Passpoint: Pharmacology and Medication Management Week 2
The nurse initiates the treatment for a delayed hypersensitivity reaction. What is the most appropriate treatment?
Corticosteroids
Negative inotropic agents are prescribed to?
Decrease contractility
Vasodilators are prescribed to?
Increase cardiac output
Ferrous sulfate is used to treat?
RA
Oral nystatin suspension is indicated for?
thrush
A nurse is caring for a child taking prednisone following a heart transplant. His pre-surgical weight was 25.6 lb (11.6 kg). The practitioner orders the child to receive 2 mg/kg/day divided every six hours. The oral solution comes prepared as 5 mg/5ml. How many milliliters will the child receive with each dose? Record your answer using one decimal place.
5.8 mL
The nurse is performing discharge teaching for a school-aged child who experienced an asthma attack. What is the most important information the nurse can provide this client about the prescription for budesonide?
Rinse the mouth after using this medication.
Which medication would the nurse expect the provider to prescribe as prophylaxis against Pneumocystis carinii pneumonia for a client with leukemia?
Co-trimoxazole Explanation: The most common cause of death from leukemia is overwhelming infection. P. carinii infection is lethal to a child with leukemia. As prophylaxis against P. carinii pneumonia, continuous low dosages of co-trimoxazole are typically prescribed.
A client is experiencing status asthmaticus. For which would the nurse anticipate an immediate order?
Inhaled Beta-2 adrenergic agonist Explanation: Inhaled beta-adrenergic agonists agents are the first line of therapy in status asthmaticus, as they help promote bronchodilation, which improves oxygenation. IV beta-adrenergic agents can be used, but must be carefully monitored because of their systemic effects. They are typically used when the inhaled beta-adrenergic agents do not work. Inhaled and oral corticosteroids are slow-acting, and their use won't reduce hypoxia in the acute phase.
The nurse has instructed a client on self-administration of heparin injections. The nurse determines that teaching is effective when the client makes which statement?
"Heparin slows the time it takes for the blood to clot." Explanation: Heparin prolongs the time needed for blood to clot.
The home health nurse is speaking to the wife of a client with neurocognitive disorder due to Alzheimer's disease. The client has been taking donepezil. The nurse is most concerned when the caregiver states:
"Yesterday, I managed to weigh my husband, and he has lost 8 lbs this month." Explanation: A side effect of donepezil is weight loss, and it would be important to discuss the weight loss with the primary care provider.
An unresponsive 41 lb (18.6 kg) child, with supraventricular tachycardia, is prescribed oral amiodarone 5 mg/kg. It comes as a solution of 150 mg/3 ml. How many milliliters should be given? Record your answer using one decimal place.
1.9 ml
Which medication will the nurse administer to a client who experienced a thrombotic stroke two days ago?
Aspirin Explanation: Aspirin interferes with platelet aggregation to prevent blood clots from forming or growing larger and is used in the treatment, and secondary prevention, of ischemic stroke due to thrombosis. Antiplatelet medication, such as aspirin, should be given by day two in the absence of a bleeding complication. ted in acute stroke.
Where is the best site for the nurse to assess a client's pulse prior to administering digoxin?
At the left fifth intercostal space, midclavicular line Explanation: The administration of digoxin requires the assessment of the client's apical pulse. The correct landmark for obtaining an apical pulse is the left fifth intercostal space at the midclavicular line. This is the point of maximum impulse, and the location of the left ventricular apex. The left second intercostal space in the midclavicular line is where pulmonic sounds are auscultated.
A client is receiving spironolactone to treat hypertension. Which instruction should the nurse provide?
Avoid salt substitutes Explanation: Because spironolactone is a potassium-sparing diuretic, the client should avoid salt substitutes because of their high potassium content. The client should also avoid potassium-rich foods and potassium supplements. To reduce fluid volume overload, sodium restrictions should continue.
A client diagnosed with uncomplicated rheumatoid arthritis is receiving naproxen. Which medication would require further intervention by the nurse prior to administration?
