PHARM STUDY SET
A nurse is teaching a client who has type 1 diabetes mellitus about a new subcutaneous insulin infusion pump. Which of the following pieces of information should the nurse include in the teaching? A . Plan to use a type of short-duration insulin in the infusion pump B. Replace the infusion pump set every 4 days C. Turn off the infusion pump for at least 3 hours each day D. Move the infusion pump catheter 1.27 cm (0.5 in) away from the old site
A . Plan to use a type of short-duration insulin in the infusion pump The client should plan to use short-duration insulin such as regular, lispro, aspart, or glulisine insulin in the infusion pump to deliver a baseline infusion of insulin. The client should also administer bolus doses of insulin before each meal.
ATI Drug Sucralfate- Complications( not a question just flip)
Constipation Client education: To prevent constipation, increase dietary fiber and fluid intake.
ATI Drug Education Metoclopramide - Nursing Administration ( not a question just flip)
Monitor for CNS depression and EPSs. The medication can be given orally or IV. If the IV dose 10 mg or less, it can be administered IVP undiluted over 2 min. If the dose is greater than 10 mg, it should be diluted and infused over 15 min. Dilute the medication in at least 50 mL dextrose 5% in water, sodium chloride, or lactated Ringer's
Drug Education Metoclopramide - Nursing Administration( not a question just flip)
Monitor for CNS depression and EPSs. The medication can be given orally or IV. If the IV dose 10 mg or less, it can be administered IVP undiluted over 2 min. If the dose is greater than 10 mg, it should be diluted and infused over 15 min. Dilute the medication in at least 50 mL dextrose 5% in water, sodium chloride, or lactated Ringer's
ATI Drug Sucralfate- Interactions( not a question just flip)
Sucralfate can interfere with the absorption of phenytoin, digoxin, warfarin, and ciprofloxacin. Nursing actions: Maintain a 2-hr interval between these medications and sucralfate to minimize this interaction. Antacids interfere with the effects of sucralfate. Nursing actions: Take sucralfate 30 min before or after antacids.
What can you NOT take with metoclopramide (Reglan)? (select all that apply) a. CNS depressants b NSAIDs c. opioids and medications with anticholinergic effects d. alcohol
a. CNS depressants c. opioids and medications with anticholinergic effects d. alcohol
Which of the following client is not to take metoclopramide (Reglan)? A. GI perforation B. GI bleeding C. bowel obstruction D.. hemorrhage E. seizure disorder
all of them!!!!
What should you monitor for when giving a client metoclopramide? a. imbalance b. vomiting c. dehydration d hair loss
c. dehydration Monitor bowel function and for indications of dehydration.
A nurse is preparing to administer 100 units of insulin glargine and 4 units of NPH insulin subcutaneously to a client. Which of the following actions should the nurse plan to take? A. Verify with the provider about giving insulin glargine at 1700 B. Ensure the insulin glargine is a cloudy suspension C. Request a prescription for giving insulin glargine twice daily D. Use separate syringes for administering insulin glargine and NPH insulin
D. Use separate syringes for administering insulin glargine and NPH insulin The nurse should not mix insulin glargine with any other insulin. The nurse should administer the NPH insulin and insulin glargine separately.
A patient complains of nausea. When administering a dose of metoclopramide (Reglan), the nurse should teach the patient to report which potential adverse effect? A. Tremors B. Constipation C. Double vision D. Numbness in fingers and toes
A. Tremors Extrapyramidal side effects, including tremors and tardive dyskinesias, may occur as a result of metoclopramide (Reglan) administration. Constipation, double vision, and numbness in fingers and toes are not adverse effects of metoclopramide.
