Pharmacology Notes etc.
A client is taking lansoprazole (Prevacid), on assessment of the client, the nurse should ask which question to determine the effectiveness of this medication?
"Are you experiencing any heartburn?" It's a gastric acid pump inhibitor used to treat gastric & duodenal ulcers, erosive esophagitis, hypersecretory conditions & gastroesophageal reflux disease (GERD).
The nurse is preparing to administer furosemide (Lasix) 40 mg by intravenous (IV) injection (IV push) to a client. The nurse should administer the medication over which time period?
1 minute
Which diet would most likely be prescribed for a client with Addison's?
A high-complex carbohydrate & high-protein diet. To prevent excess fluid & sodium loss, the client is instructed to maintain a normal salt intake daily (3 g) & to increase salt intake during hot weather, before strenuous exercise, and in response to fever, vomiting, or diarrhea.
A nurse provides instructions to a preoperative client about the use of an incentive spirometer. The nurse determines that the client needs further instruction if the client indicates that he or she will take which action?
After maximal inspiration, hold the breath for 10 seconds and then exhale. For optimal lung expansion with the incentive spirometer, the client should assume a semi-Fowler's or high Fowler's position. The mouthpiece should be covered completely and tightly while the client inhales slowly, with a constant flow through the unit. When maximal inspiration is reached, the client should hold the breath for 2 or 3 seconds and then exhale slowly.
A client has received a kidney transplant and is receiving therapy with azathioprine (Imuran)
Azathioprine is an immunosuppressant medication that is taken for life. Because of the effects of the medication, the client must watch for signs of infection, which are to be reported immediately to the health care provider. The medication may be taken with meals to minimize nausea. The client should also call the health care provider if more than one dose is missed.
Methylergonovine (Methergine) is prescribed for a woman with postpartum hemorrhage caused by uterine atony. Before administering the medication, the nurse should check which most important client parameter?
Blood pressure. It's an ergot alkaloid used for postpartum hemorrhage. It stimulates contraction of the uterus & causes arterial vasoconstriction. Ergot alkaloids are avoided in women with significant cardiovascular disease, peripheral disease, hypertension, eclampsia, or preeclampsia, such conditions are worsened.
Magnesium toxicity can occur as a result of magnesium sulfate therapy. Signs of magnesium sulfate toxicity:
relate to the central nervous system depressant effects of the medication and include respiratory depression, loss of deep tendon reflexes, sudden decrease in fetal heart rate or maternal heart rate or both, and sudden drop in blood pressure. An absence of reflexes indicates magnesium excess.
A client has received a kidney transplant and is receiving therapy with cyclosporine (Sandimmune)
Cyclosporine is an immunosuppressant medication (DMARD). Because of the effects of the medication, the client should NOT receive any vaccinations without first consulting the health care provider. The client should report decreased urine output or cloudy urine, which could indicate kidney rejection or infection, respectively. The client needs meticulous oral care and dental cleaning every 3 months to help prevent gingival hyperplasia. The client must be able to self-monitor blood pressure to check for the side effect of hypertension.
A client takes leflunomide (Arava), during assessment, what do you ask to determine effectiveness?
Do you have any joint pain? This is an immunomodulatory agent and has anti-inflammatory action; it provides symptomatic relief of rhyeumatoid arthritis
The nurse is assessing a client with a suspected diagnosis of hypocalcemia. Which cardiovascular manifestation would the nurse expect to note?
Hypotension. Hypocalcemia leads to decreased heart rate, diminished peripheral pulses, and hypotension. On the ECG, the nurse would note a prolonged ST interval and a prolonged QT interval.
A nurse is checking lochia discharge in a woman in the immediate postpartum period. The nurse notes that the lochia is bright red and contains some small clots. Based on this data, the nurse should make which interpretation?
The client is experiencing normal lochia discharge. Lochia, the uterine discharge present after birth, initially is bright red and may contain small clots. During the first 2 hours after birth, the amount of uterine discharge should be approximately that of a heavy menstrual period. After that time, the lochial flow should steadily decrease, and the color of the discharge should change to a pinkish red or reddish brown.
