ATI Pharm
A client with TB is taking rifampin. Which statement indicates an understanding of the teaching?
"I shouldn't wear my soft contact lenses because they will become discolored" Rifampin causes harmless red-orange discoloration of stool, sputum, sweat, tears. Consult with opthalmologist.
new script for allopurinal
"it decreases production of uric acid" Allopurinol, a xanthine oxidase inhibitor, acts by inhibiting the enzyme that produces uric acid, thus improving joint function. The nurse should instruct the client to increase fluid consumption to 2 L/day to reduce the risk for renal injury while taking allopurinol.
A nurse is administering haloperidol to a client with schizophrenia. For which of the following ADE should the nurse monitor?
A client who is taking haloperidol, a first-generation antipsychotic agent, can develop extrapyramidal effects, such as parkinsonism, which manifests as tremors, bradykinesia, loss of balance, mask-like facial expression, shuffling gait, and muscle rigidity.
a nurse is assessing a client with parkinson's disease and is taking levodopa/carbidopa. The nurse observes tremors and twitching. Which med should the nurse anticipate administering?
A client who is taking levodopa/carbidopa for Parkinson's disease is at risk for developing dyskinesias, which are involuntary movements. Amantadine can help alleviate this adverse effect by increasing the release of dopamine.
A nurse is reviewing lab results for a client who is taking warfarin following orthopedic surgery. Which lab result should the nurse report?
A client who is taking warfarin following an orthopedic surgery should have a therapeutic INR between 2 to 3. The nurse should identify an INR greater than 5 as a critical value. Therefore, the nurse should report this laboratory value to the provider to have the client's warfarin dosage adjusted.
A nurse on a tele unit is caring for a client with a new script for digoxin. The nurse should id that which of the following cardiac rhythms is a contraindication?
A second-degree heart block results when there is a problem in the atrioventricular conduction system. Each atrial impulse takes progressively longer to go from the AV node to the ventricles until a QRS complex drops. Digoxin slows atrioventricular conduction and can cause progression to a complete heart block; therefore, the nurse should identify second-degree heart block as a contraindication for digoxin therapy.
Comolyn for asthma
its a management inhaler. "Mast cell stabilizer to prevent chronic asthma. take 3-4x daily
The presence of food will alter the rate of which of the following pharmacokinetic processes?
Absorption
acetazolamide ADE
Acetazolamide promotes renal excretion of sodium and potassium and reduces the formation of bicarbonate, increasing the client's risk of electrolyte and acid-base imbalances. Therefore, the nurse should monitor the client for findings of electrolyte imbalance.
acyclovir 3 times IV daily. monitor for?
Acyclovir is an antiviral agent used to treat infections caused by the herpes simplex virus and the varicella-zoster virus. IV acyclovir therapy can cause reversible nephrotoxicity. The nurse should monitor the client's BUN and creatinine levels and encourage fluid intake during and after infusion to minimize the risk of nephrotoxicity.
A nurse providing teaching to a pt who is scheduled to receive chemotherapy and has a script for ondansetron for nausea and vomiting. Which of the following should the nurse include in the teaching?
Additional meds can be required. Combinations of antiemetics are usually more effective than single-medication therapy at managing chemotherapy-induced nausea and vomiting. The combination of a serotonin antagonist, such as ondansetron, with a corticosteroid, such as dexamethasone, can be highly effective in preventing chemotherapy-induced nausea and vomiting.
A nurse is assessing a client who is taking codeine to suppress a cough. Which findings is priority to report to provider?
Agitation, could indicate neurotoxicity as a result of overuse of opioids. Urinary retention and constipation are expected findings, as well as dry mouth.
client taking lovastatin just got a script for ezemtimibe to lower cholesterol levels
monitor ALT for liver toxicity/damage
A nurse is caring for a client receiving heparin by continuous iv infusion to treat venous thrombosis. Which lab value should be monitored?
The nurse should monitor the aPTT of a client who is receiving heparin by continuous IV infusion. When beginning heparin therapy, the nurse should monitor the aPTT every 4 to 6 hr. Once the client has achieved the desired range, the nurse should monitor the aPTT daily.
A nurse is teaching a pt who has a new script for beclomethasone and albuterol inhalers.
Beclomethasone is an inhaled corticosteroid that prevents bronchial inflammation. Because it can cause oral candida infections, the nurse should instruct the client to gargle with water after using beclomethasone.
A nurse in the ED is planning care for a client who had a MI and is receiving thromolytic therapy with an IV infusion of alteplase. Which interventions should the nurse include in the care plan?
Bleeding is the most common adverse effect of tissue plasminogen activator therapy. Therefore, the nurse should monitor the client for changes in level of consciousness, which can indicate potentially life-threatening intracranial hemorrhage.
accidentally doubled diazepam dose
The nurse should plan to administer flumazenil to a client who has diazepam toxicity to reverse the effects of the diazepam
Toxic acetomenophen amount. Monitor for what?
Diaphoresis Abdominal discomfort increased ALT
A nurse is preparing to administer diclofenac to a pt with chronic bursitis. Which of the following actions should the nurse take?
