Week 1 Prep U Questions Chapters 2 & 3

Why does the nurse need to be alert for any indication of an allergic reaction in clients?

To maintain the client's safety during drug therapy

The nurse administers an anticholinergic medication to the client. When assessing this client, what finding should the nurse interpret as a secondary effect of the drug?

Urinary hesitancy

A client has been prescribed 15 mL of an oral liquid potassium supplement. The nurse should administer how many ounces?

0.5 oz Explanation: 1 oz = 30 mL

The health care provider has ordered 30 mg of Demerol IM for relief of a severe migraine headache. The package insert reads meperidine hydrochloride (Demerol) 50 mg/mL. How many milliliters would the nurse inject?

0.6

The health care provider has ordered 35 mg of Demerol IM for relief of a severe migraine headache. The package insert reads meperidine hydrochloride (Demerol) 50 mg/mL. How many milliliters would the nurse administer?

0.7

A client develops a skin reaction to one of their prescribed medications. This client also has a specific underlying pathology. This underlying pathology might serve as a:

contraindication for the use of certain medications.

A nurse administers a prescribed loading dose of digoxin based on the understanding that doing so will result in:

critical concentration being reached more quickly. Explanation: Patients may need a special loading dose at the beginning of drug therapy. This dose is larger than the regular prescribed daily dosage of a medication, is used to attain a more rapid therapeutic blood level of the drug.

A client is four months' pregnant. She works in the chemical unit of a research department and is responsible for handling various chemicals. Her gynecologist advised her not to expose herself to chemical or industrial vapors and specific drugs. These restrictions are advised because exposure to industrial vapors could:

damage the immature nervous system of the fetus.

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?

decreased glomerular filtration rate.

The nurse's discussion of the role of cytochrome P450 (CYP) enzymes is focusing on what aspect of pharmacokinetics?

drug metabolism that takes place in the liver

A nurse is caring for a client who has been receiving a drug by the intramuscular (IM) route at a dose of 0.25 mg. After discharge, the client will be prescribed the same medication orally at a dose of 2.5 mg. What phenomenon should the nurse describe when explaining the reason for the increased dosage for the oral dose?

first-pass effect Explanation: Some drugs are extensively metabolized in the liver, with only part of a drug dose reaching the systemic circulation for distribution to sites of action. This is called the first-pass effect or presystemic metabolism.

A client is taking low-dose aspirin daily for her heart. The client is not receiving all the dosage of the aspirin that is being ingested because of:

first-pass effect.

A client is diagnosed with atrial fibrillation and prescribed the drug Coumadin (warfarin). The nurse would instruct the client to avoid what foods?

foods with vitamin K

A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating:

grapefruit. Explanation: Grapefruit contains a substance that strongly inhibits the metabolism of drugs normally metabolized by the CYP3A4 enzyme. This effect greatly increases the blood levels of some drugs (e.g., the widely used "statin" group of cholesterol-lowering drugs) and the effect lasts for several days.

When researching information about a drug, the nurse finds that the drug tightly binds to protein. The nurse would interpret this to mean that the drug will:

have a long duration of action.

Two years ago, a client was prescribed a medication to control hypercholesterolemia. Now the health care provider prescribes a higher dose of the medication due to enzyme induction. A student nurse asks the nurse to explain the change in the drug dosage. The nurse explains that with chronic administration, some drugs stimulate liver cells to produce:

larger amounts of drug-metabolizing enzymes.

Which client would a nurse expect to experience alterations in drug metabolism?

50-year-old man with cirrhosis of the liver Explanation: Hepatic disorders (e.g., hepatitis, cirrhosis, decreased liver function) mainly interfere with metabolism. Severe liver disease or cirrhosis may interfere with all pharmacokinetic processes.

A client with recurrent urinary tract infections was prescribed sulfamethoxazole-trimethoprim and experienced an allergic reaction. The client states, "I don't understand. I had a two-day course of the same drug last year with no problems." What is the nurse's best response?

"Allergic reactions happen after your body has been sensitized to a drug in the past." Explanation: Hypersensitivity(allergy) may occur with almost any drug in susceptible patients. It is unpredictable & unrelated to dose. Occurs in those who have previously been exposed to the drug or a similar substance (antigen) and who have developed antibodies.