A nurse is caring for a client who has diabetes and is experiencing nausea due to gastroparesis. The nurse should anticipate a prescription for which of the following medications? A Lubiprostone B Metoclopramide C Bisacodyl D Loperamide
B Metoclopramide The nurse should plan to generate solutions to address the client's nausea by anticipating a prescription for metoclopramide. This medication is a dopamine antagonist that is administered diabetic gastroparesi
A nurse is caring for a client who has been taking taken metformin for 6 months. Which of the following findings should the nurse identify as an expected therapeutic effect of the medication? A. Decreased vitamin B12 levels B. Decreased blood glucose level C. Abdominal bloating and diarrhea D. Decreased LDL level
B. Decreased blood glucose level A client who has taken metformin for 6 months should experience the expected therapeutic effect of a decrease in blood glucose levels. Metformin is a non-insulin medication for clients who have type 2 diabetes mellitus.
A nurse is providing teaching to a newly licensed nurse about metoclopramide. The nurse should highlight that which of the following conditions is a contraindication to this medication? A. Hyperthyroidism B. Intestinal obstruction C. Glaucoma D. Low blood pressure
B. Intestinal obstruction Metoclopramide reduces nausea and vomiting by increasing gastric motility and promoting gastric emptying. It is contraindicated for a client who has an intestinal obstruction or perforation.
A nurse is teaching a client who takes phenytoin and has a new prescription for sucralfate tablets. Which of the following instructions should the nurse include? A Take an antacid with the sucralfate. B Take sucralfate with a glass of milk. C Allow a 2-hr interval between these medications. D Chew the sucralfate thoroughly before swallowing
C Allow a 2-hr interval between these medications. When taking actions, the nurse should instruct the client that sucralfate can interfere with the absorption of phenytoin, so the client should allow a 2-hr interval between the sucralfate and phenytoin.
Following administration of a dose of metoclopramide (Reglan) to the patient, the nurse determines that the medication has been effective when what is noted? A. Decreased blood pressure B. Absence of muscle tremors C. Relief of nausea and vomiting D. No further episodes of diarrhea
C. Relief of nausea and vomiting Metoclopramide is classified as a prokinetic and antiemetic medication. If it is effective, the patient's nausea and vomiting should resolve. Metoclopramide does not affect blood pressure, muscle tremors, or diarrhea.
A nurse is teaching self-administration of NPH insulin to a client who has type 2 diabetes mellitus. Which of the following instructions should the nurse include? A. Alternate injecting doses between the abdomen and the thigh B. Shake the vial before withdrawing the dosage C. Rotate injection sites within the same area D. Discard the vial if the insulin is cloudy
C. Rotate injection sites within the same area To prevent lipodystrophy, the client should rotate injection sites and keep them about 2.5 cm (1 in) apart within the same anatomical area.
Drug Education Metoclopramide - Interactions ( not a question just flip)
Concurrent use of alcohol and other CNS depressants increases the risk of seizures and sedation. Nursing actions: Use cautiously with other CNS depressants. Client education: Avoid the use of alcohol. Opioids and anticholinergics decrease the effects of metoclopramide. Client education: Avoid using opioids and medications with anticholinergic effects.
A nurse working in the emergency department is admitting a client who has a gastric ulcer and gastrointestinal (GI) bleeding. Which of the following factors in the client's medical history should the nurse report to the provider? A. Arthritis treated with ibuprofen every 8 hours as needed B. Previous tobacco smoking with cessation 5 years ago C. Negative H. pylori breath test 1 year prior D. Prescribed bismuth subsalicylate as needed for GI upset
A. Arthritis treated with ibuprofen every 8 hours as needed The nurse should identify that ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID). NSAIDs can cause gastrointestinal bleeding and are contraindicated for clients who have ulcer disease. NSAIDs inhibit prostaglandin secretion, which decreases blood flow in the GI tract and decreases bicarbonate and mucus secretion. This environment promotes the secretion of gastric acid and needs to be reported to the provider.
