106 Final Pt 2 EAQ
A nurse is providing palliative care to a client who has present with chorea. The client also exhibits aspiration and malnutrition. Which medications does the nurse anticipate will be beneficial in the therapeutic management of the client's condition? Select all
Clonazepam, haloperidol, fluoxetine
A PN teaches a client with rheumatoid arthritis about precautions to be taken during the intake of methotrexate. Which statements made by the client indicate effective learning?
"I should drink lots of water" "I should not plan to become pregnant"
A child who is receiving methotrexate and undergoing cranial radiation is very weak. Her mother asks the nurse whether she may give her daughter vitamins. How does the nurse respond?
"Although I understand the idea, vitamins interfere with the action of methotrexate" Many vitamins contain folic acid, which negates the action of methotrexate.
The nurse provides education to a client about the side effects of furosemide (Lasix). Which client statement indicate the teaching is understood? Select all
"I should change position slowly" "I must eat a food that contains potassium every day"
The PCP prescribes isosorbide dinitrate (Isordil) 10 mg prn tid and a nitroglycerin transdermal disk once a day for a client with chronic angina pectoris. The client asks the nurse why the isosorbide is prescribed. What is the nurse's best response?
"The isosorbide dinitrate allows more oxygen to get to heart tissue." Isosorbide dinitrate dilates coronary vasculature, improving oxygen to the hypoxic myocardium.
Nitroglycerin sublingual tablets are prescribed for a client with the diagnosis of angina. The client asks the nurse how long it should take for the chest pain to subside after nitroglycerine is taken. What should the nurse tell the client?
1-3 minutes onset, 30-60 duration.
A client with heart failure is to receive digoxin (Lanoxin) and asks nurse why the med is necessary. The nurse explains that digoxin does what?
Slows and strengthens cardiac contractions.
A client asks a nurse why captopril (Capoten) was prescribed. What specific drug classification should the nurse include in the explanation to the client?
Antihypertensive
A client who had a tonic-clonic seizure of unknown etiology is to begin taking phenytoin (Dilantin). Which instruction should the nurse reinforce with the client?
Brush teeth and gums 3x daily. Common side effect is hypertrophy of gums.
A client is to recieve donepezil for treatment of dementia off the Alzheimer type. The nurse sits down with the PCP and client and reviews purpose of the drugs, its dosage, and side effects. What side effect is indentified by the caregiver leads the nurse to conclude further education is necessary?
Constipation Donepezil, a cholinesterase inhibitor, may cause nausea, vomiting, increased salivation, diarrhea, and involuntary defecation related to increase in GI secretions and activity caused by parasympathetic nervous stimulation. It does not cause constipation.
3 weeks after a client gives birth, DVT develops in her leg and she is admitted for bedrest and anticoagulant therapy. Which anticoagulant does the nurse expect to administer?
Continuous infusion of heparin Heparin is the med of choice during acute phase of DVT; it prevents conversion of fibrinogen to fibrin and of prothrombin to thrombin
A client is treated with lorazepam for status epilepticus. What effect of lorazepam does the nurse consider therapeutic?
Depress the CNS.
A client with cardiac dysrthymia is undergoing drug therapy. The primary health-care provider instructs the nurse to monitor the client for fatigue, dizziness, and tachycardia. Which med may be responsible for clients condition?
Diltiazem CCB such as diltiazem are used for treatment in cardia dysrhythmia. A client prescribed this drug should be monitored for fatigue, headache, dizziness, peripheral edema, and tachycardia.
A client with heart failure is digitalized and placed on maintenance of dose of digoxin (Lanoxin) 0.25 mg by mouth daily. What responses does the nurse expect the client to exhibit when a therapeutic effect is achieved?
Diuresis and decreased pulse rate
A client is to receive metoclopramide IV 30 minutes before initiating chemo for cancer of colon. The nurse explains that metoclopramide is given for what purpose?
Enhance relaxation of the upper GI tract. The relaxation effect increases the passage of food thru the GI tract, limiting reverse peristalsis, gastroesophageal reflux, and vomiting.
A client with cirrhosis of the liver develops ascites, and the PCP prescribes spironolactone (Aldactone). Which should the nurse monitor the client for?
Hyperkalemia. Aldactone is a K sparing diuretic.
A client receiving morphine is being monitored by the nurse for signs and symptoms of overdose. Which would support a conclusion of overdose?
Lethargy, bradycardia, slow respirations
Which drug is often used to treat bipolar disorder?
Lithium Lithium is commonly used to treat bipolar disorder.
A client reports fatigue and dyspnea and appears pale. The nurse questions the client about medications currently being taken. In light of symptoms, which medications causes the nurse to be most concerned?
Methyldopa Methyldopa is associated with acquired hemolytic anemia and should be discontinued to prevent progression and complications.
Valsartan (Diovan), an ARB, is prescribed for a client. For which possible side effects should the nurse monitor? Select all
Orthostatic hypotension and irregular pulse rate Dysrhythmias are side effects of valsartan. Angiotensin II receptor antagonists reduce BP, resulting in hypotension, dizziness, orthostatic hypotension.
After oral surgery the dentist writes a prescription for pain med for an 18 month old child. Which med should the nurse question?
Oxycodone/aspirin (Percodan) Aspirin should not be given to child as it may cause Reyes syndrome. Acetaminophen, codeine, and morphine are not contraindicated for a child who has undergone oral surgery.
A nurse is caring for a client who is admitted to the hospital with a diagnosis of unstable angina. Sublingual nitroglycerine has been prescribed. What client response indicates that nitroglycerine is effective?
Pain subsides as a result of arteriole and venous dilation.
After an acute episode of GI bleeding, a client diagnose with gastric ulcer. The client receives a prescription of rantidine (Zantac) 150 mg twice a day to be taken with meals. Why does the nurse contact the PCP about the prescription?
Ranitidine can be administered by a variety of routes - the PCP order was incomplete.
Metoprolol iis prescribed for a client - which medicine in the client's MAR would make the nurse question the order?
Sinus bradycardia Metoprolol is a beta blocker; it decreases the heart rate, thus contraindicating with bradycardia.
A client has been taking levothyroxine (Synthroid) for hypothyroidism for 3 weeks. The nurse suspects that a decrease in dosage is needed when the client exhibits which clinical manifestations? Select all
Tremors and heat intolerance Excessive levothyroxine produces adaptations similar to hyperthyroidism, including tremors, tachycardia, hypertension, heat intolerance, and insomnia.
A client is receiving albuterol to relieve sever bronchospasm caused by asthma. For which clinical indicators should the nurse monitor the client? Select all
Tremors and palpitations Albuterol's sympathomimetic effect causes CNS stimulation, precipitating tremors, restlessness, and anxiety.
A nurse conclude that simvastatin (Zocor) being administered to a client if effective. A decrease in what clinical finding supports this conclusion?
Triglycerides Therapeutic effects include decreased levels of serum triglycerides, LDLs, and cholesterol.
Carbidopa-levodopa is prescribed for a client with Parkinson's disease. The nurse monitors the client for which side effects? Select all
Vomiting, Anorexia, changes in mood.
For which adverse effect should the nurse continually observe a client who is receiving valproic acid?
Yellow sclerae Yellow sclerae is a sign of jaundice; pancreatitis and hepatic failure are life threatening adverse effects. The client must have frequent liver function tests.
A PCP prescribes morphine for a client who had a myocardial infarction. What clinical response will be reduced if the client experiences the intended therapeutic effect of morphine?
workload of heart