NURS 1141 Ex 3 - Aut '17
What is the MOST important action for the nurse to complete before administration of intravenous (IV) amphotericin B? Assess for nausea and vomiting. Monitor for cardiac dysrhythmias. Check for premedication prescriptions. Monitor IV site for signs of phlebitis.
Check for premedication prescriptions Almost all clients given IV amphotericin B experience fever, chills, hypotension, tachycardia, malaise, muscle and joint pain, anorexia, nausea and vomiting, and headache. Pretreatment with an antipyretic, antihistamine, and antiemetic can minimize or prevent these adverse reactions. The other choices are appropriate nursing actions after the IV infusion has begun.
The nurse is counseling a woman who is beginning antitubercular therapy with rifampin. The patient also takes an oral contraceptive. Which statement by the nurse is most accurate regarding potential drug interactions? a. "You will need to switch to another form of birth control while you are taking the rifampin." b. "Your birth control pills will remain effective while you are taking the rifampin." c. "You will need to take a stronger dose of birth control pills while you are on the rifampin." d. "You will need to abstain from sexual intercourse while on the rifampin to avoid pregnancy."
a. "You will need to switch to another form of birth control while you are taking the rifampin." Women taking oral contraceptives who are prescribed rifampin must be switched to another form of birth control because oral contraceptives become ineffective when given with rifampin. These medications must be taken long term because mycobacterium is slow growing. They can cause photosensitivity, necessitating the use of sunscreen. Finally, isoniazid may increase, not decrease, serum glucose levels.
Before administering antiprotozoal drugs, the nurse will review which baseline assessment? a. Complete blood count b. Serum magnesium level c. Creatinine clearance d. Arterial blood gas concentrations
a. CBC
Bedaquiline (Sirturo) is prescribed for a patient, and the nurse is providing instructions to the patient about the medication. Which statement by the patient indicates a correct understanding of the instructions? a. "I will take this with food." b. "I need to take this 1 hour before breakfast." c. "I can stop this drug if the side effects bother me." d. "It's okay to have a glass of wine while taking this drug."
a. "I will take this with food."
When giving metronidazole, the nurse implements appropriate administration techniques, including which of these? (Select all that apply.) a. Giving oral forms with food b. Giving oral forms on an empty stomach with a full glass of water c. Infusing intravenous doses over 30 to 60 minutes d. Administering intravenous doses by bolus over 5 minutes e. Obtaining ordered specimens before starting the medication
a. giving oral forms w/food c. infusing IV doses over 30-60 min e. obtaining ordered specimens before starting the medication
When a patient is receiving long-term NSAID therapy, which drug may be given to prevent the serious gastrointestinal adverse effects of NSAIDs? a. misoprostol (Cytotec) b. metoprolol (Lopressor) c. metoclopramide (Reglan) d. magnesium sulfate
a. misoprostol (Cytotec)
The nurse knows that antimalarial drugs are used to treat patients with infections caused by which microorganism? a. Plasmodium spp. b. Candida albicans c. Pneumocystis jirovecii d. Mycobacterium
a. plasmodium spp
A 49-year-old patient has been admitted with possible chronic salicylate intoxication after self-treatment for arthritis pain. The nurse will assess for which symptoms of salicylate intoxication? (Select all that apply). a. Tinnitus b. Headache c. Constipation d. Nausea e. Bradycardia
a. tinnitus b. headache d. nausea
ketorolac - Toradol
acetic acid derivative tx of acute painful conditions, post-partum, esp after c-section short-term use up to 5 days adverse: renal impairment, edema, GI pain, dyspepsia, N may be taken with antacids or food to decrease GI upset IV/IM: max dose 120mg/day if <65 yrs, 60 mg/day if >65yrs
indomethacin - Indocin, Indocin SR
acetic acid derivative tx: ankylosing spondylitis, gout, OA, RA, bursitis, tendonitis, preterm labor IV used to promot closure of patent ductus arteriosus PO, PR, IV adverse: n/v
Which drug does the nurse associate with the development of potentially life-threatening skin adverse effects of exfoliative dermatitis, Stevens-Johnson syndrome, and toxic epidermal necrolysis? probenecid colchicine febuxostat (Uloric) allopurinol (Zyloprim)
allopurinol (Zyloprim)
A patient is taking nystatin (Mycostatin) in an oral troche form for oral candidiasis. Which instruction is correct? Allow the troche to dissolve slowly in the mouth. Swish the medication in the mouth and then swallow it. Chew the troche thoroughly to activate the medication. Swallow the troche whole without chewing.
allow the troche to dissolve slowly in the mouth
Fifteen minutes after an infusion of amphotericin B was started, the patient begins to complain of fever, chills, muscle pain, and nausea. His heart rate has increased slightly, but his blood pressure is down to 100/68 mm Hg. What is the nurse's priority? Notify the prescriber immediately. Recognize an impending anaphylactic reaction and stop the infusion. Assess for other symptoms of this expected infusion-related reaction. Slow the infusion to reduce these adverse effects.
assess for other symptoms of this expected infusion-related reaction
When teaching a patient who is taking nystatin lozenges for oral candidiasis, which instruction by the nurse is correct? a. "Chew the lozenge carefully before swallowing." b. "Dissolve the lozenge slowly and completely in your mouth." c. "Dissolve the lozenge until it is half the original size, and then swallow it." d. "These lozenges need to be swallowed whole with a glass of water."
b. "Dissolve the lozenge slowly and completely in your mouth."