A nurse is preparing to administer medications to a client who is NPO and is receiving enteral feedings through an NG tube. Which of the following prescriptions should the nurse clarify with the provider? A. Aspirin EC 325 mg per NG tube daily B. Atorvastatin 40 mg per NG tube daily C. Propranolol 20 mg per NG tube daily D. Sucralfate 2 g oral suspension per NG tube BID
A. Aspirin EC 325 mg per NG tube daily The nurse should clarify the prescription for aspirin EC 325 mg per NG tube daily, as enteric-coated tablets should not be crushed.
A nurse is caring for a client who developed hypoglycemia following an insulin injection. The client is conscious and responds appropriately to verbal stimuli. Which of the following medications should the nurse plan to administer first? A. Oral glucose tablet B. 50% dextrose intravenously C. Glucagon intramuscularly D. Epinephrine intravenously
A. Oral glucose tablet Evidence-based practice indicates that a client who has mild hypoglycemia and is conscious and able to swallow should receive an oral agent such as an oral glucose tablet. If the client is unresponsive to the oral glucose tablet, another, more invasive form of treatment can be initiated.
A nurse is caring for a client with diabetic ketoacidosis who has a prescription for an intravenous infusion of insulin. The nurse should document that which of the following types of insulin was administered intravenously to treat ketoacidosis? A. Regular insulin B. Insulin lispro C. Insulin aspart D. Insulin glargine
A. Regular insulin Treatment for diabetic ketoacidosis is directed at correcting hyperglycemia and acidosis. Therefore, the client's insulin levels are restored with an initial IV bolus of regular insulin followed by continuous infusion.
Drug Education Metoclopramide - Complications / adverse reactions ( not a question just flip)
ATI books states the following are complications Tardive dyskinesia-A complication of high-dose, long-term therapy. Client education: Monitor for and immediately report repetitive involuntary movements. Extrapyramidal s/s- Nursing actions: Administer an antihistamine (diphenhydramine) to minimize EPSs. Client education: Possible adverse effects include restlessness, anxiety, and spasms of the face and neck. Sedation Client education-Avoid activities that require alertness (driving). Diarrhea Nursing actions: Monitor bowel function and for indications of dehydration. Constipation Can result in GI toxicity (ischemic colitis, bowel obstruction, impaction, or perforation). Nursing actions: Because of the potentially fatal outcome of GI toxicity, only clients who meet specific criteria and are willing to sign a treatment agreement can receive prescriptions for the medication. QS Client education: Watch for rectal bleeding, bloody diarrhea, or abdominal pain and report to the provider. Medication should be discontinued.
A nurse is administering a client's first dose of sucralfate. Which of the following explanations should the nurse provide about the action of sucralfate? A. "Sucralfate decreases gastric acid secretions." B. "Sucralfate forms a gel-like substance that protects ulcers." C. "Sucralfate inactivates Helicobacter pylori." D. "Sucralfate inhibits the production of gastric acid."
B. "Sucralfate forms a gel-like substance that protects ulcers." The primary action of sucralfate is the formation of a gel-like protectant that adheres to the ulcer surface. This protective mechanism lasts for 6 hours and allows the ulcer to heal.
A nurse is caring for a client who has cystic fibrosis (CF) and has a prescription for high-dose ibuprofen daily. The nurse should identify that which of the following is an expected outcome for the client receiving this medication? A. Thinned pulmonary secretions that are retained in the airways B. Slowed progression of pulmonary damage C. Potentiated action of bronchodilator therapy D. Decreased risk of fevers associated with CF
B. Slowed progression of pulmonary damage The nurse should identify that clients who have CF are prescribed high-dose Ibuprofen, which is an NSAID, to slow the progression of pulmonary damage by suppressing the inflammatory response that causes pulmonary damage. CF is a genetic disorder that primarily affects the lungs, pancreas, and sweat glands.
A nurse is teaching a client who has a new prescription for sucralfate for a duodenal ulcer. Which of the following client statements indicates an understanding of the teaching? A. "I should take this medication with my meals and at bedtime." B. "I should only have to take this medication for about 2 weeks." C. "I should wait at least 30 minutes before taking this medication after I take an antacid." D. "I should swallow these tablets whole."
