Prep U

A child with leukemia has just completed a course of methotrexate therapy. How soon should the nurse expect to see signs of bone marrow depression in this client?

within 2 weeks Bone marrow depression is most likely to occur 10 days after methotrexate is administered.

A client who has suffered a stroke is brought to the emergency department. The physician has ordered t-PA 0.9mg/kg for a client who weighs 198 lbs (90 kg). Directions for administration are to mix the 100 mg vial of t-PA with 100 ml of Sterile water to yield 1 mg/ml. How many ml of t-PA should be removed from the vial and discarded before administration? Record your answer using a whole number.

19 Each ml = 1 mg 100 mg 0.9 x 90 = 81 ml needed 100 - 81 = 19 ml discarded. For safety and to reduce errors of overdosing, only the amount of the t-PA required should remain in the vial.

A woman is taking oral contraceptives. The nurse teaches the client that medications that may interfere with oral contraceptive efficacy include:

ABX: Broad-spectrum antibiotics can cause decreased efficacy of oral contraceptives, placing the client at risk for an unplanned pregnancy. When a client is prescribed a course of antibiotics, a back-up method of contraception should be used. Antihypertensives, diuretics, and antihistamines do not interfere with oral contraceptive efficacy.

The health care provider prescribes clomiphene citrate for a woman who has been having difficulty getting pregnant. When teaching the client about this drug, the nurse should discuss what potential adverse effects?

Chance of multiple gestation. Clomiphene citrate is a fertility drug that induces ovulation in women desiring pregnancy. One of the drug's most common adverse effects is multiple gestation (twins or triplets).

When evaluating teaching a client how to administer insulin, which action indicates that additional teaching is necessary?

waits 30 minutes to eat breakfast after injecting rapid-acting insulin The nurse instructs the client to not wait any longer than 5 to 15 minutes to eat after injecting rapid-acting insulin, which has an onset action of 5 minutes and duration of 1 hour. The client is using proper technique for mixing the insulins, rotating sites, and using the U-100 syringe.