EXAM 4 PHARM

The patient diagnosed with hyperthyroidism is prescribed the antithyroid medication propylthiouracil (PTU). Which statement by the patient warrants immediate intervention by the nurse?

"I have a sore throat and have had a fever."

High Alert Drug acronym

'A PINCH' A: Anti-infective P: Potassium and other electrolytes I: Insulin N: Narcotics (opioids) and other sedatives C: Cancer agents or chemotherapy H: Heparin and anticoagulants

Check before administering Chemotherapy:

-Be sure IV is in a large vein with good blood return -Weigh the patient accurately each day -Check dose and recalculate it based on patient's weight -Take the patient's vitals

Patient Teaching for Chemotherapy:

-Temporary and permanent physical damage possible - Anemia, Neutropenia - avoid infection, Thrombocytopenia - avoid injury -Good handwashing; avoid crowds -Cancer therapy symptom distress: nausea/vomiting, alopecia, mucositis, changes in cognitive function -Management of side effect

The nurse is teaching a patient with hypertension about the use of over-the-counter (OTC) drugs. What does the nurse include in the teaching plan? Select all that apply.

A. "In general, be sure to contact your prescriber before taking any OTC preparations." D. "Avoid cold remedies that contain phenylephrine or pseudoephedrine because they can increase your blood pressure." E. "OTC nonsteroidal anti-inflammatory drugs (NSAIDs) can cause secondary hypertension."

A patient is taking levothyroxine sodium (Synthroid). Which of the following changes should you report to the prescriber as an indication that the dose may be too high? Select all that apply.

A. Nightly insomnia B. Frequent diarrhea

What category of blood pressure medications have the potential to produce a persistent dry cough?

ACE inhibitors

The nurse is scheduled to administer a dose of digoxin (Lanoxin) to an adult client with atrial fibrillation. The client has a potassium level of 4.3 mEq/L. The nurse should perform which of the following activities next?

Administer dose as ordered

Before starting a patient with a testosterone Replacement Drug

Ask about history of prostate/breast cancer Have prostate cancer screening Baseline weight and blood pressure

A client diagnosed with cancer has been receiving chemotherapy and subsequently develops a platelet count of 45,000/mm3. The nurse concludes that the client understands instructions to avoid potential complications when the client states to do which of the following?

Avoid aspirin and aspirin (salicylate) - containing products

Beta I receptors can be found in the ____ and beta 2 receptors can be found in the ___.

Beta 1 in heart and Beta 2 in lungs

What type of diabetic may be prescribed insulin?

Both Type 1 and Type 2 Diabetics

Substances or events that damage a normal cell's DNA, cause cancer are called...

Carcinogens

Describe in your own words the mechanism of action (MOA) of a cardiac glycoside AND how that MOA helps to decrease the workload of the heart and alleviate the symptoms of heart failure.

Cardiac glycosides slow the heart rate (allowing more time for the left ventricle to fill) and also increases contractility (increases force of each heart beat)to improve cardiac output.

A patient with diabetes who takes glucophage (Metformin), a Biguanide insulin sensitizer, has postoperative orders to "resume all pre-operative medications." He had a CT scan with contrast prior to surgery completed. What is the priority action for the nurse?

Contact the prescriber to obtain an order to hold the glucophage for 48 hours.

What category of medication will correct adrenal gland hypofunction and is similar to natural cortisol? Must be spelled correctly to receive credit.

Corticosteroids

Symptoms of low testosterone

Decreased interest in sex and decreased well-being Depression, irritability, difficulty concentrating/remembering Erectile dysfunction, decreased muscle, increased fat Anemia, decreased bone density, decreased body hair

Cancer is an

abnormal, invasive cell growth with no useful purpose.

When mixing two types of insulin, the cloudy insulin needs to be drawn up before the clear insulin.

FALSE The clear insulin needs to be drawn up before the cloudy insulin

Prior to administering a cardiac glycoside, the nurse should assess the patient's radial pulse for at least 10 full minutes.

FALSE The nurse should assess the patient's radial pulse for 1 full minute.

What is the preferred medication to treat diabetes for a pregnant patient?

Insulin

Which assessment is most important for the nurse to perform before administering levothyroxine (Synthroid)?

Measuring the heart rate and rhythm

Chemotherapy side effects

Normal cells most affected by chemotherapy are those that divide rapidly (e.g., skin, hair, intestinal tissue, blood-forming cells)

Before administering nitroglycerin ointment to a patient, what precaution should be taken?

Putting on gloves

Chemotherapy

Refers to medications that kills cells that divide rapidly. Damages normal cells AND cancer cells

Metastasis is

Spread of cancer cells to other body areas; cells grow, invade, damage important organs

Modes of Cancer Treatment:

Surgery, radiation, chemotherapy, biotherapy.

Although there are multiple medications that may be prescribed to treat the symptoms of heart failure, the only genuine cure is a heart transplant since damage to the heart muscle is irreversible.

TRUE

It is appropriate to administer the prescribed blood pressure medications to a patient whose blood pressure is currently "normal" at 120/80.

TRUE

There are different Chemotherapy Drug Categories, and how they work are different but the outcome is the same

TRUE

Thyroid-suppressing medications may initially take as long as 3 weeks to be effective as they do not affect hormones already stored in the thyroid gland.

TRUE

Patient Teaching for HRT

Take exactly as prescribed Annual screenings for breast, cervical, uterine, ovarian cancer Smoking cessation Monitor/report symptoms of jaundice Seek medical attention for: ØChest pain, difficulty breathing ØSwelling in one leg Symptoms of stroke

Male hormone replacement

Testosterone

The nurse is caring for a patient taking propranolol (Inderal). Which assessment finding indicates the patient is experiencing a potential adverse complication?

The development of audible wheezes and cough

A patient receives NPH and regular insulin every morning. The nurse is verifying that the patient understands that there are two different peak times to be aware of for this insulin regimen. Why is this an important concept for the nurse to stress?

The risk for hypoglycemia is greatest around the peak of insulin activity.

Adverse effects of HRT

increased blood clotting hormone-sensitive cancers; liver impairment; gallbladder disease; pancreatitis

Life span considerations for testosterone Replacement Drug

increased risk of prostate hyperplasia, or growth stimulation of occult prostate carcinoma Monitoring for any fluid retentions Use with caution in children Do not use during pregnancy or breastfeeding (For gender transitional)