Dabigatran
The nurse is teaching the family of a client with a psychiatric disorder about traditional antipsychotic drugs and their effect on symptoms. Which symptom would be most responsive to these types of drugs?
Delusions Explanation: Positive symptoms, such as delusions, hallucinations, thought disorder, and disorganized speech, respond to traditional antipsychotic drugs. Negative symptoms are more responsive to the new atypical antipsychotics, such as clozapine risperidone, and olanzapine.
Which instruction should the nurse give to a client with prostatitis who is receiving double strength co-trimoxazole?
Drink six to eight glasses of fluid daily while taking this medication Explanation: Six to eight glasses of fluid daily are needed to prevent renal problems, such as crystalluria and stone formation. The symptoms should improve in a few days if the drug is effective. Sore throat and sore mouth are adverse effects that should be reported right away. The drug causes photosensitivity, but a PABA-free sunscreen should be used because PABA can interfere with the drug's action.
A client has been prescribed sertraline. Which adverse effects are most important for the nurse to communicate to this client? Select all that apply.
Dry mouth, sleep disturbances, and agitation
Which nursing intervention would help to decrease the adverse effects of radiation therapy on the gastrointestinal tract?
Encouraging fluids and a soft diet Radiation therapy can cause adverse effects such as nausea and vomiting, anorexia, mucosal ulceration, and diarrhea.
A depressed client has been taking a selective serotonin reuptake inhibitor (SSRI) in the evening, and is upset because he cannot perform sexually due to erectile problems. What is the nurse's best response?
Engage in sexual activity prior to taking the drug Explanation: A viable option is for the client to engage in sexual activity before taking his daily antidepressant medication.
Somatropin (growth hormone) is used to treat?
Growth failure
A client is prescribed a tricyclic antidepressant after other medications were ineffective. What outcome would indicate that this medication is effective?
Helped prevent the re-experience of the trauma Explanation: Tricyclic antidepressant medications will decrease the frequency of trauma reenactment for the client. It will help memory problems, sleeping difficulties, and will decrease numbing.
Heparin
Hospital: IV or Subq Onset: rapid (minutes) Duration: brief (hours) Eliminated: renal Monitor: aPTT & aPTT Antidote: Protamine *Slows clot time*
The nurse and occupational therapist are planning an outdoor volleyball game and picnic for eight mental health clients. What action should the nurse take for the two clients taking nortriptyline for depression?
Provide protective clothing and apply sunscreen before going out Explanation: A common adverse effect of this drug is sensitivity to the sun. Protective clothing and sunscreen should be worn while the client is exposed to sunlight.
A 20-month-old toddler has been treated with permethrin for scabies. The toddler's mother asks, "Is this medication working? My child is still itching." Which response, by a nurse, is most appropriate?
Pruritus can be present for weeks after treatment
A client who had a myocardial infarction asks the nurse why he is receiving morphine. Which benefits of morphine should the nurse explain to this client?
Sedation Pain relief Diminished anxiety Decreased myocardial oxygen demand Morphine is administered because it decreases myocardial oxygen demand. Morphine will also decrease pain and anxiety while causing sedation. Vasodilation and urinary retention are associated with morphine administration.
The health care provider is preparing to write a plan of care for a client with borderline personality disorder. Which medication would the nurse anticipate for this client?
Selective serotonin reuptake inhibitors (SSRIs), along with an atypical antipsychotic, are used to treat mood instability and impulsivity Selective serotonin reuptake inhibitors and atypical antipsychotics are used to treat dysphoria, mood instability, and impulsivity in clients with borderline personality disorder. This is the best choice of medications for a client with borderline personality disorder. Monoamine oxidase inhibitors have food restrictions, and clients with borderline personality disorder would not comply with such restrictions.
Warfarin/Coumadin
Start when therapeutic Heparin is reached PO Onset: slow (hours) up to 3 days/therapeutic Duration: prolonged (days) Eliminated: hepatic Monitor: PT/INR Antidote: Vit K *Prevents further clot formation*
A client has been receiving oxytocin to augment her labor. The nurse notes that contractions are lasting 100 seconds. Which immediate action should the nurse take?
