EAQ's test 1

Which common factor contributes to the many drug interactions with antifungal agents?

Cytochrome P-450 enzyme system Rationale: Coadministration of two drugs that are both broken down by this system results in accumulation of one of the drugs in the body, which leads to undesirable side effects. Antifungal agents interact with hypoglycemic drugs and reduce their metabolism.

A patient has taken an excessive dose of acetaminophen for pain management. Which adverse effects associated with acetaminophen are likely to be found in the patient? select all that apply.

Nausea, vomiting, and elevated liver enzymes Rationale: Acetaminophen does not affect vision or hearing function.

Which patients are at risk for developing oral candidiasis (thrush)? Select all that apply

Newborns & immunocompromised patients Rationale: Pregnant women are likely to get vaginal candidiasis

Which medication is used to treat acne?

Tetracycline is the drug of choice

A patient is newly prescribed SMZ- TMP for the treatment of a UTI. Which biochemical parameter does the nurse assess before administering the drug?

Red blood cell count Rationale: this may cause anemia in a patient

The nurse anticipates that a patient with which of the following infections would be prescribed meropenem?

bacterial meningitis

The nurse cares for a postoperative patient receiving epidural analgesia. The patient is resistant to the nurse's encouragement to turn, cough, and breathe deeply. The patient says, "I'm afraid the needle will stick in my spinal cord and paralyze me." How would the nurse respond?

" There's no needle. It is a thin plastic tube in the protective covering of your spinal cord"

A nursing instructor is discussing tigecycline therapy with a group of nursing students. Which statement is the nursing instructor most likely to make?

" avoid administering tigecycline to a 7-year-old with Lyme Disease" Rationale: Tetracyclines such as tigecycline should not be given to children between 4 months and 8 years of age. They can cause discoloration of the permeant teeth and tooth enamel hypoplasia in both fetuses and children and possibly retard skeletal development if taken by the mother during pregnancy.

How would the nurse respond when a patient asks how to use a fentanyl patch at home?

"Keep new and used patches away from children" Rationale: new and used patches must be kept away from children and pets for their safety. Heat should never be applied over a patch. Dispose of patches by folding in half and flushing down the toilet. Storing the patches in the bathroom medicine cabinet exposes them to moisture which can degrade the medication.

A nurse is providing education to a a patient before administering amphotericin B. Which important information about adverse effects would the nurse include in the teaching? Select all that apply

"Overdose of amphotericin B causes abnormal renal functioning, cardiac functioning, neurologic functioning, pulmonary functioning"

The nurse works in a medical-surgical unit. Which patients should the nurse monitor for atypical signs of infection? Select all that apply.

A 78- year old patient with urinary incontinence. A 35-year-old patient who underwent a renal transplant. A 55-year-old patient who received radiation therapy for lung cancer

Which action of naloxone binding on the opioid receptor causes reversal of respiratory depression?

Binds in place of the agonist and causes no response Rationale: Naloxone is a competitive antagonist because it competes with the opioid agonist to bind with the receptor but produces no response. It reduces the response of the agonist by displacing the agonist from the receptor site. In this way, it reverses the respiratory depression caused by the opioid agonist. If a drug binds to the receptor sites and produces a response, it means that the drug is an agonist that has more affinity to the receptor site than the original drug and causes analgesia. If a drug causes less response than that produced by an agonist even at full dose, it is called agonist-antagonist or a partial agonist.

The nurse is caring for a postoperative patient. Which antibiotic is used for prophylaxis against infection in surgical patients?

Cefazolin rationale: 1st generation cephalosporins are used as prophylaxis against infection in surgical patients

A patient is prescribed sufentanil for the treatment of acute pain. The nurse instructs the patient to increase fluid intake up to 3000 mL per day to prevent which side effect of sufentanil?

Constipation Rationale: Sufentanil is an opioid drug. Administration of opioid drugs reduces peristalsis because of central nervous system depression and may result in constipation. Therefore the nurse instructs the patient to increase fluid intake up to 3000 mL per day to prevent constipation. Sufentanil does not cause crystalluria, mucosal irritation, or electrolyte imbalance.

