Chapter 3: Toxic Effects of Drugs- Prep U's

The nurse administers penicillin to a client and monitors the client for an adverse reaction despite the fact that the client claimed not to be allergic to penicillin. What is the rationale for checking for adverse reactions?

-A person can be allergic to any medication at any time. -Medications can react with other medications prescribed for the client. -Medications can react with herbal supplements to cause adverse reactions. -Medications can react with over-the-counter medications to cause toxicity.

A client is being discharged from the emergency department (ED) after being treated for an anaphylactic reaction to shrimp the client ate for dinner. The client asks the nurse to explain food reactions. Which would be correct responses? Select all that apply.

-Anaphylactic reactions involve an antibody that causes the release of histamine. -Anaphylactic reactions can lead to respiratory distress and even respiratory arrest. -Histamines produce immediate reactions.

The nurse is assessing a community-dwelling client with a history of rheumatoid arthritis. During the interview, the client states, "The last few months, I have this ringing in my ears that I just cannot seem to get away from." What assessment question should the nurse ask?

"Have you been taking aspirin on a regular basis?"

Many drugs, if taken during pregnancy, can cause adverse effects to the fetus. It is important for nurses to teach women the potential risks of fetal drug exposure. What are some potential risks?

-blindness -central nervous system defects -heart anomalies -limb deformities -facial defects

What factors can potentially contribute to a hypersensitivity reaction?

-pathological condition -age-related changes -unique receptors and cellular responses

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

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?

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects?

Be sure to drink plenty of fluids to prevent dehydration.

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 an anxiety disorder has been prescribed alprazolam 0.5 mg PO t.i.d. During a follow-up assessment, the client tells the nurse that the medication causes drowsiness that interferes with the client's work performance. What is the nurse's best action?

Educate the client about strategies for managing this primary action.

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 develops bone marrow suppression related to a drug's effects. What would be most important for the nurse to do?

Monitor laboratory blood values.

A client with a longstanding diagnosis of schizophrenia has taken antipsychotic drugs for several decades. For what adverse effect should the nurse assess?

Parkinsonian symptoms

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.

Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. What is the name of the adverse reaction that can cause birth defects?

Teratogenicity

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

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.

A parent brings a child to the clinic for an earache. The child receives a prescription for amoxicillin. The parent calls the clinic the next day and says the child has been taking the medicine and now has a rash. The nurse should give the parent instructions about which type of response?

allergic response

A client is being seen in the emergency department for a sprained ankle and is given a drug to relieve pain. When a second dose of the pain medication is given, the client develops redness of the skin, itching, and swelling at the site of injection of the drug. The most likely cause of this response is:

an allergic response.

What is an example of a secondary action?

an antihistamine causes the client to experience drowsiness

Upon assessment after giving oral penicillin, the nurse notes that a client has dilated pupils, increased blood pressure, and increased heart rate. The nurse would document these findings as which type of drug allergic reaction?

anaphylactic

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

The nurse would assess a client receiving which medication for possible superinfection?

antibiotics

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

antibodies

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

decreased glomerular filtration rate.

A client is receiving an antineoplastic medication for treatment of breast cancer and begins having tonic-clonic seizure activity. What type of toxicity does the nurse recognize that this client is experiencing?

neurotoxicity

A client is experiencing central nervous system effects related to drug therapy. Which would be most important for the nurse to emphasize in the teaching plan?

safety measures

Which skin condition would be most likely to cause increased systemic absorption of a topical medication?

severe sunburn

The nurse is assessing a client who may be experiencing an anaphylactic reaction. What assessment finding is most consistent with this diagnosis?

shortness of breath

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

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

The nurse is caring for a client with hypertension who was prescribed a loop diuretic one week ago. The client reports malaise and weakness and the nurse's assessment reveals an irregular heart rate. The nurse should prioritize assessment of the client's:

potassium levels

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of:

secondary actions

The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response?

"Do you remember what happened the last time you received penicillin?"

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."

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."

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

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.

Preoperative atropine belongs to what classification of drugs?

anticholinergic

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

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.

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

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity?

a decrease in urine output

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

When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:

hyperglycemia

What would the nurse expect to assess if a client develops neuroleptic malignant syndrome?

hypertension

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

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?

toxicity