Diclofenac is an NSAID and can cause gastric irritation. Clients should take NSAIDs with food or milk to minimize gastric irritation.
A nurse is teaching a newly licensed nurse abut didanosine therapy. Which of the following client conditions should the nurse id as an indication for treatment with didanosine?
Didanosine is a non-nucleoside reverse transcriptase inhibitor that treats human immunodeficiency virus (HIV) infection. It reduces HIV infection's cognitive manifestations by inhibiting DNA synthesis and viral replication; however, clients must take it simultaneously with other antiretroviral medications to reduce the risk for the development of resistance to this medication.
Furosemide
Eat high K foods/take supplement Report hearing loss Rise slowly from sitting/lying position Check daily weight
What should be monitored to ensure Somatropin is working?
monitor the childs height monthly. somatropin is for a GH deficiency
new script for clopidogrel after CA stent placement. Which should be reported to provider?
Ginkgo biloba is an herbal supplement that might help improve memory and decrease intermittent claudication. It can suppress coagulation; therefore, it interacts adversely with clopidogrel by increasing the risk for bleeding. Other herbal supplements that interact with clopidogrel include chamomile, feverfew, and ginseng.
a nurse assessing a pt prior to atenolol admin finds that heartrate is 61. what do?
Give it If the client's heart rate is less than 50/min, the nurse should withhold the medication and notify the provider. For a heart rate of 61/min, the nurse should administer the medication and continue to monitor the client.
A nurse receives verbal orders from the provider for Hydrochlorothiazide 25mg by mouth daily for a client with HTN. Which of the following indicates how the nurse should transcribe the script in the MAR
Hydochlorothiazide 25 mg po daily The nurse should transcribe the provider's prescription by spelling out the name of the medication, recording the dosage as a whole number, and spelling out the word "daily." The abbreviation PO is acceptable for use to indicate the route by mouth.
A client with a hx of DM has a new script for HCTZ for uncontrolled HTN, what should be included in the teaching?
Hydrochlorothiazide can cause hyperglycemia and other electrolyte imbalances. The nurse should remind the client of this adverse effect and instruct the client to report elevated glucose levels to the provider.
ipratroprium ADE
Ipratropium is an anticholinergic bronchodilator. The muscarinic blocking effects of the medication can cause the common adverse effect of xerostomia, or dry mouth.
A nurse is preparing to administer medications to a pt. The pt states "I'll take the pills but not the liquid medication." Which of the following actions should the nurse take?
It is the responsibility of the nurse to respect the client's right to refuse to take a medication and to document the reason a medication dose is not administered. This should include the client's refusal to take the medication.
a nurse accidentally removes celecoxib from the pixus instead of citalopram and almost administers the wrong medication. What should the nurse do?
The nurse should report the incident to the nurse manager to evaluate why the medication error almost occurred and to determine how to prevent this mistake from happening again in the future.
a pt receiving midazolam has a bp drop from 122/84 to 86/50
MY ANSWER The nurse should expect a prescription for flumazenil to reverse the hypotension, which is a potential adverse effect indicating midazolam toxicity. Flumazenil is a benzodiazepine derivative that counteracts CNS depression caused by the medication. The nurse should assess the client's airway for patency prior to administration.
a nurse is preparing to admin Mannitol via continuous IV infusion to a pt. Which findings should the nurse identify as expected?
Mannitol is an osmotic diuretic, which acts by drawing fluid into the nephron and increasing urinary output. The nurse should monitor the client's fluid status during treatment with mannitol.
A nurse is planning care for a pt with asthma and a script for methylprednisolone. Which of the following lab values should the nurse monitor?
Methylprednisolone tx increases the synth of glucose and decreases the uptake of glucose by the muscles and adipose tissues, resulting in increased circulating glucose. Therefore, it is important for the nurse to monitor blood glucose levels regularly while clients are receiving corticosteroid therapy.
Spironolactone
Muscle weakness is an indication of hyperkalemia, an adverse effect of potassium-sparing diuretics. The client should report any indications of hyperkalemia to the provider immediately because it can progress to life-threatening dysrhythmias and cardiac arrest.
a nurse is reviewing the lab report for a pt who has been taking sodium polystyrene sulfonate. Which of the following findings indicates a therapeutic response to the medication?
Sodium polystyrene sulfonate is a cationic exchange resin administered to treat hyperkalemia. A potassium level of 4.8 mEq/L is within the expected reference range of 3.5 to 5 mEq/L and indicates that the client has experienced a therapeutic response to the medication. The nurse should closely monitor the client's potassium level throughout treatment and notify the provider when the potassium level drops to within 4 to 5 mEq/L.
A nurse is caring for a client who is postmenopausal and has a script for raloxifene. The nurse should instruct the client that raloxifene is prescribed for which of the following?
Raloxifene can lower the risk for breast cancer in postmenopausal clients who have a high risk for developing estrogen-receptive types of breast cancer. The medication also reduces the risk for and can treat postmenopausal osteoporosis.
Esomeprazole
Take the medication 60 min before a meal. Food affects the absorption of esomeprazole. For optimal absorption, the client should take the medication at least 60 min before a meal.
