Pharmacology

The nurse is to administer ceftriaxone. The order reads: give 50 mg/kg now. The client weighs 75 kg. How many grams of ceftriaxone will the nurse give? Record your answer using one decimal place.

3.8 g "75 × 50 = 3750 mg (1 g)/(1000 mg) × 3750 mg/L = 3.8 g"

A nurse is preparing to administer digoxin elixir to a client. Which principle regarding this medication is correct?

Liquid digoxin should be measured with a calibrated dropper or syringe. "The adult therapeutic level for digoxin is 0.5 to 2 ng/ml (1.0 - 2.6 nmol/L). This narrow therapeutic range makes digoxin toxicity likely, so the nurse must measure liquid preparations with calibrated droppers or syringes. Digoxin toxicity commonly causes life-threatening cardiac arrhythmias. The nurse should hold and notify the physician about digoxin for heart rates below 60 beats/minute."

An adolescent sustains a head injury and develops diabetes insipidus. The healthcare provider orders desmopressin, 10 mcg subcutaneously (SubQ). When does the nurse assess the client to determine the need for an addional dose?

4 to 7 hours "The minimum required dose is given to avoid water retention and hyponatremia. Control of polyuria and electrolytes is the goal. Another dose is not administered until the client has another episode of brisk polyuria and diuresis, indicating the initial dose is no longer effective. The drug's half life via this route is 3 hours, indicating the drug will stop working in about 6 hours."

A client is admitted to the local psychiatric facility with bipolar disorder in the manic phase. The physician decides to start the client on lithium carbonate therapy. One week after this therapy starts, the nurse notes that the client's serum lithium level is 1 mEq/L. What should the nurse do?

Continue to administer the medication as ordered. "The serum lithium level should be maintained between 1 and 1.4 mEq/L during the acute manic phase; therefore, the nurse should continue to administer the medication as ordered. Unless the client has signs or symptoms of lithium toxicity, the nurse has no need to call the physician, withhold the medication, or repeat the laboratory test. Nonetheless, the nurse should continue to monitor the client's serum lithium level and watch for indications of toxicity if the level begins to rise. Note that it's possible for a client with a normal lithium level to experience lithium toxicity."

The nurse is preparing a client for an ileostomy. Two weeks before the surgery, what should the nurse instruct the client to do?

Stop taking drugs that will interfere with clotting. "The nurse should instruct the client to stop taking drugs that would interfere with clotting, such as aspirin or ibuprofen. The client should follow a high-fiber diet with increased fluids during the 2-week preoperative period. It is not necessary to limit fluids. The client does not need to report having a temperature above 99° F (37.2° C) to the health care provider (HCP) as this is within normal limits; however, if the temperature is higher, this could indicate an infection, and the client should notify the HCP."

Which factor best indicates that a client is complying with digoxin therapy?

ability to correctly count the radial pulse "A client who complies with drug therapy is less likely to have a recurrence of cardiac failure. Client knowledge of how to check a radial pulse and actions to take if it is not within normal limits can prevent a toxic digoxin reaction. The other choices do not indicate the client's ability to monitor effectiveness of digoxin. Weight gain is possibly reflective of activity or diet; chest pain is angina and not reflective of digoxin use."

Which factor is most important for the nurse to consider when determining the angle at which to insert the needle for a subcutaneous injection?

amount of subcutaneous tissue "The amount of subcutaneous tissue is the most important factor to consider when deciding on the angle at which to insert the needle. Clients who have a large amount of subcutaneous tissue can tolerate up to a 90-degree angle of insertion. Thin or emaciated clients with little subcutaneous tissue need to have the needle inserted at a lower angle. Size of the syringe has no bearing on the angle used. Tissue turgor can affect the ease with which the needle is inserted but not the angle. The length of the needle used for subcutaneous injections is between 3/8 and 5/8 inch (1 to 1.6 cm), which does not provide much variability unless the angle of the injection is also altered by the nurse."

A school-age child diagnosed with attention deficit hyperactivity disorder is prescribed methylphenidate. What finding should alert the school nurse to the possibility that the child is experiencing a common side effect of the drug?

loss of appetite "Loss of appetite is one of the more common adverse effects associated with methylphenidate. Although nausea is associated with this drug, vomiting is not. Photosensitivity is not associated with this drug. Because of decreased appetite, the client will not gain more weight."

A client has been on long-term prednisone therapy. What should the nurse instruct the client to include in the diet? Select all that apply.

protein potassium calcium vitamin D "Adverse effects of prednisone are weight gain, retention of sodium and fluids with hypertension and cushingoid features, a low serum albumin level, suppressed inflammatory processes with masked symptoms, and osteoporosis. A diet high in protein, potassium, calcium, and vitamin D is recommended. Carbohydrates would elevate glucose and further compromise a client's immune status. Saturated does not counteract the adverse effects of steroids such as prednisone."

The nurse works in the emergency department (ED) and is caring for a client diagnosed with a pulmonary embolus (PE). Which medication would the nurse anticipate the healthcare provider to order for a PE?

streptokinase "Streptokinase is used to break down red blood cells seen in PEs, warfarin sodium and heparin sodium deter further extension of existing thrombi and prevent new clots from forming, and vitamin K is needed for adequate blood clots."