chpts 13-17 pharm
While obtaining a patient history, the nurse notes that the patient has been prescribed ethosuximide (Zarontin). The nurse suspects that the patient has which type of seizure?
Absence
Which statement by the patient indicates the need for additional teaching on phenothiazine (Thorazine) drug therapy?
"It is okay to take this drug with a small glass of wine to help relax me."
The patient asks the nurse to explain the difference between carbidopa-levodopa (Sinemet) and ropinirole (Requip). How will the nurse respond?
"Ropinirole is a dopamine agonist that has fewer adverse effects than carbidopa-levodopa."
A patient with Parkinson's disease who has been positively responding to carbidopa-levodopa (Sinemet) asks the nurse, "Why have I suddenly developed a relapse of my symptoms." Which explanation by the nurse is appropriate?
"This is called the "on-off phenomenon." Your health care provider can change your medication regimen to help manage this effect."
A patient receiving phenytoin (Dilantin) has a serum drug level drawn. Which level will the nurse note as therapeutic?
12 mcg/mL
The nurse is providing care for a neonate diagnosed with apnea of prematurity. The prescription by the health care provider is for caffeine citrate intravenously 5 mg/kg once daily. The infant's weight is 5.4 lb. What is the correct dosage to administer to the patient?
12.3 mg
The nurse is educating a group of college students about substance abuse. When discussing the potential use and abuse of stimulants, the nurse is aware these drugs are commonly abused and cause what signs and symptoms? (Select all that apply.)
Weight loss Elevated mood Increased alertness
A child is prescribed methylphenidate (Ritalin) to treat attention deficit hyperactivity disorder (ADHD). The parent expresses concern about using a controlled substance to treat ADHD and asks the nurse about using a noncontrolled substance. The nurse knows ADHD can be treated with which noncontrolled substance?
Atomoxetine (Strattera)
A patient with a diagnosis of depression is being discharged with a prescription for an MAOI. Which instruction should the nurse include for this medication?
Avoid eating aged cheese
The nurse is providing care to a patient with a diagnosis of an overdose. The health care provider prescribes flumazenil (Romazicon) for the patient. What type of overdose does the nurse suspect?
Benzodiazepines
When doing an admission drug history, the nurse notes that the patient has a prescription for lithium (Lithobid). The nurse suspects that this patient has been diagnosed with which condition?
Bipolar disorder
Selective serotonin reuptake inhibitors (SSRIs) and tricyclic antidepressants (TCAs) both function by which mechanism?
Block the reuptake of neurotransmitters at nerve endings
A patient prescribed lorazepam (Ativan) for the treatment of anxiety states, "I feel drowsy all the time, and it's interfering with every aspect of my life." The nurse knows that a better drug therapy option for this patient is which anxiolytic medication?
Buspirone (BuSpar)
A patient diagnosed with narcolepsy is prescribed a central nervous system (CNS) stimulant. Which statement best describes the action of CNS stimulants?
CNS stimulants increase release of and block reuptake of neurotransmitters.
When teaching a patient about carbidopa-levodopa (Sinemet), what information should the nurse include about this medication?
Carbidopa decreases levodopa's conversion in the periphery, increasing the levodopa available to cross the blood-brain barrier.
The nurse explains to a patient that using caffeine may exacerbate which health condition?
Cardiac dysrhythmias
The nurse is providing care for a patient with a diagnosis of Parkinson's disease who has preexisting liver failure. What class of medications, if prescribed, would the nurse question?
Catechol ortho-methyltransferase (COMT) inhibitors
Which laboratory test should be monitored closely to assess for a potential life-threatening adverse effect to clozapine (Clozaril)?
Complete blood count
An unresponsive young adult is taken to the emergency department by friends. The friends tell the nurse, "We were too scared to call 911 because we were at a party popping roofies." Which medication would the nurse expect to administer to this patient?
Flumazenil (Romazicon)
When administering intravenous (IV) phenytoin (Dilantin), which action should the nurse perform?
Flush the line with normal saline before and after administration to prevent precipitation
The nurse instructs a patient receiving phenytoin (Dilantin) to visit the dentist regularly and perform frequent oral hygiene. What common adverse effect is the nurse educating the patient about for this medication?
Gingival hyperplasia
The nurse is caring for a postoperative craniotomy patient. Which prescribed drug does the nurse make sure is readily available to treat acute seizure activity?
Diazepam (Valium)
A patient with narcolepsy is prescribed methylphenidate (Ritalin). Which adverse effects should the nurse include in the teaching of this drug?
