nclex prep week 2 pharm final
***what statement by the parents of a child who has asthma and a new prescription for a cromolyn sodium metered dose inhaler indicates the need for further teaching?
"I will give my child a dose as soon as wheezing starts" -not a rescue med; mast cell inhibitor that has a slow onset and is given for prophylactic Tx of asthma -adverse effects: mouth and throat irritation -rinse/ gargle w/ water after each use -exhale completely and then breathe in evenly while depressing canister -spacer provides a chamber to hold med exhaled in suspension for pts who have difficulty breathing in entire dose in 1 inhalation
***I nurse is providing teaching to a patient has postmenopausal osteoporosis in a new prescription of intranasal calcitonin-salmon. Which of the following statements by the patient and the kids and understanding of the teaching?
"I will need to depress the side arms to acitvate the pump" -hold bottle upright and depress 2 white side arms toward bottle 6 times -administer 1 nostril daily, altering nostrils -d/c med if nasal bleeding/ulcerations occur and notify provider -long-term therapy Tx
***A nurse is providing discharge teaching to a patient who had a kidney transplant and has a prescription for oral cyclosporine. Which of the following statements by the patient indicates an understanding of the teaching?
"i am likely to develop high BP while taking this med" -cyclosporin pt develop 10-15% increase in BP and may need to start antihypertensive therapy -similar meds taken after transplant must be cont. for rest of pts life -can cause hirsutism (unusual hair growth) -immunosuppressive agent, prevents rejection of transplanted kidney
****I nurse is providing discharge teaching about lithium toxicity to a patient who has a new prescription for lithium. Which of the following statements by the patient indicates an understanding of the teaching?
"i can develop lithium toxicity if i experience vomiting or diarrhea" -these can cause electrolyte imbalance; if serum Na decreases, i is retained by kidneys and risk for toxicity increases -NSAID's increase renal reabsorption of Na and Li, which causes increase in Li levels and possible toxicity -acetylsalicylic acid and sulindac and NSAID's that do not affect Li levels -eat a normal dietary intake of Na to prevent Li toxicity -diuretic decrease kidney excretion of Li, causing level to rise and increase risk of toxicity
***A nurse is providing discharge teaching to a patient who has heart failure and a prescription for digoxin and 0.125 mg PO daily and furosemide 20 mg PO daily. Which of the following statements by the patient indicates an understanding of the teaching?
"i will eat fruits and vegetabls that have high K content every day" -adverse effects: hypokalemia; dogoxin toxicity: blurred vision/ yellow vision -weigh daily at same time every day, record it, and report weight gain or loss to provider -w/holhd med is HR <60/min and report HR <60/min (sign of digoxin toxicity)
****A nurse is providing discharge teaching to a patient who has been hospitalized for major depressive disorder and has a prescription for amitriptyline. Which of the following statements by the patient indicates an understanding of the teaching?
"i will move more slowly when I stand up because amitripyline can cause my BP to decrease" -adverse effects: orthostatic hypotenison; severe constipation, dry mouth, blurred vision, urinary retention (anticholinergic action of med) -tricyclic antidepressant that has sedative effect -prescribed 3X dails until therapeutic dose has been achieved and then entire dose is prescribed at bedtine to help pt sleep at ight and prevent daytime drowsiness -shouldn't be taken w/ other CNS depressants, alcohol and sedatives
***A nurse is providing teaching to a patient who has heart failure and is taking Spirinolactone. Which of the following statements by the patient indicates an understanding of the teaching?
"i will watch for increased breast tissue growth while taking this med" -spironolactone, derived from steroids, can cause endocrine effects -adverse effects: endocrine effects in M: gynecomastia, impotence; endocrine effects in F: irregular menses, hirsutism K-sparing diuretic; pt should limit intake of food w/ K d/t risk of hyperkalemia -should not use salt substitutes b/c they contain K and increase risk of hyperkalemia -drinking large amounts of water can cause dilutional hyponatremia, dangerous when taking this med since electrolyte imbalance, including hyponatremia, are common
A nurse is providing teaching to a patient who has hypertension and type 1 diabetes mellitus and a new prescription of metoprolol. Which of the following statements by the patient indicates an understanding of the teaching?