During antitubercular therapy with isoniazid, a patient received another prescription for pyridoxine. Which statement by the nurse best explains the rationale for this second medication? a. "This vitamin will help to improve your energy levels." b. "This vitamin helps to prevent neurologic adverse effects." c. "This vitamin works to protect your heart from toxic effects." d. "This vitamin helps to reduce gastrointestinal adverse effects."
b. "This vitamin helps to prevent neurologic adverse effects." Isoniazid can cause neurotoxicity. Pyridoxine, vitamin B6, is the drug of choice to prevent this adverse reaction. It is not an antiinfective drug and thus will not work to destroy the mycobacterium or prevent drug resistance.
caspofungin - Cancidas
echinocandin antifungal drug tx of severe Aspergillus infection Injectable only Assess - BP, pulse, liver function, RBC & WBC counts due to potential drug-induced advers effect of hypotension, tachycardia, decreased H&H, leukopenia, & hepatotoxicity - constantly monitor for these during therapy Monitor liver function tests, H&H b/c of possibility of drug-induced anemias Monitor for fever, hives, rash, increased feeling of warmth, flushing, chills, wheezing, or bleeding Doses need to be decreased in pts w/ impaired liver function Only use clear solutions - dilute w/ NS - never as bolus - always at room temp Rpt to HCP: any problems with SOB, itching, facial swelling, and/or rash
Which antifungal drug can be given intravenously to treat severe yeast infections as well as a one-time oral dose to treat vaginal yeast infections? Voriconazole (Vfend) Nystatin (Mycostatin) Fluconazole (Diflucan) Caspofungin (Cancidas)
fluconazole (Diflucan) Fluconazole is an antifungal drug that does not cause the major adverse effects of amphotericin when given intravenously. It is also very effective against vaginal yeast infections, and a single dose is often sufficient to treat vaginal infections.
A patient is admitted with salicylate toxicity. When assessing the patient, the nurse anticipates which manifestation associated with salicylate toxicity? Bradycardia Hypoventilation Constipation Hyperglycemia
hyperglycemia can cause - tachycardia, hyperventilation, and diarrhea
The nurse has provided education to a client about fungal skin infections. Further client teaching is necessary when the client includes which condition in the discussion of fungal skin infections? Thrush Impetigo Athlete's foot Vaginal yeast infection
impetigo Impetigo is a bacterial skin infection and would not be classified as a fungal skin infection. If the client included this in the discussion, further teaching is needed. All other skin infections listed are fungal and would be treated with antifungal medications
A nurse teaching a client receiving allopurinol (Zyloprim) should include which information? "Increase your fluid intake to 3 L per day." "This medication may cause your urine to turn orange." "Include salmon and organ meats in your diet on a weekly basis." "Take the medication with an antacid to minimize GI distress."
increase your fluid intake to 3L/day Clients taking allopurinol should be informed to increase fluid intake to 3 L per day, avoid hazardous activities if dizziness or drowsiness occurs with the medication, and avoid the use of alcohol and caffeine because these drugs will increase uric acid levels and decrease the levels of allopurinol.
A patient is taking ibuprofen 800 mg three times a day by mouth as treatment for OA. While taking a health history, the nurse finds out that the patient has a few beers on weekends. What concern would there be with the interaction of the alcohol and ibuprofen? Increased bleeding tendencies Increased chance for GI bleeding Increased nephrotoxic effects Reduced antiinflammatory effects of the NSAID
increased chance for GI bleeding
streptomycin
inhibit protein synthesis - 1st line tb drug assess hearing status, CBC, & renal functions adverse: ototoxicity, nephrotoxicity, blood dyscrasias Interaction: nephrotoxic & neurotoxic = increased toxicity / oral anticoags = increased bleeding tendencies usually not given to pregnant women part of 4-drug regimen - INH, rifampin, PZA, & either streptomycin or ethambutol deep IM
What is the mechanism of action of nonsteroidal antiinflammatory drugs (NSAIDs)? Enhancing pain perception Inhibiting prostaglandin production Increasing blood flow to painful areas Increasing the supply of natural endorphins
inhibiting prostaglandin production Prostaglandins are produced in response to activation of the arachidonic pathway. NSAIDs work by blocking cyclooxygenase (COX-1 and COX-2), the enzyme responsible for conversion of arachidonic acid into prostaglandins. Decreasing the synthesis of prostaglandins results in decreased pain and inflammation.
isoniazid - INH
inhibits cell wall synthesis - 1st choice for tx of tb Contra: liver diease Avoid alcohol and antacids adverse: peripheral neuropathy, hepatotoxicity, optic neuritis/eye disturbances, hyperglycemia vit B6 needed to combat peripheral neuropathy do not use OCs, use different type of BC max dose of 300 mg preferred 1 hr before or 2 hrs after meals, but can be given w/ food for GI upset
rifampin - Rifadin
inhibits protein synthesis - 1st line tb drug used if isoniazid does not work Contra: renal or liver dysfunction, chronic alcohol use, esp when assoc. w/ major liver damage Interaction: isoniazid = increased CNS system & hepatotoxicity/ beta blockers, benzos, cyclosporine, oral anticoags, oral antidiabetics, OCs, phenytoin, quindine, sirolimus, theophylline = increased metabolism = decreased effects Adverse: red-brown-orange discoloration of urine, sputum, sweat, & tears - even permanently stain contact lenses / hepatitis, hematologic disorders do not use OCs, use different type of BC rpt to HCP: fever, N/V/ loss of appetite, jaundice, and/or unusual bleeding
Which NSAID would the nurse anticipate administering parenterally for the treatment of acute postoperative pain? Ketorolac (Toradol) Diclofenac (Cataflam) Allopurinol (Zyloprim) Indomethacin (Indocin)
ketotolac (Toradol) Ketorolac can be administered by injection (intramuscularly or intravenously) and is indicated for the short-term treatment of moderate to severe acute pain.
