Pharm Ch 3: Toxic Effects of Drugs

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? "The sexual dysfunction is caused by an allergic reaction to the medication. We need to stop this drug immediately." "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." "This is an idiosyncratic response to the medication, not an expected result. Such responses are genetically predetermined so you will not be able to take this medication." "This is a toxic reaction to the medication and can cause permanent damage. We need to take you off this medication immediately."

"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."

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?" Ask the client, "Are you allergic to any other antibiotics, or just tetracycline?" Document an allergy to tetracycline in the client's health record Educate the client about antibiotics that are alternatives to tetracycline.

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

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. Administer prescribed epinephrine subcutaneously. Encourage the use of a MedicAlert identification. Administer topical corticosteroids.

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? Many drugs are potentially harmless if used correctly. Any effect results from the alteration of several chemical factors. Most reactions occurring with present-day therapy are less severe than before. Drugs cause unexpected or unacceptable reactions despite screening and testing.

Drugs cause unexpected or unacceptable reactions despite screening and testing.

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. Place the client on protective isolation. Facilitate cardiac monitoring. Prepare the client for dialysis.

Monitor laboratory blood values.

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? The need for follow-up blood tests The importance of a low-stimulation environment Safety measures Educating about the signs and symptoms of stroke

Safety measures

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? visual disturbances yellowing of the skin a decrease in urine output ringing noise in the ears

a decrease in urine output

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 asking if the client has tolerated narcotics and acetaminophen in the past assessing the client for signs and symptoms of inflammation assessing the client's pain tolerance and expectations for pain control

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

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: affect the eighth cranial nerve of the fetus. affect the liver of the fetus. affect the kidneys of the fetus. damage the immature nervous system of the fetus.

damage the immature nervous system of the fetus.

Which drug allergy involves antibodies bound to specific white blood cells? anaphylactic reaction cytotoxic reaction serum sickness reaction delayed allergic reaction

delayed allergic reaction

A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety? a list of pharmacies where the drug can be obtained measures to alleviate any discomfort associated with adverse effects the cost of the brand-name drug compared with the generic form statistics related to phase III of testing for the prescribed drug

measures to alleviate any discomfort associated with adverse effects

The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of: poisoning. hypersensitivity. allergies. anaphylaxis.

poisoning.

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 monitoring the client's vital signs at least every five minutes administering intravenous antihistamines as prescribed providing reassurance to the client

protecting and maintaining the patency of the client's airway

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: primary actions. secondary actions. drug allergy. hypersensitivity.

secondary actions.

The nurse is assessing a client who is distress and may be experiencing an anaphylactic reaction. What assessment finding is most consistent with this diagnosis? shortness of breath sudden somnolence swollen cervical lymph nodes swollen joints

shortness of breath

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 birth at 40 weeks' gestation heart defects

skeletal and limb abnormalities central nervous system alterations heart defects

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?" "We'll make sure that none of your antibiotics are similar to penicillin." "I'll make sure to pass that information along to the pharmacy." "Are there other antibiotics that have worked well for you in the past?"

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

A recent nursing graduate is preparing to enter the workforce. What principle should guide the nurse's administration of medications? Drugs can cause unexpected reactions even after thorough screening and testing. Several chemical and physiologic processes need to be affected before a client has an adverse effect. Drugs pose no significant risk of harm if they are used as prescribed. The effects occurring with present-day therapy are much less severe than in previous decades.

Drugs can cause unexpected reactions even after thorough screening and testing.

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? route of administration body system affected adverse effects protocols

adverse effects

A client is receiving a drug to lower blood glucose level. What would lead the nurse to suspect that the client's blood glucose level was too low? cold, clammy skin increased urination fruity breath odor increased hunger

cold, clammy skin

A client with urinary urgency and frequency has been prescribed an anticholinergic medication. The nurse should educate the client about what potential adverse effects related to secondary actions? Decreased bowel motility Urinary hesitancy Anaphylaxis Urinary incontinence

Decreased bowel motility

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? Ototoxicity Hepatotoxicity Nephrotoxicity Neurotoxicity

Neurotoxicity

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. Check the client's blood glucose level. Assess the client's level of orientation. Check the client's urine output.

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 The importance of sitting upright while eating and for 30 minutes afterwards The rationale for prophylactic antibiotics The rationale for taking probiotics for the duration of treatment

Techniques for providing safe and effective mouth care

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 Stomatitis Blood dyscrasia Cytotoxic reactions

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 a paradoxical effect of aspirin The man may be allergic to aspirin The man may be experiencing liver toxicity from the aspirin The man may be experiencing nephrotoxic effects of aspirin

The man may be experiencing nephrotoxic effects of aspirin

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: a hepatotoxic response. an idiosyncratic response. a paradoxical response. an allergic response.

an allergic response.

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? cytotoxic anaphylactic serum sickness delayed

anaphylactic

When assessing a client who has developed a serum sickness reaction, which would the nurse expect to find? hives difficulty breathing decreased white blood cell count facial edema

facial edema

A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating: grapefruit. cheese. chicken. corn.

grapefruit.

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? toxic anaphylactic shock additive synergistic

anaphylactic shock

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. Administer subcutaneous epinephrine as prescribed. Initiate emergency resuscitation measures. Administer naloxone as prescribed.

Provide supportive care to manage fever and inflammation.

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? The nurse should not be concerned. Medication is not the cause of the client's confusion. The client probably has the onset of Alzheimer disease. This may be coincidental, and the memory loss may be attributed to changes with aging. All elderly clients have dementia at some point in life, and the medication is making it worse.

This may be coincidental, and the memory loss may be attributed to changes with aging.

A client exhibits muscular tremors, drooling, gait changes, and spasms. When reviewing the client's medication history, which would the nurse most likely find? antipsychotic agent antidiabetic agent general anesthetic anticholinergic agent

antipsychotic agent

A client develops a cytotoxic reaction to a drug. What would the nurse expect to do? Administer prescribed epinephrine subcutaneously. Encourage the use of MedicAlert identification. Discontinue the drug immediately as ordered. Administer antipyretics as ordered.

Discontinue the drug immediately as ordered.

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 pregnant woman who takes tamoxifen (Nolvadex) and delivers a baby with birth defects 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

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