Stop the infusion
The client tells the nurse that she frequently experiences nausea and vomiting after receiving radiation and chemotherapy. The nurse adapts the plan of care to include antiemetics. What is the most appropriate time for the administration of the medication?
Thirty minutes before therapy begins
A nurse is teaching a client who has HIV about the adverse effects of aquinavir. What information is important to include?
Thrombocytopenia Saquinavir is an antiretroviral-protease inhibitor used in combination with other antiretroviral medications to help manage HIV. Adverse effects include hyperglycemia, bone loss, hypersensitivity reaction, hyperlipidemia, thrombocytopenia, and leukopenia.
The nurse is preparing to administer vasopressin to a client who has undergone a hypophysectomy. What is the purpose of the medication?
To replace antidiuretic hormone (ADH) normally secreted from the pituitary Explanation: After hypophysectomy, or removal of the pituitary gland, the body can't synthesize ADH; therefore, vasopressin is administered.
A child with diabetic ketoacidosis is being treated for a blood glucose level of 738 mg/dl (41.0 mmol/L). The nurse should anticipate an order for:
normal saline with regular insulin. Explanation: Short-acting regular insulin is the only insulin used for insulin infusions. Initially, normal saline is used until blood glucose levels are reduced, then a dextrose solution may be used to prevent hypoglycemia. Ultralente, NPH, and PZI insulins have a longer duration of action and shouldn't be used for continuous infusions.
Alteplase is used to?
potent medication that breaks down blood clots. It is approved by the U.S. Food and Drug Administration (FDA) for treatment within three hours of the onset of ischemic stroke. When alteplase is given, the client should have a brain scan 24-hours post infusion, and prior to the initiation of anti-platelet therapy.
Anti-psychotics are indicated for?
psychotic behaviors such as illusions, ideas of reference, and paranoid thinking.
CCB are indicated for?
reduce workload of heart by reducing contractility and vasodilation, lowering after load
How should the nurse proceed when instilling neomycin and polymyxin B sulfates and hydrocortisone optic suspension, two drops in the right ear?
Verify the proper client and route
What is the most important assessment for the nurse to make when administering tamsulosin to a client with benign prostatic hyperplasia (BPH)?
Voiding pattern Explanation: The alpha-adrenergic blocker tamsulosin relaxes the smooth muscle of the bladder neck and prostate, so the urinary voiding symptoms of BPH are reduced in many clients. These drugs do not affect the size of the prostate, renal function, or the production or metabolism of testosterone.
The home health nurse is visiting a client newly diagnosed with type 1 diabetes mellitus. The client reports nausea and abdominal pain. The nurse observes dehydration and dry skin. What question should the nurse ask the client?
"Are you taking your insulin daily?" The nurse should ask if the client is taking their insulin, as a common cause of DKA is missed insulin. Classic symptoms of diabetic ketoacidosis (DKA) include polyuria, weight loss, nausea and vomiting, altered mental status, abdominal pain, and Kussmaul's respirations.
The nurse reviews information about how to take the prescribed tetracycline. Which statement, by the client, allows the nurse to determine that the client understands the information?
"I can take tetracycline one hour before or two hours after meals with plenty of water." Explanation: Tetracycline must be taken on an empty stomach to increase absorption, and with ample water to avoid esophageal irritation. Milk products impede absorption.
A client with sickle cell disease is discussing his therapeutic regimen. Which statement by the client indicates further teaching is needed?
"I should take one baby aspirin daily to help prevent sickle cell crisis." Explanation: Aspirin inhibits platelet aggregation and won't help prevent sickle cell crisis.
The nurse is caring for a newborn with unrepaired transposition of the great vessels. Which medication should the nurse anticipate giving first for treatment of this defect?
Prostaglandin E1 Explanation: Prostaglandin E1 is necessary to maintain patency of the patent ductus arteriosus, and improve systemic arterial flow in children with inadequate intracardiac mixing.
A client with a subarachnoid hemorrhage is prescribed a 1,000 mg loading dose of IV phenytoin. What information is most important when administering this dose?