pyrantel - Pin-X
nematode anthelmitic tx giant roundworms (ascaris lunbricoides) and pinworms (enterobius vermicularis) does not require a prescription dose: PO 11mg/kg in single dose - max of 1g Interactions: concurrent use w/piperazine is not recommeneded Use w/ caution in pts w/ hepatic impairment Has been shown to increase blood levels of theophylline in peds pts adverse: headache, dizziness, insomnia, skin rash, anorexia, abd cramps, n/v/d
The pt tells the nurse, "I had a shot after I returned from my trip overseas. I thought that was supposed to stop me from getting a TB infection." What info regarding TB-related injections does the nurse identify as being true? a. BCG is used to prevent infection w/ TB for women of childbearing age b. A positive result for a PPD test is indicated by redness at the site of injection c. PPD is a diagnostic injection given intradermally to detect exposure to the TB organism d. BCG is a vaccine injection derived from an activated startin of Mycobacterium bovis.
c. PPD is a diagnostic injection given intradermally to detect exposure to the TB organism
The nurse is monitoring for liver toxicity in a patient who has been receiving long-term isoniazid therapy. Manifestations of liver toxicity include: (Select all that apply.) a. Orange discoloration of sweat and tears b. Darkened urine c. Dizziness d. Fatigue e. Visual disturbances f. Jaundice
b. darkened urine d. fatigue f. jaundice
The nurse recognizes that manifestations of NSAID toxicity include a. constipation. b. nausea and vomiting. c. tremors. d. urinary retention.
b. n/v
Praziquantel (Biltricide) is prescribed for a patient with a tapeworm infection. The nurse prepares to administer the medication via which route? a. Rectal b. Oral c. Intravenous d. Inhalation
b. oral
Which teaching point would be appropriate to include when the nurse is informing a patient about the adverse effects of antimalarials? a. The skin may turn blotchy while these medications are taken. b. These medications may cause anorexia and abdominal distress. c. These medications may cause increased urinary output. d. The patient may experience periods of diaphoresis and chills.
b. these medications may cause anorexia and abd distress
When teaching a patient about the potential drug interactions with antiprotozoal drugs, the nurse will include information about a. acetaminophen. b. warfarin. c. decongestants. d. antibiotics.
b. warfarin
When teaching a client about potential adverse effects of NSAID therapy, the nurse will teach the client to immediately notify the health care provider of which effect? Diarrhea Mild indigestion Black tarry stools Nonproductive cough
black-tarry stools A major adverse effect of NSAID therapy is gastrointestinal (GI) distress with potential GI bleeding. Black or tarry stools are indicative of a GI bleed.
The nurse knows colchicine (Colcrys) exerts its therapeutic effect by what action? Increases uric acid metabolism Decreases mobility of leukocytes Increases process of phagocytosis Increases production of lactic acid
decreases mobility of leukocytes Colchicine works by inhibiting the metabolism and migration of leukocytes into joints affected by gout, thus resulting in decreased inflammation.
When a client is receiving an IV infusion of metronidazole (Flagyl), what adverse effect would the nurse immediately report to the health care provider? Dark colored urine Dizziness or confusion Elevated blood pressure Diminished breath sounds
dizziness or confusion During use of this drug, metronidazole administered intravenously, report to the health care provider any changes in neurologic status (e.g., dizziness, confusion).
The nurse would question a prescription for chloroquine (Aralen) in a client also prescribed which medication? Diazepam (Valium) Doxycycline (Doryx) Clindamycin (Cleocin) Valproic acid (Depakote)
valproic acide (Depakote) Concurrent use of chloroquine with valproic acid may reduce serum drug levels of valproic acid and thus increase the risk of seizure activity. Chloroquine may be given concurrently with clindamycin or doxycycline for synergistic actions.
anthelmitic drugs
very specific to the organism some may cause urine to have an asparagus-like odor or cause an unusual skin odor or a metallic taste take w/food to decrease GI upset
celecoxib - Celebrex
COX-2 inhibitor - only one left on the market tx: OA, RA, acute pain, primary dysmenorrhea, ankylosing sponndylitis DO NOT use in pts w/ sulfa allergy document any CV disorders - may pose risk for CV events avoid alcohol, aspirin, salicylates, & OTC drug w/ any of these adverse: headache, sinus irritation, diarrhea, fatigue, dizziness, lower extremity edema, & HTN rpt to HCP: any stomach or abd pain, GI problems, unusual bleeding, blood in stool or vomitus, chest pain, edema, and/or palpitations take w/ food to decrease GI upset
Four weeks after beginning antitubercular drug therapy on an outpatient basis, the patient reports that he still experiences night sweats. What does the nurse identify as the main concern at this time? He is not taking his medication properly. More time is needed to see a therapeutic response. His infection may be resistant to the drug therapy ordered. He may have contracted a different strain of TB.
His infection my be resistant to the drug therapy ordered
Before administration of primaquine, it is most important for the nurse to assess the patient for a history of which condition? Asthma Diabetes mellitus Hypertension Rheumatoid arthritis
RA
P.T., 68 years of age, is instructed to take aspirin, 81 mg every morning with breakfast, as part of treatment after having a myocardial infarction. When discussing the aspirin therapy, he asks the nurse, "Will this also help my arthritis?" What is the nurse's best answer?
The lower daily aspirin dosage of 81 to 325 mg will not help arthritis pain. Aspirin dosage for arthritis is 3 g/day given in divided doses every 4 to 6 hours. The lower dosage is used for aspirin's antiplatelet effects.
A patient has an extremely severe infection with a Mycobacterium that is resistant to all but one antitubercular drug; however, the patient has had an allergic reaction to that drug in the past. What does the nurse anticipate as being ordered for this patient? a. A combination of antitubercular drugs will be chosen to fight the infection. b. The patient will receive the drug and supportive care to help him tolerate the antitubercular therapy. c. The patient will remain on isolation precautions until his cough clears. d. There is nothing that can be done for this patient.
