Medications! (Random notes&Questions)

18.propranolol (Inderal)

- prevent bleeding in pt with esophageal varicies

8.dicyclomine hydrochloride (Bentyl)

-anticholenergic, tx of IBS decreased GI motitlity

16.natalizumab (Tysabrri)

-can cause progressive multifocal leukoencephalopathy (PML), a deadly infection of the brain must be free of all infections before giving and monitor LOC

7.diphenoxylate hydrochloride & atropine sulfate (Lomotil)

-habit forming, use with caution in gastroenteritis

11.azathioprine (Imuran)

-immunospuressant, do not give with allupurinal, take with food, ly down if nausea, report abd pain, jaundice, vomiting, sore throat infection, dyspnea, dizziness, bleeding/bruising

6.metronidazole (Flagyl)

-less potential for renal toxicity , BUT SHOULD ONLY USE FOR SHORT PERIOD OF TIME, can be useful for fistulas assoc w/ CD

21.lactulose

-may eliminate or reduce ammonia levels in the body; used in patients with encephalopathy; used for a laxative effect, drug is vicscous and sticky, given PO or NGT, increases osmotic pressure to draw fluid into the colon and prevents absorption of ammonia in the colon, desired effect is 2-3 soft stools/day with decreased confusion, may report bloating/cramping, do NOT give with NONABSORBIC ANTIBIOTICS (FLAGYL, NEOMYCIN,) FREQUENTLY ASSES FOR LOC, ASTERIXIS & FETOR HEPATICUS

14.inflixicab (Remicade)

-used in combo with steroids for the tx of U.C, can be used for Toxic megacolon

15.adalimumab (Humira)

-with steroids for U.C, Mostly used for Crohns disease

1. Which finding suggests to the nurse that a client with bleeding esophageal varices is experiencing an adverse effect of vasopressin therapy? 1. Complaints of chest pain 2. Temperature of 102° F 3. Bounding peripheral pulses 4. Blood urea nitrogen (BUN) of 20 mg/dL

1

A health care provider has written a prescription for ranitidine (Zantac) 300 mg once daily. The client indicates understanding of use of this medication by stating that the prescribed dose is best taken at what time? 1. At bedtime 2. After lunch 3. With supper 4. Before breakfast

1

A preoperative client receives a dose of scopolamine. The nurse determines that which sign or symptom later displayed by the client is a result of medication side effects? 1. Dry mouth 2. Diaphoresis 3. Excessive urination 4. Pupillary constriction

1

The nurse has just given a client a dose of a PRN medication called loperamide (Imodium). The nurse documents in the client's record that the client received this medication for complaints of what symptom? 1. Diarrhea 2. Tarry stools 3. Constipation 4. Abdominal pain

1

17.certizumab pegol (Cimzia)

1282

A client has been taking omeprazole (Prilosec) for 4 weeks. The ambulatory care nurse evaluates that the client is receiving the optimal intended effect of the medication if the client reports the absence of which symptom? 1. Diarrhea 2. Heartburn 3. Flatulence 4. Constipation

2

A client has just been given a prescription for diphenoxylate with atropine (Lomotil). The nurse determines that the client understands important information about this medication if the client makes what statement? 1. "It's best to take this medication with a laxative." 2. "This medication contains a habit-forming ingredient." 3. "Drooling may occur while I am taking this medication." 4. "Irritability may occur while I am taking this medication."

2

Dicyclomine hydrochloride (Bentyl) has been prescribed for a client with irritable bowel syndrome, and the nurse provides instructions to the client about how to take this medication. Which statement, if made by the client, best indicates an understanding of how to take this medication? 1. "I should take the pill with food and at meal times." 2. "I should take the pill 30 minutes before each meal." 3. "I should take the pill after I have finished eating my meal." 4. "I should take the pill when I first wake up in the morning and right before I go to bed."