"it might be difficult recognizing when my blood sugar is low?" -med is a beta-adrenergic blocker used to treat HTN -decreases HR, a common manifestation of hypoglycemia can be masked and hard to recognize -teach other manifestations of hypoglycemia: hunger, nausea, sweating -med doesn't decrease risk of infection, cause weight loss, or extend/increase risk for hyperglycemia adverse effects: weight gain d/t water retention, prolonged hypoglycemia -report unexpected weight gain, edema, cough when taking med
***a patient who has been taking isoniazid and rifampin for 3 weeks for the treatment of active TB reports his urine is an orange color. what statement should the nurse make?
"rifampin can turn body fluids orange" -rifampin- tears, sweat, saliva, urine can turn reddish-orange, side effect doesn't cause harm to pt; can cause hematuria -active TB pt should not stop taking meds -isoniazid- doesn't cause bladder irritation
***A nurse is providing discharge teaching to a patient who has angina pectoris and a new prescription for verapamil. The patient tells the nurse, "my brother takes verapamil for high blood pressure. Do you think the provider made a mistake?" Which of the following responses should the nurse make?
"verapamil is used to treat both high BP and angina" -Ca channel blocker that dilates arteries and decreases afterload -respond to pts concerns then, not later -not used to prevent HTN
***A nurse is providing discharge teaching to patient who had a bleeding duodenal ulcer and is prescribed omeprazole. Which of the following statements should the nurse include in the teaching?
"you should take this med before breakfast every day" -pts w/ active duodenal ulcer or gastric reflux dz should take once daily before meals b/c med is less effective when taken w/ food -used for no more than 1-2 months d/t long-term adverse effects: risk for Fx and hypomagnesemia -increases risk of acquiring pneumone, both in acute care facilities and at home during 1st few days of use -adverse effects: diarrhea, n/v, headache (report severe diarrhea)
A nurse is preparing to administer digoxin 0.2 MG via IV bolus to a patient. The amount available is digoxin 0.25 mg/1mL. How many mL should the nurse administer? (Round the answer to the nearest 10th. Use the leading there of the place. Do not use a trailing zero)
0.8 mL -Ratio and Proportion: 0.25 mg / 1 mL = 0.2 mg / X mL X = 0.8 mL -Desired over Have: 0.2 mg x 1 mL / 0.25 mg = X mL 0.8 mL = X
a nurse is preparing to administer heparin 8000 units subcutaneously every 8 hr. available is heparin 10000 units/1 mL. how many mL should the nurse administer per dose? (round the andwer to the nearest tenth. use a leading zero if it applies. do not use trailing zero.)
0.8 mL ways to solve equation: -ratio and proportion 10,000 units/ 1 mL = 8,000 units/ X mL X = 0.8 mL -desired over have 8,000 units x 1 mL/ 10,000 units = X mL 0.8 mL = X
***A nurse is administering insulin glulisine 10 units subcutaneously at 0730 to an adolescent patient who has type 1 diabetes mellitus. The nurse should anticipate onset of action of the insulin at which of the following times?
0745 -very short onset of action of 15 min -ensure pt eats breakfast immediately following administration -regular insulin: onset of action 30-60 min -NPH: onset of action 1-2 hr
***A nurse is teaching a patient who has chronic stable angina pectoris and a prescription for sub lingual nitroglycerin tablets. Identify the sequence of instructions that the nurse should tell the patient to use if he experiences chest pain.
1. stop activity 2. place tablet under tongue 3. wait 5 min 4. call 911 if pain is not relieved
A nurse is preparing to administer codeine 30 MG PO every four hours PRN to a patient for pain. The amount available is codeine oral solution 15 mg/5 mL. How many milliliters should the nurse plan to administer per dose? (Round the answer to the nearest whole number. He's a leading zero if it applies. Do not use a trailing zero)
10 mL 15 mg / 5 mL = 30 mg / x mL X = 10 mL
A nurse is preparing to administer heparin 900 units/he via IV infusion. The amount available is heparin 25,000 units in 500 mL 5% dextrose in water. The nurse should set the IV pump to deliver how many milliliters per hour? (Round to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero)
18 mL/hr -Ratio & Proportion: 25,000 units / 500 mL = 900 units / hr / X mL X = 18 mL/hr -Desired over Have: 900 units / hr x 500 mL / 25,000 units = X mL/hr X= 18 mL/hr
a nurse is preparing to administer prochlorperazine 2.5 mg IV. available is prochlorperazine injection 5 mg/mL. how many mL should the nurse administer? (round answer to the nearest tenth. use leading zero if it applies. do not use trailing zero.)
