Week 2 meds

A client is being discharged following an allergic reaction after ingesting aspirin. When providing client education about the allergy, the nurse would provide the client with what information?

''Do not take any NSAIDs.'' because cross-hypersensitivity reactions may occur with any drugs that inhibit prostaglandin synthesis.

A client diagnosed with iron deficiency has been taking oral ferrous sulfate for the past several days. When the nurse is assessing for therapeutic effects, what question is most warranted?

''How is your energy level compared with a few days ago?'' The nurse should assess for increased energy, vigor, and feeling of well-being

An adult client has asked the nurse about the potential need for calcium supplements. What should the nurse identify as the daily upper intake level for this mineral?

2500 mg

What drug groups are considered teratogenic?

A teratogen is an agent that can disturb the development of the embryo or fetus. Classes of teratogens include antiepileptic drugs, ''statin'' cholesterol-lowering drugs, antidepressant drugs, and nonopioid analgesics.

Acetaminophen antidote

Acetylcysteine (Oral or IV) Most beneficial if given 8 to 10 hours after ingestion, may be helpful within 36 hours Does NOT reverse damage already sustained

The ability of older adults to adequately distribute drugs that are ingested is highly dependent on serum levels of what factor?

Albumin

The nurse knows, that as a COX-1 inhibitor, indomethacin inhibits prostaglandins associated with which tissues?

All tissues and cell types

Which drug would be avoided for a client with a high risk for bleeding?

Aspirin, Ibuprofen, Naproxen, Indomethacin

water soluble vitamins

B and C and folic acid

Which characteristic allows for a drug to be stored in the body and released as needed?

Being protein bound

What unique characteristic is present in lipid-soluble drugs?

Can cross the blood-brain barrier

Lab test for anemia

Check the complete blood count for decreased red blood cells, hemoglobin, and hematocrit. Reduced values may indicate iron deficiency

What factors contribute to the decrease in absorption that accompanies aging?

Decreased blood flow in the GI tract, Decreased surface area of the GI tract, Decreased gastric emptying

The process that largely determines serum drug levels, adverse effects, and other important aspects of drug therapy is known by what term?

Drug clearance

The nurse's discussion of the role of cytochrome P-450 (CYP) enzymes is focusing on what aspect of pharmacokinetics?

Drug metabolism that takes place in the liver

The nurse is caring for an older adult client who has been prescribed multiple medications. How can the nurse best work with the care team to prevent polypharmacy-related issues?

Ensure that each of the client's medications is genuinely necessary and discontinue those that are not.

The nurse administers ibuprofen to adult clients experiencing a variety of health disorders. Following administration, the nurse should assess for therapeutic effects related to what symptoms?

Fever, Inflammation, Moderate pain

A client has just presented for care after a positive over-the-counter pregnancy test. When performing health education with this client, the nurse should emphasize the need for supplementation with what nutrient?

Folic acid Women who are pregnant or who may become pregnant should increase their intake of folic acid.

When conducting health promotion education with older adults, the nurse should encourage what intervention to help reduce their risks of altered drug responses?

Frequent physical activity

Which medication being taken regularly by a client may create a need for oral potassium supplementation?

Furosemide (potassium-depleting diuretics)

Vitamin K

Green leafy vegetables, cauliflower, tomatoes, wheat bran, cheese, egg yolk, liver

Excess Vitamin A

High doses of vitamin A can result in headaches; diarrhea; nausea; loss of appetite; dry, itching skin; and elevated blood calcium, anorexia, pain in muscles, bones, joints

Ibuprofen parm action

Inhibits prostaglandin synthesis in both the central and peripheral nervous systems

During a routine visit to the clinic, a client reports taking a daily vitamin and mineral supplement. What important fact should the nurse teach the client to promote safe use?

Large doses of any mineral are potentially toxic.

An adult client is brought to the emergency department after deliberately overdosing on acetaminophen. The care team should prioritize interventions based on the client's risk for which adverse reaction?

Liver failure

Race is a variable that is known to influence what aspect of pharmacokinetics in older adults?

Metabolism Clients of Asian descent can metabolize and excrete medications more quickly than White or Black clients.

Nursing interventions for patient's getting parenteral nutrition?

Monitor weight, fluid intake, urine output, vital signs, blood glucose, serum electrolytes, and complete blood count

Which characteristic may allow a drug to cross the blood-brain barrier?

Only drugs that are lipid soluble or have a transport system can cross the blood-brain barrier and reach therapeutic concentrations in brain tissue

A client has been prescribed supplemental iron tablets. What instruction is most appropriate for the nurse to include in teaching to maximize absorption?

Oral iron preparations are better absorbed if taken on an empty stomach

What substance is necessary to facilitate absorption of fat-soluble vitamins? Select all that apply.

Pancreatic lipase, Bile salts

Tube feeding supplements:

Patient in sitting position, solution at room temp ( cold will cause abdominal cramping), no more than 5oomL per feeding (vomiting) , should take 30-60 mins, tubes should be rinsed after each use and replaced ever 24h. DO NOT mix meds.

Acetaminophen Toxicity

Prevention: maximum daily dose is 4 g from all sources. Overdose causes hepatotoxicity. 24 to 48 hours after overdose, liver function tests begin to show increased levels. Gastric lavage and activated charcoal (If overdose detected within 4 hours after ingestion)

Aspirin

Reduce fever by acting on the hypothalamus Diminish inflammation Suppress platelet aggregation Low dose for Ischemic stroke, transient ischemic attack, angina, and acute myocardial infarction

The nurse is educating a client regarding a newly prescribed oral prescription with a name that includes initials SR. What information should the nurse provide concerning the drug's delivery system

Slow-release (SR) dosage forms absorb more slowly and maintain concentrations within an acceptable therapeutic range over a long period of time It provides for a more consistent serum level. It allows for less frequent dosing.

