Uworld 15 questions
Lithium toxicity occurs with
dehydration, hyponatremia, DECREASED RENAL FUNCTION, and drug-drug interactions (eg, nonsteroidal anti-inflammatory drugs, thiazide diuretics)
A client is brought to the emergency department with multiple trauma injuries. The nurse sees the client's Jehovah's Witness identification card. As part of providing culturally competent care, the nurse would anticipate the client accepting which of the following? Select all that apply.
-Epoetin alfa -normal saline
The health care provider (HCP) prescribes an oral iron suspension for 3 months for a 2-year-old with iron deficiency anemia. Which instructions should be given to the parent? Select all that apply.
-administer doses between meals -administer doses with citrus juice: to promote absorption -place medicine at the back of the mouth- to prevent tooth staining
The therapeutic PTT target is
1.5-2.0 times the normal reference range of 25-35 seconds.
A normal prothrombin time is
11-16 seconds
Disulfiram (Antabuse) is a form of aversion therapy that promotes abstinence from alcohol.
If the client consumes alcohol while taking disulfiram, unpleasant side effects (headache, intense nausea/vomiting, flushed skin, sweating, dyspnea, confusion, tachycardia, hypotension) can occur. DON'T DRINK WHILE ON MEDS
Grave's disease is an autoimmune condition characterized by an enlarged thyroid gland and excessive thyroid hormone secretion.
A bounding, rapid pulse (110/min) is an expected cardiovascular manifestation of hyperfunction of the thyroid gland.
It is a priority for the nurse to educate the client about the hazards of drinking alcohol and about sources of hidden alcohol:
Avoid hidden alcohol in: liquid cold and cough medications aftershave lotions, colognes, and mouthwashes foods such as sauces, vinegars, and flavor extracts Abstain from alcohol for 2 weeks after the last dose as the disulfiram reaction could still occur Wear a bracelet alerting others of being on disulfiram therapy
A client with active pulmonary tuberculosis is prescribed 4-drug therapy with ethambutol. The community health nurse instructs the client to notify the health care provider immediately if which adverse effect associated with ethambutol occurs?
Blurred vision Think of the African documentary
The clinic nurse evaluates a client who was prescribed lithium therapy a month ago for bipolar disorder. Which client statement would cause the most concern?
I've had the stomach flu for the past couple of days Dehydration and sodium loss from vomiting and diarrhea can lead to toxic lithium levels in clients receiving lithium therapy
NEAR-DROWNING occurs when a client is under water and unable to breathe for an extended period.
In a matter of seconds, major body organs begin to shut down from lack of oxygen and permanent damage results. Decerebrate posturing is a sign of severe brain damage
The nurse provides teaching for a client newly prescribed disulfiram for alcohol abstinence. Which information is the priority for the nurse to include?
List of everyday items containing hidden alcohol
If diarrhea and low grade fever occurs more than 48 hours
Must see the health care provider immediately
A female client with liver cirrhosis and chronic anemia is hospitalized for a deep venous thrombosis. The client is receiving a heparin infusion and suddenly develops epistaxis. Which laboratory value would indicate that the heparin infusion needs to be turned off?
Partial thromboplastin of 110 seconds
The nurse is assessing a client who had an esophagogastroduodenoscopy (EGD) 2 hours ago. Which finding requires an immediate report to the health care provider?
Temp spike to 101.2 F
Ethambutol for active TB
The client must have baseline and periodic EYE examinations during therapy as OPTIC NEURITIS is a potentially reversible adverse effect.
The nurse is caring for a client who had a near-drowning accident in cold weather. Which assessment finding indicates the most severe injury?
Toes pointed straight down Decerebrate posturing (arms and legs straight out, toes pointed down, head/neck arched back) usually indicates severe brain injury.
Fever after an esophagogastroduodenoscopy (EGD) or colonoscopy could be
a sign of infection from perforation and should be reported. The Gag reflex may take a few hours to return
Increased intracranial pressure
hearing loss, permanent brain damage, detath
Dark-colored urine and yellow skin can indicate the presence of hepatotoxicity, which
is associated with many drugs used to treat tuberculosis (eg, isoniazid, pyrazinamide, rifampin). However, hepatotoxicity is not common with ethambutol.
Oral iron should not be taken with?
milk: ruins absorption of calcium and ruins the teeth
Iron pills
no more than a 1-month supply on hand: because overdose is toxic and lethal
Creatinine
normal 0.6-1.3 mg/dL
Blood urea nitrogen (BUN)
normal 6-20 mg/dL
Seizures may occur in infants with bacterial meningitis and are often accompanied by a
shrill, high-pitched cry.
Difficulty hearing (tinnitus, subjective hearing loss) is an adverse reaction to
streptomycin streptomycin is second-line used for MRSA so watch for ototoxic and nephrotoxic effects
meningitis
the client must remain on isolation for a minimum of 24 hours
Instructions on rest, fluids, and acetaminophen are helpful and would be the primary choice if
the diarrhea had been occurring ≤48 hours without other symptoms.