C. "I should wait at least 30 minutes before taking this medication after I take an antacid." The nurse should recognize that antacids can raise the gastric pH above 4, which can interfere with the effects of sucralfate. To minimize these interactions, sucralfate should be taken at least 30 minutes apart from antacids.
A nurse is teaching a client who has type 2 diabetes mellitus about a prescription for insulin lispro. Which of the following statements should the nurse include in the teaching? A. "The effects of the insulin lispro can last for 8 to 12 hours." B. "Administer insulin lispro 30 to 60 minutes before eating." C. "Insulin lispro has an onset of about 15 minutes." D. "This insulin can be given as a continuous intravenous bolus."
C. "Insulin lispro has an onset of about 15 minutes." Insulin lispro is a rapid-acting insulin and has an onset of 15 to 30 minutes.
A nurse is caring for a client who receives gastrostomy tube feedings and insulin. The client is scheduled to receive a tube feeding at 0700. At which of the following times should the nurse plan to administer insulin lispro subcutaneously? A. 0600 B. 0630 C. 0645 D. 0730
C. 0645 Lispro is a rapid-acting insulin with an onset of 15 minutes. The nurse should administer the insulin dose 15 min prior to the feeding.
ATI Drug Sucralfate- Contraindications/Precautions( not a question just flip)
Contraindicated in clients who are hypersensitive to the medication. Use cautiously in clients who have chronic kidney disease or diabetes mellitus. Warnings Pregnancy: Sucralfate is safe. Lactation: Sucralfate is safe.
Drug Education Metoclopramide -Contraindications/Precautions ( not a question just flip)
Contraindicated in clients who have GI perforation, GI bleeding, bowel obstruction, and hemorrhage. Contraindicated in clients who have a seizure disorder due to an increased risk of seizures. Use cautiously in children and older adults due to the increased risk for EPS.
A nurse is teaching a client who has type 2 diabetes mellitus about storing unopened vials of insulin. Which of the following pieces of information should the nurse include in the teaching A. Store the vials in the freezer B. Store the vials at room temperature C. Store the vials by a window D. Store the vials in the refrigerator
D. Store the vials in the refrigerator The nurse should tell the client to store unopened vials of insulin in the refrigerator. The client can use the unopened vials of insulin up to the printed expiration date.
ATI Drug Education Metoclopramide - Client Education ( not a question just flip)
Nursing actions: Use cautiously with other CNS depressants. Client education: Avoid the use of alcohol. Opioids and anticholinergics decrease the effects of metoclopramide. Client education: Avoid using opioids and medications with anticholinergic effects. Do not take prior to driving or activities requiring mental alertness.• Sit or lie down if feeling drowsy.• Change positions gradually.• Report diarrhea.• Drink plenty of clear fluids.• Report restlessness, anxiety, or spasms of the face and neck, lipsmacking, writhing motions, and involuntary movements
ATI Drug Sucralfate- Nursing Administration ( not a question just flip)
Take four times a day, 1 hr before meals, and again at bedtime. If needed, break or dissolve the medication in water, but do not crush or chew the tablet. take with empty stomach Complete the course of treatment.
When administering metoclopramide IVP which of the following is appropriate? a. If the IV dose 10 mg or less, it can be administered IVP undiluted over 2 min b. greater than 10 mg, it should be IVP over 15 min. c. Dilute the medication in at least 50 mL dextrose 5% in water, sodium chloride, or lactated Ringer' d. IVP over 1 min
a. If the IV dose 10 mg or less, it can be administered IVP undiluted over 2 min If the IV dose 10 mg or less, it can be administered IVP undiluted over 2 min. If the dose is greater than 10 mg, it should be diluted and infused over 15 min. Dilute the medication in at least 50 mL dextrose 5% in water, sodium chloride, or lactated Ringer's
What is metoclopramide used for? a. diabetes b. cerebral palsy c. nausea d. fever
c. nausea
