Pharm. Exam 2

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Depresses the CNS

A client is treated with lorazepam for status epilepticus. Which effect of lorazepam is the reason it is given? -Decreases anxiety associated with seizures -Promotes rest after the seizure episode -Depresses the CNS -Provides amnesia for the convulsive episode

Contacting the primary health care provider

A client receiving high-dosage risperidone exhibits hand tremors. Which would be the nurse's *FIRST* intervention? -Withholding the medication -Telling the client it is transitory -Giving the client finger exercises -Contacting the primary health care provider

Depression

A client reports to the nurse "I've been using St. John's wort to try and feel more like myself again. I'm not sure whether it's going to work." Which symptom would the nurse further assess? -Depression -Sleep disturbance -Diminished cognitive ability -Sensory-perceptual disturbance

Muscle tremors

A client take an antipsychotic medication. When assessing the client for signs and symptoms of pseudoparkinsonism, the nurse will be alert for which complication? -Drooling -Blurred vision -Muscle tremors -photosensitivity

Withdrawing the medication

A client with depression was prescribed fluoxetine and reports restlessness, confusion, an elevated body temperature, and poor concentration. Which intervention would the nurse anticipate preparing for in the treatment of these signs and symptoms? -Withdrawing the medication -Administering isocarboxazid -Reducing the dose of the medication -informing the client that these are expected side effects

You should rise slowly when getting up from a sitting or lying position

A client with urinary incontinence is prescribed amitriptyline. Which specific instruction would the nurse provide to the client? -You should avoid dehydration -You should monitor your urine output -You should rise slowly when getting up from a sitting or lying position -You should periodically check your blood pressure when starting the medication

Withholding the next dose of lithium and drawing blood for a lithium level

An older adult living in a long-term care facility has been receiving 600 mg of lithium twice a day for 3 weeks to ease manic behavior. The client is experiencing nausea and vomiting, diarrhea, thirst, polyuria, slurred speech, and muscle weakness. Which intervention is appropriate? -Withholding the next dose of lithium and drawing blood for a lithium level -Obtaining a prescription for the antidote to lithium and administering it immediately -Suggesting that the health care provider replace the lithium for an antiepileptic that will control the mania -Assessing the client for coarse hand tremor and, if it is present, giving the daily dose of lithium with a bit of water

cognitive impairment

Two weeks after starting phenobarbital sodium, the client develops new symptoms. Which symptom is probably caused by the medication? -Cognitive impairment -Frequent urination -Abdominal pain -Mania

Question if dizziness is experienced

Which assessment will assist the nurse in determining whether a client is experiencing adverse effects of risperidone? -Monitor for episodes of diarrhea -Test sensation of lower extremities -Question if dizziness is experienced -Auscultate breath sounds to detect wheezing

MANY drug interactions (including other CNS depressants)

Contraindications for cyclobenzaprine:

peripheral areas

DO NOT use lidocaine w/ epinephrine where?

rate at which 50% of a drug is eliminated from the plasma

Define "half-life"

Acetaminophen

Which medication is safer to take for pain in the week before a surgical procedure? -Naproxen -Aspirin -Ketorolac -Acetaminaphen

The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks

Fluoxetine is prescribed for a client with depression. Which precaution will the nurse consider when initiating treatment with this medication? -It must be given with milk and crackers to prevent hyperacidity and discomfort -Eating chees or pickled herring or drinking wine may cause a hypertensive crisis. -The blood level may not be sufficient to cause noticeable improvement for 2 to 4 weeks -The blood level should be checked weekly for 3 months to make sure it is appropriate

Acetaminophen extra strength

For a client with difficulty swallowing, the nurse will crush which medication? -Metoprolol extended release -Felodipine sustained release -Acetaminophen extra strength -Potassium chloride extended release

Cardiac dysrhythmias, hypertension

List 2 side effects of Naloxone:

GI irritation, Rash, Photosensitivity

List the 3 side effects for Ibuprofen:

Opioid Agonists, Opioid w/ non-opioid, Non- opioid

List the 3 sub classes of Analgesics:

drowsiness, dizziness, dyspnea, dry mouth

List the side effects (4 D's) of ketorolac:

paradoxical

Methylphenidate is prescribed to treat a child's ADHD. The nurse understands that methylphenidate is used in treatment of ADHD in children because it has which effect? -Diuretic -Synergistic -Paradoxical -Hypotensive

Mild to moderate pain

NSAIDs treat what level of pain?

Symptoms of the heroin overdose may return after the naloxone metabolizes

Naloxone effectively reverses a client's respiratory depression from an overdose of heroin. Why will the nurse continue to closely monitor this client's status? -The medication may cause peripheral neuropathy -Naloxone and heroin can cause cardiac depression when combined -Symptoms of the heroin overdose may return after the naloxone metabolizes -Hyperexcitability and amnesia may cause the client to thrash about and become injured.