Which phrases describe risk factors for developing vaginal candidiasis infections? Select all that apply

Corticosteroid use; Oral contraceptive use; Hyperglycemic conditions Rationale: The risk factors for the development of vaginal candidiasis include corticosteroid use, oral contraceptive use, and hyperglycemic conditions such as diabetes; all of these situations increase Candida colonization in the vaginal area.

Why is epinephrine co-administered with lidocaine used as a local anesthetic?

Epinephrine acts as a vasoconstrictor. Rationale: Epinephrine minimizes the chance of drug toxicity while administering local anesthesia. It also reduces local blood loss during minor surgical procedures. Epinephrine is not a sedative and does not induce sleep. Midazolam is used to induce mild amnesia. Skeletal and smooth muscles are paralyzed when spinal anesthesia is used.

The patient has been diagnosed with Legionnaires' disease. Which drug does the nurse anticipate the health care provider will order?

Erythromycin Rationale: macrolides such as erythromycin are effective against Legionella.

The nurse teaches a patient prescribed the fentanyl transdermal delivery system to change the patch at which interval?

Every 72 hours Once a week; every 24 hours; when pain recurs Rationale: This delivery system is designed to slowly release analgesic over a 72 hour time frame. The patient would not change the patch when pain recurs, once a week, or every 24 hours.

A patient is to receive an intramuscular injection of a drug that has a high first-pass effect but asks for an preparation of the drug instead. Which action would the nurse choose in this situation?

Explain to the patient that the drug becomes inactive if it is taken orally. Explain to the patient that the drug will have a reduced effect if it is taken orally.

Which anesthetic technique involves the injection of anesthetics into the subarachnoid space?

Intrathecal anesthesia Rationale: Infiltration is an anesthetic technique that involves injecting small amounts of anesthetic into the tissue that surrounds the operative site. Nerve block is an anesthetic technique in which the anesthetic solution is injected at the site where a nerve innervates a specific area, such as a tissue. Epidural anesthesia is a local anesthetic technique in which the drug is injected through a small catheter into the epidural space.

A patient is prescribed azithromycin for the treatment of a respiratory tract infection. Which parameters need to be assessed in the patient to ensure safe drug administration? Select all that apply.

Liver function; baseline hearing status & baseline cardiac function. Rationale: the macrolide can cause hearing loss, tinnitus, hepatotoxicity, jaundice, palpations, chest pain and electrocardiogram changes

Which information would the nurse draw upon to explain to a patient why a lower dose of intravenous pain medication is being given than the previous oral dose?

Medications given intravenously are not affected by the first pass effect When drugs with a high-first pass effect are administered orally, a large amount of the drug may be metabolized before it reaches the systemic circulation. The same drug given intravenously will bypass the liver. This prevents the first-pass effect from taking place, and therefore more of the drug reaches the circulation. Parenteral doses of drugs with a high first-pass effect are much smaller than oral doses, yet they produce the same pharmacologic response.

Which medication will assist a patient's recovery from a narcotic addiction?

Methadone Naloxone; vitamin K, Protamine sulfate Rationale: Methadone is a synthetic opioid analgesic. Controlled distribution of this medication helps the patient prevent symptoms of withdrawal and craving. Naloxone is used to reverse central nervous system depression that is sometimes caused by opioids. In patients who are treated with warfarin, Vitamin K is used to reduce warfarin's ability to prevent clots. Protamine sulfate is used to reverse the effects of heparin.

A patient is diagnosed with fibromyalgia. Which drug does the nurse expect to administer?

Milnacipran Tramadol hydrochloride; Naloxone hydrochloride; Naltrexone hydrochloride Rationale: Fibromyalgia is a condition in which the level of norepinephrine is reduced in the brain. Milnacipran is used for the treatment of fibromyalgia. Milnacipran is a selective serotonin and norepinephrine reuptake inhibitor, increases norepinephrine levels and reduces pain associated with the fibromyalgia. Tramadol hydrochloride is indicated for the treatment of moderate to moderately severe pain. Naloxone hydrochloride and naltrexone hydrochloride are opioid antagonists.