A black male client asks the nurse why the health care provider orders a diuretic as part of his treatment plan for hypertension, when the health care provider ordered an ACE inhibitor for his friend with the same diagnosis. After consulting with the provider, how would the nurse respond?

"Diuretics are shown to be more effective than ACE inhibitors for black males with hypertension." Explanation: African Americans respond differently to some CV drugs. For example, for with hypertension, angiotensin-converting enzyme (ACE) inhibitors and beta-adrenergic blocking drugs are less effective, and diuretics and calcium channel blockers are more effective.

Mrs. Geonity is prescribed a medication, and the health care provider modifies the dose on multiple occasions to achieve the maximum therapeutic effect of the drug. The client asks the nurse what the rationale is for the dosage changes. How should the nurse respond?

"Dosage determines whether the drug actions may be therapeutic or toxic."

Mrs. Hone asks the nurse to open her Effexor XR capsule and mix the contents in applesauce to make it easier to swallow. How should the nurse respond?

"I am sorry, but opening the capsule may cause you to absorb too much medication too quickly."

A nurse is caring for a client who has been receiving an adrenergic medication. Which statement by the client alerts the nurse about an adverse effect of the medication and a reason to call the prescriber?

"I feel a "fluttering" feeling of my heart."

The nurse is caring for a client with a gastrointestinal bleed. Which statement by the client would alert the nurse to a potential cause of the bleed?

"I take aspirin a couple times a day to manage aches and pains." Explanation: ulceration and GI bleeds are often caused by NSAIDs like ibuprofen/aspirin

A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?

"This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression." Explanation: Cardiovascular meds decrease blood flow. Attitudes and expectations related to drugs influence patient response, compliance & willingness to carry out the prescribed drug regimen, especially with long-term drug therapy.

Which Ethic variations are true in regards to drug therapy? Select all that apply.

- African Americans with heart failure seem to respond better to a combination of hydralazine and isosorbide than do Caucasian patients with heart failure. - Those of Asian descent usually require much smaller doses of some commonly used drugs, including beta-adrenergic blockers and several psychotropic drugs (e.g., alprazolam, an antianxiety agent, and haloperidol, an antipsychotic). - Diuretics are shown to be more effective than ACE inhibitors for black males with hypertension. Explanation: many drug trials are completed with white males, and unexpected responses including toxicity have been found in other ethnic groups.

Place these steps in the nursing process in the proper sequence from beginning to end.

- Assessment - Nursing diagnosis - Implementation - Evaluation

Drugs used for parenteral administration may be available in which of the following forms? Select all that apply.

- Disposable syringes - Ampules containing liquid form of the drug - Reusable vial containing liquid form of the drug - Vial containing drug powder

A client has been diagnosed with gonorrhea and has been prescribed oral tetracycline. What should the nurse include in health education about tetracycline? Select all that apply.

- Do not take the drug with foods or other drugs that contain calcium. - Do not take the drug at the same time as an iron supplements or high iron foods Explanation: The antibiotic tetracycline reacts with dairy products, such as milk and cheese. The drug combines with the calcium in milk products to form a nonabsorbable compound that is excreted in the feces.

What does successful use of the nursing process require? (Select all that apply.)

- Observation - Teaching - Practice - Experience - Updating

A nurse can administer parenteral drugs via what routes? Select all that apply.

- Subcutaneous - Intramuscular - Intravenous - Intradermal

Which of the following statements is true? Select all that apply.

- Women who are depressed are more likely to respond to the selective serotonin reuptake inhibitors (SSRIs), such as fluoxetine (Prozac), than to the tricyclic antidepressants (TCAs), such as amitriptyline (Elavil). - Women with anxiety disorders may respond less well than men to some antianxiety medications. - Women with schizophrenia seem to need smaller doses of antipsychotic medications than men. If given the higher doses required by men, women are likely to have adverse drug reactions. - Women may obtain more pain relief from opioid analgesics (e.g., morphine) and less relief from nonopioid analgesics (e.g., acetaminophen, ibuprofen), compared with men.

The nurse is caring for a group of clients and is aware that which client may require a reduction in medication dosage? (Select all that apply.)

- client with chronic hepatitis C - client with cirrhosis of the liver - client with cancer of the liver Explanation: Hepatitis C is a viral infection that causes liver inflammation

The nurse administers a medication and the client has an immediate anaphylactic reaction following injection. What symptoms assessed by the nurse would indicate anaphylaxis? (Select all that apply.)