A nurse is assessing a client who has a positive Trousseau's sign. Which of the following should the nurse plan to administer?
The nurse should identify that a positive Trousseau's sign is a manifestation of hypocalcemia. Therefore, the nurse should plan to administer calcium gluconate to treat hypocalcemia.
A pt on IV furosemids is at risk for developing dehydration. Which clinical finding suggests this
The nurse should identify that a urinary output of 240 mL in a 12-hr period (20 mL/hr) indicates oliguria.
ketorolac
The nurse should identify that the greatest risk to the client is renal insufficiency or renal toxicity, both of which are potential adverse effects of ketorolac
A nurse is assessing a pt with ovarian cancer and is receiving paclitaxel. Which of the following is priority to report to the provider?
When using the airway, breathing, and circulation (ABC) approach to client care the priority finding for the nurse to report to the provider is bradycardia. Clients who have cardiovascular problems, such as bradycardia, require continuous ECG monitoring during the infusion of paclitaxel because of the cardiovascular effects of the medication, such as bradycardia and hypotension.
A nurse is caring for a client who is receiving meperidine. Which of the following is the priority assessment before administering the medication?
When using the airway, breathing, and circulation (ABC) approach to client care, the nurse should determine that the priority assessment is to check the client's respiratory rate. Opioid therapy can result in respiratory depression, which can lead to respiratory arrest. The nurse should withhold the opioid medication and notify the provider if the client's respiratory rate is below 12/min.
Someone on metformin should be screend for
alcohol use disorder Metformin can inhibit the breakdown of lactic acid, causing life-threatening lactic acidosis. The nurse should identify alcohol use disorder as a contraindication because alcohol further inhibits the breakdown of lactic acid.
A pt reports an increase in migranse over the past 2 weeks asks if sumatriptan would be helpful. What would be important about their medical history to know as a contradindication for this med?
angina pectoris - sumatriptan is a vasoconsctrictor
warfarin antidote inr of 4
vitamin k. A client who is receiving warfarin should have an expected INR between 2 to 3. An INR greater than 3 can indicate a risk for hemorrhage.
a nurse is caring for a pt with ventricular dysrhythmia and a new script for amiodarone. Which of the following interventions should the nurse include in the plan of care?
Amiodarone can be toxic to the liver. Therefore, the client should undergo baseline liver function testing, and the nurse should instruct the client to have regular liver enzyme testing and to report the development of jaundice while taking amiodarone.
A nurse is assessing a client who is receiving androgen therapy for endometriosis. The nurse should monitor for which of the following ADE?
Androgens treat endometriosis and fibrocystic breast disease, and can cause fluid retention; therefore, androgen therapy should be used cautiously with clients who have existing cardiac or renal impairment. The nurse should monitor the client for edema and instruct the client to measure weight daily.
A nurse is preparing to admin topotecan IV for a client with metastatic ovarian cancer. Which of the following meds should be expected to control ADE of topotecan
Granisetron is an antiemetic medication that helps prevent nausea and vomiting for clients who are receiving chemotherapy medications such as topotecan. The client should apply the transdermal patch to the upper outer arm up to 48 hr prior to receiving topotecan and continue to wear the patch until 24 hr after the completion of chemotherapy to prevent chemotherapy-induced nausea and vomiting.
A nurse is planning care for a client who is taking Tamoxifen for tx of breast cancer. Which of the following interventions should the nurse include in the plan?
Monitor the client's calcium level is correct. Tamoxifen increases the risk for hypercalcemia. The nurse should monitor the client's pulse and blood pressure, which are increased in mild hypercalcemia and decreased in severe or prolonged hypercalcemia. Other manifestations include cyanosis, pallor, muscle weakness, and decreased deep tendon reflexes. Monitor the client for pulmonary embolus is correct. Tamoxifen increases the risk for pulmonary embolus. The nurse should instruct the client to report any chest pain or difficulty breathing. Advise the client of the potential for menstrual irregularities is correct. Tamoxifen can cause menstrual irregularities, pain, and bleeding. Therefore, the nurse should instruct the client to notify the provider. Advise the client of the potential for hot flashes is correct. Hot flashes are a common occurrence in clients taking tamoxifen. The nurse should inform the client that hot flashes are reversible with discontinuation of the medication.
a nurse is providing teaching to a client who has a new script for ciprofloxacin. Which of the following ADE should the nurse include in teaching?
Most fluoroquinolones cause phototoxicity. The nurse should instruct the client to avoid direct sunlight and to wear sunglasses, sunscreen, and protective clothing. The nurse should also inform the client that effects can occur even after applying sunscreen and from indirect light sources. The client should stop taking ciprofloxacin immediately if phototoxicity occurs.
ethinyl estradiol and norethindrone for contraception. ADE
breakthrough bleeding and spotting during menstrual cycle. take at the beginning of the cycle. bleeding might resolve in 3mo
pt received clonidine instead of clonazepam, after checking BP, what should the nurse do next?
review ADE of clonidine The first action the nurse should take using the nursing process is to analyze the potential risks to the client. Clonidine is a centrally acting alpha2 agonist that decreases blood pressure.