Chapter 3: Toxic Effects of Drugs

The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize?

asking the client what the response is to taking NSAIDs

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?

discontinue the drug immediately as ordered

The pharmacology instructor explains to the students that adverse effects can be extensions of:

primary action of a drug

The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath, and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action?

protecting and maintaining the client's patency of the airway

The nurse administers an anticholinergic medication to the client. When assessing this client, what finding should the nurse interpret as a secondary effect of the drug?

urinary hesitancy

The nurse is assessing a community-dwelling client with a history of rheumatoid arthritis. During the interview, the client states, "The last few months, I have this ringing in my ears that I just cannot seem to get away from." What assessment question should the nurse ask?

"Have you been taking aspirin on a regular basis"

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other ways for sexual expression"

The nurse should consider teratogenic effects when caring for what clients? (Select all that apply.)

-a 29 yo client receiving prenatal care in her first trimester -a 37 yo client receiving fertility drugs

A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize:

BUN and creatinine levels

What can the tissue damage noted as an adverse effect of antirheumatoid drugs include? (Select all that apply.)

GI motility super infections skin problems hypoglycemia

All drugs have adverse reactions when taken. Organ and tissue damage is one such adverse reaction. Which is an example of organ and tissue damage caused by a drug?

Stevens-Johnson's Syndrome (a rare and serious disorder affects skin and mucus membranes

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

a 20 yo female who has been diagnosed with a chlamydial infection

The most serious allergic response is called anaphylaxis. Which clients exhibit possible symptoms of anaphylaxis? (Select all that apply.)

a client showing signs of acute respiratory distress a client marked with hypotension and experiences convulsions a client with laryngeal edema, pale, cool skin

The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration?

adverse effects

Upon assessment after giving oral penicillin, the nurse notes that a client has dilated pupils, increased blood pressure, and increased heart rate. The nurse would document these findings as which type of drug allergic reaction?

anaphylactic

The nurse is caring for a client with a drug allergy and understands the allergy is the result of the client developing:

antibodies

Preoperative atropine belongs to what classification of drugs?

anticholinergic

The nurse is assessing a client for anticholinergic effects of a prescribed drug. What assessments should the nurse perform? (Select all that apply.)

assess moisture level of client's skin assess the client's recent bowel pattern assess the client's visual acuity

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects?

be sure to drink plenty of fluids to prevent dehydration

For several days, a client with hypertension has been inadvertently taking an excessive dose of spironolactone, a potassium-sparing diuretic. The client has presented to the emergency department with signs and symptoms that suggest hyperkalemia. What assessment should the nurse prioritize?

cardiac monitoring

A client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a:

contraindication for the use of certain medications

A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could:

damage to the immature nervous system of the fetus

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include?

drugs can causes unexpected or unacceptable reactions despite screening and testing

A client diagnosed with cancer has been receiving antineoplastics for several weeks. What assessment finding should the nurse interpret as a possible indication of blood dyscrasia?

hemoglobin of 6.0g/dL (60.0g/L)

What does the nurse need to do when there is any indication of an allergic reaction in clients?

maintain the clients safety during drug therapy

A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety?

measures to alleviate any discomfort associated with adverse effects

A client develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

monitor laboratory blood values

A client is receiving an antineoplastic medication for treatment of breast cancer and begins having tonic-clonic seizure activity. What type of toxicity does the nurse recognize that this client is experiencing?

neurotoxicity

The nurse is reviewing the laboratory test results of a client receiving drug therapy. What would the nurse suspect if the results reveal an elevation in the blood urea nitrogen level and creatinine concentration?

renal injury

A client with hypertension has been taking spironolactone, a potassium-sparing diuretic, 75 mg PO daily for several weeks. What assessment findings should prompt the nurse to suspect hyperkalemia? (Select all that apply.)

reports thigh and calf cramps HR of 58 bpm BP 88/63mmHg Urine output 375mL over the past 24 hours

A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan?

safety measures

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of:

secondary actions (effects that happen besides the desired effect)

Which skin condition would be most likely to cause increased systemic absorption of a topical medication?

severe sunburn

A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client?

techniques for providing safe and effective mouth care

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?

the man may be experiencing nephrotoxic effects of aspirin

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?

this may be coincidental, and the memory loss may be attributed to changes in aging

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity?

a decrease in urine output

A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize?

provide supportive care to manage fever and inflammation

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?

decreased glomerular filtration rate

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?

toxicity

A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client?

ototoxicity from the ibuprofen

What client is experiencing an adverse effect that is a result of primary action?

a client taking anticoagulants who develops a GI bleed