndrome are grossly edematous. Those who have the steroid-sensitive form of nephrotic syndrome respond to corticosteroids with diuresis within 7 to 21 days after therapy is started, and the edematous weight is lost. Once the child feels better, lethargy decreases, and the activity level increases. Nephrotic syndrome causes the liver to produce large amounts of cholesterol, effective treatment results in normalization of lipid levels. The loss of appetite associated with nephrotic syndrome should resolve with adequate treatment. Steroid therapy does not affect the blood pH. There is no increase in the blood pressure of a child with nephrotic syndrome and no change in blood pressure when the child improves.

The nurse is caring for an 8-year-old child with acute poststreptococcal glomerulonephritis (APSGN). Which medication would the nurse anticipate incorporating into the plan of care? Select all that apply. One, some, or all responses may be correct. Penicillin Morphine Ibuprofen Docusate Labetalol Furosemide Loperamide Midodrine

Labetalol Furosemide The child with APSGN is hypertensive; antihypertensives, such as labetalol, are used to reduce the blood pressure. The child is oliguric; diuretics, such as furosemide, are used to increase urine output. APSGN is a post-infection complication, the causative infection has already been treated, likely with penicillin, and no further antibiotic therapy is warranted. Pain is not an expected clinical manifestation of APSGN in children; therefore, morphine or ibuprofen would not be needed. Gastrointestinal manifestations are not noted to be associated with APSGN, therefore the client would not need to be treated with docusate for constipation or loperamide for diarrhea. Midodrine is used to treat hypotension and its related symptoms, it would not be used in a hypertensive client.

Expected Effect of improved cardiac output

Increased urine output

A client with hypertension is prescribed an angiotensin II receptor blocker (ARB). Which instruction will the nurse provide about this medication? Select all that apply. One, some, or all responses may be correct. "Monitor the blood pressure often." "Discontinue treatment if a cough develops." "Stop the medication if swelling of the mouth, lips, or face develops." "Have blood drawn for potassium levels 2 weeks after starting the medication." "Do not take nonsteroidal anti-inflammatory drugs (NSAIDs) concurrently with this medication." "Notify other prescribers of new ARB prescription." "Report lightheadedness or dizziness upon standing to the provider." "Serum levels will be drawn at least once a month to ensure therapeutic levels."

"Monitor the blood pressure often." "Stop the medication if swelling of the mouth, lips, or face develops." "Have blood drawn for potassium levels 2 weeks after starting the medication."

A client receiving chemotherapy develops bone marrow suppression. The nurse will monitor for which thrombocytopenic effect? Select all that apply. One, some, or all responses may be correct. Fatigue Pale skin Deep vein thrombosis Dizziness Melena Purpura Emboli Hematuria

Melena, Purpura, Hematuria Black tarry feces caused by the action of intestinal secretions on blood are associated with bleeding in the gastrointestinal tract; bleeding is related to a reduced number of thrombocytes. hemorrhages into the skin and mucous membranes (purpura) may occur with reduced numbers of thrombocytes, which are part of the coagulation process. Blood in the urine (hematuria) may occur with a reduced number of thrombocytes, which are part of the coagulation process.

A child undergoing prolonged steroid therapy takes on a cushingoid appearance. The nurse would expect to find which manifestation during further assessment? Select all that apply. One, some, or all responses may be correct.

Obesity Truncal Obesity Thin extremities Bruising Obesity is a presenting symptom in the majority of pediatric clients with Cushing Syndrome. An increase in appetite results in deposition of fat on the abdomen and trunk. Muscle wasting results in thin extremities. Increased excretion of calcium causes retardation of linear growth and a resulting short stature. Because of the excess production of androgens, virilization and hirsutism occur. Increased salt and water retention cause hypertension and hypernatremia. The thin fragile skin of Cushing Syndrome presents with easy bruising and purple striae.

Which newborn characteristic associated with renal excretion will the nurse consider to ensure safe medication administration? Select all that apply. One, some, or all responses may be correct. Reduced bladder capacity Renal blood flow Nephron location Immature metabolizing Glomerular filtration rate Incomplete tubular development Decreased plasma proteins Increased total body water

Renal blood flow, Glomerular filtration rate, Incomplete tubular development In a newborn, medications are excreted more slowly due to the kidneys having a higher resistance to blood flow. The glomerular filtration rate is reduced, partially because of incomplete glomerular and tubular development of the kidneys, which also reduces the newborn's ability to excrete medications. Bladder capacity is not associated with the reduction of renal excretion in newborns. The nephron is a structural and functional unit of the kidneys. Immature metabolizing enzymes in the liver, not the kidneys, can delay medication excretion. Regarding distribution of medications in the newborn, decreased plasma proteins available to bind with the drug contribute to the medication staying in the body longer. The total body water content of a newborn compared to an adult, 80% and 50% respectively, attribute to increased distribution of water-soluble medications.

Digoxin toxicity s/s

confusion, headache, nausea, bradycardia, visual disturbances (blurred vision or yellow vision), and dizziness (ECG) findings may include heart block, atrial tachycardia with block, or ventricular dysrhythmias, all causing an irregular pulse