Pharmacology study set NCLEX

Magnesium levels

1.5-2.5

Phenytoin (Dilantin) therpeutic index

10-20

Platelet range

150,000-400,000

INR therapeutic range

2-3

A nurse on the behavioral health unit is reviewing medication prescriptions for 4 clients. Which combination of medications does the nurse question?

A client w/depression prescribed escitalopram and selegiline (MAOI's interact w/many meds including many antidepressants)

The nurse reviews assigned client's medical and medication administration records. Which prescription should the nurse validate w/the HCP before administering?

Azathioprine for a client w/Crohn disease who reports fatigue and nausea and has leukopenia (Azathioprine (Imuran) is an immunosuppressant drug that can cause bone marrow suppression and increase the risk for infection)

A client w/a brain tumor is admitted for surgery. The HCP prescribes levetiracetam. The client asks why. What is the nurses's response?

"It prevents seizure development" (Levetiracetam/KEPPRA is used to treat seizures)

Lithium therpeutic index

0.6-1.2 >1.5=toxicity

The nurse is caring for a client taking tamoxifen for breast cancer. Which client statement is most concerning and a priority to report to the HCP?

"My periods have been heavy lately" (Tamoxifen is associated w/increased risk of endometrial cancer and venous thromboembolism; excessive menstrual bleeding can be a sign of endometrial cancer)

A nurse teaches a client who is being d/c'd on warfarin for a-fib. Which client statements indicate that teaching has been effective?

1. "Antibiotics can affect my INR value" 2. "I will take warfarin at the same time daily." 3. "I will shoot for my INR value to be between 2-3

The home health hospice nurse visits a client who is newly prescribed extended release oxycodone 40mg orally, scheduled every 12 hours to treat severe chronic cancer pain. Which information is most important to reinforce to the clients caregiver?

Administer the medication around the clock even if the clock even if the client denies having pain. (administration twice daily is necessary to maintain a therapeutic level and provide continuous relief as the duration of the analgesic effect is 12 hours)

The nurse is preparing to administer 160mg of furosemide via IV piggyback to a client w/chronic kidney disease and fluid overload. The nurse plans to give the dose slowly over 40 minutes to prevent which adverse effect?

Ototoxicity (rate of administration should not exceed 4mg/min in dosed >120mg)

Urine specific gravity

1.003-1.030 elevated SG=dehydration

Insulin peak times

-Rapid acting (lispro/humalog, aspart/novolog, glulisine/apidra) 30min-3hours; make sure client eats wiin 15 minutes of administration -Intermediate acting (NPH) 4 hours -Detemir-4-9 hours -Long acting (glargine) no peak

Potassium levels

3.5-5.0

Calcium levels

8.6-10.2

Ethambutol

Frequent eye examinations are needed

Commonly used MAOI's

Isocarboxazid, phenelzine, tranylcypromine

The HCP prescribes simvastatin for a client w/hyperlipidemia. The nurse instructs the client to take this medication in which manner?

With the evening meal

A client has been on long-term therapy w/esomeprazole. What is essential for the nurse to ask the client?

"Have you had a bone density test recently?" (Proton Pump Inhibitor/PPI may decrease the absorption of calcium and promote osteoporosis.)

The home health nurse prepares to give benztropine to a 70yo client w/parkinsons disease. Which client statement is most concerning and would warrant HCP notification?

"I am going for repeat testing to confirm glaucoma" (anticholinergic medications are c/i in pt's susceptible to glaucoma or BPH)

A nurse has completed teaching a client who is being dc'd on lithium for a bipolar d/o. Which statement by the client indicates a need for further teaching?

"I should use ibuprofen for pain relief" (dehydration, decreased renal function, diet low in sodium, NSAID's and thiazide diuretics can cause lithium toxicity)

The nurse has provided education for a client newly prescribed alprazolam for generalized anxiety d/o. Which client statement indicates that teaching has been effective?

"I will take my daily dose at bedtime" (Benzo's have a sedative effect and should be given at bedtime. They should never be stopped abruptly in long-term users)

The nurse reinforces education w/a client starting isotretinoin for acne. Which statement indicates the client needs further instruction?

"I will take vitamin A supplements" (can cause vitamin A toxicity, manifestation include elevated ICP, GI upset, liver damage and changes in skin and nails)

The nurse obtains a health hx from a client who states "I skip dinner most nights to lose weight. I don't want to get low blood sugar, so I don't take my evening dose of metformin when I skip dinner" Which response by the nurse is appropriate?