Rapid phenytoin administration can cause cardiac arrhythmias. Explanation: Intravenous phenytoin should not exceed 50 mg/min, as rapid administration can depress the myocardium, causing lethal dysrhythmias. Therapeutic drug levels range from 10 to 20 mg/ml. Phenytoin is only compatible with normal saline, not dextrose in water. Phenytoin is very irritating to the blood vessels, and may cause purple glove syndrome when administered IV into a hand.
A client who is receiving acetaminophen for osteoarthritis reports continuing pain. The health care provider prescribes celecoxib. What important information regarding this medication, should the nurse share with this client?
Report black and tarry stools to the health care provider Explanation: Black and tarry stools are a sign of gastrointestinal (GI) bleeding, and may necessitate a medication change. Dairy products can help reduce GI irritation. The celecoxib dose should never be doubled.
A nurse is about to give a client with type 2 diabetes mellitus her insulin before breakfast on her first day postpartum. Which client statement indicates an understanding of insulin requirements immediately postpartum?
"I will need less insulin now than during my pregnancy." Explanation: Postpartum insulin requirements are usually significantly lower than requirements during pregnancy. Occasionally, clients may require little or no insulin during the first 24 to 48 hours postpartum. Management of type 2 diabetes includes: healthy eating, regular exercise, possibly diabetes medication or insulin therapy, and blood sugar monitoring. However, there is not way of knowing if the client will now be able to control her diabetes without insulin.
The nurse is teaching a client with iron-deficiency anemia about ferrous gluconate therapy. Which statement, if made by the client, would indicate a correct understanding of the teaching?
"I will take the medication on an empty stomach with orange juice." Explanation: Preferably, ferrous gluconate should be taken on an empty stomach with orange juice. Ferrous gluconate shouldn't be taken with antacids, milk, or whole-grain cereals because these foods reduce iron absorption.
The effectiveness of selective serotonin reuptake inhibitor (SSRIs) therapy, in a client with post traumatic stress disorder (PTSD), can be verified when the client states:
"I'm sleeping better now."
A nurse is teaching a client about tricyclic antidepressants. The nurse determines that teaching has been effective when the client states:
"Improvement in my mood will take up to 28 days."
A client has just started treatment with *rifampin* for *tuberculosis*. Which statement indicates that the client has a good understanding of his medication?
"My urine will look orange because of the medication."
31s A client who, at 33 weeks' gestation, is leaking amniotic fluid. She is placed on an external fetal monitor. The monitor indicates uterine irritability, and contractions are occurring every four to six minutes. The provider orders nifedipine 20 mg po now and every eight hours until birth or contractions cease. What is the most important information for the nurse to teach this client concerning nifedipine?
"You may experience nausea and some dizziness." Common side effects of nifediine are feelings of dizziness, nausea and headache.
Vincristine is what type of med?
Anti-eoplastic agent
Dimenhydrinate is what type of drug?
Antiemetic
Ketoconazole is what type of drug?
Antifungal
One hour after receiving pyridostigmine bromide for myasthenia gravis, a client reports difficulty swallowing and excessive respiratory secretions. What medication would the nurse anticipate to reverse the effects of pyridostigmine bromide?
Atropine Explanation: These symptoms suggest cholinergic crisis or excessive acetylcholinesterase medication, typically appearing 45 to 60 minutes after the last dose of acetylcholinesterase inhibitor. Atropine, an anticholinergic drug, is used to antagonize acetylcholinesterase inhibitors..
The nurse understands that certain medications protect the ischemic myocardium by blocking catecholamines and sympathetic nerve stimulation. Which class of medications serve this function?
Beta-adrenergic blockers Explanation: Beta-adrenergic blockers work by blocking beta receptors in the myocardium, reducing the response to catecholamines and sympathetic nerve stimulation. They protect the myocardium, and help reduce the risk of another infarction by decreasing the workload of the heart and decreasing myocardial oxygen demand.
