Chapter 57- Pharmacology
When describing the drugs used to treat traveler's diarrhea, which would the nurse identify as the most common cause?
E.coli
A client diagnosed with metabolic syndrome is encouraged to implement nonpharmacologic measures to improve existing risk factors. What actions demonstrate an understanding of appropriate measures? Select all that apply.
Eating a high-fiber diet Maintaining a healthy weight Adhering to a low-fat diet Avoiding tobacco products Walking for 30 minutes several times a week
A nurse is preparing to administer a drug that reduces the secretion of gastric acid by inhibiting the action of histamine at H2 receptors in the stomach. Which medication might the nurse be preparing to administer? Select all that apply.
Famotidine Ranitidine
After reviewing the various agents used to lower lipid levels, the students demonstrate understanding of the information when they identify which agents as stimulating the breakdown of lipoproteins from the tissues and their removal from the plasma? (Select all that apply.)
Fenofibrate Gemfibrozil
The nurse instructs a client to take the prescribed pravastatin at bedtime based on understanding that:
Greater drug effectiveness is achieved at this time.
Ranitidine and cimetidine are both H2RAs used in the treatment of peptic ulcer disease. Of the two, ranitidine is preferred in critically ill clients because it is less likely to:
Interfere with the metabolism of other drugs.
What information would be included in a lipoprotein profile? Select all that apply:
LDL Triglycerides Total cholesterol
Which lipid level would the nurse interpret as being high?
LDL cholesterol of 190 mg/dL
A client is diagnosed with Helicobacter pylori infection. The health care provider will order amoxicillin and what other type of medication?
Proton pump inhibitors
What is the most common reason for an elevated cholesterol level in a client who does not have a genetic disorder of lipid metabolism?
His dietary intake of saturated fat
After teaching a client about prescribed statin therapy, the nurse determines that additional teaching is needed when the client makes which statement?
"I can take the drug with grapefruit juice."
A client is taking cholestyramine to reduce LDL cholesterol. Cholestyramine will cause a decrease in absorption of which medication?
Digoxin
After teaching a client who is receiving sucralfate about the drug, which statement indicates that the teaching has been successful?
"I should eat a high-fiber diet."
A client who is receiving cholestyramine also takes digoxin. The nurse teaches the client about the drug and administration. The client demonstrates understanding of the teaching when stating:
"I will take the digoxin about an hour before the cholestyramine."
A client has been prescribed omeprazole by the primary health care provider. When the nurse asks whether the medication is providing relief, the client replies, "I think it's working quite well, and I've gotten in the routine of taking it every morning before breakfast." How should the nurse respond?
"I'm glad to hear that. It sounds like you're taking it exactly like it should be taken."
The nurse is providing education to an older adult client who has been prescribed atorvastatin. How should the nurse describe the common adverse effects of the drug?
"The most common side effects of atorvastatin include some mild gastrointestinal upset."
A client is prescribed a proton pump inhibitor to treat erosive gastritis. How soon will the client's symptoms be resolved?
1 to 2 weeks
A client is receiving sucralfate. The nurse understands that this drug would begin to act within which time frame?
30 minutes
Which would the nurse identify as being affected by dexpanthenol?
Acetylcholine
The nurse cautions a client with what allergy to avoid the use of bismuth salts in the treatment of diarrhea?
Aspirin
Elevated blood lipids are a major risk factor for atherosclerosis and vascular disorders. From where are blood lipids derived?
Diet
A client who has been taking a statin has seen an improvement in his cholesterol laboratory values; however, the low-density lipoprotein remains elevated. What medication will be added to the medical regime?
Cholestyramine
Which would be classified as a bile acid sequestrant?
Cholestyramine
Which would a nurse anticipate as having antiandrogenic effects?
Cimetidine
A nurse is caring for an elderly patient who has been administered cimetidine. Which intervention should the nurse perform?
Closely monitor the patient for confusion and dizziness.
What is the benefit of adding proton pump inhibitors (PPIs) to the treatment regime treating an H. pylori bacterial infection?
Decreases production of gastric secretions
Treatments for clients with dyslipidemia are determined according to blood levels of total and LDL cholesterol and risk factors for cardiovascular disease. What does the impact of existing cardiovascular disease have on treatment recommendations?
Decreases target serum LDL level
A nurse is providing care to a client who has elevated levels of low-density lipoprotein (LDL). A review of the client's history reveals a sedentary lifestyle and a history of being overweight. The nurse understands that this combination of factors places the client at risk for which condition?
Heart disease
While reviewing the medication history of a client newly prescribed omeprazole, the nurse sees that the client is also taking warfarin. What potential interaction should the nurse account for when developing the plan of care for this client?
Hemorrhage
A client is taking cimetidine for increased gastric pain and hypersecretion. Nurses should use caution when administering cimetidine to those with which condition?
Hepatic disease
Which statement made by a client currently being treated for several medical conditions requires additional medication education by the nurse concerning the use of calcium salts?