- difficulty breathing - increased blood pressure - diaphoresis Explanation: anaphylaxis symptoms include dyspnea, cardiovascular collapse. Diaphoresis = profuse sweating.

The nursing student is studying drug dosage and has learned that there are three systems of measurement associated with drug dosing. What are these systems? (Select all that apply.)

- metric system - apothecary system - household measurement system

The nurse multiplies and divides simple fractions when calculating drug doses for clients. Which fraction is a result of multiplying 2/5 by 5/8?

1/4

The nurse understands that the dosage recommended by drug manufacturers is based on an individual weighing:

150 lb (68 kg).

The health care provider prescribes ascorbic acid 0.5 g daily. The drug label reads ascorbic acid 250 mg/tablet. The nurse would administer how many tablets?

2 Explanation: 0.5 g/250 mg x 1000mg/1 g x 1 tab = 2 tabs

A nurse should use how many methods to identify the client before administering the medication?

2 Full name, DOB, and check wristband to verify

A client's prescriber has suggested 10 mL of guaifenesin (Robitussin) PO q4h as needed. What dose using household measurement will be given?

2 tsp Explanation: 1 tsp = 5 mL

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

20-year-old female client who has been diagnosed with a chlamydial infection Explanation: Child bearing age, sexually active. Teratogenicity is the ability of a substance to cause abnormal fetal development when taken by pregnant women. Drug groups considered teratogenic include antiepileptic drugs, "statin" cholesterol-lowering drugs, antidepressant drugs, nonopioid analgesics, and the antiflu drug oseltamivir (Tamiflu).

A client is receiving 250 mg of a drug that has a half-life of 12 hours. How much drug would remain after 36 hours?

31 mg

The client is a 6-year-old who is taking 125 mg of amoxicillin every 6 hours. Assuming that the half-life of amoxicillin is 3 hours, approximately how much amoxicillin would be in the child's body at the time of the next administration of the drug?

31 mg Explanation: 125/2 = 62.5 (hour 2) 62.5/2 = 31.25 (hour 3)round to 31 mg

A client is receiving 250 mg of a drug that has a half-life of 8 hours. How much drug would remain after 24 hours?

31.25 mg

The client is taking a 2-mg dose of ropinerol XR. The drug has a half-life of 12 hours. In how many hours will 0.25 mg of this drug remains in the client's system?

36

A client is taking Ropinerol XR 2 mg. The drug has a half-life of 12 hours. How long will it be before only 0.25 mg of this drug is remaining in the client's system?

36 hours

When a drug is given at a stable dose, how many half-life periods are required to achieve steady-state concentrations and develop equilibrium between tissue and serum concentrations?

4 to 5

The nurse is preparing medication for a 30-month-old with right otitis media. The child weighs 33 pounds. The health care provider has ordered cephalexin, 50 mg/kg/day in divided doses every 8 hours. The medication concentration is 250mg/5mL. How many milliliters should the nurse give the toddler?

5 Explanation: 33 lbs/2.2 = 15 kg 15 kg x 50 mg = 750 mg / day 750 mg/250 mg x 5 mL = 15 mL/day = 5 mL/8 hr

A client presents to the emergency department with a drug level of 50 units/mL. The half-life of this drug is 1 hour. With this drug, concentrations above 25 units/mL are considered toxic and no more drug is given. How many minutes will it take for the blood level to reach the non-toxic range? Provide your answer measured in minutes.

60

Fluoxitine is given to a client at a dosage of 500 mg every 6 hours. Assuming that the half-life of this drug is 3 hours, at what point would the drug level in the body be 62.5 mg of the original dose?

9 hours after the original dose

For which of the following patients would a nasogastric tube most likely be considered to aid in the administration of medications?

A 78-year-old man who is unable to swallow following an ischemic stroke Explanation: functioning GI system, dysphasia

What action should the nurse perform during the implementation step of the nursing process?

Administrations and documentation of medications.

A client has developed a tolerance to a drug. How should the nurse address this when providing care?

Assess whether the client needs larger doses to achieve the effect. Explanation: Tolerance may be acquired to the pharmacologic action of many drugs, especially opioid analgesics, alcohol, and other CNS depressants.

