renal medication questions

Laboratory analysis of urine for culture and sensitivity reveals a gram-negative bacterial infection. Nalidixic acid (NegGram) is prescribed for the client. The nurse questions the prescription if the client has which of the following disorders? 1. Seizure disorder 2. Diabetes mellitus 3. Peptic ulcer disease 4. Coronary artery disease

1. Nalidixic acid (NegGram) is contraindicated in seizure patients. Other caution use are in liver and renal disorder patients. Nalidix acid (NegGram) is to treat UTI, acute and chronic, especially gram negative bacteria.

A client with chronic renal failure (CRF) is receiving epoetin alfa (Epogen). The nuse is reviewing the laboratory results and notes that which of the following results indicates a therapeutic effect of the medication? 1. Hematocrit level, 32% 2. Platelet count, 4000,000 cells/mm3 3. White blood cell (WBC) count, 6000/mm3 4. Blood urea nitrogen (BUN) level, 15 mg/dL

1. normal hematocrit: 30%-33% epoetin is used to reverse anemia associated with CRF.

Cinoxacin (Cinobac), a urinary antiseptic, is prescribed for the client. The nurse reviews the client's medical record and would contact the physician regarding which documented finding to veify the prescription? 1. Client's history: renal insufficiency 2. Medication history: Folic acid (vitamin B6) 0.5 mg orally daily 3. Diagnostic test result : chest x-ray normal 4. Laboratory test results: blood glucose 102 mg/dL

1. Cinoxacin (Cinobac) may be toxic in patients with renal insufficiency. Cinoxacin could accumulate and be toxic. Therefore, the dosage of Cinoxacin (Cinobac) should be reduced. verify with the physcian about the client history of renal insufficiency.

Bathanechol chloride (Urecholin) is prscribed for the client with urinary retention. The nurse reviews the client's record, knowing that which of the following preexisting disorders would be a contraindication to the administration of this medication? 1. Gastric atony 2. Urinary strictures 3. Neurogenic atony 4. Gastroesophageal reflux

2. Urecholin works by contracts the bladdor and helps to empty the bladder. If the patient has urinary tract obstruction or weakness of the bladder wall, the drug could elevate the pressure of the urinary tract and possibly causes rupturing.

A client receiving nitrofurantoin (Macrodantin) calls the physician's office complaining of side effects related to the medication. Which side effect indicates the need to stop treatment with this medication? 1. Nausea 2. Diarhea 3. Anorexia 4. Cough and chest pain

4. stop nitrofurantoin (Macrodantin) when pulmonary adverse effects occur: dyspnea, chest pain, chill, fever, cough, and the presence of alveolar infiltrates on the x-ray. Above symptoms usually disappear in 2 to 4 days following discontinuation. GI adverse effects of this medication, frequently, could be alleviated by admnistering with milk or a meal. nitrofurantoin (Macrodantin) is an antibiotic for UTI.

Mycophenolate mofetil (CellCept) is prescribed for a client as prophylaxis for organ rejection following allogneic renal transplant. Which of the following instructions dose the nurse provide regarding administration of this medication? 1. Administer following meals 2. Contact the physician if a sore throat occurs 3. Take the medication with a magnesium type antacid 4. Open the capsule and mix with food for administration

2. Mycophenolate mofetil (CellCept) suppresses B cells and T cells. It is always used with cyclosporin and glucocorticoid. This increases the risk of infection and malignancy. adverse effect: severe neutropenia, sepsis, n/v, diarrhea. administer on an empty stomach meganesium and antiacid reduces its effect contact the physician for unusual bleeding, bruising, sore throat, mouth sore, abdominal pain, fever.

A nurse is monitoring a client receiving cyclosporine (Sandimmune). Which of the following indicates to the nurse that the client is experiencing an adverse effect from this medication? 1. Nausea 2. Tremor 3. Alopecia 4. Hypotension

2. the most common adverse effects of cyclosporine are nephrotoxicity, hypertension, tremor, infection, hircutism (reversible). Out of these, the most serious are nephrotoxicity and infection.