During a home health visit, a nurse assesses a client's medication and notes that the client has two prescriptions for fluid retention. One prescription reads, "Lasix, 40 milligrams one tablet daily." The next prescription reads, "Furosemide, 40 milligrams one tablet daily." Which instruction should be given to the client?
Call the health care provider for verification Explanation: The nurse understands that Lasix and furosemide are the same drug. Calling the health care provider to determine the correct dosage and frequency the nurse's role as a client advocate.
Liquid oral iron supplements have been prescribed for a child. What is the most important information for the nurse to provide to this child's parents?
Give the medicine via a dropper or through a straw Liquid iron preparations may temporarily stain the teeth. The drug should be given by dropper or through a straw. Iron supplements should be given between meals, when the presence of free hydrochloric acid is greatest. If vomiting occurs, supplementation should not be stopped, but it should be administered with food. Constipation can be decreased by increasing intake of fruits and vegetables.
A definitive diagnosis of pulmonary embolism has been made for a client. Which medication would the nurse anticipate for this client?
Heparin
A nurse is reviewing the health care provider's orders for a client admitted with systemic lupus erythematosus (SLE). Which medication would the nurse expect to find in this client's plan of care?
Hydroxychloroquine Explanation: Fatigue, photosensitivity and a "butterfly" rash on the face are all signs and symptoms of SLE. Hydroxychloroquine is used in the treatment of SLE to prevent inflammation. Pharmacological treatment of SLE also involves nonsteroidal anti-inflammatory drugs, corticosteroids, and immunosuppressive agents.
The nurse is preparing to administer IV insulin to a client diagnosed with diabetic ketoacidosis (DKA). What will the nurse monitor while the client is receiving this intervention?
Hypokalemia and hypoglycemia
Which nifedipine-related side effect should the nurse be most concerned with when caring for a new stroke admission?
Hypotension Explanation: Nifedipine is a calcium channel blocker used to lower blood pressure. It is avoided in acute stroke due to the potential of hypotension. Hypotension in acute ischemic stroke reduces brain perfusion and is associated with poor stroke outcomes. Treatment for an acute stroke includes permissive hypertension.
A nurse is teaching a client with bipolar disorder about the drug carbamazepine. The nurse determines teaching was effective when the client states:
I need to have my blood counts checked periodically." Explanation: The most dangerous adverse effect of carbamazepine is bone marrow depression. Other medications may be taken with carbamazepine.
A client with a large cerebral intracranial hemorrhage was given mannitol to decrease intracranial pressure (ICP). What therapeutic effect should the nurse anticipate from mannitol?
Increased urine output Explanation: Mannitol promotes osmotic diuresis by increasing the pressure gradient in the renal tubules, thus increasing urine output. Fixed and dilated pupils are symptoms of increased ICP or cranial nerve damage, seen in herniation associated with a deteriorating cerebellar hemorrhage.
The nurse is providing discharge instructions for a client who is receiving chemotherapeutic medications. Which intervention is most important to prevent hemorrhagic cystitis?
Increasing fluid intake
Prednisone increases risk for?
Infection
A client, hospitalized for pulmonary embolism, is being discharged on warfarin therapy. The client asks the nurse to explain how warfarin works. What is the nurse's best response?
It inhibits the formation of blood clots. Explanation: Warfarin inhibits clot formation by interfering with clotting factors that are dependent on vitamin K. Warfarin doesn't dissolve clots, and won't reduce the size of a pulmonary embolus. It doesn't reduce blood pressure and won't prevent venous stasis. Coagulation studies will be performed every 2 to 4 weeks while the client is receiving warfarin.
A nurse is assessing a client with bipolar disorder. The client tells the nurse his family health care provider prescribed lithium. Which symptom would indicate that the client is developing lithium toxicity?
Lethargy Explanation: Nausea, vomiting, diarrhea, thirst, polyuria, lethargy, slurred speech, hypotension, muscle weakness, and fine hand tremors are signs of lithium toxicity.
What is the most important information for the nurse to include when teaching a client about metronidazol?