Which medical condition would the nurse assess for before administering a neuromuscular blocking drug?

Narrow-angle glaucoma Rationale: Contraindications for neuromuscular blocking drugs include narrow-angle glaucoma, burns, recent cerebrovascular accidents, crush injuries, penetrating eye injuries, and history of malignant hyperthermia. Diabetes, renal failure, and congestive heat failure are not contraindications for the use of these drugs.

A nurse has a sample of the medicine nystatin. Which type of patient will receive this medication?

Patients with oral candidiasis infection. Rationale: Nystatin is not available for parenteral administration; therefore it's use is restricted to managing oral and pharyngeal candidiasis.

Which term would best describe a possible drug reaction resulting in very low blood glucose levels that can cause lightheadedness and profuse sweating?

Pharmacologic- known and predictable reaction to a drug when it is administered

Why are vital functions of an anesthetized patient unaffected by the anesthetic agents?

The medullary center of the brain is the last area affected by anesthetics. Rationale: It is the last area of the brain that is affected by anesthetics and the first one to regain function, therefore the patients vital functions are not affected by anesthetics.

A patient is prescribed sulfadiazine. After checking the patient's history, the nurse finds that the patient has glucose-6-phosphate dehydrogenase (G6PD) deficiency. Which will the nurse do in this situation?

The nurse contacts the primary health care provider before administration of the drug. Rationale: Sulfadiazine belongs to the class of sulfonamides. The administration of sulfonamides to a patient with G6PD deficiency may result in hemolysis, or destruction of red blood cells.

Which description is the primary aim of using local anesthesia while suturing a wound?

Eliminate pain rationale: Local anesthesia is used to reduce neurologic function locally to eliminate pain in a particular body part.

A patient's prescription is changed from conventional amphotericin B to the lipid formulation of amphotericin B. The patient asks why the drug formulation was changed. How would the nurse respond to this question? select all that apply.

"this drug has fewer adverse effects" & "this drug formulation is more effective"

Which response would the nurse give to explain why codeine has been prescribed for a patient admitted to the hospital with a chronic nonproductive dry cough?

"this medication is used as a cough suppressant" Rationale: Codeine provides both analgesic and antitussive (cough suppressant) therapeutic effects. Codeine does not help the immune system. It is inaccurate to say that codeine gets rid of mucous or opens up the airways.

Which patient will the nurse expect to be at higher risk while undergoing anesthesia?

A 50-year-old alcoholic patient who is scheduled for hernia surgery rationale: Excessive intake of alcohol alters a patient's response to general anesthesia. In addition, patients with hernias are at greater risk of having malignant hyperthermia. A 15 year old who is scheduled for a leg fracture surgery is at low risk because they are old enough to tolerate anesthesia. A 30-year-old who is undergoing surgery for the first time may have a fear of surgery, but it can be reduced by preparing the patient for surgery. Athletes have a lower pulse, so a 48-year-old athlete who is undergoing LASIK eye surgery is not at high risk, because this surgery only requires local anesthesia.

Which patients in the surgical unit are at high risk for developing malignant hyperthermia? select all that apply.

A newborn who has gastroschisis. A patient who has muscular dystrophy. An adolescent patient who has gallstones. Rationale: Newborns have higher sensitivity to anesthetics and related drugs because they do not have a well-developed liver and kidneys. Gastroschisis does not increase the risk of developing malignant hyperthermia. Adolescents have an increased risk of malignant hyperthermia, but gallstones are not associated with risk of malignant hyperthermia. In muscular dystrophy, the patient's skeletal muscle system is weakened allowing general anesthetics to increase the risk of malignant hyperthermia.