2 mL Ways to solve equation: -ratio and proportion 5 mg/ 1 mL = 2.5 mg/ X mL X = 0.5 -desired over have 2.5 mg x 1 mL/5mg = X mL 0.5 mL = X
***A nurse is preparing to administer chlorothiazide 20 MG/KG/day PO divided equally and administered twice daily for a toddler who weighs 28.6 pounds. The amount available is chlorothiazide oral suspension 250 MG/5 mL. How many milliliters should the nurse administer per dose? (Round the answer to the nearest 10th. Use a leading zero if it applies. Do not use a trailing zero)
2.6 mL 1 kg = 2.2 lbs 28.6 lbs/ 2.2 lbs = 13 kg 20 mg x 13 kg = 260 mg/day 260 mg/day / 2 doses = 130 mg every 12 hr 250 mg / 5 mL = 130 mg / X mL X= 2.6 mL
a nurse is preparing to administer furosemide 4 mg/kg/day PO divided into 2 equal doses daily to a toddler who weights 22 lbs. how many mg should the nurse administer per dose? (round the answer to the nearest whole number. use a leading zero if it applies. do not use a trailing zero.)
20 mg 22 lbs / 2.2 kg = 10 kg (pt weight) mg x kg/ day = X 40 mg x 10 kg = 40 mg/day 40 mg/day / 2 doses = 20 mg/dose
A nurse is planning to administer LR 1000 mL IV to infuse over 8 hrs. The drop factor of the manual IV tubing is 10 gtt/mL. The nurse should set the manual IV tubing to infuse for how many gtt/min? (Round to nearest whole number)
21 gtt/min 1000 mL / 8 hrs x 10 gtt / 1 mL x 1 hr / 60 min = 20.8 gtt/min --> 21 gtt/min
A nurse is preparing to administer ampicillin 500 MG and 50 mL of dextrose 5% and water to infuse over 15 minutes. The drop factor of the manual IV tubing is 10 GTT/ML. The nurse should set the manual IV infusion to deliver how many GTT per minute? (Round the answer to the nearest whole number. Use the leading zero if it applies. Do not use a trailing zero)
33 gtt/min 10 gtt / 1 mL x 50 mL / 15 min = X gtt / min X = 33.3333 --> 33 gtt/min
a nurse is preparing to administer amoxicillin 250 mg liquid suspension PO every 8 hr to an older adult patient. the amount available is amoxicillin 50 mg/mL. how many mL should the nurse administer per dose? (round the answer to the nearest whole number. use aleading zero if it applies. Do not use a trailing zero.)
5 mL 50 mg / 1 mL = 250 mg / X mL X = 5mL
A nurse is preparing to administer dextrose 5% in 0.45% sodium chloride 400 mL IV to an older adult patient over eight hours. The nurse should set the IV pump to deliver how many milliliters per hour? (Round the answer to the nearest whole number. use a leading zero if it applies. Do not use a trailing zero)
50 mL/hr 400 mL / 8 hr = XmL/hr X = 50 mL/hr
A nurse is preparing to administer an IV fluid bolus of 1 L 0.9% sodium chloride over two hours to a patient who is dehydrated. The nurse should set the IV pump to deliver how many milliliters per hour? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero)
500 mL 1 L = 1,000 mL 1,000 mL / 2 hr = 500 mL
a nurse is preparing to administer an enteral tube feeding throug an NG tube at 250mL over 4 hr. the nurse should set the pump to deliver how many mL/hr? (round to the nearest whole numer. use a leading zero if it applies. do not use a trailing zero)
63 mL/hr 250 mL / 4 hr = 62.5 62.5 --> 63 mL/hr
A nurse is preparing to administer ampicillin 50 MG/KG/day PO divided into four equal doses for a toddler who weighs 33 pounds. Available is ampicillin 125 mg/5 mL oral solution. How many milliliters should the nurse administer per dose? (Round the answer to the nearest 10th. use a leading zero if it applies. Do not use A trailing zero)
7.5 mL 2.2 lbs = 1 kg 33 lbs/ 2.2 lb = 15 kg 50 mg x 15 kg = 750 mg/day --> 750 mg / 4 doses = 187.5 mg every 6 hrs 125/5 mL = 187.5 mg / X mL X= 7.5 mL
***A nurse is caring for a patient who has a positive tuberculin skin test and is beginning a prescription of isoniazid. The nurse should teach the patient that which of the following lab values should be monitored while taking isoniazid?