A client in distress is brought to the emergency department by ambulance. Emergency medical technicians state that an anaphylactic reaction from oral penicillin is suspected. Which of the nurse's assessment findings best supports this diagnosis?

Blood pressure: 186/100 mm Hg, shortness of breath Explanation: . Anaphylactic shock is a life-threatening hypersensitivity reaction characterized by respiratory distress and cardiovascular collapse. It occurs within a few minutes after drug administration and requires emergency treatment with epinephrine. Some allergic reactions (e.g., serum sickness) occur 1 to 2 weeks after the drug is given.

Whereas some drugs or metabolites are excreted in bile and then eliminated in feces, others are excreted in bile, reabsorbed from the small intestine, and then returned to the liver. What is the name of this process?

Enterohepatic recirculation Explanation: Entero = intestines, hepatic = liver

The nurse is caring for a client scheduled for surgery this morning who is not to be given anything orally. The nurse reviews the medication administration record and finds the client has an important medication due but it is supposed to be given orally. What is the nurse's best action?

Call the ordering health care provider and clarify administration.

For several days, a client with hypertension has been inadvertently taking an excessive dose of spironolactone, a potassium-sparing diuretic. The client has presented to the emergency department with signs and symptoms that suggest hyperkalemia. What assessment should the nurse prioritize?

Cardiac monitoring Explanation: Hyperkalemia presents an acute threat to normal cardiac function due to the effect on cardiac action potentials.

A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?

Discontinue the drug immediately as ordered.

A nurse has administered narcotics to a client. Which intervention should the nurse perform immediately after administering the drug?

Document administration of the drug. Explanation: Controlled drugs, such as opioid analgesics, are usually kept as a stock supply in a locked drawer or automated cabinet and replaced as needed. The nurse must sign for each dose and record it on the patient's MAR.

The processes involved in dynamic equilibrium are key elements in determining what?

Dosage scheduling

An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include?

Drugs cause unexpected or unacceptable reactions despite screening and testing.

The nurse is preparing to administer a prescribed drug to a client with a history of renal disease. Why should the nurse anticipate administering a lower dose than for a client with healthy kidneys?

Excretion is likely to take place slowly. Explanation: Excretion via the kidneys nephrons, through urine

The nurse is educating the patient about potential negative effects with monoamine oxidase inhibitors (MAOIs). What type of foods should the nurse inform the patient to avoid?

Foods high in tyramine Explanation: Tyramine causes release of norepinephrine, a strong vasoconstrictive agent, from the adrenal medulla and sympathetic neurons. Normally, norepinephrine is quickly inactivated by MAO. However, because MAO inhibitor drugs prevent inactivation of norepinephrine, ingesting tyramine-containing foods with an MAO inhibitor may produce severe hypertension/intracranial hemorrhage. MAO inhibitors include antidepressants isocarboxazid and phenelzine and anti-Parkinson drugs rasagiline and selegiline. Tyramine is in aged cheeses, sauerkraut, soy sauce, tap or draft beers, and red wines.

The nurse knows that a client is at high risk for developing drug tolerance because the client will be taking which drug for a long period of time?

Hydromorphone (Dilaudid) for pain Explanation: Tolerance is common in opioid analgesics

Assessment of a client receiving drug therapy reveals that the client has been experiencing gastrointestinal upset related to the drug. The client states, "My stomach has been so upset that all I've been able to eat is soup and dry crackers." Which nursing diagnosis would be most likely?

Imbalanced nutrition: Less than body requirements

An unconscious client has been brought to the hospital, and the client has prescribed a life-saving drug to be administered parenterally. Which method would be the most appropriate for the nurse to use when administering the medication?

Intravenous infusion

The nurse is explaining to the client what bioavailability is. What statement is true of bioavailability?

It is the portion of a dose that reaches the systemic circulation and is available to act on body cells.

The triage nurse in the emergency department admits a 16-year-old boy brought in by ambulance and accompanied by a friend. The client is in respiratory distress, is vomiting, and blood is noted in the vomitus. The client is somnolent and the electrocardiogram demonstrates an arrhythmia. The friend admits that the client took a "bunch of little green pills" from the cupboard at the grandparents' house. The nurse should recognize the likelihood of what adverse reaction?

