chp.3 pharm

a client is experiencing a serum sickness reaction to a recent rubella vaccination. what interventions would be appropriate when caring for this client?

1. cool environment 2. positioning to provide comfort 3. ice to joints as needed 4. administration of anti-inflammatory agents

what would the nurse expect to assess in a patient experiencing an anaphylactic reaction?

1. dilated pupils 2. feeling of panic 3. difficulty breathing

a patient is taking a drug that is known to be toxic to the liver. the patient is being discharged to home. what teaching points related to liver toxicity and the drug should the nurse teach the patient to report to the physician?

1. fever, changes in the color of urine 2. changes in the color of stool; malaise 3. yellowing of the skin or the whites of the eyes

a client is experiencing a reaction to the penicillin injection that the nurse administered approx. 1/2 hr ago. the nurse is concerned that it might be an anaphylactic reaction. what signs and symptoms would validate her suspicion?

1. rapid heart rate 2. diaphoresis 3. rash 4. client report of a panic feeling

what would lead the nurse to suspect that a patient has developed blood dyscrasia related to drug therapy?

1. thrombocy 2.anemia 3.sore throat

pregnant women should be advised of the potential risks to the fetus any time they take a drug during pregnancy. what fetal problems can related to drug exposure in utero?

1.fetal death 2. nervous system disruption 3. skeletal and limb abnormalities 4. cardiac defects 5. low-set ears 6. deafiness

what is an example of a secondary action?

an antihistamine causes the patient to experience drowsiness

the nurse would assess a patient receiving what medication for possible superinfection?

antibiotics

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

be sure to drink plenty of fluids to prevent dehydration

patients receiving antineoplastic drugs that disrupt cell function often have adverse effects involving cells that turn over rapidly in the body. these cells include?

bone marrow cells

an example of a drug allergy is?

breathing difficulty after an injection of penicillin

blood dyscrasia

cell death in cells produced in the bone marrow - low platelet count, low white blood cell count

a patient is receiving a drug to lower his blood glucose level. what would lead the nurse to suspect that his blood glucose level was too low?

cold, clammy skin

a patient develops a cytotoxic reaction to a drug. what would the nurse expect to do?

discontinue the drug immediately as ordered

an instructor is preparing a class that describes the toxic effects of drugs. what would the instructor expect to include?

drugs cause unexpected or unacceptable reactions despite screening and testing

when assessing a patient who has developed a serum sickness reaction, what would the nurse expect to find?

facial edema

a patient develops stomatitis from drug therapy. what measure would be most appropriate for the nurse to suggest?

frequent rinsing with cool liquids

hyperglycemia

high blood glucose -Fatigue, increased urination, increased thirst, increased hunger, hot or flushed skin, fruity breath

hyperkalemia

high serum potassium levels -weakness, diarrhea, cardiac arrhythmias

what would the nurse expect to assess if a patient develops neuroleptic malignant syndrome?

hypertension

a patient taking glyburide (an antidiabetic drug) has his morning dose and then does not have a chance to eat for several hours. an adverse effect that might be expected from this would be?

hypoglycemia

superinfections

infections caused by organisms that are usually controlled by the body's normal flora -fever, diarrhea, black hairy tongue, vaginal discharge

hypoglycemia

low blood glucose -Fatigue, drowsiness, hunger, anxiety, headache, cold, clammy skin, shaking, confusion

drug allergy

occurs when the body forms antibodies to a drug, causing an immune response when the person is re-exposed to the drug

examples of dermatological reactions are?

rash (steven-johnson syndrome) stomatitis

cytotoxic reaction

reaction involving antibodies circulating in the blood and attacking antigens on cell sites, causing cell death -few days later, not immediate

serum sickness reaction

reaction involving antibodies circulating in the blood and causing damage to tissues via deposition in blood vessels -1 WEEK OR MORE LATER

delayed allergic reaction

reaction involving antibodies that are bound to specific white blood cells -SEVERAL HOURS AFTER, USUALLY SAME DAY

anaphylactic reaction

reaction involving antibody with specific sites in the body causing the release of chemicals to produce an IMMEDIATE REACTION

the nurse is reviewing the lab test results of a patient 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 patient with a severe infection is given gentamicin, the only antibiotic shown to be effective in culture and sensitivity tests. a few hours after the drug is started IV, the patient becomes very restless and develops edema. blood tests reveal abnormal electrolytes and elevated blood urea nitrogen. this reaction was most likely caused by?

renal toxicity associated with gentamicin

when instructing a patient who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of?

secondary actions

a woman has had repeated bouts of bronchitis through-out the fall and has been taking antibiotics. she calls the clinic with complaints of vaginal pain and itching. when she is seen, it is discovered that she has developed a yeast infection. you would explain to her that?

she has developed a superinfection b/c the antibiotics kill bacteria that normally provide protection

what would the nurse expect the physician to order for a patient with a delayed allergic reaction?

topical corticosteroid

knowing that a patient is taking a loop diuretic and is at risk for developing hypokalemia, the nurse would assess the patient for?

weak pulse, low blood pressure, and muscle cramping * low serum potassium levels