Insomnia, headache, weight loss
A patient is prescribed selegiline (Eldepryl), an MAO-B inhibitor, as adjunctive therapy in treatment of Parkinson's disease. What potential adverse effects should the nurse include in education for this patient? (Select all that apply.)
Insomnia, weight gain, depression
Which instructions should the nurse discuss to reduce the gastrointestinal (GI) adverse effects of orlistat (Xenical)?
Limit dietary intake of fat
While teaching a patient newly diagnosed with a seizure disorder, what does the nurse state as the goal of pharmacologic therapy of this medication?
Maximally reducing seizure activity while minimizing the adverse effects of medication therapy
The nurse is monitoring a patient taking an antipsychotic medication for extrapyramidal symptoms. Which clinical finding indicates an adverse effect of this drug?
Muscle cramps of the head and neck
While obtaining a medication history from a patient, the nurse notes that the patient is currently prescribed naltrexone (ReVia). The nurse should question the patient about a previous history of which substance abuse?
Opioid
A patient reports severe back pain and asks the nurse for medication "to take the pain away." Nursing assessment findings on the physical examination include mydriasis, rhinorrhea, diaphoresis, lacrimation, blood pressure of 160/84 mmHg, heart rate of 116 beats/min, and respiratory rate of 24 breaths/min. Which condition would the nurse suspect?
Opioid withdrawal
While completing discharge teaching for a patient prescribed an antiepileptic drug, the nurse instructs the patient of which potential complication if the medication is stopped abruptly?
Rebound seizure activity
What atypical antipsychotic medication should the nurse anticipate the health care provider prescribing for treatment of refractory schizophrenia?
Risperidone (Risperdal)
A nurse working with patients who are diagnosed with ADHD is aware that such patients often take CNS stimulant drugs. These medications are potent with a high potential for abuse and dependence. Based on this potential, how are these medications classified?
Schedule II
Which antiparkinson drug causes an increase in the levels of dopaminergic stimulation in the central nervous system (CNS) and therefore allows a decreased dose of other medications?
Selegiline (Eldepryl)
What is another approved and indicated use for the antidepressant bupropion (Zyban)?
Smoking cessation
A patient who is prescribed duloxetine (Cymbalta) comes to the medical clinic complaining of restlessness, sweating, and tremors. The nurse suspects serotonin syndrome and questions the patient regarding concurrent use of which herbal product or dietary supplement?
St. John's wort
The nurse is providing care for a patient in the emergency department who reports a headache and weakness and is noted to have cardiac dysrhythmias on the electrocardiogram. The patient is talkative, restless, anxious, and asking to leave the emergency department. The nurse suspects that the patient might be taking which abuse substance?
Stimulants
A patient diagnosed with depression is being discharged with a prescription for TCAs after no improvement of symptoms on an SSRI. Which instruction should the nurse include about this new medication?
There is a risk of toxicity when this medication is taken with alcohol.
The nurse is caring for a patient with Parkinson's disease who has been taking entacapone (Comtan) for the past week to treat an on-off phenomenon. The patient expresses concern over brown-orange urine. What information will the nurse provide to the patient?
This is a normal adverse effect of entacapone (Comtan) and is not harmful.
What is the goal of pharmacologic therapy in treating Parkinson's disease?
To balance cholinergic and dopaminergic activity in the brain
The nurse is reading a patient's substance abuse history on admission to inpatient rehabilitation. The patient states to the nurse, "I have been increasing my drug dosage to get the same effect." What is the patient experiencing?
Tolerance
The nurse is caring for a patient with a history of chronic alcohol abuse. The nurse recognizes the need to closely monitor the patient for which withdrawal signs and symptoms?
Tremors Agitation Hypertension
A patient receiving valproic acid (Depakote) should be monitored for which adverse effects? (Select all that apply.)
Tremors Weight gain Hepatoxicity
A patient with Parkinson's disease discusses with the nurse experiencing insomnia recently. The patient asks the nurse, "Can I take my old prescription of benzodiazepine that is prescribed to treat my insomnia?" What does the nurse know about the use of benzodiazepines in patients taking levodopa (Larodopa)?
Use of benzodiazepines decreases the therapeutic effect of the levodopa and may result in an increase in the symptoms of Parkinson's disease.
Ergot alkaloids exert their therapeutic effect by which action?
Vasoconstriction.
A nurse working in behavioral medicine is aware of associated long-term consequences of alcohol abuse. What potential vitamin deficiency can occur and potentially lead to Wernicke's encephalopathy?
Vitamins B1
A patient who has been taking antiparkinson medications for years begins to have increased symptoms on a constant basis. In documenting these symptoms, what term will the nurse use?
Wearing-off phenomenon