AST -can be toxic to liver -notify provider if juandice, nausea, dark-colored urine or other findings of hepatitis occur -no need to monitor TSH, K, Na
A nurse is planning to administer Epoetin alpha to a patient who has chronic kidney failure. Which of the following data should the nurse plan to review prior to administration of this medication?
BP -adverse effects: HTN (can lead to stroke, other cardiovascular compliations) -frequent use of this med requires concurrent use of antihypertensive meds -doesn't affect: body temp, blood glucose levels, total protein levels
***A nurse is preparing a discharge teaching plan for a six-year-old patient who has asthma and several prescription medications using metered dose inhaler's. Which of the following interventions should the nurse include in the plan?
add a spacer to each med -makes up for lack of ahng-lung cooridnation by increasing amount of med delivered to lungs -inhale over 3-5 seconds for max effectiveness -advantages to inhaler: enhanced therapeutic effects, decreased systemic adverse effects, quick relief when short-acting bronchodilators are used -O2 administration doesn't aid in delivery of med
***A nurse is preparing to administer iron dextran IV to a patient. Which of the following actions should the nurse plan to take?
administer a small test dose before giving the full dose -d/t serious adverse effect of med- anaphylaxis cause by hypersensitivity to med -give small test dose over 5 min before giving full dose and monitor for possible rxn -IV blus over 1 min; IV infusion over 10-15 min -adverse effects: hypotension, anaphylaxis -antidote for Fe toxicity: deferoxamine -cyanocobalamin (B12): administered to pts who have megaloblastic anemia
***A nurse is providing teaching to the parents of a school age child who has asthma about medications for bronchospasm. Which of the following and health medications should the nurse instruct the parents to use to relieve an acute asthma attack?
albuterol -short-acting beta2-adrenergic agonist used to provide immediate relief for acute asthma attacks -1/2 puffs every 4-6 hrs PRN is usual Px dose for school-age child -salmeterol: long-acting beta2-adrenergic agonist used for prophylaxis of asthma; should use prior to planner exercise, but not effective for relieving acute attack -cromolyn: mast cell stabilizer w/ anti-inflammatory action designed for prophylaxis of asthma; used on fixed schedule, prior to exercise, not effective for relieving acute attack -fluticasone propionate: gluccocoticoid for long-term prophylaxis of asthma, not effective for relieving acute attacks
***a nurse is assessing a patient who has a new prescription for chlorpromazine to treat schizophrenia. the patient has a mask-like facial expression and is experiencing involuntary movements and tremors. what medication should the nurse anticipate administering?
amantadine -used to treat extrapyramidal manifestations (parkinsonism) adverse effects: parkinsonism (manifestations include mask-like facial expression, involuntary movements and tremors) -bupropion: atypical antidepressant -phenelzine: MAIO antidepressant -hydroxyzine: antihistamine used to treat mild to moderate anxiety
***A nurse is planning to administer diphenhydramine 50 MG via IV bolus to a patient who is having an allergic reaction. The patient has an IV infusion containing a medication that is incompatible with diphenhydramine in solution. Which of the following actions should the nurse take?