"The risk of low blood sugar is minimal when metformin is taken w/out food" (Metformin does not increase insulin secretion, so the risk of hypoglycemia is minimal even when meals are skipped)

A 21 yo client is being evaluated in the outpatient psychiatric clinic after starting isocarboxazid 2 weeks ago. Which of the clients statements needs to be addressed first?

"This medication is not working; I am so tired of being depressed" (MAOI's and other antidepressants are associated w/an increased risk of suicidal ideation during the first few weeks of treatment)

Different types of Insulins and when they are used

-Basal (long-acting): Glargine; Detemir; 1x daily usually in the evening; DO NOT MIX WITH OTHER INSULINS (IN SAME SYRINGE) -Basal (intermediate): NPH; 2x daily -Postprandial (short acting): *Regular: Peak 2-5hrs; best for IV use (DKA) Regular insulin is only insulin that can be via IV push *Lispro; Aspart; Glulisine: Peak 0.5-3hrs; best for post-meal hyperglycemia (give before meals)

The nurse provides instructions to a client d/c'd on warfarin, after being treated for a PE following surgery. Which statements made by the client indicate the need for further teaching?

1. "I will place small rugs on my wood floors to cushion a fall" 2. "I will take a baby aspirin if i have mild chest pain" (Clients on warfarin or heparin should avoid using aspirin or nonsteroidal anti-inflammatory drugs, wear a MedicAlert device, avoid activities that increase the risk for bleeding and limit alcohol intake.)

The nurse provides medication teaching to a client w/primary adrenal insufficiency (Addison's) who is prescribed hydrocortisone 10mg by mouth 3 times/day. Which instructions should be included in the client's teaching plan?

1. "Make an appointment w/an optometrist yearly to assess for cataracts" 2. "Report even a low grade fever to the HCP immediately" 3. "Report signs of hyperglycemia including increased urine, hunger and thirst"

A community health nurse evaluates several clients' vaccination status. Which clients would the nurse recommend receive the influenza vaccine injection?

1. 9mo old w/no known medical conditions 2. 5yo w/congenital heart defect 3. 23yo recently dx'd w/HIV 4. 45yo caretaker of elderly patient 5. 75yo w/end stage renal failure (all clients >6mo old should receive the flue shot unless the client has a life threatening allergy to the vaccine)

The nurse reviews an elderly client's medication administration record and identifies which prescriptions as having the potential for injury in the elderly?

1. Amitriptyline 2. Chlorpheniramine 3. Lorazepam (Beers criteria classifies potentially harmful drugs w/the elderly...antipsychotics, anticholinergics, antihistamines, antihypertensives, benzodiaepines, diuretics, opioids, sliding scale insulins)

The clinic nurse evaluates a client's response to levothyroxine after 8 weeks of treatment. What therapeutic responses to the medication should the nurse expect?

1. Apical heart rate of 88/min 2. Elevation of mood 3. Improved energy levels (used to treat hypothyroid. Notify HCP is HR is >100 or if the pt reports c/p, nervousness, or tremors...dose may be too high)

The community health nurse prepares a teaching plan for a client w/latent tuberculosis who is prescribed oral isoniazid (INH). Which instructions should the nurse include?

1. Avoid drinking alcohol 2. Report yellowing of skin or sclera 3. Report numbness and tingling of extremities

The nurse is providing d/c instructions to several clients w/new prescriptions. Which instructions by the nurse are correct in regard to medication administration?

1. Avoid salt substitutes when taking valsartan for hypertension 2. When taking ethambutol, notify the HCP of any changes in vision

The nurse is caring for a client dx'd w/endometrial cancer who is receiving brachytherapy. Which interventions should the nurse implement while caring for this client?

1. Cluster care to limit each staff member's time in the room to 30 min a shift 2. Keep the door to the room closed as radiation is emitting constantly from the client 3. Teach family members and visitors to stay at least 6 feet away from the client 4. Use a lead apron when providing direct client care to reduce exposure to radiation 5. Wear a radiation film badge while in the client's room to monitor radiation exposure.

The nurse is reviewing the medication administration record of a client w/a-fib. Which of the following should the nurse monitor before giving these medications? Prednisone 20mg Metoprolol 50mg Digoxin 0.5mg Enoxaparin 40mg

1. Digoxin level (Digoxin) 2. Glucose (Prednisone) 3. Platelet count (Enoxaparin) 4. Serum potassium (Digoxin)

The nurse administers a prescribed oral dose of radioactive iodine (RAI) to a female client w/hyperthyroidism. The nurse should instruct that the client utilize the following home precautions during the first 3-7 days after ingestion?

