Pharmacological therapies
The nurse is caring for a client receiving a nitroglycerin infusion for a myocardial infarction. When titrating this infusion, for which adverse effect should the nurse monitor? Confusion Hypotension Diaphoresis Tachycardia
Hypotension The nurse should monitor for hypotension, as nitroglycerin is a potent vasodilator. Often upward titration is limited by blood pressure. Tachycardia and diaphoresis may be present in this cardiac client, but these symptoms would not be caused by the medication. Confusion would not be an adverse reaction to nitroglycerin but would be an ominous finding of declining condition in this client
The nurse should inform a client taking carbamazepine that it can affect other medications in which way? It decreases the effects of oral anticoagulants. It decreases the serum concentration of verapamil. It increases the serum concentration of other anticonvulsants. It increases the effects of oral contraceptives
It decreases the effects of oral anticoagulants. The nurse should inform the client that carbamazepine can decrease the effects of oral anticoagulants. Carbamazepine can increase the serum concentration of verapamil and can decrease the serum concentration of other anticonvulsants and the effects of oral contraceptives.
The clinic nurse is teaching caregivers of a 6-year-old client how to administer eye drops for bacterial conjunctivitis. Which will the nurse include in the plan of care? Select all that apply. Remove any drainage from the eye prior to administration of the eye drops. Position the client in a prone position with eyes closed. After administration of the eye drops, keep the eye lid closed for several seconds. Administer eye drops after the eye drops have been refrigerated overnight. Encourage the client to rub the eyes after eye drops are administered.
Remove any drainage from the eye prior to administration of the eye drops. After administration of the eye drops, keep the eye lid closed for several seconds
The client has just undergone abdominal surgery and returned from the post-anesthesia care unit (PACU) with a patient-controlled analgesia (PCA) pump. Which interventions should the nurse implement? Select all that apply. Administer a bolus of pain medication. Check the patient-controlled analgesia (PCA) settings with another nurse. Tell the client to push the button when in pain. Change the patient-controlled analgesia (PCA) cartridge. Assess the IV insertion site.
Tell the client to push the button when in pain. Check the patient-controlled analgesia (PCA) settings with another nurse. Assess the IV insertion site.
An adolescent is brought to the emergency department (ED) after accidentally taking an overdose of heroin. The adolescent is semiconscious, unable to respond appropriately to questions, slurs words, and has constricted pupils; the client's vital signs are blood pressure 60/50 mm Hg, pulse 50 beats/min, and respirations 8 breaths/min. Naloxone is administered to temporarily reverse the effects of the heroin. Which finding would first indicate that the naloxone administration has been effective? The client's memory and attention become normal. The client's respirations improve to 12/min. The client becomes talkative and physically active. The client's blood opiate level drops to a nontoxic level.
The client's respirations improve to 12/min.
Which assessment findings indicates that epoetin alfa is having a therapeutic effect? neutrophil count 8.0 × 109/L hemoglobin 12 g/dL platelet count 150 × 109/L white blood cell count 7.0 × 109/L
hemoglobin 12 g/dL Epoetin alfa is a colony-stimulating factor used help boost red blood cell count. Indications for use are a hemoglobin level < 10 g/dL. It will not improve white blood cells or components (neutrophils) or platelet counts.
The health care provider (HCP) has prescribed nitroglycerin to a client with angina. The client also has closed-angle glaucoma. The nurse should contact the HCP to discuss the potential for which drug interaction? decreased intraocular pressure increased intraocular pressure hypotension hypertension
increased intraocular pressure Nitroglycerin causes vasodilation, which results in increased intraocular pressure. The vasodilatory effects of the medication can trigger an attack, causing pain and loss of vision. Hypotension is a common side effect of nitroglycerin, which dilates the blood vessels but is not a concern in the client with glaucoma.
An older adult is receiving morphine to manage pain after abdominal surgery. The nurse should observe the client for which side effect of this drug? respiratory depression constipation seizures dysrhythmias
respiratory depression
The nurse works in the emergency department (ED) and is caring for a client diagnosed with a pulmonary embolus (PE). Which medication would the nurse anticipate the healthcare provider to order for a PE? streptokinase heparin sodium vitamin K warfarin sodium
streptokinase
Which finding is the best indication that fluid replacement for the client in hypovolemic shock is adequate? diastolic blood pressure greater than 90 mm Hg respiratory rate of 20 breaths/minute urine output greater than 30 ml/hour systolic blood pressure greater than 110 mm Hg
urine output greater than 30 ml/hour Urine output provides the most sensitive indication of the client's response to therapy for hypovolemic shock. Urine output should be consistently greater than 35 mL/h. Blood pressure is a more accurate reflection of the adequacy of vasoconstriction than of tissue perfusion. Respiratory rate is not a sensitive indicator of fluid balance in the client recovering from hypovolemic shock.