aspirate to check for IV patency before administering the med -some meds cause severe tt damage when inadvertently administered into tissue rather than vein -choose injection port nearest pt to administer IV bolus injection -flush tubing w/ 10 mL of .9% sodium chloride befoer and after administration
A nurse is caring for a patient and realizes after administering the 0900 medications that she administered digoxin 0.25 MG PO to the patient instead of the prescribed digoxin 0.125 MG PO. Which of the following actions should the nurse take first?
assess apical pulse -assessment will provide further info to make appropriate decision
****A nurse is providing teaching to a patient who has hypertension and a new prescription for oral clonidine Which of the following instructions should the nurse include in the teaching?
avoid driving until pts rxn to med is known -adverse effects: drowsiness, weakness, sedation, other CNS effects, dry mouth (esp during 1st few wks of therapy) -do not d/c abruptly d/t risk of hypertensive crisis -report rash to provider -suck of hard candy, sip on water to relieve dry mouth
***A nurse is planning discharge teaching for a patient who has major depressive disorder and a new prescription for phenelzine. Which of the following foods should the nurse include in the plan as safe for the patient to consume while taking phenelzine?
broiled beef steak -MAIO antidepressant -med interacts w. variety of food to produce hypertensive crisis -seef steaks and fresh meats are okay to eat -cheese (except cottage cheese and cream cheese), pepperoni, salami, other dried or cured meats, and smoked salmon
***a nurse is providing discharge teaching to a patient who has venous thrombosis and a prescription for warfarin. which of the following instructions should the nurse include in the teaching?
carry a medic alert ID card -in case of emergency, d/t increased risk of bleeding -avoid aspirin and ibuprofen d/t antiplatelet effects; ask provider before taking any meds or herbal substances -PT and INR, drawn daily for 1st 5 days, then twice weekly for the next 1-2 weeks during warfarin therapy -dietary vitamin K has potential to reduce anticoagulation effects of med; green leafy vegetable should be increased b/c they're rich in vitamin K -aPTT is used to monitor heparin therapy
A nurse is caring for a patient who has congestive heart failure and is taking digoxin. The patient reports nausea and refuses to eat breakfast. Which of the following action should the nurse take first?
check apical pulse -assessing helps gather further info before making appropriate decision -digoxin toxicity: nausea, anorexia, fatigue, visual effects, cardiac dysrhthmias, slow pulse rate -instruct pt to eat toast b/c its easily digested -should administer antiemetic -notfiy provider d/t sign of toxicity
*****A nurse is caring for a patient who has alcohol use disorder and is admitted with lower extremity fractures following a motor vehicle crash. A few hours after admission, the patient develops restlessness and tremors. Which of the following medications should the nurse anticipate administering to the patient first?
chlordiazepoxide -long-acting oral benzidiazepine, 1st line med use for pts experiencing manifestations of acute alcohol w/drawal -pts who have n/v can be iven lorazepam IV acamprostate: used to maintain abstinence in pts who have alcohol use disorder -naltrexone: decreases pts cravings for alcohol -disulfiram: help pts w/ disorder avoid drinking
***A nurse is administering oral hydroxyzine to a patient. Which of the following adverse effects should the nurse instruct the patient to expect?
dry mouth -has anticholinergic properties -adverse effects: dry mouth -H1 receptor antagonist- can treat anxiety -has antiemetic properties
***A nurse is administering adenosine via IV bolus for a patient who has developed paroxysmal atrial tachycardia. For which of the following findings should the nurse assess the patient during administration of adenosine?
dyspnea -can occur during administration of med d/t bronchoconstriction -short half-life of 10 sec, dyspnea effect is short lived -flushing of face and feeling of warmth are transient findings occuring during administration of med -quinidine: anti-dysrhythmic med; cinchonism, manifested by tinnitus, headache, vertigo, visual disturbances
***A nurse is planning to administer diltiazem via IV bolus to a patient who has atrial fib relation. When assessing a patient, the nurse should recognize that which of the following findings is a contraindication to administration of diltiazem?
hypotension -Tx option for essential HTN -lowers BP and contraindicated for pt whose hypertensive -self-monitor BP and keep record -decreased LOC is contraindicated -no interaction w/ diuretics
***A nurse is preparing to administer oxytocin to a patient who is at 41 weeks of just station and is experiencing an affective labor. Which of the following actions should the nurse plan to take?
