Chapter 6: Challenges to Effective Drug Therapy

A client with newly diagnosed hypertension has received a prescription from the care provider reading "Vasotec 5 mg PO daily." The client has expressed concern to the nurse about the possible cost of the medication. What is the nurse's best action?

Encourage the client to inquire about purchasing a generic equivalent.

The nurse should plan care with the goal of preventing which primary signs of alcohol withdrawal?

delirium tremens

A nurse has admitted a client diagnosed with substance abuse intoxication to the unit. The nursing assessment will first be directed toward data regarding:

drug use.

The home care nurse is paying a scheduled visit to an older adult client who has a complex medication regimen. The nurse should prioritize what action related to the client's medications during this visit?

educating the client about the management of possible adverse effects

Which aspect of medical care is an overriding concern of a health maintenance organization (HMO)?

financial

Cimetidine (Tagamet) is an OTC drug used to treat:

heartburn.

Which practice has contributed to the problem of resistant bacteria?

Clients saving remaining antibiotics for the next time they feel sick

Heroin is classified as which type of street drug?

opioid

The nurse is caring for a client who has strong beliefs about the effectiveness of a specific alternative therapy. The nurse recognizes the effectiveness of this therapy is increased by what effect?

placebo effect

When caring for a client with alcohol dependence who is prescribed a benzodiazepine, which side effects is it most important that the nurse monitor for?

sedation

Clients who use garlic with co-administration of antidiabetic drugs may run into which serious problem?

hypoglycemia

Which website extension represents a professional group?

.org

A client reporting to the emergency department reports possible ingestion of "that date rape drug." The nurse suspects that the client is referring to what drug?

rohypnol

The nurse is assessing a client and is asking about the client's current medication regimen. The client states, "I'm not taking anything that you need a prescription to get." What is the nurse's best response?

"Which drugs do you take that don't require a prescription?"

Off-label use refers to uses of a drug that are not part of the stated therapeutic indications for which the drug was approved by the FDA. When a nurse is using a medication for its off label use, the nurse should be very cognizant of certain factors in order to ensure patient safety.

+Clear about the intended use +Why the drug is being given +Its potential for problems

What are accurate regarding herbal remedies?

+Clients often do not mention their use to health care providers. +Herbal remedies produce unexpected effects. +Herbal remedies can interact with prescription drugs.

Which data would be helpful in determining the accuracy of information found on the Internet?

+navigation +contributors +dates +reliability

Ipecac was found to be ineffective for its intended use in 2003. What was previously an intended use of this drug?

Induce vomiting.

Access to information has become so broad over the last decade that consumers are often overwhelmed with details, facts, and choices that affect their health care. What factors have influenced how a client approaches the health care provider when it comes to prescriptions?

Internet alternative therapy media

It is common practice for a pharmacy to provide written information with each drug that is dispensed. However, it is not always within the consumer's ability to sort through this information and understand it. Whose task does this become?

Nurse

Which drug would be classified as a hallucinogen?

PCP

What patient populations are more commonly prescribed off-label drugs?

Pediatrics and geriatrics

A client reports that, "The alcohol treatment programs I've tried in the past have only helped for a little and then I start drinking again." This statement best describes which type of alcohol-related behavior?

Psychological dependence

A 70-year-old with a history of atrial fibrillation has been admitted with a lower gastrointestinal bleed. During the nurse's admission assessment, the nurse realizes that the client has been taking ginkgo biloba supplements in addition to prescribed warfarin, a combination that has resulted in bleeding. What nursing diagnosis should the nurse identify when planning this client's care?

Risk for Injury related to drug interactions of vitamins, herbs, or food intake with prescribed drug therapy

A client has been prescribed a selective serotonin reuptake inhibitor (SSRI) to treat depression. The regular use of which herbal supplement requires intervention by the nurse?

St. John's wort

With the increasing number of clients who go to their physician and request a drug they have seen advertised on television or in a magazine, a continuing challenge to health care providers to do what has emerged?

Stay knowledgeable about drug therapy.

A patient tells the clinic nurse that they have been taking OTC Pepcid to relieve acid indigestion for several years. This is the first time the patient has ever reported this problem to a health care provider. Why should the patient share their use of Pepcid with their health care provider?

The drug could mask symptoms of a serious problem that is undiagnosed.

The nurse is discharging a client with atrial fibrillation who has been prescribed "Warfarin 4 mg PO daily DAW." What should the nurse teach the client about this prescription?

The pharmacy cannot dispense a generic equivalent.

What would be most appropriate to teach a client about over-the-counter drugs?

They are safe when you use them as directed.

A client has been prescribed a diuretic and asked the health care provider to write a prescription for twice the daily dose so that the client could split each pill and reduce costs. The nurse should:

caution the client that this practice can lead to inconsistent doses.

A client, admitted for the treatment of a fracture, has a history of heavy alcohol use. What event should suggest the implementation of pharmacologic treatment for alcohol withdrawal?

signs/symptoms of withdrawal are noted

The nurse is admitting a client who has been on a three-day binge of methamphetamine. The nurse should anticipate what sign or symptom?

tachycardia

When describing the characteristics of the client who comes into the health care system today, which would most likely apply?

the use of a complex array of OTC and alternative therapies