The pt will rcv the drug and supportive care to help him tolerate the antitubercular therapy
When monitoring a patient who is receiving caspofungin, the nurse will look for which serious adverse effects? (Select all that apply.) a. Blood dyscrasias b. Hypotension c. Pulmonary infiltrates d. Tinnitus e. Hepatotoxicity
a. blood dyscrasias b. hypotension d. hepatotoxicity
The nurse is reviewing a patient's medication list during a preoperative visit. The patient is scheduled for diagnostic laparoscopy in 2 weeks. He asks the nurse, "I hope I can continue the Motrin, because I really ache if I don't take it. It's just minor surgery, right?" What is the nurse's best response? a. "You can continue to take it as the laparoscopy is considered minor surgery." b. "You will need to take a lower dosage during the preoperative period. c. "I'll check with your prescriber, but this drug is usually stopped a week before the surgery because it can cause increased bleeding tendencies." d. "You can switch to aspirin before the surgery; both aspirin and Motrin are over-the-counter pain relievers."
c. I'll chekc with your prescriber, but this drug is usually stopped a week before the surgery b/c it can cause increased bleeding tendencies.
The nurse anticipates the patient with giardiasis to exhibit which of the following manifestations? Difficulty breathing Foul smelling vaginal discharge Red rash on the skin Diarrhea, bloating, and foul-smelling stools
diarrhea, bloating, and foul-smelling stools
A patient with TB has been taking antitubercular drugs. A sputum culture is ordered to test for acid-fast bacilli. When is the best time for the nurse to obtain the sputum culture? In the morning Noon 5 pm 10 pm
in the morning
What conditions are considered contradictions for use of antifungal medications? (Select all that apply.) Heart failure Liver failure Correct Kidney failure Incorrect Pancreatic failure Correct Respiratory failure
liver failure kidney failure pancreatic failure Drug allergy, liver failure, kidney failure, and porphyria (for griseofulvin) are the most common contraindications for antifungal drugs
Before starting treatment with antiprotozoal therapy, it is most important for the nurse to asses the patient's baseline? Blood sugar Blood pressure QT interval Liver function
liver function
A patient has developed an aspergillosis infection. Which tissue does the aspergillosis affect? Skin Nails Blood Lungs
lungs
What is advantage of COX-2 inhibitors over other NSAIDs? Maintain GI mucosa Have a longer duration of action Have a more rapid onset of action Are less likely to cause hepatic toxicity
maintain GI mucosa By not inhibiting the COX-1 enzyme to maintain an intact gastric mucosal barrier by increasing secretion of mucus, the risks of GI adverse effects are decreased.
What is the MOST common drug used to treat oral candidiasis? Oseltamivir (Tamiflu) Nystatin (Mycostatin) Amantadine (Symmetrel) Griseofulvin (Fulvicin P/G)
nystatin (mycostatin) Nystatin is an antifungal drug that is used for a variety of candidal infections. It is applied topically as a cream, ointment, or powder. It is also available as a troche and an oral liquid or tablet.
primaquine
only antimalarial to work in exoerythrocytic phase tx; pneumocytosis contra: RA, SLE use w/ caution: methemoglobinemia, porphyria, methoglobin reductase deficiency, G6PD deficiency adverse: n/v, abd distress, headache, pruritis, dark discoloration of urine, hemolytic anemia due to G6PD deficiency interaction: other hemolytic drugs - unknown mechanism - increased risk for myelotoxic effects prophylaxis - 30 mg PO for 1-2 days before and continue until 7 days after travel tx - 30 mg/day for 14 days
When admitting a client to a medical-surgical unit with a diagnosis of Pneumocystis jirovecii pneumonia, the nurse will anticipate administering which medication? Iodoquinol (Yodoxin) Albendazole (Albenza) Pentamidine (Pentam) Paromomycin (Humatin)
pentamidine (Pentam) Iodoquinol and paromomycin are used to treat intestinal amebiasis, and albendazole is used to treat helminthic infections.
The nurse would question a prescription to administer misoprostol (Cytotec) to a client with which condition? Pregnancy Peptic ulcer Gastroesophageal reflux disease Chronic obstructive pulmonary disease
pregnancy Misoprostol is an abortifacient and thus is contraindicated in pregnancy
ibuprofen - Motrin, Advil
propionic acid derivative tx: dysmenorrhea, headache, arthritis, fever pain, RA, OA, gout, dental pain, musculoskeletal disorders, antipyretic 1200-3200 mg/day divided 3-4x/day antiinflammatory response up to 7 days anagelsic response - 30-60 min
fluconazole - Diflucan
synthetic triazole - antifungal PO & IV tx: vaginal candidiasis(one dose), oropharyngeal/esophageal candidiasis, systemic candidiases, cryptococcal meningitis use alternative methods of BC assess preexisting GI problems & renal and/or hepatic function only administer clear solutions - never add anything - diluted solutions are only good for 24hr adverse: n/v/d, stomach pain, increased liver enzyme levels, dizziness monitor IV site for extravasation, leads to tissue necrosis - check hourly monitor K, BUN, creatinine rpt to HCP: jaundice, nausea, vomiting, clay-colored stools, and/or dark urine Stop infusion if itching/rash occurs
voriconazole - Vfend
synthetic triazole antifungal tx of invasive aspergillosis, cadida infections, & infections caused by Fusarium spp. contra: can cause fetal harm in pregnant women - pts who are taking certain other drugs metabolized by cytochrome P-450 enzyme b/c of risk for induction of serious cardiac dysrhythmias adverse: hallucinations, n/v, increased liver enzymes, rash, photophobia, hypokalemia use effective contraceptives b/c of teratogenic effects give PO doses 1 hr before or after meals IV may be diluted with 5% dextrose in water or NS, w/ accurate dose infused over recommended time monitor for visual acuity - esp if ordered over 28 days - advise pt not to drive @ night rpt to HCP: bleeding, bruising, soft-tissue swelling, dark urine, peristant N/D, rash or yellow skin/eyes
A patient is diagnosed with onychomycosis. The nurse anticipates use of which medication for the treatment of this condition? terbinafine (Lamisil) voriconazole (Vfend) fluconazole (Diflucan) amphotericin B (Amphocin, Fungizone)
terbinafine (Lamisil) - toenail fungus CORRECT voriconazole - invasive aspergillosis fluconazole - vag, oral, esophageal thrush amphotericin B - severe systemic fungal infections
A hospitalized patient has an order for ketorolac (Toradol). The nurse notes that the order is only for 5 days. What is the reason for this? The patient's pain should subside by that time. There are concerns about addiction to the drug. The drug can cause severe renal and GI effects. The drug loses its effectiveness over time.