A nurse is reviewing the laboratory results documented in the record of a client receiving tacrolimus (Prograf). Which of the following indicates to the nurse that the client is experiencing an adverse effect of the medication? 1. Potassium level, 3.8 mEq/L 2. Blood glucose level, 200 mg/dL 3. Platelet count, 300,000 cells/mm3 4. White blood cell (WBC) count, 6,000/mm3

2. most common adverse effect of tacrolimus (Prograf) is nephrotoxicity. Other adverse effects are neurotoxicity (It's signs and symptoms are: headache, tremor, insomnia); GI effects (vomitting, nausea, diarrhea); hypertension; hyperkalemia; hyperglycemia. * tacrolimus (Prograf): an immunosuppressant for preventing organ rejection.

A nurse is administering 5 mg of bethamechol chloride (Urecholine) subcutaneously to a client with urinary retention. Which of the following would the nurse prepare to have readily available when administering this medication? 1. Vitamin K 2. Mucomyst 3. Atropine sulfate 4. Protamine sulfate

3. antidote of this medication: atropine sulfate. ethamechol chloride (Urecholine) is a cholinergic agent. It helps by helping the bladder to squeeze better and to empty and bladder. administered subcutaneously or IV.

A nurse is provding dietary instructions to a client who has been prescribed cyclosporine (Sandimmune). Which of the following food items would the nurse instruct the client to avoid? 1. Red meats 2. Orange juice 3. Grapefruit juice 4. Green leeafy vegetables

3. grapefruit juice increases the toxicity of cyclosporine. grapefruit juice inhibits metabolism of cyclosporine; therefore, increases the toxicity of the drug by 50% to 100%.

Trimethoprim-sulfamethoxazole (Bactrim) is prescribed for the client. The nurse tells the client to report which of the following symptoms if it develops during the course of this medication therapy? 1. Nausea 2. Diarrhea 3. Headache 4. Sore throat

4. Bactrim may cause blood disorder. Report s/s of blood disorders. the signs include: sore throat, fever, or pallor. Bactrim is use to treat UTI, ear infection, bronchitis, diarrhea, pneumonia, shigellosis

A nurse is monitoring the client receiving epoetin alfa (Epogen) for adverse effects of the medication. The nurse notes that whic of teh follwing indicates an adverse effect? 1. Depression 2. Bradycardia 3. Hypotension 4. Hypertension

4. Epoetin causes a sense of well being, a positive effect For adverse effects, the most common adverse effect is hypertension; ocassionally tachycardia. The drug effects start in 1 to 2 weeks; It bring the hematocrit to normal (30%-33%) in 2 to 3 months.

Phenazopyridine hydrochloride (Pyridium) is prescribed for the client for symptomatic relief of pain resulting from a lower urinary tract infection (UTI). The nurse tells the client: 1. To take the medication on an empty stomach 2. To discontinue the meidcation if a headache occurs 3. To take the medication at bedtime on an empty stomach 4. That a reddish-orange discoloration of the urine may occur

4. Pyridium usually causes a reddish-orange discoloration of the urine. This discoloration stains fabric. take after meal to reduce GI irritation ocassion side effect: headache (does not warrant discontiuation of the medicine)

Following kidney transplant, cyclosporine (Sandimmune) is prescribed for the client. Which of the following laboratory results indicates an adverse effect from the use of this medication? 1. Decreased creatinine level 2. Decreased hemoglobin level 3. Decreased white blood cell (WBC) count 4. Elevated blood urea nitrogen (BUN) count

4. nephrotoxicity can occur from teh use of cyclosporine. Nephrotoxicity is evaluated by monitoring for elevated BUN and serum creatinine levels. Cyclosporine does not depress the bone marrow.

Oxybutynin chloride (Ditropan) is prescribed forthe client with neurogenic bladder. The nurse monitors the client, knowing that which of the following would indicate a possible toxic effect related to this medication? 1. pallor 2. Drowsiness 3. Bradycardia 4. Restlessness

4. the toxicity produces central neuvous system excitation, such as nervousness, restlessness, hallucinations, and irritability. other signs: hypotension/hypertension, confusion, tachycardia, flushed or red face, and signs of respiratory depression. Drowsiness is a side effect of the medication, does not indicate toxicity