increase dose of oxytocin to obtain uterine contractions that occur every 2-3 min -effective uterine contractions occur every 2-3 min -used for labor induction -decreases PP hemorhage -other meds used for cervical ripening prior to oxytocin administration: dinoprostone and misoprostol, given vaginally -BP and pulse should be continuously monitored during labor induction w/ oxytocin -goal: contractions lasting from 45-60 sec; if prolonged, d/c infusion
***You nurses caring for a patient who is in preterm labor and has a new prescription for Nifedipine. The patient states she is concerned because her father takes Nifedipine for his angina pectoris. The nurse should explain to the patient nifedipine works for patients who are pregnant by which of the following mechanisms?
inhibits uterine contractions by blocking entry of Ca into uterine cells -Ca channel blocker, causes uterine relaxation -mechanism of action that occurs when antibiotic are administered to prevent preterm labor: decreases incidence of bacterial vaginosis, preventing uterine contractions -mechanism of action of terbutaline to suppress preterm labor: stimulates beta2 receptors in uterus which results in decreased frequency of contractions; has more adverse effects affecting health of pt compared to nifedipine
***a nurse is reviewing lab values for a patient who reports fatigue and cold intolerance, has increased TSH level and decreased T3 and T4 level. the nurse should anticipate a prescription for what medication?
levothyroxine -it replaces thyroid hormone for pt w/ hypothyroidism, which is indicated by lab values -manifestations of hypothyroidism: fatigue, cold intolerance, decreased body temp and pulse -methimazole/ propylthiouracil: inhibits thyroid production for pt w/ hyperthyroidism -somatropin: growth hormone prescribed for pt w/ growth hormone deficiency of anterior pituitary gland
***A nurse is teaching a patient who has type 2 diabetes mellitus and a new prescription for Metformin. Which of the following adverse affects of metformin should the nurse instruct the patient to watch for and report to the provider?
myalgia -adverse effects: myalgia, malaise, somnolence, hyperventilation (manifestations of lactic acidosis, rarely occurs d/t blockage of lactic acid oxidation); weight loss, n/v, diarrhea -report findings of lactic acidosis immediately -sulfonylureas/ glitazone: T2DM meds that can cause severe hypoglycemia when used in combination w/ metformin -glipizide/ tolbutamide: T2DM meds that cause weight gain
***what medication should the nurse plan to administer to a patient who is at 28 weeks of gestation and is experiencing preterm labor?
nifedipine -tocolytic to stop preterm labor -oxytocin (Pitocin): used to stimulate contraction for term pts and control PP hemorrhage; contraindicated for preterm labor -dinoprostone: oxytocic med used to stimulate contractions for term pts and control PP hemorrhage; contraindicated for preterm labor -misoprostol: prostaglandin used to promote cervical ripening of cervix and induce labor; contraindicated for preterm labor
***A hospice nurse is caring for a patient who has cancer and is taking naproxen 250 MG three times daily PO and gabapentin 1800 mg three times daily PO to manage pain. The patient tells the nurse, "I'm having pain that keeps me from doing what I'd like most of the time." Which of the following additions should the nurse anticipate to the patient's medication regimen?
oral oxycodone -relieves moderate to moderatley severe pain -meperidine: opioid analgesic, not indicted for cancer pain b/c it can cause severe toxic effect when given for more than a few doses -parenteral naloxone: opioid anatagonist, not indicated for cancer pain; for pts who have opioid overdose -diazepam: no analgesic effects and can cause sedation, interfere's w/ daily activities
***A nurse is caring for a patient who is brought to the ED by friends who report the patient has overdosed on heroin. Which of the following findings should the nurse expect to assess?
pinpoint pupils -opioid toxicity: pinpoint pupils, euphoria, relaxation, freedom from pain; hyperppyrexia (extreme increased body temp), greatly reduced RR (8/min) (both can also be seen in cocaine overdose) -opioid w/drawl : severe abdominal cramping, mm spasms, bone pain
***A nurse is monitoring lab values for a male patient who has leukemia and is receiving weekly chemotherapy with methotrexate via IV infusion. Which of the following lab values should the nurse report to the provider?