The use of amphotericin B should be avoided for patients with which conditions? Select all that apply

Abnormal kidney function test results; A neutrophil count of 500/mm3 and a platelet count of 20,000/mm; Immune globulin E (IgE) antibodies to components of amphotericin B Rationale: An abnormal kidney function test indicates renal impairment. A neutrophil count of 500 and a platelet count of 20,000 indicates bone marrow suppression. IgE antibodies to components of amphotericin B are indicative of a hypersensitivity reaction. Amphotericin B is contraindicated in patients who have renal impairment, bone marrow suppression, or hypersensitivity.

A patient with cancer who has had adequate pain control with a long-acting opioid reports severe pain. The nurse understands that the patient is experiencing breakthrough pain, and the time of the next scheduled opioid dose is in 2 hours. Which action does the nurse take?

Administer a short-acting opioid and follow the regular opioid schedule for the next dose Rationale: a short-acting opioid can be administered for pain relief, maintaining the same schedule for the regular opioid. The nurse would not administer the regular long-acting opioid for breakthrough pain because it can cause an overdose.

How can the nurse determine whether a patient will tolerate an amphotericin B infusion?

Administer a test dose Rationale: To assess a patient's ability to tolerate amphotericin B, a test dose of 1 mg should be administered over 20 to 30 minutes. Desensitization is a therapeutic procedure used to manage patients who have hypersensitivity reactions. Administration of corticosteroids and antihistamines are measures used to prevent amphotericin B infusion reactions.

A patient with type 2 diabetes mellitus is started on sulfamethoxazole/trimethoprim. Which nursing intervention is a necessary priority for this patient?

Assess blood sugar monitor platelet count, assess hemoglobin and hematocrit & taking BP every 4 hours does not matter Rationale: This drug is a sulfa drug. It increases the hypoglycemic response when taken with sulfonylureas (oral hypoglycemic agents). The nurse would asses blood sugar and determine what oral hypoglycemic the patient is taking.

Which sign will the nurse monitor closely in a patient who underwent spinal anesthesia for a hernia repair?

Blood pressure rationale: Spinal anesthesia can result in a sudden drop in blood pressure as a result of vasodilation caused by the anesthetic block to sympathetic vasomotor nerves. Therefore the nurse would monitor the patient's blood pressure to prevent hypotension. Monitoring of heart rate, temperature, and pupillary reflexes are more important if the patient received general anesthesia.

A patient has started on a fentanyl patch. After 3 hours, the patient continues to complain of pain of 8 on a scale of 0 to 10." Which action would the nurse take?

Call the primary health care provider Rationale: the patch takes 12 to 24 hours to reach steady-state pain control after the first patch is applied. The nurse would call the primary health care provider for a medication to control pain immediately until the full effect of the patch is realized.

Which body functions are affected last after administration of an anesthetic drug? select all that apply.

Cardiac function & pulmonary function Rationale: These would be interrupted last after administration of an anesthetic agent because these functions are controlled by the medulla of the brainstem. Visual acuity, consciousness & hearing sensation are interrupted first because these functions are not regulated by the medulla of the brainstem. These are the first sensations that are lost after administering anesthesia.

A patient with pain & UTI develops fever, chills, and sores on the tongue. In the chart, he nurse finds an allergy to sulfonamides. Which drug does the nurse suspect is responsible for the patient's reaction?

Celecoxib Rationale: it is a cox-2 inhibitor NSAID that treats acute pain. it contains sulfonamide which is why it should be avoided in sulfa allergies

When monitoring a patient for adverse effects related to morphine sulfate, the nurse assesses for stimulation of which response?

Chemoreceptor trigger zone Circulation; cough reflex; respiratory reflex Rationale: Morphine sulfate can irritate the gastrointestinal tract, causing stimulation of the chemoreceptor trigger zone in the brain, which in turn causes nausea and vomiting. Opioids do not stimulate circulation. Opioids cause a decrease in respiratory rate, not stimulation. Opioids suppress the cough reflex.

