Pharm Exam 3 ATI

A nurse is caring for a child who is experiencing status asthmaticus. Which of the following interventions is the priority for the nurse to take?

Administer a SABA (Remember Airway). When using the urgent versus non-urgent approach to client care, the nurse should determine that the priority action is to administer a nebulized high-dose SABA to relieve bronchoconstriction and improve inhalation.

PT has HF and a script for Digoxin. A/E of dig

Anorexia, N/V, and abdominal discomfort are early signs of digoxin toxicity.

Nurse is reviewing the health history for a client who has angina pectoris and a script for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider?

Beta-Adrenergic blockers can cause BRONCHOSPASM in clients who have bronchial asthma; therefore, this is a contraindication to its use and should be reported to the provider.

Pt has a script for potassium chloride 20 mEq PO daily. Pt's potassium level is at 5.2mEq/L. What should the nurse do?

Call the prescribing physician and inform her of the client's serum potassium level results. (As a potassium level of 5.2 mEq/L is above the expected reference range, the nurse should hold the medication and notify the provider of the client's serum potassium level.

Nurse preparing to administer digoxin to pt with HF. What should the nurse do?

Evaluate the client for N?V and anorexia since dig causes a loss of appetite, N?V and blurred vision...this may all be signs of Dig toxicity!

Discharge teaching for a pt who has asthma and a new script for fluticasone/salmeterol. What adverse effects should the nurse instruct the client to report to the Provider?

Fluticasone/salmeterol is an inhaled glucocorticoid and LABA combination inhalation med that is used for daily mgmt of asthma. It is NOT A RESCUE MEDICATION. An A/E of the medication is oropharyngeal candidiasis. The nurse should instruct the client to gargle after each use, use a spacer to reduce the amount of drug in the mouth and throat, and report any white patches inside the mouth or on the tongue to the provider.

Nurse assessing client prior to administering atenolol (BB). Why would you hold the med?

HR 46/min. ALWAYS check HR prior to administering BB and hold if rate is less than 50/min. Used to treat hypertension and angina, and following a MI. This medication works by slowing the HR, decreasing the speed of electrical impulses through the AV Node, and decreasing the force of contraction.

Pt has DVT been on continuous infusion for 5 days. Provider prescribes Warfarin PO without DC of heparin. Client asks why both anticoagulants are necessary?

Heparin and warfarin (coumadin) are both anticoagulants that decrease the clotting ability of the blood and help prevent thrombosis formation in the blood levels. However, these medications work in different ways to achieve therapeutic coagulation and must be given together until therapeutic levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to 5 days. When the client's PT & INR are within therapeutic range, the heparin can be discontinued.

HF Pt has a new script for furosemide (Lasix). Which lab value should the nurse review BEFORE administering furosemide?

Potassium because furosemide is a loop diuretic therefore its a potassium waster. So the serum potassium levels should be checked before administering to prevent hypokalemia.

Nurse is caring for a client who has a script for digoxin 0.25mg PO daily. Available is digoxin 0.125mg/tab. How many tablets should the nurse administer?

2 tablets

A nurse is providing discharge teaching to a client who has a new prescription for verapamil for angina. What should the nurse include in instructions?

Increase your daily intake of fiber to reduce the risk of constipation associated with verapamil. ALSO FYI Do NOT expect swelling...this is an A/E instruct the client to report ANY swelling of the ankles or feet to the provider immediately.

Nurse is teaching baseline examinations with a female client who is to start taking atorvastatin. Which of the following baseline examinations should the nurse include in the teaching?

Liver Function Test.....teach pt that statins such as atorvastatin can cause liver damage and should NOT BE TAKEN by clients who have a HX OF LIVER DISEASE. Pt should undergo baseline LFT BEFORE beginning therapy and q. 6-12 months.

Pt has a new script for Hydrochlorothiazide for mgmt of HTN. Which instructions should the nurse include?

Monitor for leg cramps...because diuretics can be potassium wasters.

Pt has cirrhosis and new script for lactulose. Which of the following manifestations indicates an A/E of the med.

Monitor for vomiting as an A/E of lactulose.

Nurse providing discharge instructions to a client who has asthma and an new script for montelukast (Singular). Nurse should teach the pt which A/E should the pt report to the provider?

Montelukast can cause neuropsychiatric effects such as depression, behavior changes, hallucinations, and suicide ideation. The nurse should instruct the client to report such A/E. A change in medication might be prescribed.

A nurse is teaching a client who has a new prescription for bumetanide. Which of the following instructions should the nurse include in the teaching?

Report changes in hearing. Bumetanide is a "High-Ceiling" loop diuretic. It promotes diuresis by inhibiting sodium and chloride reabsorption in the thick ascending limb of the loop of Henle. High-ceiling loop diuretics can cause ototoxicity. Concurrent use of aminoglycosides, such as gentamycin, increases the risk of ototoxicity. Inform clients about possible hearing loss, and instruct clients to notify the prescriber if a hearing deficit or tinnitus develops.

Nurse teaching pt with angina pectoris about starting therapy with SL nitroglycerin tablets. Nurse should teach pt

Take nitroglycerin as soon as he feels pain, pressure, or tightness in his chest and not wait until his chest pain is severe.

Pt teaching for a client who has hypertension and a script change from metoprolol to metoprolol/hydrochlorothiazide. Which statement indicates pt understands?

The client has stated an understanding of the purpose of the addition of Hydrochlorothiazide (HCTZ) (a diuretic) to the metoprolol dosage. When used in combination with thiazide diuretics, a lower dose of the BB can be used. The benefit is there are fewer side effects when BB (and other anti hypertensives) are used in lower dosages.

A nurse is preparing to administer heparin to a client. Which of the following actions should the nurse plan to take?

The nurse should inject the medication into the abdomen above the level of the iliac crest, at least 2 inches from the umbilicus.

Discharge teaching for pt with new script for warfarin. What instructions should the nurse include?

Use an electric razor while on this medication. Because warfarin is an anticoagulant which increases the risk for bleeding. The nurse should teach the client safety measures, such as using an electric razor, to decrease the risk for injury and bleeding. DO NOT double your dose if you miss a dose as this will cause an increase in the possibility of bleeding. IF PT EXP Bloody nose...STOP THE MED and notify the provider for manifestations of bleeding. NO NEED to INCREASE Fiber to tx constipation...warfarin can cause diarrhea.