Chapter 3: Toxic Effects of Drugs

A client comes to the clinic reporting vaginal discharge with itching. Which statement would alert the nurse to the possibility that the client's reports are related to a superinfection?

"I just completed a course of antibiotics prescribed by my dentist to treat a tooth abscess."

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 bestexplanation 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."

Many drugs can affect the functioning of the nerves in the periphery and central nervous system. Which are examples of potential neurologic effects of drugs? Select all that apply.

+a postoperative client with extrapyramidal symptoms, hyperthermia, and autonomic disturbances +a client taking an antipsychotic who exhibits akinesia, muscular tremors, drooling, changes in gait, jitters (akathisia), or spasms (dyskinesia) +a postoperative client who had atropine and exhibits dry mouth, altered taste perception, dysphagia, heartburn, constipation, and bloating

Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply.

+skeletal and limb abnormalities +central nervous system alterations +heart defects

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

A client develops a cytotoxic reaction to a drug. What would the nurse expect to do?

Discontinue the drug immediately as ordered.

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.

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.

A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primaryrationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?

It is necessary to ensure that the client's drug levels are therapeutic but not toxic.

What does the nurse need to do when there is any indication of an allergic reaction in clients?

Maintain the client's safety during drug therapy.

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.

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?

Review the client's most recent potassium level.

A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client?

Techniques for providing safe and effective mouth care

A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?

The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays.

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

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 called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication?

anaphylactic shock

Preoperative atropine belongs to what classification of drugs?

anticholinergic

Which drug classification is used to treat superinfections?

antifungals

A nurse is administering gentamicin, an antibiotic that is ototoxic. Which report or sign would indicate that the client is suffering from ototoxicity?

buzzing or ringing sound in the ears (tinnitus)

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 has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action?

protecting and maintaining the patency of the client's airway

The nurse is reviewing the laboratory test results of a client receiving drug therapy. What would the nurse suspect if the results reveal an elevation in the blood urea nitrogen level and creatinine concentration?

renal injury

The nurse is conducting an admission assessment of a new client. When asked about any food or drug allergies, the client states that the client is allergic to tetracycline. What action should the nurse next perform?

Ask the client, "What happens when you take a dose of tetracycline?"

The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize?

asking the client what the client's response is to taking NSAIDs