NU220 pharm Chapter 23: Drug Therapy for Viral Infections

For which clients would treatment with acyclovir be most clearly indicated?

A 77-year-old whose recent debilitating pain has been attributed to a herpes zoster infection

A client is being treated for a herpes outbreak, and the healthcare provider has prescribed acyclovir. In order to screen for potential problems with the client's excretion of the drug, which assessment data should the nurse review?

blood urea nitrogen and creatinine levels

In which clients are the use of cidofovir contraindicated?

clients with renal impairment

A nurse is providing care to a client who is receiving a protease inhibitor with a nursing diagnosis of Disturbed Body Image related to a redistribution of fat to the abdomen. Which intervention would the nurse include in the client's plan of care?

encouraging the client to verbalize feelings about body changes

While reviewing a newly admitted client's previous health records, the nurse notes that the client is currently prescribed acyclovir. The nurse should assess the client for signs and symptoms associated with what medical diagnosis?

herpes simplex virus

A nursing student is reading a journal article about highly active antiretroviral therapy (HAART). The nurse would expect to find which condition as being treated with this therapy?

human immunodeficiency virus (HIV)

An immunocompromised 3-year-old has been exposed to avian flu. The client is brought to the clinic, and the mother reports that the client has had flu-like symptoms for the past 12 hours. What medication should the nurse expect to administer?

oseltamivir

A nurse is administering a drug that blocks the protease enzyme so new viral particles cannot mature. Which category of drugs is the nurse most likely administering?

protease inhibitors

When fighting the human immunodeficiency virus (HIV), the nurse knows that the drug regimen usually includes which?

several medications, which combined are the most effective treatment.

As the nurse caring for Ms. Quil, you discuss home administration of zidovudine. Which statement by Ms. Quil indicates she needs additional teaching in order to understand correct self-administration?

"I can consume as many fats as I want."

The nurse is teaching a male client with HIV about his new antiviral drug regimen. Which client statement would suggest that the teaching plan was effective?

"I should expect some nausea and vomiting."

An adult client is being treated for genital herpes with acyclovir. Which client statement indicates a need for further health education?

"It's a relief to know that this drug will stop me from spreading the infection."

The nurse is giving discharge instruction to a client who has been prescribed efavirenz as treatment for HIV. Which instruction is most important for the nurse to give this client to minimize the CNS adverse effects of this medication?

"Take the medication at bedtime."

The nurse is reviewing the medication instruction for the client taking acyclovir. Which statement by the client would indicate the need for additional teaching?

"This medication will maintain the symptoms and cure my disease."

The nurse is teaching a 21-year-old client with AIDS about zidovudine, a nucleoside reverse transcriptase inhibitor (NRTI) that the health care provider has prescribed for treatment of the disease. Which client statement suggests that the nurse's teaching has been successful?

"This medication will slow the progression of the disease but will not cure it."

A nurse is teaching a client with herpes zoster to apply acyclovir ointment. What guidance should the nurse include in the instructions?

"Wear gloves when applying the ointment."

The nurse's teaching plan for antiviral drugs should include what information? Select all that apply:

-Antiviral drugs are not a cure for viral infection, but will shorten the course of disease. -Mark a calendar to designate the days the drug is to be taken for clients on alternate dosage schedule. -Some antiviral drugs cause photosensitivity, so precaution should be taken when going outdoors

A client comes to the health care facility reporting flulike symptoms. After a thorough assessment, the client is diagnosed with influenza and is to receive oseltamivir. The nurse understands that this drug has been prescribed because the client been symptomatic for less than:

2 days.

A client taking nevirapine as part of combination therapy for treatment of HIV took 200 mg/daily PO for 14 days. The client is now taking 200 mg PO twice daily. How many milligrams of the medication is the client taking daily?

400

A nurse is assessing a 66-year-old man who is HIV-positive. The patient has been prescribed didanosine (Videx). It would be most important to question the patient about which of the following?

Alcohol use

Viral infections commonly occur in what age group?

All age groups

Which of the following represents the categories of drugs used to treat viral infection? (Select all that apply.)

Antiretroviral Antiviral

A client is receiving a nonnucleoside reverse transcriptase inhibitor. Why should the nurse caution the client to avoid the concurrent use of St. John's wort?

Antiviral effects may be reduced.

Which statement regarding antiviral medications is true?

Antivirals do not eliminate existing viruses from tissues.

To prevent viral infections, what precaution should the general public take?

Become vaccinated against prevalent virus infections.

A client is diagnosed with HIV infection. What is the most important factor to consider when initiating chemoprophylaxis?

CD4 count

Jeff's mother tells you that she finds it difficult to give ritonavir solution to him. Jeff is an 8-year-old boy suffering from HIV infection. Your advice is to combine the drug with chocolate milk, which will mask its bitter taste. Which of the following actions is important for Jeff's mother to learn?

Have Jeff drink the milk with the drug within 1 hour of mixing.

A patient with skin lesions due to a viral infection has been prescribed topical application of an antiviral. Which of the following points should the nurse inform the patient regarding the therapy and the infection?