A primary health care provider prescribes a medication along with ampicillin to enhance the effectiveness of the antibiotic. Which medication will be added to enhance the effectiveness of the ampicillin?

Clavulanic acid Rationale: Clavulanic acid is a beta-lactamase inhibitor. Administered concurrently, it augments the therapeutic effect of antibiotics such as ampicillin. When ampicillin is administered by mouth, concurrent administration of calcium citrate can diminish its absorption. Acetaminophen and carbamazepine do not affect the pharmacokinetics of ampicillin.

Which antibiotic may cause hemolysis in a patient who has G6PD deficiency?

Sulfonamide Rationale: G6PD deficiency is an inherited disorder in which the red blood cells are partially or completely deficient in the enzyme G6PD. It is an enzyme that is required in the metabolism of glucose. Sulfonamide antibiotics may cause hemolysis in a patient who has G6PD deficiency.

Which clinical applications use the infiltration method of anesthesia?

Dental surgery & wound suturing Rationale: Infiltration is a local anesthetic technique that involves injecting small amounts of anesthetic drug into the tissue that surrounds the operative site. Dental surgery and wound suturing are the common clinical applications of infiltration. Epidural anesthesia is a common method for reducing maternal discomfort during labor, delivery and pain after pelvic surgery. Intrathecal anesthesia is used for abdominal or limb surgery. Nerve block anesthesia is used for severe pain, such as chronic orthopedic pain.

The nurse prepares to administer 5 mg of intravenous (IV) morphine sulfate to a patient who underwent surgery 30 minutes earlier. What is the most important reason for the nurse to record baseline vital signs before administering this drug?

Depresses the respiratory center Rationale: Respiratory depression is the most important reason for the nurse to record baseline vital signs before administering the IV morphine.

The nurse is caring for a patient who has a urinary tract infection and is being treated with sulfamethoxazole/trimethoprim (SMZ-TMP). Which findings does the nurse report to the primary health care provider to prevent complications? select all that apply

Diarrhea; blood in the urine & shortness of breath Rationale: these indicate an adverse reaction to the drug.

Which finding alerts the nurse to the possibility that the patient is experiencing adverse effects of morphine sulfate?

Drowsiness diarrhea; insomnia; hyperactive bowel sounds Rationale: Morphine sulfate depresses the central nervous system, resulting in drowsiness. It also causes a decrease in gastrointestinal motility, leading to constipation. This effect is helpful in treating diarrhea. Morphine sulfate does not cause insomnia. Morphine dose not cause hyperactive bowel sounds.

Non-selective interaction

Drugs that act nonselectively do not interact with specific receptors and enzymes but target cell structures and intracellular metabolic processes.

A patient who enjoys drinking socially has been prescribed cefotetan. The nurse explains to the patient that alcohol should be avoided for how long?

During drug therapy and for 3 days afterward.

A patient who is on long-term antibiotic therapy complains of watery diarrhea and abdominal pain. Further assessment reveals that the patient's body temperature is 39° C. Which medication does the nurse expect will be prescribed by the health

Fidaxomicin rationale: watery diarrhea, abdominal pain & fever in the patient on long-term antibiotic therapy indicate pseudomembranous colitis or C. diff infection. It is a new macrolide antibiotic indicated for c. diff associated diarrhea.

Which common adverse effect would the nurse monitor in a patient who receives intravenous amphotericin B?

Hypotension The nurse would monitor the patient for adverse effects such as fever, tachycardia, hypotension, chills, malaise, muscle and joint pain, anorexia, nausea, and vomiting, and headache.

The nurse is performing a follow-up assessment of a patient who was prescribed a week's worth of antibiotics for gastroenteritis. Which signs and symptoms in the patient may indicate the need for referral to the primary health care provider?

Jaundice; excessive fatigue & elevated temperature

Which medication will assist a patient who is experiencing constipation as a side effect of opioid therapy?