the drug can cause severe renal and GI effects
The nurse is administering medications. One patient has an order for aspirin 325 mg by mouth daily and another patient has an order for aspirin 650 mg 4 to 6 times daily (maximum 4 g/day). The nurse understands that the indication for the 325 mg of aspirin once daily is: pain management. fever reduction. treatment of OA. thromboprevention.
thromboprevention
probenecid
uricosurcs - antigout tx of gout contra: PUD, blood dyscrasias ineffective & not to be used in pts w/ renal impairment tx - 250 mg 2x/day w/food, milk, or antacid for 1 wk, then 500 mg 2xday - may be adjusted as needed to maintain desirable serum uric acid levels
Which client statement indicates to the nurse that the client understands the discharge teaching for ethambutol (Myambutol)? "Constipation will be a problem, so I will increase the fiber in my diet." "Dizziness and drowsiness are common adverse effects with this drug." "I will need to have my vision checked periodically while I am taking this drug." "This medication may cause my bodily secretions to turn red-orange-brown."
"I will need to have my vision checked periodically while I am taking this drug." Ethambutol can cause optic neuritis. Ophthalmologic examinations should be performed periodically to assess visual acuity.
When counseling a patient who has been newly diagnosed with TB, the nurse will make sure that the patient realizes that he or she is contagious a. during all phases of the illness. b. any time up to 18 months after therapy begins. c. during the postictal phase of TB. d. during the initial period of the illness and its diagnosis.
d. during the initial period of the illness and its diagnosis.
An order for a child reads: "Give ibuprofen suspension 30 mg/kg/day, divided into four doses, for pain." The child weighs 33 pounds. How many milligrams will this child receive per dose?
112.5 mg
The nurse should question a prescription to administer acetylsalicylic acid (aspirin) to which client? A 62-year-old patient with a history of stroke A 45-year-old patient with a history of heart attack A 28-year-old patient with a history of sports injury A 14-year-old patient with a history of flulike symptoms
14-yr old w/ hx of flulike symptoms Aspirin should never be administered to children with flulike symptoms. The use of aspirin in children with flulike symptoms has been associated with Reye's syndrome.
When preparing to administer an intravenous (IV) infusion of metronidazole (Flagyl), the nurse will anticipate infusing the medication over how many minutes? 1 to 5 5 to 10 15 to 30 30 to 60
30-60 min Infuse IV doses of metronidazole as prescribed and generally are to infuse over 30 to 60 minutes and never as an IV bolus.
A client, who weighs 45.4 kg, is prescribed pyrantel (Pin-X) for a roundworm infection. The dosage is 11 mg/kg in one single dose to a maximum of 1 g. What is the appropriate dosage for this client?
499 mg
The order reads, "Give nystatin (Mycostatin) suspension, 500,000 units by mouth (swish and swallow) 4 times a day for 1 week." The medication is available in a suspension of 100,000 units per mL. How many milliliters will the nurse give per dose?
5 mL
A 5-year-old patient has been diagnosed with malaria after returning from an overseas trip. The patient is to receive one dose of mefloquine (Lariam), 25 mg/kg PO. The child weighs 44 lb. How much mefloquine will this child receive?
500 mg
The order for isoniazid (INH) reads: "Give 5 mg/kg PO daily." The patient weighs 275 pounds. What is the amount per dose? Is this a safe dose?
625mg/dose; no, max dose is 300 mg
The nurse is teaching a client who is preparing to travel to a malarious country about the prophylactic medication chloroquine (Aralen). The nurse would instruct the client to take this drug for how long after leaving the affected area? 2 weeks 4 weeks 8 weeks 12 weeks
8 wks Treatment for malaria prophylaxis is usually started 2 weeks before travel and continues for 8 weeks after travel is completed.
The acetic acid derivative indomethacin (Indocin) has which properties? (Select all that apply.) Antinausea Antipyretic Anticonvulsant Antirheumatic Antiinflammatory
antipyretic antirheumatic antiinflammatory NSAIDs are known for their antiinflammatory effects. Indomethacin, in addition, is also used for its antirheumatic and antipyretic properties. NSAIDs are often known to have nausea as a common adverse effect. Indomethacin is not used as an anticonvulsant.
The nurse is providing education to a client who is prescribed metronidazole (Flagyl) for trichomoniasis. What client statement indicates that the client understood the teaching? "I will have my partner evaluated and treated." "I won't get this again because I have had it once." "I will stop taking the medication when the discharge stops." "I can continue to have intercourse as long as we use condoms."
I will have my partner evaluated and treated Inform the client taking metronidazole for a sexually transmitted infection to avoid sexual intercourse until the prescriber states otherwise. The partner, and any sexual partners possibly exposed, need to be evaluated and treated if positive. All other statements would require further teaching by the nurse.
