Pharm chapter 13

A client with renal insufficiency is being treated with allopurinol and asks the nurse why the health care provider decided on allopurinol instead of probenecid, which his friend is on. The nurse's best reply is:

"Allopurinol is less likely to make your kidney problems worse."

Allopurinol is an agent used to treat hyperuricemia. Which of the following statements by the nurse recruit will show that she understands the action of allopurinol?

"It prevents the formation of uric acid in the body."

he client receives a prescription for Uloric. Which of the following instructions would be appropriate information for the nurse to provide to the client? Select all that apply.

a. Liver function tests will be done at 2 months, 4 months, and again periodically during therapy. c. The medication may be taken without regard to food intake. d. Notify the health care provider if you experience chest pain or any neurologic changes. e. NSAIDs may be taken for a gout attack. f. You may have a gout flare after beginning the medication regimen.

When assessing a client's ability to perform self-care and increase activities, the nurse is addressing which nursing diagnosis?

activity intolerance

The nurse caring for clients taking allopurinol (Zyloprim) for long-term therapy understands that which of the following will maximize the benefits of allopurinol?

alkalinization of the urine.

During an acute attack of gout, the nurse should advise the client to avoid:

beer- is a purine-rich beverage and should be avoided.

An elderly client taking a nonsteroidal anti-inflammatory drug (NSAID) for gout pain is admitted to the hospital with altered mental status. As the nurse reviews drug use, the client's condition is anticipated because of:

indomethacin.

A client is prescribed sulfinpyrazone 400 mg by mouth in two divided doses. The pharmacy sends 0.1 gram tablets. How many tablets should the client receive for each dose?

2 tablets

The nurse is providing instructions for the client who is experiencing an acute attack of gout. All of the following information is true about an acute attack of gout, EXCEPT:

opioids are the drugs of choice for pain relief.

An agent used to treat gout that can inhibit the excretion of penicillin is:

probenecid. Probenecid inhibits penicillin excretion, so it raises the level of penicillin in the body.

A client with insulin-dependent diabetes is being treated with probenecid for hyperuricemia and gout. For this client the nurse should:

provide client teaching about the increased risk for hypoglycemia.

The nurse knows the client needs further teaching regarding a low-purine diet when the client makes which of the following statements?

"I can have red wine with my meals."

A client is to receive a 1.2 mg loading dose of colchicine by mouth for an acute attack of gout. The pharmacy sends 600 mcg tablets. The nurse should administer:

Correct: 600 mcg = 0.6 mg; 1.2 mg divided by 0.6 mg = 2 tablets.

A hospitalized client is experiencing the pain of an acute gout attack. Which action of the nurse will most help this client?

Place a bed cradle on the foot of the bed.

The nurse should include which of the following information to the client who has hyperuricemia and is experiencing an acute attack of gout? Select all that apply

a. Consuming a high-fat diet can provoke an acute attack of gout. b. Taking thiazide diuretics can provoke an acute attack of gout. e. During an acute attack of gout, increase fluid intake unless there is an underlying condition that would require restriction of fluids. f. The use of a bed cradle will keep linens off the tender areas affected by gout.

The client is taking the NSAID Motrin. The nurse would monitor for:

a. gastric irritation b. vertigo c. rash d. visual changes e. bleeding, if used concurrently with oral anticoagulants f. intracerebral mass bleeding if used concurrently with ginkgo biloba

A client is experiencing the pain of an acute gout attack. The first nursing action is to:

administer naproxen as prescribed. Naproxen is one of the NSAIDs (nonsteroidal anti-inflammatory drugs) most commonly used to treat acute attacks.

The nurse is teaching a client about gout medication treatment. Teaching should include:

begin taking the medications for gout at the first sign of an attack.

The client is experiencing an acute attack of gout. The nurse would expect an order from the health care provider for which of the following agents?

colchicine.

A common nursing diagnosis during an acute attack of gout is acute pain related to:

deposition of urate crystals in body tissues.

The nurse understanding the pathophysiology of hyperuricemia monitors the client with gouty arthritis for:

deposits of tophi in subcutaneous tissues.

The nurse understands the most common joint to be affected by hyperuricemia is the:

metatarsophalangeal joint. The metatarsophalangeal joint in the great toe is the most common site.

Of the following, which are high-purine foods?

mushrooms, anchovies, meat gravy

When treating a client during an acute attack of gout, the nurse would monitor for which of the following to determine when to terminate the administration of colchicine?

nausea or diarrhea occurs.

The nurse monitors the client for colchicine therapy for:

nausea, vomiting, and diarrhea.

When caring for a client being treated with allopurinol, the nurse notes the client has developed a skin rash. The nurse should:

notify the health care provider promptly.

The client would be advised to take acetaminophen, rather than aspirin, with which of the following medications?

probenecid.

An agent that increases uric acid excretion and prevents blood clot formation is:

sulfinpyrazone. Sulfinpyrazone alters platelet function, preventing blood clot formation.

A client with hyperuricemia has a nursing diagnosis of acute pain. The nurse evaluates the plan of care and determines that a successful resolution of this nursing diagnosis has been achieved when:

the client states pain level of 0 on a 1-to-10 scale.