1. Do not use bare hands to handle food that is to be served to others 2. Isolate personal clothing, towels and linens; wash them separately from rest of laundry in the home 3. Use a separate toilet and flush 2-3 times after each use (Do not breastfeed, avoid being around pregnant mothers, sleep in separate bed)

A diabetic client is prescribed metoclopramide. Which of the following side effects must the nurse teach the client to report immediately to the HCP?

1. Excess blinking of eyes 2. Lip smaking 3. Puffing of cheeks (Metoclopramide/REGLAN, is prescirbed for the treatment of GERD and delayed gastric emptying and as an antiemetic. It can cause extrapyramidal side effects similar to antipsychotics)

The HCP has just prescribed tetracycline for an adolescent w/acne vulgaris. The client takes oral contraceptives. The nurse should educate the teen about which topics?

1. Not taking tetracycline w/dairy products 2. Using additional contraceptive techniques 3. Using sunblock 4. Take on an empty stomach 5. Take w/a full glass of water 6. Avoid antacids

The nurse plans teaching for a client who was newly prescribed levothyroxine sodium after thyroid removal. Which instructions will the nurse include in the teaching plan?

1. Notify the HCP if you feel a fluttering or rapid heartbeat 2. You will need to take this medication for the rest of your life (is safe to take during pregnancy, take first thing in the morning on an empty stomach)

A client w/a hx of HF calls the clinic and reports a 3lb weight gain over the past 2 days and increased ankle swelling. The nurse reviews the client's medications and anticipates the immediate need for dosage adjustment of which medication?

Bumetanide (loop diuretic)

Phosphate levels

2.4-4.4

The nurse should call the primary health care provider to obtain a new prescription prior to administering which medication to a client w/type 1 diabetes?

20 units NPH insulin IV push administered every morning at 7:00am

The nurse administers 8 units of regular insulin at 11:30 am to a client w/type 1 diabetes and serves the client lunch 30 minutes later. The client eats a few bites, becomes nauseated and is unable to finish the meal. When is the client at highest risk for experiencing an insulin-related hypoglycemic reaction

2:00pm (The client is at highest risk for experiencing an insulin-related hypoglycemic reaction when the drug peaks. Regular insulin is short acting and peaks 2-4 hours after administration

BUN levels

6-20

Which client is at greatest risk for respiratory depression when receiving opioids for pain control?

70yo w/COPD w/knee replacement this morning (factors that increase risk for respiratory depression r/t opioid use for pain control include advanced age, underlying pulmonary disease, snoring, obesity, smoking, opiate naive and surgery)

Recommended A1C level for pt w/diabetes

<7%

Kawasaki disease

>5 days of fever, bilateral nonexudative conjunctivitis, mucositis, cervical lymphadenopathy, rash and extremity swelling; Coronary artery aneurysms are most serious sequelae if left untreated; can lead to MI and death; IVIG and aspirin are used to prevent aneurysms

A nurse is caring for a client w/a dx of fibromyalgia. During care, the client reports having suicidal thoughts. What currently prescribed medication should the nurse question in regard to this new finding?

Amitriptyline (antidepressants may increase suicidal behaviors)

Commonly used Tricyclic antidepressants

Amitriptyline, Nortriptyline, desipramine, imipramine...also used to treat neuropathic pain

The home health nurse visits a client w/hand osteoarthritis topical capsaicin for pain relief. Which instruction about capsaicin should the nurse provide the client?

Apply cream to hands and wait at least 30 minutes before washing them

The hospice nurse is caring for an actively dying client who is unresonsive and has developed a loud rattling sound w/breathing (death rattle) that distresses family members. Which prescription would be the most appropriate to treat this symptoms?

Atropine sublingual drops (atropine dries up secretions that cause the rattle noise)

Theopylline

Bronchodilator; therapeutic index 10-20; monitor levels frequently; can cause seizures and arrhythmias; dose adjusted based on peak drug levels, obtained 30 minutes after the dose is given/ avoid caffeinated products; avoid cimetidine, ciprofloxacin

A nurse is assessing a client w/type 2 diabetes mellitus who was recently started on pioglitazone. Which client data obtained by the nurse is most important to bring to the attention of the HCP?

Bilateral pitting edema in ankles (Thiazolidinediones ((rosiglitazone/avandia, pioglitazone/actos)) increase the risk of cardiovascular events and bladder cancer; similar to metformin)

A client w/active pulmonary TB is prescribed 4-drug therapy ethambutol. The community health nurse instructs the client to notify the HCP immediately if which adverse effect associated with ethambutol occurs?