2

The nurse is preparing to administer prescribed medications to a client with hepatic encephalopathy. The nurse anticipates that the health care provider's prescriptions will include which medication? 1. Bisacodyl (Dulcolax) 2. Lactulose (Chronulac) 3. Magnesium hydroxide (Milk of Magnesia) 4. Psyllium hydrophilic mucilloid (Metamucil

2

1. A client with Crohn's disease is scheduled to receive an infusion of infliximab (Remicade). What intervention by the nurse will determine the effectiveness of treatment? 1. Monitoring the leukocyte count for 2 days after the infusion 2. Checking the frequency and consistency of bowel movements 3. Checking serum liver enzyme levels before and after the infusion 4. Carrying out a Hematest on gastric fluids after the infusion is completed

2. Checking the frequency and consistency of bowel movements

1. A client has begun medication therapy with pancrelipase (Pancrease MT). The nurse evaluates that the medication is having the optimal intended benefit if which effect is observed? 1. Weight loss 2. Relief of heartburn 3. Reduction of steatorrhea 4. Absence of abdominal pain

3

1. A client is experiencing diarrhea. The nurse reviews the client's PRN medication prescription sheet and should plan to administer which medication for this problem? 1. Psyllium (Metamucil) 2. Sennosides (Senokot) 3. Loperamide (Imodium) 4. Bisacodyl (Dulcolax Bowel Prep Kit)

3

1. A client with portal-systemic encephalopathy is receiving oral lactulose (Chronulac) daily. The nurse should check which item to determine the effectiveness of this medication? 1. Lung sounds 2. Blood pressure 3. Blood ammonia level 4. Serum potassium level

3

1. Lactulose (Chronulac) is prescribed for a client with a diagnosis of hepatic encephalopathy. The nurse should determine that this medication has had a therapeutic effect if assessment reveals which finding? 1. Increased protein level 2. Increased red blood cell count 3. Decreased serum ammonia level 4. Decreased white blood cell count

3

1. Mineral oil has been prescribed for a child with constipation, and the nurse teaches the mother about administration of the mineral oil. Which statement by the mother indicateseffective teaching? 1. "I will administer the mineral oil before each meal." 2. "I will administer the mineral oil followed by a glass of warm water." 3. "I will mix the mineral oil with a chilled drink before administration." 4. "I will mix the mineral oil with 8 ounces of warm juice before administration."

3

1. The adult client with hepatic encephalopathy has a serum ammonia level of 95 mcg/dL and receives treatment with lactulose (Chronulac). The nurse determines that the client had the best and most realistic response if the serum ammonia level changed to which value after medication administration? 1. 5 mcg/dL 2. 10 mcg/dL 3. 40 mcg/dL 4. 90 mcg/dL

3

1. The nurse has administered prochlorperazine to a client for relief of nausea and vomiting. The nurse should then assess the client for which frequent side effect of this medication? 1. Diarrhea 2. Drooling 3. Blurred vision 4. Excessive tearing

3

A client reports frequent use of sodium bicarbonate to relieve heartburn after meals. The nurse should monitor the client for which condition that the client is at risk for with long-term frequent use of this medication? 1. Urinary calculi 2. Chronic bronchitis 3. Metabolic alkalosis 4. Respiratory acidosis

3

The client has a prescription for sucralfate (Carafate) four times daily. The nurse teaches the client to administer the medication at which best times? 1. Every 6 hours starting at 6:00 am 2. With breakfast, lunch, dinner, and at bedtime 3. One hour before breakfast, lunch, dinner, and at bedtime 4. One hour after breakfast, lunch, dinner, and with an evening snack

3

1. A client has a PRN prescription for loperamide hydrochloride (Imodium). For which condition should the nurse administer this medication? 1. Constipation 2. Abdominal pain 3. An episode of diarrhea 4. Hematest-positive nasogastric tube drainage

3. An episode of diarrhea

1. A client has a PRN prescription for ondansetron (Zofran). For which condition should the nurse administer this medication to the postoperative client? 1. Paralytic ileus 2. Incisional pain 3. Urinary retention 4. Nausea and vomiting

4

1. A client has a prescription for magnesium citrate to prevent constipation after undergoing barium studies of the gastrointestinal tract. How should the nurse administer the magnesium citrate? 1. With fruit juice only 2. At room temperature 3. With a full glass of water 4. After it is chilled in the refrigerator

4

1. A client has begun medication therapy with pancrelipase (Pancrease MT). Which finding indicates that the medication is effective? 1. Relief of heartburn 2. Elimination of abdominal pain 3. Stabilization of blood glucose levels 4. A decrease in the amount of fat in the stools

4

1. A client with gastrointestinal hypermotility has a prescription to receive atropine sulfate. The nurse should withhold the medication and question the prescription if the client has a history of which disease process? 1. Biliary colic 2. Sinus bradycardia 3. Peptic ulcer disease 4. Narrow-angle glaucoma

4

1. Oral neomycin has been prescribed for a client with a diagnosis of portosystemic encephalopathy. The nurse reviews the health care provider's prescription and determines that this medication has been prescribed for which purpose? 1. Prevent infection. 2. Prevent restlessness in the client. 3. Prevent fluid retention and ascites. 4. Destroy normal bacteria found in the bowel.

