Hesi Stuff

What further teaching is needed when rifampin (rifordin) is given for TB?

Reduces effectiveness of oral contraceptives; turns skin, sweat, tears, urine, feces, sputum, saliva, & tongue red/orange/brown; stains contacts.

A 52-year-old has made an appointment with his primary care provider and has reluctantly admitted that his primary health concern is erectile dysfunction (ED). He describes the problem as increasing in severity and consequent distress. Which of the nurse's assessment questions is most likely to address a common cause of ED?

"Are you taking any medications for High blood pressure

A patient is ordered by the physician to take allopurinol (Zyloprim) for treatment of gout. You've provided education to the patient about this medication. Which statement by the patient requires you to re-educate them about this medication? A. "This medication will help relieve the inflammation and pain during an acute attack." B. "It is important I have regular eye exams while taking this medication." C. "I will not take large doses of vitamin C supplements while taking this medication." D. "Allopurinol decreases the production of uric acid."

A. "This medication will help relieve the inflammation and pain during an acute attack" Explanation: The answer is A. Allopurinol is used to PREVENT gout attacks.... not treat an acute attack. NSAIDs and Colchicine are best for treating the inflammation and pain during a gout attack.

A client who has been taking phenazopyridine (Pyridium) for symptoms of urethritis and cystitis comes to the clinic because her urine is reddish-orange. Which question should the practical nurse ask to determine if the medication has been effective?

A: Have you had any relief from urinary pain, burning, or urgency?

A group of students are reviewing the drugs available for treating penile erectile dysfunction. The students demonstrate understanding when they identify which drug as a PDE5 inhibitor?

A: Sildenafil

An older adult client's current medication regimen includes tamsulosin and sildenafil. The combination of these two medications should prompt what action by the nurse?

A: assessing the client regularly for signs of orthostatic hypotension

a patient who is about to be given octreotide is also taking a diuretic IV heparin, ciprofloxacin and an opioid as needed for pain. the nurse should be watchful for what possible interaction?

A: prolongation of the OTC interval due to an interaction with ciprofloxacin

What are some Adverse Effects of sildenafil

Adverse effect: headache and flushes

Allopurinol can cause what type of change and what should be done about the change?

Allopurinol can cause vision changes; therefore, the patient should receive annual eye exams along with avoiding large doses of vitamin C due to the risk of renal calculi formation.

Allopurinol will increase the effect of what 2 classes?

Allopurinol will increase the effect of anticoagulant and antiplatelet agents.

What are the adverse effects of allopurinol?

CNS adverse effect include drowsiness and vertigo. Hematologic - agranulocytosis, aplastic anemia, and bone marrow depression. GI - N&V, diarrhea, abdominal pain, and indigestion. Hepatoxicity and renal insufficiency are risk factors with the use of allopurinol

Mark, age 42, is prescribed sildenafil for the treatment of pulmonary hypertension. The nurse caring for Mark would explain that sildenafil works by what mechanism?

Causing vasodilation in the pulmonary vascular bed

A nurse is caring for a client who has a new diagnosis of benign prostatic hyperplasia (BPH). The nurse should anticipate a prescription for which of the following medications? A. Oxybutynin (Ditropan) B. Diphenhydramine (Benadryl) C. Ipratropium (Atrovent) D. Tamsulosin (Flomax)

D. Tamusolosin (Flomax)

Which instruction should the nurse give to a female client who just received a prescription for oral metronidazole (Flagyl) for treatment of trichomonas vaginalis?

Increase fluid intake, especially cranberry juiceAvoid drinking alcohol while taking this medicationUse condoms until treatment is completedEnsure that all sexual partners are treated at the same time

A nurse is caring for a client with irritation of the lower genitourinary tract. The client is administered phenazopyridine. Which condition in clients contraindicates the use of the drug?

Renal Impairment

A client taking Tamsulosin returns to the outpatient department for a follow-up. Which of the following statements made by the client indicates the need for further assessment? a. "I get out of bed by sitting for a while first before standing up." b. "I always have my blood pressure taken by my niece who is taking up nursing." c. "Yesterday I was feeling tired and sleepy while driving to the laundromat." d. "I have started cooking with less salt than before."

c. "Yesterday I was feeling tired and sleepy while driving to the laundromat."

A 66-year-old man has made an appointment with his primary care provider to discuss his recent erectile dysfunction (ED) and has requested a prescription for sildenafil (Viagra) based on television commercials he has seen. What characteristic of this client would contraindicate the use of sildenafil for his ED?

has unstable angina and uses a nitroglycerin patch

The nurse assesses aspartate aminotransferase and alanine aminotransferase levels for what?

hepatoxicity and creatinine clearance for renal insufficiency.