Poisoning Explanation: Drug toxicity (also called poisoning or overdose) results from excessive amounts of a drug and may damage body tissues.Clinical manifestations are often nonspecific and may indicate other disease processes.

A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize?

Provide supportive care to manage fever and inflammation. Explanation: Drugs can cause fever by several mechanisms: allergic reactions, damaging body tissues, interfering with dissipation of body heat, or acting on the brain's temp-regulating center. Usually subsides within 48 to 72 hours unless drug excretion is delayed or significant tissue damage has occurred (e.g., hepatitis).

During a health care visit, a client reveals having stopped taking a prescription because the drug made the mouth dry. What would be most appropriate for the nurse to do?

Suggest taking frequent sips of water or sucking on hard candy.

Which organization is responsible for the continuation of defining, explaining, classifying, and researching summary statements about health problems related to nursing?

The North American Nursing Diagnosis Association-International (NANDA)

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion?

The client's blood urea nitrogen level and creatinine clearance rate

An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?

This may be coincidental, and the memory loss may be attributed to changes with aging.

How would the dosage of a partly protein-bound drug be altered if another drug having a higher attraction to albumin than the first drug is administered?

The dosage of the first drug may have to be decreased. Explanation: Displacement of one drug from plasma protein-binding sites by a SECOND drug increases the effects of the displaced FIRST drug. This increase occurs because the displaced first drug becomes pharmacologically active. The overall effect is the same as taking a larger dose of the displaced drug. For example, aspirin displaces warfarin and increases the drug's anticoagulant effects.

The nurse is caring for a client who is receiving Gentamycin, 250 mg, and Diflucan, 500 mg at the same time. What effect should the nurse anticipate if these two drugs compete with each other for protein binding sites?

The effectiveness of both drugs will be altered.

Written prescriptions for the client to take home must include the following information:

The full name of the client; the name of the drug; the dose, route, frequency of administration; the date, time, and signature of the prescriber; and any refills authorized.

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?

The man may be experiencing nephrotoxic effects of aspirin Explanation: urea = kidneys = nephrons = nephrotoxic effects. Nephrotoxicity (nephritis, renal insufficiency or failure) occurs with several antimicrobial agents, NSAIDs and others. It is potentially serious, may interfere with drug excretion causing drug accumulation and increased adverse effects.

What action by the nurse can assist in detecting changes in drug absorption caused by drug interactions?

The nurse needs to monitor for signs of decreased drug effects.

A nurse is administering digoxin to a client. To administer medications so that the drug is as effective as possible, the nurse should prioritize what factor?

The process of pharmacokinetics

Which of the following is not a client right regarding his or her prescribed medication?

The right to refuse a court ordered medication

The nurse is assessing factors that may affect the absorption of a drug that the nurse will soon administer. What factor should the nurse prioritize?

The route of administration that has been prescribed Explanation: Routes of administration affect drug actions and patient responses by influencing absorption and distribution. For rapid drug action and response, the IV route is most effective because the drug is injected directly into the bloodstream. For some drugs, the IM route also produces drug action within a few minutes because muscles have a large blood supply. The oral route usually produces slower drug action than parenteral routes. Absorption and action of topical drugs vary according to the drug formulation, whether the drug is applied to skin or mucous membranes, and other factors.

What would the nurse identify as the desired response of the combination of codeine and acetaminophen rather than each given separately?

When the drugs are combined, the additive effect is better control of pain. Explanation: Synergism occurs when two drugs with different sites or mechanisms of action produce greater effects when taken together (acetaminophen [nonopioid analgesic] + codeine [opioid analgesic] increases analgesic effects)

An experienced nurse has observed that female clients sometimes experience a drug's effects for a longer time than male clients of similar age and size. The nurse should attribute this to what factor?

Women have more fat cells so drugs depositing in fat will have a prolonged effect. Explanation: Women also have less muscle tissue, smaller blood volume, and hormonal fluctuations due to menstrual cycle. In general, women given equal dosages or equal weight-based dosages are thought to be exposed to higher concentrations of medications compared to men

A female client has a 12-year history of ETOH abuse. The client is injured in a motor vehicle accident and requires surgery with general anesthesia. What would the nurse expect for this client?

a larger-than-normal dose of the general anesthetic Explanation: A person who regularly drinks large amounts of alcohol (Ethanol) becomes able to ingest even larger amounts before becoming intoxicated—this is tolerance to alcohol. If the person is then given sedative-type drugs or a general anesthetic, larger-than-usual doses are required to produce a pharmacologic effect—this is cross-tolerance.