I take an antacid with my morning medications to minimize their effect on my stomach
A client diagnosed with hyperlipidemia is prescribed a statin. The nurse is reviewing the client's history and would notify the client's health care provider if which condition was noted in the client's history?
Liver disease
A client is diagnosed with peptic ulcer due to H. pylori. The nurse would anticipate administering which agent in conjunction with an antibiotic?
Omeprazole
After teaching a group of students about proton pump inhibitors, the instructor determines that the students have understood the information when they identify which agent as the prototype proton pump inhibitor?
Omeprazole
HMG-CoA reductase inhibitors (statins) are classified as which pregnancy category?
Pregnancy Category X
Antacids have not been effective in managing a client's gastroesophageal reflux disease, so the health care provider is prescribing a proton pump inhibitor. Why might the health care provider prescribe a proton pump inhibitor (PPI) rather than a histamine2 receptor antagonist (H2RA)?
PPIs suppress acid more strongly and for a longer time.
The nurse knows that part of the education plan for a client with the diagnosis of hyperlipidemia needs to include which lifestyle changes? (Select all that apply.)
Reduction of the intake of saturated fats Weight loss Increased physical activity
A nurse is planning care for a 59-year-old woman who is on ranitidine therapy. The nurse is concerned for the client's safety. What would be an appropriate nursing diagnosis?
Risk for Injury related to drug-induced somnolence, dizziness, confusion, or hallucinations
A client is receiving a liquid antacid. Which would the nurse instruct the client to do?
Shake the antacid thoroughly before using.
A client with moderately elevated lipid levels requests immediate pharmacotherapy for dyslipidemia. The nurse explains that a period of intensive diet therapy and lifestyle modification will be utilized before drug therapy is considered based on what rationale?
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
What is the basis for a nurse's recommendation of a period of intensive diet therapy and lifestyle modification before initiation of drug therapy for a client newly diagnosed with dyslipidemia?
Therapeutic lifestyle changes are the preferred method for lowering blood lipids.
Pancrelipase would most likely be used to treat a patient with cystic fibrosis. true/false
True
A client diagnosed with an H. pylori-associated ulcer has been prescribed treatment that includes two antimicrobials. What does the nurse identify as the reason for using multiple antimicrobials?
Two antimicrobials help prevent the emergence of drug-resistant H. pylori organisms.
A 30-year-old nonpregnant patient is prescribed misoprostol. Which of the following should the nurse instruct the patient as part of the teaching plan?
Use a reliable contraceptive.
A client who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess:
serum phosphate level.
A 39-year-old nulliparous woman has been taking atorvastatin for 2 years and has now decided that she would like to become pregnant. What health education should the nurse provide to this client?
"It's important that you stop taking atorvastatin before you stop using contraception."
A woman with numerous chronic health problems has been diagnosed with a benign gastric ulcer has begun treatment with ranitidine (Zantac). Which of the following teaching points should the nurse provide to this patient?
"Quitting smoking will significantly increase the chance that this drug will heal your ulcer."
Which might occur in a client receiving colestipol?
Vitamin A deficiency
A nurse is conducting a presentation for a local community group about hyperlipidemia. When discussing the factors that individuals can work on to reduce their risk, which information would the nurse include? Select all that apply.
Weight Diet
The nurse is assessing a client who reports taking cholestyramine mixed with diet cola twice per day. What is the most appropriate nursing diagnosis for this client?
Deficient knowledge regarding drug therapy
An 8-year-old male client requires treatment for dyslipidemia. What would the nurse expect the health care provider to order?
Pravastatin
A client who takes aluminum hydroxide with magnesium hydroxide (Mylanta) frequently for upset stomach, heartburn, and sour stomach is seen regularly in the clinic. The nurse should assess:
Serum phosphate level.
A 58-year-old man has recently been prescribed atorvastatin (Lipitor) in an effort to reduce his cholesterol levels. The man has acknowledged the potentially harmful effects of hyperlipidemia and is motivated to make changes to resolve this health problem. What advice should the nurse give to this client?
"It's a good idea to keep your intake of saturated fat to a bare minimum."
When describing the possible adverse effects associated with omeprazole therapy, which of the following would the nurse identify as least common?
Alopecia
A patient with hyperlipidemia is prescribed ezetimibe. Which ongoing assessment should the nurse perform during treatment?
Frequently monitor blood cholesterol.
After reviewing information about antihyperlipidemic drugs, a group of nursing students demonstrate understanding when they identify which medication as a fibric acid derivative (fibrate)?
Gemfibrozil
Which adverse effect is more likely to be caused by cimetidine than by other H2RAs?
Gynecomastia
A 52-year-old man is suffering from a deficiency of exocrine pancreatic secretions and is prescribed pancrelipase (Pancrease MT). Before the medication therapy begins, the nurse will assess for allergies related to
Pork