Chapters 54, 55, 57, 58, & 59 (Wolters Kluwer Focus on Nursing Pharmacology Amy M. Karch 8th edition)

A client, who is a truck driver, is concerned about his seasonal allergies, a friend suggested diphenhydramie. What would the nurse's best response?

"The drug may cause drowsiness and make driving unsafe."

A nurse is teaching a client who has just been prescribed lansoprazole (Prevacid). What statement would indicate that the client correctly understands the action of this medication?

"The medication inhibits acid secretions."

A female client has been administered metoclopramide (Reglan) for nausea. Which statement indicates that she has understood the teaching provided by the nurse?

"I may experience drowsiness on this medication."

A 94-year-old client is to begin taking psyllium hydrophilic mucilloid daily. What instructions should the nurse include in the discharge teaching? - Add all of the medications to the mucilloid. - Drink at least 8 ounces of fluid with the medication. - Mix the medication with your food at your evening meal. - Discontinue the mucilloid if no bowel movement occurs in 24 hours.

Drink at least 8 ounces of fluid with the medication. Rationale: Psyllium needs to be taken with at least 8 oz of water or other liquid. The nurse would not tell the patient to mix the medication with food, to add all medications to the psyllium, or to discontinue the drug.

Which instruction would be most important to give to a client who is receiving omeprazole (Prilosec)?

"Swallow the tablet whole with a large glass of water."

A nurse is preparing to administer dolasetron (Anzemet) orally to a child who is unable to swallow the tablets. The nurse would expect to mix the solution with: - Apple juice - Orange juice - Cranberry juice - Grapefruit juice

Apple juice

Misoprostol is a synthetic form of prostaglandin E prescribed to protect the gastric mucosa from erosion and ulceration. The drug is contraindicated in clients who:

Are pregnant

A client recently began taking theophylline for treatment of asthma. Which changes in the client's lifestyle would suggest that the client understands proper use of the drug and management of the disease?

Avoiding caffeine. Rationale: Some bronchodilating drugs, such as theophylline, can cause tachycardia, dysrhythmias, palpitations, agitation, and insomnia.

A nurse is caring for a client with pseudomembranous colitis. The health care provider has prescribed loperamide (Imodium) to the client. How does the nurse know that the drug has been effective?

Diarrhea is resolved. Rationale: Loperamide HCl (Lomotil) is an antidiarrheal medication. The nurse will know that the medication is effective if the diarrhea is resolved in the patient. The nurse should monitor the patient for an elevation in body temperature, severe abdominal pain, abdominal rigidity, or distention because these are the indicators of intestinal perforation. The nurse should monitor for rectal bleeding when laxatives are administered.

A client presents at the clinic with a dry, non-productive cough. The client is diagnosed with bronchitis, and it is determined that the client needs help thinning the sputum so the cough can become productive. What does the nurse expect the health care provider will prescribe?

Guaifenesin (Mucinex)

An older adult client has been prescribed budesonide (Pulmicort) for the treatment of chronic obstructive pulmonary disease (COPD). Which action should the nurse perform to reduce the client's risk for developing oral candidiasis?

Have the client rinse his or her mouth after each dose of the drug.

The client will receive ranitidine (Zantac) 150 mg PO at bedtime. Prior to administration, the nurse should inform the client that common side effects related to this medication include:

Headache

The nurse is about to administer a laxative to a client for the first time. What should be included in client education?

Laxatives may cause diarrhea, abdominal discomfort, nausea, vomiting, perianal irritation, and flatulence, as well as a number of other side effects. Prolonged use of a laxative can result in a "laxative habit," or dependence on a laxative to have a bowel movement. Some laxatives contain tartrazine (a yellow food dye), which may cause allergic-type reactions (including bronchial asthma) in susceptible individuals. Obstruction of the esophagus, stomach, small intestine, and colon has occurred when bulk-forming laxatives are administered without adequate fluid intake, or in clients with intestinal stenosis.

A client has an important presentation to make in 4 hours and needs relief from the congestion of seasonal rhinitis. The client calls the nurse, explains the situation, and tells the nurse that he cannot afford to be drowsy. Which antihistamine would be a good choice for this client?

Loratidine (Claritin) Rationale: The first-generation antihistamines, including diphenhydramine, dexchlorpheniramine, and hydroxyzine, are associated with drowsiness. Loratadine is one of the second-generation antihistamines, which have fewer anticholinergic effects and are less likely to cause drowsiness.

The nursing instructor is discussing the administration of nasal spray with the nursing students. What information is most important to include in this discussion?

Overuse of nasal spray may cause rebound congestion. Rationale: The use of topical decongestants is controversial because of the potential for a rebound effect. The patient should hold his or her head back for maximum distribution of the spray. Only the patient should use the bottle.

A client needing to evacuate the colon for endoscopy would likely be prescribed which medication?

Polyethylene glycol electrolyte solution Rationale: polyethylene glycol electrolyte solution. A client needing to evacuate the colon for endoscopy would likely take polyethylene glycol electrolyte solution as it is a bowel evacuant. Methylcellulose and psyllium are bulk-forming laxatives and will not evacuate the bowel for endoscopy. Mineral oil is an emollient that lubricates the intestinal walls and softens the stool, thereby enhancing passage of fecal material.

The nurse caring for a 38-year-old client started on albuterol (Proventil) should advise the client that they might experience what adverse effect?

Tachycardia

A clinic nurse is caring for a 55-year-old farmer who has been prescribed prochlorperazine for nausea and vomiting. The client states, "I need to get back to work." What is the most important teaching instruction the nurse should provide for this client?

Use protective sunscreen when outside. Rationale: Photosensitivity is a common adverse reaction with many antiemetics. The nurse should advise the patient to use sunscreen and wear protective garments if exposure cannot be avoided, which is unlikely considering the patients occupation.

An inhaled sympathomimetic drug has been ordered for a teenage athlete who has exercise-induced asthma. What should the client be instructed to do?

Use the inhaler 30-60 minutes before exercising.

A nurse reviewing the electronic health record of a client notes the regular ingestion of ginger. What is a possible reason for this client's use of ginger? - decreases blood pressure - decreases blood glucose levels - lessens nausea and vomiting

lessens nausea and vomiting