Karch's Focus on Pharmacology 8th Ed. | Chapter 10
To prevent viral infections, what precaution should the general public take?
Become vaccinated against prevalent virus infections.
A neonatal intensive care unit nurse is caring for an infant diagnosed with respiratory syncytial virus. What route of delivery will the nurse use when ribavirin is administered to this infant?
Inhaled
What drug used to treat influenza A should not be used by nursing mothers?
Rimantadine
A client is administered a nucleotide reverse transcriptase inhibitor in combination with a nonnucleotide reverse transcriptase inhibitor. What is the rationale when administering these medications together?
They have synergistic antiviral effects.
An adult client is being treated for genital herpes with acyclovir. Which client statement indicates a need for further health education?
"It's a relief to know that this drug will stop me from spreading the infection."
A client is receiving tenofovir as part of a therapy regimen for HIV infection. The nurse should provide what teaching related to what the client may experience?
"It's possible you might have changes in body fat distribution."
A 50-year-old HIV-positive client is being treated for cytomegalovirus (CMV) with intravenous acyclovir. The nurse should recognize the possibility of a serious adverse drug effect directly associated with this medication if the client reports:
Hallucinations
A nurse is caring for a patient with HIV. What lab tests would the nurse monitor when a protease inhibitor has been ordered for this patient?
Serum alanine aminotransferase and bilirubin
A pregnant client's prenatal blood work has returned positive for HIV. What antiretroviral medication would be safest to give this client?
Zidovudine
A client is receiving a nonnucleoside reverse transcriptase inhibitor. Why should the nurse caution the client to avoid the concurrent use of St. John's wort?
Antiviral effects may be reduced.
What laboratory studies would be important for the nurse to especially monitor to check for lactic acidosis in the pregnant client on zidovudine therapy, especially during the last trimester?
Serum electrolytes and liver function tests
The nurse is caring for a patient who has HIV and is taking saquinavir therapy. What should the nurse include in the dietary education for this patient?
The patient should not take this medication with grapefruit or pomegranate juice.
A client with HIV is frustrated by the size and complexity of the current medication regimen. What should the nurse teach the client about combination therapy for the treatment of HIV?
Use of combination therapy attacks the virus at different stages of the life cycle.
The nurse is providing health education to a client who has recently been diagnosed with HIV and will soon begin antiretroviral therapy. What teaching point should the nurse prioritize?
The need to adhere rigidly to the prescribed drug schedule
Children younger than the age of 12 years should not receive indinavir.
True
A patient with AIDS is being prepared for discharge. The nurse caring for the patient with AIDS knows the patient receives Agenerase. What dietary counseling will the nurse provide based upon the patient's medication regimen?
Avoid high-fat meals while taking this medication
An immigrant and his wife are both HIV positive. The physician prescribes antiretroviral medications. However, the client, tell the nurse he is concerned about his ability to afford the treatment. What advice can the nurse provide to the client to help begin the treatment?
The client can approach social agencies and pharmaceutical companies that provide antiretroviral drugs on compassionate grounds
A 42-year-old client, diagnosed with human immunodeficiency virus (HIV), has been receiving antiretroviral therapy for several years. Recently, raltegravir was added to the drug regimen. When assessing the success of this addition to the treatment, the nurse should prioritize which laboratory value?
The client's CD4 count
A client comes to the health care facility reporting flulike symptoms. After a thorough assessment, the client is diagnosed with influenza and is to receive oseltamivir. The nurse understands that this drug has been prescribed because the client been symptomatic for less than:
2 days
Which of the following represents the categories of drugs used to treat viral infection? (Select all that apply.)
Antiretroviral Antiviral
Which statement regarding antiviral medications is true?
Antivirals do not eliminate existing viruses from tissues.
A patient diagnosed with acute primary HIV infection is in the clinic. What treatment should be initiated for this patient?
Combination antiretroviral therapy
Which microorganism is known to cause retinitis in people with HIV/AIDS?
Cytomegalovirus
A client has been treated with abacavir for the past 6 weeks. The client contacts the physician's office with reports of diarrhea, abdominal pain, sore throat, cough, and shortness of breath. Which is the appropriate action to take for this situation?
Discontinue the therapy.
A client is receiving nevirapine as part of a treatment for HIV infection. The nurse would instruct the client about which adverse effects as most commonly experienced?