Blurred vision (Ethambutol/MYAMBUTOL, is used in combination w/other antitubercular drugs to treat active TB. The client must have baseline eye examinations during therapy as optic neuritis is a potentially reversible adverse effect)

A client w/schiophrenia that is resistant to other antipsychotic medications is about to start on a course of clozapine. Which of these periodic measurements as the highest priority in this client?

CBC and ANC/absolute neutrophil count (associated w/risk for agranulocytosis; WBC must be >3500 and ANC of >2000 before initiating therapy)

A client has a follow up checkup in the urology clinic. Six months ago, the client started taking tolterodine. What data collected from the client should the nurse report to the HCP?

Client excitedly reports being able to go an entire work day w/out having to urinate. (Tolterodine/Detrol, oxybutynin/ditropan and solifenacin/vesicare are anticholinergic medications; they decrease the urgency and frequency of urination; not urinating the entire day while at work may indicate that the dosage is too high and is causing urinary retention)

A nurse has received new medication prescriptions for a client admitted w/hypertension and an exacerbation of COPD. Which prescription should then nurse question?

Codeine

The nurse is reviewing prescriptions for the assigned clients. Which prescription should the nurse question?

Dicyclomine for a client w/a hx of IBS who develops a postoperative paralytic ileus (Dicyclomine is an antispasmodic drug that decreases intestinal motility and is c/i in clients w/paralytic ileus)

A client is 6 hours from hip surgery after receiving regional anesthesia and has epidural continuous anesthesia in place. Which is the most important reason for the nurse to contact the HCP?

Fondaparinux is prescribed for STAT administration (Arixtra is an anticoagulant)

The nurse performs medication reconciliation for a 94yo client who has type 2 diabetes, hypothyroidism, and heart failure caused by a previous MI. D/t risks outweighing benefits, the nurse plans to talk w/the HCP about d/c'ing which medication?

Glyburide 10mg PO/once day (Beers criteria; glyburide should be avoided d/t potential delayed elimination causing risk for prolonged hypoglycemia)

A client w/bronchial asthma and sinusitis has increased wheezing and decreased peak flow readings. During the admission interview, the nurse reconciles the medications and notes that which of the following over the counter medications taken by the client could be contributing to increased asthma symptoms?

Ibuprofen 400mg orally every 6 hours for pain as needed (Ibuprofen and aspirin are common OTC anti-inflammatory drugs that can cause bronchospasm in some clients w/asthma

The nurse teaches the client taking atorvastatin to call the HCP if experiencing which symptom associated w/a serious adverse effect of atorvastatin?

Muscle aches (symptom of myopathy)

The nurse reviews a client's medical record and notes the following PRN medication prescriptions: acetaminophen, haloperidol, and benztropine. The nurse would administer a dose of benztropine on assessing which client behavior?

Muscle rigidity and shuffling gait (Benztropine/cogentin is an anticholinergic drug used to treat extrapyramidal symptoms, which are side effects of some antipsychotic medications.

aPTT

Normal level 25-35 seconds Therapeutic level 46-70 seconds

Teratogenic medications

Phenytoin (dilantin) Lithium Valproate Isotretinoin Methotrexate Ace Inhibitors Warfarin

The nurse precepts a nursing student caring for a client w/glaucoma and observes the student administer timolol maleate, an opthalmic medication. Which student action indicates that further instruction is needed?

Removes dried secretions w/moistened sterile gauze pads by wiping from the outer to inner canthus (client should remove contact lenses; uses aseptic technique; remove dried secretions w/moistened sterile gauze by wiping from inner to outer canthus; place client in supine or sitting w/head tilted back toward side of affected eye; rest hand on clients forehead and hold dropper 1-2cm above conjunctival sac; pull lower lid down gently; instruct client to look upward; then apply pressure to the lacrimal duct for 30-60 seconds)

A nurse is dc'ing a client who is receiving lithium for treatment for a bipolar d/o. It is most important for the nurse to provide which instruction to the client?

Report excessive urination and increased thirst

A new graduate nurse is preparing to administer the following analgesics to clients w/post-op pain. Which situation require intervention by the precepting nurse?

Selects a 25g 1/2" needle to inject ketorolac IM (use a 1 to 1 1/2" needle)

A client w/seizure activity is receiving a continuous tube feeding via a small bore enteral tube. The nurse prepares to administer phenytoin oral suspension via the enteral route. What is the nurse's priority action before administering this medication?