Lactulose Constipation is a common side effect of opioid therapy. Agents such as lactulose have been proven to be effective in the treatment of constipation. Naloxone is an opioid antagonist used to improve respiratory status. Promethazine is an antiemetic used if the patient is experiencing nausea and vomiting. Diphenhydramine is used in the treatment of pruritus, which is an adverse effect of opioid therapy.

Which outcomes are adverse effects of Chrysanthemum parthenium? select all that apply

Nausea, joint pain, muscle stiffness Rationale: this is also called feverfew. It is commonly used for the treatment of migraine headaches, menstrual cramps, inflammation, and fever. Nausea, joint pain, and muscle stiffness are the adverse effects of this disease. It does not produce any effect on skin integrity or vision.

The nurse is assessing a patient who underwent surgery and is prescribed oxycodone. Which assessment finding requires the nurse to take action?

No bowel movement in 72 hours! heart rate 90 beats/min; vague feeling of anxiety; respiratory rate 12 breaths/min Rationale: Oxycodone is an opioid drug, which may decrease peristalsis because of its depressive effect on the central and peripheral nervous system, resulting in constipation. A vague feeling of anxiety can be assessed further after physical problems are treated.

Which medication may sometimes be overlooked when considering penicillin allergies in patients?

Piperacillin/tazobactam (ZOSYN)

After the placement of a new transdermal opioid patch, the patient complains of an increase in level of pain. Which error in placement of the new patch is the reason?

Placed on a hairy area Rationale: the presence of hair on the application area may interfere with absorption of the medication, resulting in ineffective pain relief. The new patch may cause skin irritation if placed on the same place as the old patch, but it would not affect the drug's effectiveness.

The nurse is caring for a patient with systemic mycoses who is on amphotericin B. Which parameters would the nurse monitor for safe and effective care? select all that apply.

Potassium, creatinine and Blood Urea Nitrogen levels Amphotericin B is a polyene antifungal drug in the treatment of various fungal infections such as systemic mycoses and dermatomycoses. The major adverse effect associated with the use of amphotericin B is nephrotoxicity. Because nephrotoxicity is associated with electrolyte disturbances, it is important to monitor potassium, sodium and magnesium levels.

Which phrase describes general anesthesia?

Produces deep relaxation (both visceral and skeletal) as well as loss of consciousness.

A patient admitted to the unit is prescribed oral naltrexone hydrochloride daily. Which admission assessment would the nurse include for the patient?

Questions regarding past history of drug and alcohol use Rationale: it is used as an adjunct to psychosocial treatments for alcoholism. It is an opioid antagonist. The medication is not prescribed as a treatment for infection or chronic pain. There is no need to ask the date of the last flu vaccine, it is not relevant.

Which types of cells are destroyed as a result of an idiosyncratic reaction in a patient with G6PD deficiency with certain medications?

Red blood cells G6PD is a metabolic enzyme. In these patients, certain drugs induce life-threatening hemolysis of red blood cells.

Which medication may result in ineffectiveness of penicillin V potassium?

Rifampin

Which possible effect will the nurse anticipate in a patient who has received amphotericin B along with thiazide diuretics?

Severe hypokalemia or decreased adrenal cortex response to corticotrophin

transdermal fentanyl is indicated for which type of pain?

Severe pain resulting from cancer metastasis Rationale: indicated only for persistent severe pain in patients who already tolerate opioids because it can cause fatal respiratory depression in patients who are opioid naïve. For this reason, the patch is not indicated for acute pain such as postoperative pain, intermittent pain, or pain that responds to a less powerful analgesic.

Somatic pain originates from which location in the body?

Skeletal muscles, ligaments, and joints Rationale: Somatic pain does not originate from organs, skin and mucous membranes, or blood vessels. Pain that originates from organs and smooth muscles is called visceral pain. Pain that originates from skin and mucous membranes is called superficial pain. Pain that originates from vascular or perivascular tissues is called vascular pain.

Which effect is a notable complication associated with the use of centrally acting local anesthesia?