The drug will not prevent the spread of the disease to others.

The nurse is caring for a client who is taking adefovir to treat hepatitis B. The nurse's most recent assessment reveals that the client's skin and sclerae are visibly jaundiced. What is the nurse's best action? Select all that apply.

Document the finding as expected in a client with hepatitis.

A male patient is taking indinavir (Crixivan) for HIV. To decrease the risk of kidney stones, the nurse's teaching plan will include which of the following?

Drink 1 to 2 L of water a day

There are many antiviral medications on the market. What is the clinical reason for this?

Each medication is only effective against a small number of specific viral infections.

A client with active AIDS is infected with a retrovirus. This virus is better known as which?

HIV

Retroviruses are often treated with a regiment of multiple antiretroviral drugs. What is this therapy called?

Highly active antiretroviral therapy

The nurse admits a client for treatment of cytomegalovirus (CMV). The client has been ordered foscarnet, 40 mg/kg q12h given over 2 hours. By what route should the nurse expect to administer this drug?

IV

The patient receiving IV acyclovir should be monitored for which adverse reaction?

Increased BUN and creatinine levels

A 58-year-old with HIV is starting treatment with Combivir. He currently has a CD4+ cell count of less than 200 cells/mL and a viral load greater than 45,000 copies/mL. The nurse treating the client knows that what is a sign of effective drug therapy?

Increased CD4+ cell counts

You are caring for a 32-year-old client who is receiving saquinavir, a protease inhibitor. What effect can saquinavir have on other medications that the client is already taking?

It can increase the risk of toxicity associated with the other medications.

A nurse is giving discharge instructions to a client taking entecavir. What is an important teaching point the nurse should provide about taking entecavir?

It should be taken on an empty stomach.

A patient with chronic hepatitis B (HBV) infection is scheduled to begin a new treatment regimen that will include adefovir dipivoxil. What assessments should be prioritized before the initiation of this drug treatment?

Liver function testing and HIV testing

How is the risk of renal impairment best minimized when foscarnet is administered?

Monitoring renal function two or three times weekly during induction

A 2-year-old is prescribed ribavirin for RSV. He has a medical history of hand, foot, and mouth disease; decreased liver function; coughing; and severe cardiac arrhythmia. What part of his history most concerns the nurse to question the provider who prescribed the ribavirin?

The history of severe cardiac arrhythmia

The nurse is providing health education to a client who has recently been diagnosed with HIV and will soon begin antiretroviral therapy. What teaching point should the nurse prioritize?

The need to adhere rigidly to the prescribed drug schedule

A client with a diagnosis of HIV has impaired renal function due to a concurrent diagnosis of diabetic nephropathy. What medication is most appropriate to treat this client's HIV?

Nelfinavir

A nurse is preparing to administer famciclovir to a client with a herpes virus infection. The nurse should expect to administer this drug by which route?

Oral

A client who is hospitalized and receiving antiretroviral therapy has a nursing diagnosis of Risk for Injury related to weakness and dizziness. Which would be most appropriate for the nurse to do?

Provide for frequent rest periods.

When providing care to a client with a viral infection, the nurse knows that ribavirin (Virazole) for inhalation is used to treat which virus?

RSV

A 70-year-old man is being treated for herpes zoster virus. He has been prescribed acyclovir (Zovirax). The clinic nurse should prioritize assessments of which of the following?

Renal function

An elderly female client is admitted to the medical floor with pustules on her body that travel along the nerve route in her legs and arms. The health care provider prescribes the drug acyclovir (Zovirax). What disease is this client demonstrating?

Shingles

A 45-year-old client is prescribed acyclovir for the treatment of genital herpes. Which is an expected outcome for this client?

The client will experience fewer recurrences.

A student nurse, under the supervision of a preceptor, is caring for a patient who is receiving ganciclovir. The preceptor asks the student to identify potential adverse effects of the drug. Which of the following would the student include in his response?

Thrombocytopenia

A client with HIV is frustrated by the size and complexity of the current medication regimen. What should the nurse teach the client about combination therapy for the treatment of HIV?

Use of combination therapy attacks the virus at different stages of the life cycle.

What client is most vulnerable to infection with cytomegalovirus (CMV)?

a client being treated for acquired immunodeficiency syndrome

Administration of antiviral therapy for influenza requires monitoring of clients for which adverse effects? Select all that apply.

anorexia nausea dizziness

The nurse is caring for a school-aged child with human immunodeficiency syndrome (HIV). In order to confirm that the client's prescribed doses of antiretroviral medications are safe and effective, the nurse should obtain what assessment data?

the client's weight

A 38-year-old man is being treated for HIV-1 with nevirapine (Viramune). Signs of severe liver dysfunction have been noted by the health care provider and a change in the drug therapy is necessary. The nurse explains to the client that:

the therapy will be discontinued.

A client 45-years-old just received a heart transplant. One of the clients medications is ganciclovir. The nurse knows this medication was prescribed why?

to prevent CMV infection.