Stop the feeding for 1 to 2 hours (Phenytoin/Dilantin, is an anticonvulsant drug commonly used to treat seizures d/o's. Steady absorption is necessary to maintain a therapeutic dosage range and drug level to control seizure activity)

The nurse is preparing to administer a scheduled dose of metoclopramide IV to a client w/diabetic gastroparesis. Which clinical finding causes the nurse to question the prescription?

Sucking lip motions (Tardive dyskinesia/TD)

The clinic nurse reviews the medical record of the client who was prescribed etanercept, a tumor necrosis factor (TNF) inhibitor. Which test result is most important for the nurse to check before initiating this treatment?

Tuberculin skin test (TST) (major side effects of TNF's include severe infections and bone marrow suppression. TB reactivation is a major concern)

A client w/latent TB has been taking oral isoniazid (INH) 300mg daily for 2 months. The client tells the nurse that for the past week she had numbness, a burning sensation and tingling in her hands and feet. Additional intake of which of the following would most likely have prevented this?

Vitamin B6 (INH interferes w/the action of vitamin B6, resulting in peripheral neuropathy)

Anticholinergic medications

atropine=bradyarrythmias benztropine=parkinsons ipatropium=bronchospasm oxybutynin=urinary tract antispasmodics scopolamine=nausea/vomitting (motion sickness) propantheline/glycopyrrolate=decrease gastric secretory activity c/i in clients susceptible to glaucoma or BPH

Tardive Dyskinesia symptoms

caused from: Metoclopramide (Reglan) and antipsychotic drugs -Protruding and twisting of the tongue -Lip smacking -Puffing of cheeks -Chewing movements -Frowning or blinking of eyes -Twisting fingers -Twisted or rotated neck

Uric acid levels

male 4.4-7.6; female 2.3-6.6

Calcium channel blockers

nifedipine; amlodipine; felodipine; nicardipine -Treat HTN and chronic stable angina. -Important adverse effects: dizziness; flushing; headache; peripheral edema; constipation

The nurse is providing d/c instructions to a client receiving oxybutynin for overactive bladder. Which client statement indicates that further teaching is required?

"I am looking forward to our summer vacation at the beach" (anticholinergic medications can lead to hyperthermia d/t constipation, urinary retention, flushing, dry mouth, heat intolerance)

A behavioral health clinic nurse assesses a 23yo client who started taking paroxetine 3 weeks ago. Which statement made by the client is most important for the nurse to investigate?

"I have a lot more energy, but I'm feeling just as depressed" (needs immediate assessment for suicide risk)

The nurse assesses a client who is receiving methotrexate for rheumatoid arthritis. Which statement by the client is most concerning?

"I have small, purple spots all over my body" (adverse effects include hepatotoxicity, GI irritation and bone marrow suppression. Bone marrow suppression can lead to anemia, leuokpenia and thrombocytopenia which is characterized by petechia)

The nurse is performing d/c teaching for the parents of a 4yo w/HF. Which statement by the parents indicates the need for further teaching r/t the administration of digoxin?

"We will hold the dose if our child's HR is above 90/min" (parent teaching for digoxin: hold <90-110 for infants and young children and <70 in older children; do not mix the drug w/food or liquids; if dose is missed do not give extra or increase dose, stay on same schedule; if more than 2 doses missed notify HCP; if child vomits do not give 2nd dose...could indicate toxicity; give water or brush teeth after)

Neuroleptic Malignant Syndrome (NMS)

-uncommon but life threatening adverse reaction to anti-psychotic medications (haloperidol, fluphenazine). Symptoms are high fever, muscular rigidity, ams, autonomic dysfunction Treatment is rehydration, cooling body temp and immediate d/c of the medication and notify HCP immediately

Creatinine levels

0.6-1.3

The nurse reviews the serum lab results and medication administration records for assigned clients. Which prescriptions should the nurse question and validate w/the HCP before administering?

1. Bumetanide in the client w/HF who has hypokalemia 2. Isoniazid in the client w/latent TB who has elevated liver enzymes

Which medication prescriptions should the nurse question?

1. Cephalexin for a client w/severe allergy to penicillin 2. Ibuprofen for a client w/asthma and nasal polyps 3. Propanolol for a client w/asthma (clients w/nasal polyps often have sensitivity to NSAIDs; non-selective BB's are c/i in clients w/asthma)

The nurse is preparing medication for 4 clients on a respiratory medical-surgical unit. Which situation would prompt the nurse to clarify the prescribed treatment w/HCP?