Absorption of a drug administered orally will take place primarily in what anatomical location?

Small intestine

COX-1 inhibitor has known protective effects on what organ?

Stomach, Kidneys

An adult client has told the nurse that vitamin supplements should be avoided because ''natural foods are the only good source of vitamins.'' What information about synthetic vitamins should be the basis of the nurse's response?

Synthetic vitamins are less expensive than some natural sources., Natural and synthetic sources of vitamins are equivalent in function.

VItamin K supplement

Take this vitamin only as directed by a health care provider. Keep intake of vitamin K-containing foods constant. Avoid sudden increases or decreases in the amounts of these foods. If taking warfarin, report any use of vitamin K to your health care provider. During warfarin therapy, intake of vitamin K-containing foods should remain constant.

How is pharmacodynamics best defined?

The action that the drug has on body cells

The client's admission blood work indicates a low creatinine clearance rate (CrCl). A low CrCl may have what implication for the client's pharmacotherapy?

The client may require lower-than-normal doses of a drug.

How should the nurse best describe prostaglandins when asked to do so?

They are chemical mediators that participate in the inflammatory response and that are found in most body tissues.

The nurse is providing education to the caregiver of a client who is receiving a commercially prepared enteral formula. The nurse should indicate that, when given in sufficient amounts, these products can meet all nutritional needs except for what?

Water

Tube feeding and drug absorption

administer med 30 mins before

B3 (niacin) sources

all protein foods and whole grain and enriched breads and cereals.

Person should avoid potassium supplements and foods if taking which meds for BP?

angiotensin converting enzyme inhibitor

Iron sources

beef liver, red meats, fish, poultry, clams, tofu, oysters, lentils, dried peas and beans, fortified cereals, bread, and dried fruit

Iron therapeutic effect check

check for reticulocyte count (immature RBC)

Vitamin C sources

citrus fruits and juices, red and green peppers, broccoli, cauliflower, brussels sprouts, cantaloupe, kiwi fruit, mustard greens, strawberries, and tomatoes.

Vitamin E overdose

fatigue, headache, blurred vision, nausea, diarrhea

Patient with dehydration symptoms include

fever

Loss of minerals and electrolytes

gastric suction, polyuria, diarrhea, excessive perspiration, and other conditions.

Pottasium

helps to maintain electrolyte balance, nerve impulse transmission

Potassium deficiency and surplus

hypokalemia and hyperkalemia.

Well balanced diet can lack what nutrients?

iron and calcium (mostly in women and children)

Succimer chelates

lead to form water-soluble complexes that are excreted in the urine

lithium with meloxicam (osteoarthritis)

lithium toxicity results

The nurse assesses the function of what organ to evaluate the client's ability to effectively absorb medications prescribed in tablet and capsule forms?

liver

Folic acid sources

liver, okra, spinach, asparagus, dried peas and beans, seeds, and orange juice. Breads, cereals, and other grains are fortified with folic acid.

B6 (pyridoxine) sources

meats, fish, poultry, fruits, green leafy vegetables, whole grains, and dried peas and beans.

Signs and symptoms of hyperkalemia

muscle weakness, palpitations, slow pulse, fatigue, shortness of breath

Vitamin A deficiency

night blindness, change in skin and mucus membranes

Acetaminophen

not an NSAID Does not cause nausea, vomiting, GI bleeding, or interfere with blood clotting Equal to ASA in analgesic and antipyretic effects Lacks anti-inflammatory activity Metabolized in the liver; small amount remains in the body as toxic metabolite Usual therapeutic doses may cause/increase liver damage in those who abuse alcohol. Available in tablet, liquid, rectal suppository

ASA (aspirin) risk for children

not used with children because of risk of Reye's syndrome

Vitamin B12 sources

occurs in meat, fish, poultry, shellfish, milk, dairy products, eggs, and some fortified foods. Vitamin B12 does not occur in plant sources.

Vitamin B1 sources (thymine)

occurs in whole grain and enriched breads and cereals, liver, nuts, wheat germ, pork, and dried peas and beans.

Signs and symptoms of hypokalemia

palpitations, confusion, dizziness, muscle weakness, abdominal distension, frequent voiding of large amounts of urine

Vitamin A sources

retinols: liver, milk, butter, cheese, cream, egg yolk, fortified milk, margarine, and ready-to-eat cereals. Beta-carotenes occur in spinach, collard greens, kale, mango, broccoli, carrots, peaches, pumpkin, red peppers, sweet potatoes, winter squash, watermelon, apricots

Salicylates toxicity sign

ringing in the ears

Anemia and vitamin B

should be administer IM bcuz. is not absorbed orally in case of anemia

Aspirin take with food or no

take after meal to reduce gastric irritation

Pregnancy and vitamin A

teratogenic

Penicillamine chelates

vcopper, zinc, mercury, and lead to form soluble complexes that are excreted in the urine.

vitamin E sources

vegetable oils, margarine, salad dressing, other foods made with vegetable oil, nuts, seeds, wheat germ, dark green vegetables, whole grains, and fortified cereals.

A history of liver disease and vitamins

vit deficiency

Vitamin C and iron

vitamin C improves the absorption of iron.