Mixing this drug with alcohol causes severe nausea and vomiting. When mixed with alcohol, metronidazole causes a disulfiram-like effect involving nausea, vomiting, and other unpleasant symptoms. Urine may turn reddish brown, not greenish, from the drug.
The nurse makes initial rounds for his clients. Five medication are scheduled for administration at the same time to five different clients. Which medication should the nurse administer first after initial rounds?
Morphine sulfate to a client with a myocardial infarction reporting chest pain
What adverse reaction might the nurse observe after administering enteric-coated erythromycin to a client?
Nausea and vomiting Erythromycin is an antibiotic. Common adverse effects include nausea, vomiting, diarrhea, abdominal pain, and anorexia. It should be given with a full glass of water and after meals, or with food, to lessen gastrointestinal symptoms.
Tricyclic antidepressants (Pamelor) are administer at?
Night. may cause drowsiness and can cause HTN
A 12-year-old child sustains a moderate burn injury. The mother reports that the child last received a tetanus injection when he was five years old. Which immunization would the nurse anticipate an for this child?
Tetanus prophylaxis is given to all clients with moderate to severe burn injuries if it has been longer than five years since the last immunization, or if there is no history of immunization. The correct dosage is 0.5 ml IM, one time, if the child was immunized within 10 years. If it has been more than 10 years, or the child hasn't received tetanus immunization, the dosage is 250 units of tetanus immune globulin, one time.
A client with acute pulmonary edema has been taking an angiotensin-converting enzyme (ACE) inhibitor. The nurse explains that this medication has been ordered to:
reduce blood pressure. Explanation: ACE inhibitors are given to reduce blood pressure by inhibiting aldosterone production, which in turn decreases sodium and water reabsorption. ACE inhibitors also reduce production of angiotensin II, a potent vasoconstrictor.
The alpha-adrenergic blocker tamsulosin relaxes the smooth muscle of the bladder neck and prostate, so the urinary voiding symptoms of BPH are reduced in many clients. These drugs do not affect the size of the prostate, renal function, or the production or metabolism of testosterone.
reduce blood pressure. Explanation: ACE inhibitors are given to reduce blood pressure by inhibiting aldosterone production, which in turn decreases sodium and water reabsorption. ACE inhibitors also reduce production of angiotensin II, a potent vasoconstrictor.
A neonate is admitted to the neonatal intensive care unit with persistent pulmonary hypertension. Which medication should the nurse anticipate for this neonate?
Inhaled nitric oxide
A client with joint pain, tenderness and swelling has been admitted to the hospital. A disease modifying anti-rheumatic drug (DMARD) is prescribed by the health care provider. Which medication should the nurse expect to administer?
Methotrexate Methotrexate is considered a first-line DMARD for most clients with rheumatoid arthritis (RA). NSAIDs, such as aspirin, cannot be tolerated. Prednisone may be used to control inflammation when NSAIDs cannot be used.
Acyclovir is what type of drug?
Antiviral
Anxiolytics may be prescribed for?
Anxiolytics may be prescribed for Clients with borderline personality disorder experience symptoms other than anxiety.
The nurse is caring for a client with Reye syndrome who is receiving *pancuronium bromide*. What is the most important intervention for the nurse to include in the plan of care?
Applying artificial tears as needed
A depressed client, who is taking fluoxetine, tells the nurse that he has difficulty sleeping at night, is often sleepy during the day, and does not feel like doing anything. What is the nurse's best response?
Ask the prescriber whether the medication can be given early in the day
The nurse is teaching the parents of a child with growth hormone deficiency how to administer growth hormone to their child. At what time should the nurse suggest administration of this medication?
At bedtime Explanation: Optimal therapeutic effect is typically achieved when the prescribed growth hormone is administered at bedtime. Pituitary release of growth hormone occurs during the first 45 to 90 minutes after the onset of sleep, so normal physiological release is mimicked with bedtime dosing.
Where is the best site for the nurse to assess a client's pulmonic sounds?
At the left second intercostal space in the midclavicular line.
23s A definitive diagnosis of pulmonary embolism has been made for a client. Which medication would the nurse anticipate for this client?