P.T., a 48-year-old businessman, has been taking rifapentine as part of therapy for TB. He has been told that his bodily secretions will turn a reddish orange-brown color, and he asks, "What about my contact lenses? I can still wear them, right?" What is the nurse's best answer?
Patients taking rifampin, rifabutin, or rifapentine may experience red-orange-brown discoloration of the skin, sweat, tears, urine, feces, sputum, saliva, cerebrospinal fluid, and tongue as an adverse effect of the drug. The discoloration reverses with discontinuation of the drug; however, contact lenses may be permanently stained.
Which nursing diagnosis is appropriate for a client prescribed colchicine (Colcrys)? Constipation related to adverse effect of the medication Risk for infection related to medication-induced leukocytosis Risk for injury related to adverse effect of life threatening seizures Risk for fluid volume deficient related to nausea, vomiting, and diarrhea
Risk for fluid vol deficit r/t n/v/d Colchicine is administered on an hourly basis until pain is relieved, the client develops severe nausea and diarrhea, or the maximum dose (6 mg) has been administered. Bleeding into the GI or urinary tracts is a potential serious adverse effect of colchicine.
A 28-year-old patient has been diagnosed with active TB and will be taking rifampin. She is reviewing her current list of medications with the office nurse and asks, "I use birth control because we really don't want children right now. Can I still use 'the pill'?" What is the nurse's priority when answering the patient's questions?
Safety is the priority. In this scenario, the patient must be counseled to use other forms of contraception during treatment with rifampin. There are concerns regarding the interaction between these two drugs because the effectiveness of oral contraceptives is impaired by rifampin, which could result in pregnancy. Keep in mind, too, that rifampin is pregnancy category C.
J.D. has been diagnosed with gout and will be taking colchicine. When reviewing the instructions for the medication, he asks, "I like to take my pills with breakfast." What is the nurse's priority when providing teaching to J.D.?
The priority is teaching the patient about the proper timing of the colchicine dose. Colchicine must be taken on an empty stomach for more complete absorption; therefore, it needs to be taken 1 hour before or 2 hours after meals.
The nurse is reviewing newly written orders for a patient who has a vaginal yeast infection. One order reads, "Fluconazole, 150 mg, one tablet by mouth now for vaginal yeast infection." When the nurse goes to administer the medication, the patient asks, "Is that a mistake? How can one pill help that problem?" What is the nurse's best answer to this question?
The nurse will explain that diflucan (fluconazole) is very effective against vaginal candidiasis, and one oral dose can cure many vaginal candidal infections.
When the nurse is administering medications, the patient takes the dosage cup of the oral nystatin suspension and says, "I know how to take this." He then swallows the liquid medication all at once. What is the nurse's priority action at this time?
The priority action is to review with the patient the proper technique for taking the oral nystatin suspension. Oral nystatin suspension for oral candidiasis should not be swallowed directly; the patient needs to be instructed to swish the medication solution thoroughly in his mouth for as long as possible before swallowing so as to allow the medication the time to have adequate direct contact with the affected oral tissues.
A patient with a history of AIDS has severe Pneumocystis jirovecii pneumonia. As you prepare the ordered dose of pentamidine inhalation, the patient asks you, "What are you doing? Why can't you give that to me in a pill?" What is the nurse's priority when answering the patient's questions?
The priority is helping the patient to understand the purpose of this medication. This patient has severe Pneumocystis jirovecii pneumonia, which is treated by pentamidine. Pentamidine does not come in an oral form but can be given intramuscularly, intravenously, or by inhalation. P. jirovecii pneumonia is commonly fatal if not treated adequately.
You are preparing to give pyrantel (Pin-X) to a patient who has an infection with intestinal roundworms. The patient is very worried about this infection and its treatment, and asks you, "What will this drug do to me? Does it have bad side effects? I'm already sick enough!" What is the nurse's priority when answering the patient's questions?
The priority is to provide information in a clear manner that the patient is able to understand. The nurse will tell the patient that the pyrantel is given to kill the worms that have infected him. However, he also needs to be warned that the adverse effects of this medication include anorexia, abdominal cramps, diarrhea, nausea, vomiting, headache, dizziness, and insomnia while the medication works to kill the worm infection and as his body works to expel the worms. Discuss with the patient the need to replace fluids if he experiences vomiting and diarrhea, and that he will be monitored for dehydration if he is losing fluids.
The client asks the nurse about the use of herbal and dietary supplements to treat arthritis pain. What is the nurse's best response? "High doses of vitamins and minerals have been used for many years to help maintain joint health." "There really are no safe herbal treatments for pain. Your best action would be to take your prescription medications." "Ginkgo biloba has shown tremendous benefit as an antiinflammatory drug and is used to treat the symptoms of pain." "There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your health care provider."
There is evidence that glucosamine sulfate with chondroitin does decrease joint stiffness and pain. Discuss this with your HCP There is evidence that clients would benefit from glucosamine and chondroitin supplements to decrease the pain of osteoarthritis. However, they should always be used in consultation with a health care provider.