Methotrexate
used to treat certain types of cancer or to control severe psoriasis or rheumatoid arthritis that has not responded to other treatments. It may also be used to control juvenile rheumatoid arthritis
The nurse is monitoring a client who is attached to a cardiac monitor and notes the presence of U waves. The nurse assesses the client and checks his or her most recent electrolyte results. The nurse expects to note which electrolyte value?
Potassium 3.0 mEq/L. In hypokalemia, the ECG changes that occur include inverted T waves, ST segment depression, heart block, and prominent U waves.
The nurse receives a telephone call from the admissions office and is told that a child with acute bacterial meningitis will be admitted to the pediatric unit. The nurse prepares for the child's arrival and plans to implement which type of precautions?
Droplet; The child will be placed in a private room, with droplet transmission precautions, for at least 24 hours after antibiotics are given.
Orthodox Judaism believers adhere to dietary kosher laws:
In this religion, the dairy-meat combination is unacceptable. Only fish that have scales and fins are allowed; meats that are allowed include animals that are vegetable eaters, cloven-hoofed, and ritually slaughtered. Chicken is ok; pork, crab or shrimp are not.
A nurse provides dietary instructions to a client at risk for hypokalemia about which foods are high in potassium and should be included in the daily diet. The nurse should tell the client that which fruit is highest in potassium?
Kiwi. Foods that are high in potassium include bananas, cantaloupe, kiwi, and oranges. Fruits low in potassium include apples, cherries, grapefruit, peaches, pineapple, and cranberries.
A client is receiving lamivudine (Epivir), the nurse determines that this medication has been prescribed to treat which condition?
Lamivudine is a nucleoside reverse transcriptase inhibitor & antiviral medication. It slows HIV replication and reduces the progression of HIV infection. It also is used to treat chronic hepatitis B & provide prophylaxis in health care workers who are at risk of acquiring HIV infection after occupational exposure to the virus.
After a tonsillectomy, a child is brought to the pediatric unit. The nurse should appropriately place the child in which position?
Prone; The child should be placed in a prone or side-lying position after tonsillectomy to facilitate drainage.
The RN has provided dietary instructions to a pt with a Dx of hypoparathyroidism. The RN should instruct the pt that it is acceptable to include which item in the diet?
The client with hypoparathyroidism is instructed to follow a calcium-rich diet and to restrict the amount of phosphorus in the diet. Vegetables are allowed in the diet. The client should limit meat, poultry, fish, eggs, cheese, and cereals.
A client is taking ticlopidine hydrochloride (Ticlid). The nurse should tell the client to avoid which substance while taking this medication?
Ticlopidine hydrochloride is a platelet aggregation inhibitor. It is used to decrease the risk of thrombotic stroke in clients with precursor symptoms. Because it is an antiplatelet agent, other medications that precipitate or aggravate bleeding should be avoided during its use. Therefore, aspirin or any aspirin-containing product should be avoided.
A health care provider writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is most important to be sure to implement which measure?
Withhold the medication, and call the health care provider if the pulse is slower than 60 beats/min.
A nurse is preparing to administer digoxin (Lanoxin) to an infant with heart failure. Before administering the medication, the nurse double-checks the dose, counts the apical heart rate for 1 full minute, and obtains a rate of 88 beats/minute. Based on this finding, which is the appropriate nursing action?
Withhold the medicine. Digoxin is a cardiac glycoside that is used to treat heart failure. A primary concern is digoxin toxicity and the nurse needs to monitor closely for signs of toxicity and monitor digoxin blood levels. The medication is effective within a narrow therapeutic digoxin range (1.0 to 2.0 ng/mL). Safety in administration is achieved by double-checking the dose and counting the apical heart rate for 1 full minute. If the heart rate is less than 100 beats/minute in an infant, the nurse would withhold the dose and contact the health care provider.
foods high in tyramine
aged cheeses, cured meats, fermented cabbage, soy sauce, fish sauce, shrimp sauce, yeast extract spreads, improperly stored foods, broad bean pods
The most common manifestations of hypocalcemia
are caused by overstimulation of the nerves and muscles: tetany & presence of Chvostek's sign; cardiac contractility is decreased & hypotension; could also lead to severe ventricular dysrhythmias & prolonged QT and ST intervals
Vitamin K-rich foods include
green leafy vegetables, fish, liver, coffee, and tea
