PrepU- Pharm- Ch 2: Basic Concepts and Processes

A black male client asks the nurse why the health care provider orders a diuretic as part of his treatment plan for hypertension, when the health care provider ordered an ACE inhibitor for his friend with the same diagnosis. After consulting with the provider, how would the nurse respond?

"Diuretics are shown to be more effective than ACE inhibitors for black males with hypertension."

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?"

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?

"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."

What factors does the nurse take into account that may influence the rate of absorption of medication? (Select all that apply.) -biotransformation of the medication -condition of the body tissues -solubility of the medication -half-life of the medication -route of administration

-condition of the body tissues -solubility of the medication -route of administration

The client has a diagnosis of multiple sclerosis and is taking the drug interferon beta-1a. The client takes this drug by subcutaneous injection three times a week. The dosage is 44 mcg per injection. If the client takes an injection on Monday, how many micrograms of the drug would still be in the client's system when he or she takes the next injection on Wednesday, assuming the half-life of the drug is 24 hours?

11

The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

20-year-old female client who has been diagnosed with a chlamydial infection

A client is receiving 250 mg of a drug that has a half-life of 12 hours. How much drug would remain after 36 hours?

31 mg

Which client is most likely to experience the benefits of the placebo effect?

A client who states, "I know this drug is going to work for me

A client has developed a tolerance to a drug. How should the nurse address this when providing care?

Assess whether the client needs larger doses to achieve the effect.

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.

Mrs. Geonity is prescribed a medication, and the health care provider modifies the dose on multiple occasions to achieve the maximum therapeutic effect of the drug. The client asks the nurse what the rationale is for the dosage changes. How should the nurse respond?

Dosage determines whether the drug actions may be therapeutic or toxic

Whereas some drugs or metabolites are excreted in bile and then eliminated in feces, others are excreted in bile, reabsorbed from the small intestine, and then returned to the liver. What is the name of this process?

Enterohepatic recirculation

The nurse is preparing to administer a prescribed drug to a client with a history of renal disease. Why should the nurse anticipate administering a lower dose than for a client with healthy kidneys?

Excretion is likely to take place slowly.

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

The nurse administers a loop diuretic to the client. In addition to sodium and water, what other electrolyte would the nurse expect to be excreted in significant amounts?

Potassium

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.

A client prescribed a drug that has an exceptionally narrow margin of safety should be educated about the need for what intervention?

Serum drug level monitoring

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion?

The client's blood urea nitrogen level and creatinine clearance rate

The nurse is caring for a client who is receiving gentamicin, 250 mg, and fluconazole, 500 mg, at the same time. What effect should the nurse anticipate if these two drugs competed with each other for protein-binding sites?

The effectiveness of both drugs will be altered.

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 nephrotoxic effects of aspirin

The nurse is caring for a patient who is taking bisoprolol, a cardio-selective beta-blocker. She expects that the patient will have a drop in blood pressure, but during her assessment of the patient she notes the blood pressure to be 210/112, which is elevated. What is the explanation of this reaction?

The patient had an idiosyncratic response to the medication, causing the opposite effect.

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?

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

An experienced nurse has observed that female clients sometimes experience a drug's effects for a longer time than male clients of similar age and size. The nurse should attribute this to what factor?

Women have more fat cells so drugs depositing in fat will have a prolonged effect.

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?

adverse effects

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:

an allergic response.

A client has not experienced the desired therapeutic effects of a medication. When considering factors that may affect the dynamic equilibrium that influences drug concentration, the nurse should:

assess for factors that may reduce absorption.

What would be a key element associated with pharmacodynamics?

enzyme systems

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.

A drug is 100% bioavailable when it is administered by what routes?

intravenous

The nurse is administering a drug that is known to be absorbed by passive diffusion. The nurse should plan care in the knowledge that this drug will:

move from areas of high concentration to areas of low concentration.

The client expresses relief to the nurse after being prescribed a new medication, stating that they expect to experience great benefits. The nurse suspects this drug will be more effective than usual for this client because of what effect?

placebo effect

How is pharmacodynamics best defined?

the action that the drug has on body cells