metronidazole - Flagyl
amebicide, antibacterial, trichomonacide tx - effective against several forms of bacteria (including anaerobic), protozoal, & helminthic infections contra: 1 trimester avoid alcohol 24 hrs before therapy & @ least 48 hrs after last dose assess: any allergy to nitroimidazole derivatives as well as parabens (topical) - blood counts, presencde of CNS disorders or abnormalities, & bladder function prior to use if taking for STD, avoid sexual intercourse until dr states otherwise rpt to HCP: any changes in neurolgic status - dizziness, confusion IV doses - infuse over 30-60 min - never as bolus give PO w/food tx of amebiasis, including amebic liver disease - PO: 750 mg 3x/day for 7-10 days tx of tichomoniasis, giardiasis - PO 250-500 mg 3x/day for 5-7 days adverse: headache, dizziness, confusion, fatigue, peripheral neuropathy, weakness, blurred vision, sore throat, dry mouth, metallic taste. glossitis, anorexia, v/d, constipation, dysuria, cystitis, neutropenia, rash, pruritis, urticaria interaction: decreased absorption of vit K from the intestines due to elimination of the bacteria needed to absorb vit K, increased plasma acetaldehyde concentration after ingestion of alcohol
The nurse needs to know that major adverse effects are MOST common by which drug? Fluconazole (Diflucan) Ketoconazole (Nizoral) Griseofulvin (Fulvicin P/G) Amphotericin B (Amphocin)
amphotericin B (Amphocin) he major adverse effects caused by antifungal drugs are encountered most commonly in conjunction with amphotericin B treatment. Drug interactions and hepatotoxicity are the primary concerns in clients receiving other antifungal drugs, but the IV administration of amphotericin B is associated with a multitude of adverse effects.
atovaquone - Mepron
anti-pneumocystis drug tx of acute mild to moderately severe P. jirovecii infections in pts who cannot tolerate co-trimoxazole assess: baseline blood counts due to risk for drug-induced anemia/neutropenia & leukopenia - serum K, NA, glucose levels given w/proguanil (Malerone) as antimalarial - interferes with nucleic acid synthesis Interaction: highly protein-bound drugs (warfarin, phenytoin) may increase atovaquone's concentrations & risk for adverse reactions Prophylaxis - PO: 1500 mg daily w/ food Tx - PO: 750 mg bid for 21 days adverse: anemia, neutropenia, leukopenia, pruritus, urticaria, rash, anorexia, elevated liver enzymes, N, constipation, dizziness, headache, anxiety, fever, hyperkalemia, hypoglycemia, hyponatremia, cough
allopurinol
antigout tx: gout caused by the excess production of uric acid - also used to prevent acute tumor lysis syndrome interactions: azathioprine, mercaptopurine increase fluid intak to 3L/day unless contraindicated avoid caffeine and alcohol adverse: agranylocytosis, aplastic anemia contra: serious & potentially fatal skin conditions such as exfoliative dermatitis, Stevens-Johnson syndrome, & toxic epidermal necrolysis give w/ meals to minimize n/v & anorexia therapeutic effect may not be seen for 3-4 weeks
colchicine - Colcrys & Mitigarc
antigout - 2nd line therapy after NSAIDs short-term or prophylaxis of acute attacks contra: severe renal, GI, hepatic, or cardiac disorders, & blood dyscrasias assess: hx of GI distress, ulcers, or cardiac, renal or liver disease take on empty stomach for more complete absorption, but it is best tolerated w/food increase fluid up to 3L/day if not contraindicated avoid alcohol adverse: short-term leukopenia, bleeding into the GI and urinary tracts (stop immediately) no specific antidote for poisoning - start low and increase if needed max dose is 6mg, some drs keeps it to 3mg in a day - 3 days must pass before the second course of therapy is initiated Monitor for any increase in pain, blood in urine, excessive fatigue/lethargy, or chills or fever
hydroxychloroquine - Plaquenil
antimalaria tx of malaria, RA,SLE contra: optic neuritis, psoriasis adverse: n/v/d, anorexia, dizziness, headache, seizures, personality changes, alopecia, rash, pruritis baseline visual acuity tests, skin assessment b/c of contra for psoriasis prophylaxix - 400 mg/wk - 1-2 wks before & continuing through 4 wks after travel tx - 800 mg on day 1, followed by 310 mg 6 hr later & once daily on days 2 & 3 take with 8 oz water on same day each week rpt recurrence of symptoms immediately only give to pregnant pts in truly emergent situations
pyrimethamine - Daraprim
antimalaria/folic acid antagonist/ antitoxoplasmotic often used w/ a sulfonamide b/c of synergistic effects contra: pts w/ megaloblastic anemia caused by folate deficiency assess baseline hearing & G6PD deficiency due to drug-induced hemolytic anemia adverse; anorexia; vomiting; taste disturbances; redness, swelling, or burning of the tongue; diarrhea, throat pain, swallowing difficulties, mouth sores & ulcerations, malaise, weakness, rash, abnormal skin pigmentation, hemolytic anemia prophylaxis - 25 mg weekly; continue 10 days after travel tx - 50 mg/day for 2 days
chloroquine - Aralen
antimalarial - 4-aminoquinolone derivative tx/prophylaxis of malaria contra: optic neuritis, psoriasis adverse: n/v/d, anorexia, dizziness, headache, seizures, personality changes, alopecia, rash, pruritis only give to pregnant pts in truly emergent situations potential for dig tox if given with dig prophylaxis - 300 mg base weekly 2 wks before travel and continuing 300 mg weekly for 8 weeks after travel treatment - 600 mg base dose on day 1, followed by 300 mg 6 hr later & on days 2 & 3 pt must adhere to tx regimen for it to be effective & take with 8oz of water seek immediate care if recurrence of symptoms occur rpt to HCP: ringin in ears, hearing decrease, visual difficulties, n/v, profuse diarrhea, or abd pain
mefloquine - Lariam
antimalarial - prophylaxis and tx no longer available in US - FDA warning b/c of serious neurological & psychiatric side effects prophylaxis - 250 mg 1-2 wks before and continuing 4 wks after travel tx - 1250 mg (5 tabs) in a single dose
A female patient has been diagnosed with giardiasis. The nurse anticipates treatment of the patient with which of the following types of medications? Antibiotics Antimalarial Antiprotozoal Anthelmintic
antiprotozoal
pentamidine - NebuPent, Pentam 300
antiprotozoal tx of pneumocytosis pneumonia in immunocompromised pts always fatal if left untreated contra: serious renal, liver, & other illnessdes - seriousness of infection weighed against pt's overall condition use w/ caution - blood dyscrasis, hepatic or renal disease, DM, cardiac disease, hypcalcemia, or HTN interaction: use w/ aminoglycoside, amphotericin B, coliston, cisplatin, or vanco may result in nephrotoxicity hypersensitivity is more common w/ inhalation - allergic reaction to inhalation does not preclude its administration by IV/IM assoc w/ serious cardiac, hematologic, skin, renal, GI, & resp adverse effects
A male patient with an HIV infection has a severe case of P. jirovecii pneumonia (PJP) and needs to be treated with pentamidine. However, he is allergic to the inhaled form of this medication. Considering the seriousness of his condition, what does the nurse expect will be done in this situation? a. He will be given the inhaled form of pentamidine and be monitored closely. b. He will be given the pentamidine in an intravenous or intramuscular injection and be monitored closely. c. Another drug, such as metronidazole (Flagyl), will be ordered. d. He will receive supportive care because he is unable to take pentamidine.