Spinal headache Rationale: Intrathecal anesthesia and epidural anesthesia are two types of spinal or intraspinal anesthesia that are given locally, but they act centrally. Spinal headache is a notable complication with spinal anesthesia because of injury to the spinal layers or structures involved.

Which route of administration would be ideal for a patient with acute angina-like chest pain who is to receive nitroglycerin?

Sublingual is highly vascularized, so drugs that are administered this route are rapidly absorbed into the bloodstream.

The patient has been diagnosed with ulcerative colitis. The nurse recognizes that which medication may be ordered to treat this condition?

Sulfasalazine Rationale: this is the drug of choice for treatment of ulcerative colitis

A mechanically ventilated patient receiving a neuromuscular blocking drug has tearing in the eyes and increased heart rate and blood pressure. Which conclusion does the nurse make?

The level of sedation is inadequate. Rationale: tearing in the eyes and increased heart rate and blood pressure are symptoms of increased anxiety or pain. A patient receiving a neuromuscular blocking drug cannot more or communicate; thus the nurse must rely on subtle changes to assess adequate sedation.

When reviewing a patient's medical records, the nurse finds that the patient had developed an idiosyncratic reaction to aspirin. Which information would the nurse infer?

The patient may have a deficiency of drug-metabolizing enzymes. An idiosyncratic reaction occurs unexpectedly in certain patients. It is genetically determined reaction and occurs when a patient has a deficiency or excess of drug-metabolizing enzymes. Patients with a G6PD may have idiosyncratic reactions to drugs such as aspirin.

Which factor associated with a drug that has a low therapeutic index would the nurse be aware of?

There is a high possibility that overdose events will occur A low TI indicates that the difference between the therapeutically active dose and the toxic dose of the drug is small. Therefore a drug that has a low TI has a greater likelihood of side effects relative to other drugs.

A patient has a serious intraabdominal infection. Which antibiotic will the nurse expect to administer to this patient as empiric therapy?

Ticarcillin-clavulanic acid Rationale: one of the broadest penicillins

The nurse is assessing a patient who is prescribed SMZ-TMP for the treatment of shigellosis enteritis. For which reason does the nurse instruct the patient to increase fluid intake up to 3000 ml per day?

To prevent drug-related crystalluria

Which postoperative nursing action will help the patient recover from the effects of anesthesia?

Turning, coughing, and deep breathing every 2 hours. rationale: This can help prevent postoperative atelectasis, a sequela of generalized anesthesia and mechanical ventilation.

When would the nurse expect intravenous midazolam to be administered to a patient scheduled for minor surgery?

Twenty minutes before the surgery rationale: This sedative shows its peak 20 to 60 minutes after administration. Patient needs to have conscious sedation during the procedure to reduce pain.

Which of the following drugs is contraindicated for a patient who is receiving erythromycin therapy?

Warfarin Rationale: taking warfarin with erythromycin therapy may result in decreased warfarin metabolism and excretion thereby leading to an increased risk of bleeding or hemorrhage

How does superinfection occur in a patient?

When the antibiotic eliminates the normal bacterial flora Rationale: if the serum level of the antibiotic is too high, it causes a toxic reaction.

An 11-year-old patient is prescribed carbamazepine for a generalized seizure disorder. The nurse instructs the parents about the drug regimen. What food item will the nurse recommend the parents avoid serving their child?

a. Yogurt b. Cheese c. Spinach d. Grapefruit Consuming grapefruit when taking carbamazepine would initiate a typical food-drug interaction, resulting in decreased drug metabolism and an increased drug concentration and associated side effects. Carbamazepine does not interact with foods like spinach, yogurt, and cheese.

The nurse instructs a patient taking feverfew to discontinue the herb a few days before surgery. Which risk is the nurse trying to prevent in the patient?

bleeding rationale: Feverfew is a herbal medication that interacts with anesthetic agents and increases the risk of bleeding.

A patient has taken an enteric coated medication with a large amount of food. Which effect will this have on the bioavailability of the drug?

it will be decreased