Client w/bronchospasm who is d/t receive nebulized acetylcysteine (medication is inhaled to help loosen thick respiratory secretions. Nurses caring for pt's w/reactive airway disease, eg. asthma, who are prescribed acetylcysteine should clarify w/HCP as it may cause or worsen bronchospasm)

The nurse administers the prescribed dose of hydromorphone 2mg to a client who is 2 days postoperative from a colostomy. Which assessment finding is most important for the nurse to follow-up?

Client falls asleep while talking to the nurse

The nurse is working in the ER. Which client should the nurse see first?

Client taking clozapine who has sudden onset of high fever, diaphoresis and change in mental status (Neuroleptic Malignant syndrome)

The nurse receives handoff report on 4 clients. Which client should the nurse assess first?

Client w/MDD taking phenelzine and pseudoephedrine who has a HA (A client who reports a HA and has taken an MAOI and a nasal decongestant like pseudoephedrine, should be evaluated immediately for hypertensive crisis)

The nurse is caring for a client w/cirrhosis who has hepatic encephalopathy. The client is prescribed lactulose. Which assessment by the nurse will most likely indicate that the medication has achieved the desired therapeutic effort?

Improved mental status (Hepatic encephalopathy in cirrhosis results from higher serum ammonia levels that cause neurtoxic effects)

A client is receiving scheduled doses of carbidopa-levodopa. The nurse evaluates the medication as having the intended effect if which finding is noted?

Improvement in spontaneous activity

The nurse is caring for a client who started receiving chemotherapy 10 days ago. Today the HCP prescribes Filgrastim. Which of the following is an expected outcome of this medication?

Increase in neutrophil count

A nurse is caring for a client w/an exacerbation of COPD and a hx of type 2 diabetes requiring insulin. The client has been prescribed prednisone. The nurse anticipates which need?

Increasing the insulin dose (corticosteroids cause hyperglycemia and worsen hypertension)

An elderly client w/depression, diabetes, and HF has received a new digoxin prescription for daily use. Which client assessment indicates that the nurse should follow up on serum digoxin levels frequently?

Serum creatinine is 2.3

A client is receiving chemotherapy for acute myeloid leukemia. The HCP prescribes allopurinol to prevent tumor lysis syndrome (TLS). Which lab value indicates a therapeutic response to the medication?

Serum uric acid level of 6.0 (the therapeutic effect of allopurinol is to decrease hyperuricemia caused by TLS. Lab values include rising blood uric acid, potassium and phosphate levels with decreasing calcium levels)

A client has a serum potassium level of 2.8 and the HCP prescribes IV potassium chloride. The nurse administers 10mEq KCL/100 mL5% dextrose in water at 100ml/hr through the client's peripheral IV line sing an infusion pump. Shortly after the initiation of the infusion, the client reports feeling burning and discomfort at the IV site. What is the nurses priority action?

Slow the rate of the KCL infusion (It is irritating to the vein but can be administered slowly through a peripheral vein)

A client has just been prescribed allopurinol for chronic gout. Which instruction is most important for the nurse to emphasize to the client?

Take the medication w/a full glass of water and increase fluids during the day. (increase fluids to help prevent renal stones and promote diuresis and uric acid excretion)

The nurse develops a teaching care plan for the client w/a prescription to change antidepressant medications from imipramine to phenelzine. Which instruction is appropriate to include in the teaching?

Taper down the imipramine, then discontinue for 2 weeks before starting phenelzine. (when switching from a tricyclic antidpressant to a MAOI, withdraw gradually w/a drug free period before the new antidepressant is initiated to avoid adverse reactions)

A client has a DVT and is receiving a heparin drip. The client's aPTT has been in the therapeutic range for the past 24 hours. The most recent labs show that the current aPTT equals the control value. What explanation should the nurse consider?

The client's IV line is infiltrated. (d/t the short half life, the possibility of infiltration should be assessed if the PTT level suddenly drops despite heparin administration.)

A client w/cancer is to receive a third dose of cisplatin. The client's lab results are shown in the exhibit. Which factor would be important for the nurse to assess before confirming the dose w/the HCP?

Urine output (Cisplatin is an antineoplastic med that can cause renal toxicity.)

The nurse admits a client w/newly dx'd unstable angina. Which information obtained during the admission health hx is most important for the nurse to report to the HCP immediately?

Uses sildenafil occasionally (Sildenafil/viagra)