Barbiturates and Benzodiazepines

Name the 2 sub classes of CNS depressants:

Insomnia, tachycardia, anorexia, growth suppression in children

Side effects of methylphenidate:

muscle rigidity, tremor, changes in LOC, tachycardia, high fever

Symptoms of Neuroleptic Malignant Syndrome:

Prolonged bleeding time

The nurse is caring for a client who is receiving aspirin therapy. Which clinical indicator would be related to this therapy? -Urinary calculi -Atrophy of the liver -Prolonged bleeding time -Premature erythrocyte destruction

The free levels of a medication will increase

The protein binding capacity of drugs in infants is low. The nurse understands which is an implication of this physiological process? -The free levels of a medication will increase -The free levels of a medication will decease -The free levels of a medication will remain constant -The free levels of a medication will disappear once administered

Pharmacogenetics

The study of how people's genes affect their response to medicines:

Pharmacokinetics

The term that means "How the body acts on the drugs"

Pharmacodynamics

The term that means "How the drugs affect the body"

Respiratory depression, hypotension

What are 2 side effects of morphine sulfate?

hypotension, respiratory depression, apnea

What are ADVERSE effects of oxycodone w/ acetaminophen?

anxiety and preoperative sedation

What are Benzodiazepines used for?

Non-steroidal anti-inflammatory drugs

What are NSAIDs?

absorption, distribution, metabolism, excretion

What are the 4 stages of pharmacokinetics?

Anxiety and seizures

What can Barbiturates be used to treat?

relieve muscle spasms

What does cyclobenzaprine treat?

pain scale, respirations, BP

What does the nurse have to monitor after a patient takes morphine sulfate?

ADD/ADHd

What is Methylphenidate used to treat?

Inhibits COX 1 and 2

What is the MOA for acetylsalicylic acid and Ibuprofen?

Inhibits prostaglandin synthesis

What is the MOA for ketorolac (Toradol)?

Increases GABA, non-selective CNS depression

What is the MOA of Barbiturates?

Increases GABA, CNS depression in select areas of the brain

What is the MOA of Benzodiazepine?

Completely blocks the effects of opioids

What is the MOA of Naloxone?

inhibits prostaglandin synthesis

What is the MOA of Non-opioids?

stimulate opioid receptors to alter pain perception

What is the MOA of opioid agonists?

Mucomyst

What is the antidote for an Acetaminophen Overdose?

4000 mg/day

What is the daily adult limit for Acetaminophen?

Naloxone (Narcan)

What is the prototype for Narcotic Antagonists?

Methylphenidate (Ritalin)

What is the prototype for a CNS stimulant?

Propofol (Diprivan)

What is the prototype for general anesthesia?

Lidocaine (Xylocaine)

What is the prototype for local anesthetics?

Cyclobenzaprine (Flexeril)

What is the prototype for skeletal muscle relaxants?

ketorolac (Toradol)

What is the prototype for the sub class drug Acetic acid derivatives?

Lorazepam (Ativan)

What is the prototype for the sub class drug Benzodiazepines?

Acetaminophen (Tylenol)

What is the prototype for the sub class drug Non-opioid?

Ibuprofen (Motrin)

What is the prototype for the sub class drug Propionic acid derivatives?

Phenobarbital (Luminol)

What is the prototype for the sub class drug barbiturates?

morphine sulfate

What is the prototype for the sub class drug opioid agonists?

oxycodone & acetaminophen (Percocet)

What is the prototype for the sub class drug opioid w/ non-opioid?

Acetylsalicylic acid (Aspirin)

What is the prototype for the sub class drug salicylates?

BP, pulse, respiratory rate, LOC

What should the nurse assess while a patient is under general anesthesia?

Acetylsalicylic Acid (Aspirin)

Which NSAID drug cannot be given to children because it causes "Reye syndrome"?

Acetaminophen

Which analgesic can cause liver damage with large doses?

The combat the extrapyramidal side effects of the neuroleptic medication

Which reason explains why so many psychiatric clients are given benztropine or trihexyphenidyl in conjunction with phenothiazine-derivative neuroleptic medications? -They reduce postural hypotension -They potentiate the effects of the neuroleptic medication - They combat the extrapyramidal side effects of the neuroleptic medication -They ameliorate the depression that may accompany schizophrenia

The medication should be taken with meals

Which would the nurse include when teaching a client with Parkinson disease about Carbidopa-levodopa? -Multivitamins should be taken daily -A high-protein diet should be followed -The medication should be taken with meals -Alcohol consumption should be in moderation


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