Chapter 3

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The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?

20 year old female diagnosed with chlamydia

Which client is experiencing a secondary action of a medication?

A client who has developed hives and a rash after taking an antibiotic

Which client is experiencing a secondary action of a medication?

A client who is drowsy after taking antihistamine

A client with recurrent urinary tract infections was prescribed sulfamethoxazole-trimethoprim and experienced an allergic reaction. The client states, "I don't understand. I had a two-day course of the same drug last year with no problems." What is the nurse's best response?

Allergic reactions happen after your body has been sensitized to a drug in the past."

A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?

Review the client's most recent potassium level

A newly admitting client has signs and symptoms of an infection and the nurse anticipates that the client will be prescribed antibiotics. What assessment should the nurse prioritize when determining the client's risk for an excessive drug response due to impaired excretion?

The client's blood urea nitrogen level and creatinine clearance rate

A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?

The man may be experiencing nephrotoxic effects of aspirin

An older adult client has an elevated serum creatinine level. This client is at greatest risk for which medication-related effect?

Toxicity

The nurse administers typical antipsychotic medications to the client who has taken these same drugs for many years. What signs and symptoms should the nurse attribute to secondary actions of the drug? Select all that apply

muscular tremors drooling changes in gait

client diagnosed with cancer has been receiving antineoplastics for several weeks. What assessment finding should the nurse interpret as a possible indication of blood dyscrasia?

Hemoglobin of 6.0 g/dL (60.0 g/L)

Preoperative atropine belongs to what classification of drugs?

anticholinergic

The nurse is caring for a client with a drug allergy and understands the allergy is the result of the client developing

antobodies

A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize

blood urea nitrogen and creatinine levels

The nurse is caring for a client receiving an aminoglycoside (antibiotic) that can be nephrotoxic. Which will alert the nurse that the client may be experiencing nephrotoxicity?

decrease in urine output

What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?

decreased glomerular filtration rate

A client develops stomatitis from drug therapy. Which measure would be most appropriate for the nurse to suggest?

frequent rinsing with cool liquids

The nurse is assessing a community-dwelling client with a history of rheumatoid arthritis. During the interview, the client states, "The last few months, I have this ringing in my ears that I just cannot seem to get away from." What assessment question should the nurse ask?

have you been taking aspirin on a daily basis

Drugs can produce a wide variety of effects in addition to the desired pharmacological effect. Sometimes the drug dose can be adjusted so that the desired effect is achieved without producing undesired secondary reactions. Which are examples of this secondary action? (Select all that apply.)

reports of drowsiness after taking an diphenhydramine (Benadryl) diarrhea after taking cefuroxime (Ceftin)

When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of

secondary actions

What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects?

stay hydrated

The nurse at a campus medical clinic is administering a new medication to a 22-year-old female client. The nurse should educate the client about what potential risk of drug therapy?

teratogenicity

The nurse is providing for a client who is being treated for a Pseudomonas infection in the intensive care unit. The client's medication regimen includes gentamicin 75 mg IV t.i.d. When monitoring the client for adverse effects, what assessment should the nurse prioritize?

urine output and creatinine clearance note: gentamicin is frequently associated with renal toxicity

For several days, a client with hypertension has been inadvertently taking an excessive dose of spironolactone, a potassium-sparing diuretic. The client has presented to the emergency department with signs and symptoms that suggest hyperkalemia. What assessment should the nurse prioritize?

cardiac monitoring


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