Heparin Explanation: Intravenous heparin is started once a pulmonary embolism is diagnosed to reduce clot formation. When a therapeutic level of heparin is established, warfarin is started. It can take up to three days before a therapeutic level of warfarin is achieved.
A nurse is teaching a client who received a dose of Rho(D) immune globulin at 28 weeks' gestation to prevent Rh isoimmunization. Which statement most accurately describes isoimmunization?
Rh-positive fetal blood crosses into maternal blood, stimulating maternal antibodies. Explanation: Rh isoimmunization occurs when Rh-positive fetal blood cells cross into the maternal circulation and stimulate maternal antibody production. In subsequent pregnancies with an Rh-positive fetus, maternal antibodies may cross back into the fetal circulation and destroy the fetal blood cells.
The nurse is providing information to a client who is taking chlorpromazine. What is the most important information for the nurse to provide?
Schedule routine medication checks Explanation: It is important to continually assess for adverse reactions and continued therapeutic effectiveness.
The nurse is caring for a client receiving digoxin. Which symptoms would the nurse anticipate with a digoxin level of 2.3 ng/dl (0.08 nmol/l)? Select all that apply.
Seeing halos around bright objects, Photophobia, Drowsiness, Nausea
A client with suspected myasthenia gravis is to undergo a test with edrophonium. The client asks if edrophonium can be used to treat myasthenia gravis. What is the nurse's best response?
The short half-life of edrophonium makes it impractical for long-term use Explanation: Edrophonium is not available in an oral form and the duration of action is 1 to 2 minutes, making it impractical for the long-term management of myasthenia gravis.
A client with suspected myasthenia gravis is to undergo a test with edrophonium. The client asks if edrophonium can be used to treat myasthenia gravis. What is the nurse's best response?
The short half-life of edrophonium makes it impractical for long-term use Explanation: Edrophonium is not available in an oral form and the duration of action is 1 to 2 minutes, making it impractical for the long-term management of myasthenia gravis. Immunosuppression with repeated use is an adverse effect of steroid administration.
The nurse receives an order to administer morphine to a client with an acute myocardial infarction. What is the purpose of this medication?
To decrease myocardial oxygen demand Explanation: Morphine will calm and relax the client and decrease respiratory rate, anxiety, and stress, thus decreasing myocardial oxygen demand. It doesn't have any effect on cardiac output or preload or afterload.
A client with chronic obstructive bronchitis asks the nurse why he is receiving diuretic therapy. What is the nurse's best response?
To reduce fluid volume and reduce oxygen demand
Which oral medication would the nurse anticipate being prescribed to prevent further thrombus formation?
Warfarin
Nitrates reduce?
myocardial oxygen consumption by decreasing left ventricular end-diastolic pressure and systemic vascular resistance
Opioids reduce?
myocardial oxygen demand, promote vasodilation & decrease anxiety
Rebound cerebral hypertension is caused by?
ongoing Mannitol use
A client has been prescribed corticosteroids. The nurse would also anticipate an order for:
blood glucose checks every 6 hours. Explanation: Corticosteroids cause elevated blood glucose levels; insulin may be necessary to maintain normal blood glucose levels. Corticosteroids can cause edema, but fluid restrictions are generally unnecessary unless the client also has renal or cardiac disease.
While administering medication, the client tells the nurse, "I've never seen this pill before." The nurse should:
check the medication orders.
What is lactulose given for?
constipation and encephalopathy
The nurse is aware that antihypertensives should be used cautiously in clients already taking:
thioridazine. Explanation: Thioridazine affects the neurotransmitter norepinephrine, which causes hypotension and other cardiovascular effects. Administering an antihypertensive to a client who already has hypotension could have serious adverse effects.
A client was admitted to the hospital because of a transient ischemic attack (TIA) secondary to atrial fibrillation. The nurse anticipates that the provider will prescribe:
warfarin. Atrial fibrillation may lead to the formation of mural thrombi, which may embolize to the brain. Warfarin will prevent further clot formation and prevent clot enlargement.