4

1. The nurse is preparing to give a client directions for proper use of aluminum hydroxide tablets. Which instruction by the nurse is appropriate? 1. "Take the tablet at the same time as an antacid." 2. "Swallow the tablet whole with a full glass of water." 3. "Take each dose with a laxative to prevent constipation." 4. "Chew the tablet thoroughly and then drink 8 ounces of water."

4

A client admitted to the medical nursing unit has a diagnosis of gastroesophageal reflux disease (GERD). Metoclopramide (Reglan) has been prescribed four times a day. The nurse should schedule administration of the medication for which times? 1. Every 8 hours 2. With meals and at bedtime 3. Right after meals and at bedtime 4. 30 minutes before meals and at bedtime

4

A client with peptic ulcer disease who has been given a prescription for propantheline (Pro-Banthine) asks the nurse how to take the medication. The nurse explains that this medication should be taken in which way? 1. With meals 2. With antacids 3. Just after meals 4. 30 minutes before meals

4

sulfasalazine

5 ASA, take with food, avoid sun, urine and skin may appear yellow or brown, CONTRAINDICATED IN SULFA ALLERGY; decrease inflammation

9.sulfasalazine=

5 ASA-anti inflam

10.mesolamine-

5ASA

mesolamine

5ASA NONSULFA, report headache or GI probs, side effects not as bad as sulfasalazine

1.Your client is dx with end stage liver failure and receiving lactulose/granulote. which lab test tells you it is effective? A. serum ammonia B. BUN C. sodium D. serum Creatinine

A. serum ammonia

3.A nurse is caring for a client with cirrhosis who has a new prescription for cephulac (Lactulose). Following administration, the nurse will monitor the client for which adverse effect of this medication? A. Dry mouth B. Diarrhea C. Headache D. Peripheral edema

B. Diarrhea

2.Your elderly pt is being administered Lomotil, what kind of drug? A. Antiflatulent B. Laxative C. Antidiarrheal D. Emetic

C. Antidiarrheal

12.A client has begun medication therapy with pancrelipase (Pancrease). The nurse determines that the medication is having the optimal intended benefit if which effect is observed? A. Weight loss B. Relief of heartburn C. Reduction of steatorrhea D. Absence of abdominal pain

C. Reduction of steatorrhea

bevacizumab (Avastin)-

Monoclonal antibodies; colorectal cancer; stops cancer cell growth and increase cell death; THROMBOEMBOLISM, CVA, MI, alopecia, hemorrhage, hypertension, GASTRIC PERFORATION-notify HCP of ABD pain associated with vomiting and constipation, do not use with low WBC or liver/kidney failure

4.the nurse administers antidiarrheal drugs... a. after each loose bowel movement b. hourly until diarrhea ceases c. with food d. BID, in the AM and at bedtime

a. after each loose bowel movement

5.trimethoprim/sulfa (Bactrim)-

antibiotic tx of spontaneous bacterial peritonitis if pt is allergic to quinolones, gastroenteritis

A client has a PRN order for loperamide (Imodium). The nurse should plan to administer this medication if the client has: A. constipation B. abdominal pain C. episode of diarrhea D. Hematest-positive nasogastric tube drainage

c. episode of diarrhea

Polyethylene glycol-electrlyte solution (GoLYTELY) is prescribed for the female client scheduled for a colonoscopy. The client begins to experience diarrhea following administration of the solution. What action by the nurse is appropriate?

explain that diarrhea is expected

20.somatostatin (Ostreotide)

same as terlipressin but with more serious side effects

19.terlipressin

vasoactve drugs, may cause ischemic complications and dysrhytmias- used for bleeding