The nurse recognizes that metoclopramide (Reglan) is useful in treating postoperative nausea and vomiting because it

promotes motility in the small intestine.

After teaching a client who is prescribed sildenafil about using the drug, the nurse determines that the teaching was successful when the client states:

"I need to take the pill about an hour before any sexual stimulation."

A patient with type 2 diabetes wants to stop taking metformin (Glucophage) and manage the diabetes with diet and exercise. The patient states that cutting out carbohydrates was featured on television recently as a treatment for diabetes and is considering the paleo diet. Which responses by the nurse are most appropriate?

"Weight loss for overweight patients is recommended as a management strategy for type 2 diabetes."

A nurse is caring for a patient who is being administered phenazopyridine. The patient is distressed on seeing that the urine is exhibiting a reddish-orange discoloration. Which is the most appropriate response by the nurse?

"You don't have to worry. This is normal with this medication."

A 59-year-old man with a recent history of erectile dysfunction has been assessed and prescribed sildenafil (Viagra). When providing patient education to this man, the nurse should tell him:

"You might find that your face becomes flushed or you get a headache after you take Viagra."

A client has been given a prescription for sildenafil (Viagra) for treatment of erectile dysfunction. The nurse will instruct the client to take this medication at what time prior to the onset of sexual intercourse?

30 minutes

A client diagnosed with erectile dysfunction has been advised to take (sildenafil) Viagra. For up to how many hours does the action of the drug persist?

4 hours

A nurse has educated a client about the drug phenazopyridine. Which client statement indicates clear understanding?

A. "My urine could be reddish orange."

A 72-year-old client has been diagnosed with benign prostatic hypertrophy (BPH) and will begin treatment with tamsulosin. The client admits that he is skeptical about the drug's ability to relieve his distressing symptoms. The nurse should respond in what way?

A. "Tamsulosin can relax your prostate and your bladder neck, making it easier to pass urine."

A client has begun treatment for penile erectile dysfunction. What explanation should the nurse provide regarding the primary effect a prescribed phosphodiesterase type 5 inhibitor (sildenafil) will have on this condition?

A. Blood flow to the penis will be improved

Which of the following clients can't be prescribed with Tamsulosin? a. Benign Prostatic hyperthropy b. Coronary atherosclerosis c. Raynaud's disease d. Pheochromocytoma

B: coronary Atherosclerosis

The nurse should advise clients taking phenazopyridine (Pyridium) that they may notice a change in urine color. Which color would the nurse identify?

Brown

A man with an acute gouty flare-up is taking allopurinol. Which of the following subjective statements indicates that he has developed uric acid kidney stones? A. "I have pain in my right toe and left elbow" B. "I am dizzy and feel like I am going to faint" C. "I am urinating every hour - approximately 8 ounces." D."I have excruciating pain in my lower abdomen"

C. "I am urinating every hour - approximately 8 ounces" Explanation: The nurse assesses for diminished urine output or cloudy urine, which may be indicative of the development of uric acid kidney stones. It is also important to asses for GI effects such as N&V, diarrhea, and abdominal pain.

A man is taking allopurinol for acute gout. He has also been receiving anticoagulant therapy since having a myocardial infarction. What is the priority assessment? A. Diminished pain in the inflamed joint B. Adherence to the medication regimen C. Bleeding D. Abdominal pain

C. Bleeding

What are the indications of uric acid?

Gout, leukemia, lymphoma, and malignancies that result to increase in uric acid.

The pharmacology students are learning about medications used to treat urinary tract problems. What symptoms does phenazopyridine treat?

Pain and urgency

A 68-year-old male client tells the nurse that he has been unable to maintain an erection for the past 6 months and he guesses his sex life is over. The provider orders diagnostic testing to determine whether sildenafil (Viagra) is appropriate for the client. What is the most appropriate nursing diagnosis for this client?

Sexual dysfunction

What aspect of a client's current health status may contraindicate the use of a PDE5 inhibitor?

The client has a history of unstable angina pectoris.

Sildenafil in contraindicated with?

The sildenafil is contraindicated those taking nitroglycerin

Uricosoric agents are drugs use to lower?

Uric Acid

An adolescent is brought to the ED by a parent who reports that the patient took a whole bottle of extended-release acetaminophen tablets somewhere between 8 and 10 hours ago. The nurse will anticipate administering which of the following? a. acetylcysteine (mucomyst) b. activated charcoal c. hemodialysis d. respiratory support

a. acetylcysteine

Hepatoxicity and renal insufficiency are risk factors with the use of what medication?

allopurinol