platelets 78,000/ mm3 -nurse should monitor platelet count b/c med can cause thrombocytopenia -low platelets = increase risk of bleeding -monitor BUN levels b/c med cause cause kidney injury -monitor hemoglobin b/c med can cause bone marrow suppression -monitor AST b/c med can cause liver damage
***what therapeutic effect of epoetin alfa should the nurse include in the teaching for a patient who has chronic kidney failure with an AV fistula for hemodialysis?
promotes RBC production -stimulates erthyropoiesis in bone marrow to increase RBC production and reduce anemia -anemia common in CKF pts, since erythropoietin is produced by kidneys -adverse effects: HTN, clot formation of AV fistula -med doesn't: stimulat neutrophil gorwth (filgrastim)
***a nurse is planning care for a female patient who has severe IBS with diarrhea and a new prescription for alosetron. which of the following interventions should the nurse include in the plan of care?
pt must sign agreement w/ provider before beginning med -potentially fatal adverse effects associated w/ constipation and bowel obstruction -FDA only allowed it to be placed on market if pts sign and adhere to risk management program -notify provider and stop med if diarrhea is not controlled after 1 month of starting -notify provider about tachydysrhhthmias (adverse effect of med) -few med interactions and doesn't interact w/ oral contraceptives
***a nurse is reviewing the lab values for a patient who is receiving a continuous IV heparin infusion and has an aPTT of 90 seconds. what action should the nurse prepare to take?
reduce the infusion rate -reference range of aPTT is 60-80 - increased aPTT can cause anticoagulation -nurse should reduce infusion rate and assess for bleeding -Vitamin K reverse effects of warfarin -aspirin inhibits platelet aggregation and is contraindicated for pt receiving heparin -INR is indicated for pt receiving warfarin
***A nurse is preparing a discharge teaching plan for a patient who is to begin long-term oral prednisone for asthma. Which of the following instructions should the nurse include in the plan?
scheudle med on alternate days to reduce adverse effects -can avoid adverse effects such as, suppression of adrenal gland -should not stop taking abruptly if taking for >10days -decrease dosage gradually to prevent w/drawal during long-term therapy -adverse effects: GI distress, ulcer formation -do not take on an empty stomach d/t GI adverse effects -not a rescue med
A home health nurse is visiting an older adult patient who has Alzheimer's disease. His caregiver tells the nurse she has been administering prescribed lorazepam, 1 mg three times per day, to the patient for restlessness and anxiety during the past few days. For which of the following adverse effects of the nurse assess the patient?****
sedation -benzodiazepine w/ anti-anxiety and sedative effects -older adults especially at risk for CNS depression even w/ los doses
***the nurse should instruct the patient who has rheumatoid arthritis and a prescription for long-term prednisone therapy to monitor for what adverse effect?
stress Fx -med can cause demineralization of bones and lead to osteoporosis and stress Fx -adverse effects: HTN d/t Na and fluid retention; gingival ulcerations, weight gain d/t water retention
***A nurse is assessing a patient who has hypothyroidism and takes levothyroxine. Which of the following findings should alert the nurse that the patient is experiencing acute levothyroxine overdose?
tremor -acute levothyroxine overdose: tremor, anxiety, tachycarida, heat intolerance, hyperthermia
***A nurse is assessing a patient who takes oral theophylline for relief of chronic bronchitis. The nurse should recognize that which of the following findings indicates toxicity of theophylline?
tremors -med is a xanthine derivative bronchodilator -theophylline toxicity: CNS stimulation/ tremors (early manifestation), diarrhea adverse effects: tachycardia -an increase in blood level of this med causes restlessness and irritability
***nurse is assessing a patient who reports using several herbal and vitamin supplements daily, including Saw Palmetto. The nurse should recognize that Saw Palmetto is a supplement used by patients to elicit which of the following therapeutic effects?
urinary health promotion -used primarily for manifestation r/t prostatic conditions, such as prostatic hypertophy -echinacea: herb used to reduce manifestations and duration of colds and flu-like illnesses -ginko biloba: dietary supplement used for cognitive function in elderly, improves leg pain of intermittent caludication and other peripheral arterial disorder
