1235 EAQ Patient Education

Which medication action would the nurse identify as the purpose of azathioprine, cyclosporine, and prednisone given before receiving a kidney transplant?

Reduce antibody production RATIONALE: These drugs suppress the immune system, decreasing the body's production of antibodies in response to the new organ, which acts as an antigen. These medications decrease the risk of rejection. These medications inhibit leukocytosis. These medications do not provide immunity; they interfere with natural immune responses. Because these medications suppress the immune system, they increase the risk of infection.

Which reason would the nurse include in a response to a client with rheumatoid arthritis who asks the nurse why it is necessary to inject hydrocortisone into a knee joint?

Reduces inflammation RATIONALE: Steroids have an anti-inflammatory effect that can reduce arthritic pannus formation. Injecting hydrocortisone into the joint does not provide lubrication. Injection of a medication into a joint is not physiotherapy. Ankylosis refers to fusion of joints. It is only indirectly influenced by steroids, which exerts their major effect on the inflammatory process.

Which mechanism of action explains how glyburide decreases serum glucose levels?

Stimulates the pancreas to produce insulin. RATIONALE: Glyburide, an antidiabetic sulfonylurea, stimulates insulin production by the beta cells of the pancreas. Accelerating the liver's release of stored glycogen occurs when serum glucose drops below normal levels. Increasing glucose transport across the cell membrane occurs in the presence of insulin and potassium. Antidiabetic medications of the biguanide chemical class improve sensitivity of peripheral tissue to insulin, which ultimately increases glucose transport into cells. Beta cells must have some function to enable this medication to be effective. Glyburide does not decrease the absorption of glucose from the gastrointestinal system.

Which reply by the nurse is appropriate when a client asks how psychotropic medications work?

"These medications affect the chemicals used in communication between nerve cells." RATIONALE: Most psychotropic medications affect neurotransmitters such as dopamine and norepinephrine., which enter the synapses between neurons, allowing them to signal each other. Psychotropic medications do not work by changing the metabolic needs of the brain. They do not increase the production of nervous tissue. Although there may be some effect on sensory input, this is because of the change in neurotransmitters.

Which explanation would the nurse provide for administering prednisone to a client with an exacerbation of colitis?

Although the medication decreases intestinal inflammation, it will not cure the colitis. RATIONALE: Prednisone inhibits phagocytosis and suppresses other clinical phenomena of inflammation; this is a symptomatic treatment that is not curative. The medication suppresses the immune response and increases the potential for infection. The response usually is rapid. Appetite is increased; weight gain may result from this or from fluid retention.

Which property of acetylsalicylic acid would a nurse recall when administering to a client?

Analgesic RATIONALE: Acetylsalicylic acid (aspirin) acts as an analgesic by inhibiting production of inflammatory mediators. Acetylsalicylic acid does not act as a sedative to calm individuals. Acetylsalicylic acid does not act as a hypnotic to induce sleep. Acetylsalicylic acid does not destroy or control microorganisms

By which process would total parenteral nutrition (TPN) on an outpatient basis help a client with Crohn's disease prepare for surgery?

Decreasing fecal bulk RATIONALE: by decreasing fecal bulk and bowel stimulation, TPN provides rest for the bowel while the client awaits surgery. TPN does not prevent a bowel infection. TPN does not stimulate gastrointestinal secretions. TPN promotes positive nitrogen balance

Which advise will the nurse provide about doxorubicin to a client with Hodgkin's disease?

Expect urine to turn red for a few days after taking this medication. RATIONALE: Doxorubicin causes the urine to turn red for a few days; the client should be informed of this expectation so as not to become alarmed when it occurs. Discontinuing the intake of vitamin D is true for plicamycin, not the medications in this protocol. It is unnecessary to keep doxyrubicin in a dark area, protected from light. Doxorubicin is not given orally, only via the intravenous route.

Which information would the nurse provide to a client with hyperthyroidism receiving methimazole?

Initial improvement will take several weeks. RATIONALE: Methimazole blocks thyroid hormone synthesis; it takes several weeks of medication therapy before the hormones stored in the thyroid gland are release and the excessive level of thyroid hormone in the circulation is metabolized. There are many common side effects that include nausea, vomiting, diarrhea, rash, urticaria, pruritus, alopecia, hyperpigmentation, drowsiness, headache, vertigo, and fever. Methimazole should be spaced at regular intervals because blood levels are reduced in approximately 8 hours. Large doses cause toxic side effects that can be life-threatening, including nephritis, hepatitis, agranulocytosis, leukopenia, thrombocytopenia, hypothrombinemia, and lymphadenopathy.

How will the nurse evaluate the effectiveness of the training after teaching a family member how to administer subcutaneous enoxaparin sodium?

Observing the family member administering enoxaparin sodium to the client. RATIONALE: The best way to evaluate the effectiveness of the teaching is to observe the family member administering the medication to the client. The family member may be able to perform a subcutaneous injection on a manikin but fear hurting the family member. Knowing the side effects of enoxaparin sodium is important, but it does not provide any information as to the family member's ability to administer the medication. The family member may be able to verbalize all the steps but fear puncturing the skin with the needle.