A nurse is caring for a client who has had part of her small intestine removed due to cancer. She has also now developed hypertension and has been prescribed a new medication to decrease her blood pressure. While planning the client's care, the nurse should consider a possible alteration in which aspect of pharmacokinetics?

absorption

The nurse is assessing a client who has developed shortness of breath, a rash, panic, and a blood pressure of 189/106 mm Hg after being administered a new medication. In addition to promptly informing the care team, the nurse should:

administer epinephrine as prescribed.

The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration?

adverse effects

The nurse is caring for a client with a drug allergy and understands the allergy is the result of the client developing:

antibodies. Explanation: Hypersensitivity(allergy) may occur with almost any drug in susceptible patients. It is unpredictable & unrelated to dose. Occurs in those who have previously been exposed to the drug or a similar substance (antigen) and who have developed antibodies. When readministered, the drug reacts with antibodies to cause cell damage & the release of histamine

A client has not experienced the desired therapeutic effects of a medication. When considering factors that may affect the dynamic equilibrium that influences drug concentration, the nurse should:

assess for factors that may reduce absorption.

When a client is taking more than one drug, a significant drug-drug interaction can occur resulting in one drug stimulating or blocking the metabolism of the other drug. What phase can this occur in?

biotransformation

What unique characteristic is present in lipid soluble drugs?

can cross the blood-brain barrier Explanation: Drug distribution into the central nervous system (CNS) is limited because the blood-brain barrier, which is composed of capillaries with tight walls, limits movement of drug molecules into brain tissue. Only drugs that are lipid soluble or have a transport system can cross the blood-brain barrier and reach therapeutic concentrations in brain tissue.

A nurse is preparing to administer a prescribed drug to a client who has liver disease. The nurse expects a reduction in dosage based on the understanding that what might be altered?

metabolism Explanation: Hepatic disorders (hepatitis, cirrhosis, decreased liver function), mainly interfere with metabolism. Severe liver disease or cirrhosis may interfere with all pharmacokinetic processes.

A nurse in a nutrition clinic is to give 2 cups of organic prune juice to a client every night. The nurse is to document this on the nursing chart. What unit will the nurse use to document the amount of juice according to the metric system of measurement?

milliliter

What is cross tolerance?

one drug can produce tolerance to other drugs that act by the same mechanism/pharmacologically related drugs

The nurse is administering an antibiotic to a client with a diagnosis of cellulitis of the left leg. Which client condition would have the greatest effect on the drug's distribution?

peripheral vascular disease Explanation: Cardiovascular disorders interferes with all pharmacokinetic processes, mainly by decreasing blood flow to sites of drug administration, action, metabolism (liver), and excretion (kidneys)

The nurse is caring for a client who experienced a severe headache. When the prescribed dose of analgesics did not cause relief the client took double the dosage one hour later. The nurse should assess the client for what adverse effect?

poisoning

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of:

poisoning Explanation: Drug toxicity (also called poisoning or overdose) results from excessive amounts of a drug and may damage body tissues. The main goals of treatment are starting treatment as soon as possible after drug ingestion, supporting and stabilizing vital functions, preventing further damage from the toxic agent by reducing absorption or increasing elimination, and administering antidotes when available and indicated.

A client, prescribed a drug that has an exceptionally narrow margin of safety, should be educated about the need for what intervention?

serum drug level monitoring Explanation: A serum drug level is a laboratory measurement of the amount of a drug in the blood at a particular time, it reflects dosage, absorption, bioavailability, half-life, and the rates of metabolism and excretion. With narrow margins of safety the therapeutic dose is close to a toxic dose. This is also done for suspected overdose or unexpected responses.

How is pharmacodynamics best defined?

the action that the drug has on body cells

A drug's ability to alter basic processes in body cells allows for what function?

the alternation in specific cellular functions Explanation: Drugs are chemicals that alter basic processes in body cells. They can stimulate or inhibit normal cellular functions; however, they cannot change the type of function that occurs normally.

The client with a history of ischemic heart disease is taking aspirin 81 mg daily. The nurse should explain that less than 81 mg actually reaches target tissue due to:

the first-pass effect.