Dry mouth and dyspepsia
A nurse is preparing to administer IV acyclovir to a client diagnosed with a herpes simplex viral infection. The health care provider has ordered 5 mg/kg every 8h. The client weighs 60 kg. How much medication will the nurse administer per dose?
Each dose will contain 300 mg of acyclovir. (60 kg × 5 mg/kg = 300 mg.)
The nurse is caring for a client with AIDS who has developed cytomegalovirus (CMV). The nurse anticipates the health care provider will order which drug to treat this client?
Ganciclovir
A 21-year-old woman diagnosed with HIV/AIDS 4 years ago now presents with cytomegalovirus (CMV). The nurse explains to the woman that this infection is caused by a common organism that normally does not cause infection in someone who is not what?
Immunocompromised
When describing the action of an integrase inhibitor, the nurse understands that this class of drug acts by which mechanism?
Inhibiting the activity of a virus specific encoded enzyme needed for viral replication
It will be most important for the nurse to monitor nevirapine therapy for a male patient during the first few months of therapy in order to:
It will be most important for the nurse to monitor nevirapine therapy for a male patient during the first few months of therapy in order to:
A client with HIV has had a CCR5 co-receptor antagonist added to the antiretroviral regimen. What assessment should the nurse prioritize?
Liver function
A patient with chronic hepatitis B (HBV) infection is scheduled to begin a new treatment regimen that will include adefovir dipivoxil. What assessments should be prioritized before the initiation of this drug treatment?
Liver function testing and HIV testing
Which was the first class of drugs developed to treat HIV infections?
Nucleoside reverse transcriptase inhibitors
A group of students are reviewing information about antiviral agents used to treat influenza and respiratory virus infections. The students demonstrate understanding of the material when they identify which drug as appropriate for treating Avian flu?
Oseltamivir
A client who is hospitalized and receiving antiretroviral therapy has a nursing diagnosis of Risk for Injury related to weakness and dizziness. Which would be most appropriate for the nurse to do?
Provide for frequent rest periods.
A patient being treated for HIV with saquinavir informs the nurse they he has been "suffering from depression" and taking St. John's wort to help. What is important for the nurse to discuss with this patient?
Refraining from use of St. John's wort, which can cause decreased effectiveness of saquinavir
When administering the fusion protein inhibitor enfuvirtide, the nurse should include which technique to assure the medication's continued effectiveness?
Regularly rotate the subcutaneous injection sites that are used.
The nurse is caring for a child with respiratory syncytial virus (RSV). Which drug should the nurse expect the pediatrician to order?
Ribavirin
An HIV-positive patient is being treated for hypothyroidism with levothyroxine. The patient is also taking saquinavir therapy for HIV. Which clinical manifestations by the patient should the nurse be concerned about?
Tachycardia, intolerance to heat, weight loss
An HIV-positive patient is taking efavirenz and tells the nurse that she now has fat on the upper back and neck but is losing fat in the extremities and face. What does the nurse determine is causing this patient's symptoms?
The patient has lipodystrophy from the efavirenz.
A nurse is explaining the rationale for the use of combination therapy in the treatment of HIV infections. Which would the nurse include as the primary reason?
The use of multiple drugs allows attack on the virus at different points in its life cycle.
A client is being treated with saquinavir for AIDS. The client history includes a BMI of 37.98%, hyperlipidemia, and sleep apnea. Based on the client history, why would caution be used when the client is started on saquinavir?
There are potential adverse effects associated with hyperlipidemia.
The nursing instructor is discussing HIV/AIDS with the junior nursing class. The instructor tells the students that it is important to understand how HIV-1 integrates itself into a person's immune system and how immunity plays a role in the course of HIV disease. What else is this knowledge essential for?
Understanding medication therapy
A nurse is caring for a patient, who has been prescribed the antiviral drug amantadine. Which of the following adverse reactions specific to amantadine should the nurse monitor for?
hypotension and insomnia
An influenza outbreak has spread through a long-term care residence, affecting many of the residents with severe malaise, fever, and nausea and vomiting. In an effort to curb the outbreak, the nurse has liaised with a health care provider to see if residents may be candidates for treatment with what drug?
oseltamivir phosphate
A nurse is administering a drug that blocks the protease enzyme so new viral particles cannot mature. Which category of drugs is the nurse most likely administering?
protease inhibitors