b. He will be given the pentamidine in an IV or IM injection and be monitored closely
The nurse is assessing a patient who is about to receive antifungal drug therapy. Which problem would be of most concern? a. Endocrine disease b. Hepatic disease c. Cardiac disease d. Pulmonary disease
b. Hepatic disease
The pt's wife is taking rifampin to prevent her from developing a TB infection. Which statement by the wife indicates that further teaching is needed? a. because my OCs will not work while I am taking rifampin, I will use another form of BC. b. I will take the medication for 1 wk, then stop c. I will avoid prolonged exposure to the sun d. my urine may turn a reddish color when taking rifampin
b. I will take the medication for 1 wk, then stop therapy is 6mos-24mos
A home care nurse is visiting a pt dx w/ TB. The pt traveled abroad 2 mos ago. He lives w/ his wife & 5yr old son. The pt tell the nurse that he is concerned his son will also get TB, so he wants to share his pills with his son. What is the best response by the nurse? a. that is a good idea. Children should not be exposed to TB b. you should give your son 1/2 the dose you take c. do not share any of your medications with anyone. Contact your son's HCP to discuss your concerns. d. children have an immune system that make them immune to TB
c. DO NOT share any of your medications with anyone. Contact your son's HCP to discuss your concerns
When pyrimethamine is used to treat malaria, a sulfonamide antibiotic is often also used. The purpose of the antibiotic is to: a. treat the bacterial infections that often accompany malaria. b. allow the antimalarial drug to be effective in the exoerythrocytic phase. c. cause synergism, allowing for a stronger antimalarial effect. d. allow for reduced adverse effects because smaller doses of each drug are used.
c. cause synergism, allowing for a stronger antimalarial effect
While monitoring a patient who is receiving intravenous amphotericin B, the nurse expects to see which adverse effect(s)? a. Hypertension b. Bradycardia c. Fever and chills d. Diarrhea and stomach cramps
c. fever and chills
During an infusion of amphotericin B, the nurse knows that which administration technique may be used to minimize infusion-related adverse effects? a. Forcing of fluids during the infusion b. Infusing the medication quickly c. Infusing the medication over a longer period of time d. Stopping the infusion for 2 hours after half of the bag has infused, and then resuming 1 hour later
c. infusing the medication over a longer period of time
The nurse is teaching a patient who is starting antitubercular therapy w/ rifampin. Which adverse efects would the nurse expect to see? a. headace b. gynecomastia c. reddish brown urine d. numbness or tingling of extremities
c. reddish brown urine Red-orange-brown discoloration of the skin, sweat, tears, urine, feces, sputum, saliva, and tongue as an adverse effect of the drug, but it is not harmful. Rifampin does not cause peripheral neuropathies (isoniazid does), but it does interfere with the effectiveness of oral contraceptives. All antitubercular drugs need to be taken long term to eradicate the slow-growing mycobacterium lying deep within the tissues.
A mother calls the clinic to ask what medication to give her 5-year-old child for a fever during a bout of chickenpox. The nurse's best response would be: a. "Your child is 5 years old, so it would be okay to use children's aspirin to treat his fever." b. "Start with acetaminophen or ibuprofen, but if these do not work, then you can try aspirin." c. "You can use children's dosages of acetaminophen or ibuprofen, but aspirin is not recommended." d. "It is best to wait to let the fever break on its own without medication."
c. you can use children's dosages of acetaminophen or ibuprofen, but aspirin is not recommended
A patient is receiving amphotericin B lipid complex. The nurse knows that an advantage of the lipid formulations of this drug is that they: have a lower cost. can be administered quickly. take longer to be absorbed. cause fewer adverse effects.
can have fewer adverse effects
A nurse is caring for a client diagnosed with malaria. What drug would the nurse expect to be prescribed? Chloroquine (Aralen) Penicillin Metronidazole (Flagyl) Pentamidine (Pentam)
chloroquine (Aralen) Chloroquine is a standard drug used for the treatment of malaria in an acute stage.
What are important for the nurse to monitor in a client receiving an antifungal medication? (Select all that apply.) Creatinine Daily weights Mental status Intake and output Blood urea nitrogen
creatinine daily weights I & O BUN Nursing interventions appropriate to clients receiving antifungal drugs vary depending on the particular drug. However, it is important for the nurse to monitor all clients for indications of possible medication-induced renal damage so that prompt interventions can occur to prevent further dysfunction. Monitoring intake and output amounts, daily weights, and renal function tests will help prevent such damage.
During a teaching session about antigout drugs, the nurse tells the patient that antigout drugs work by which mechanism? a. Increasing blood oxygen levels b. Decreasing leukocytes and platelets c. Increasing protein and rheumatoid factors d. Decreasing serum uric acid levels
d. decreasing serum uric acid levels
The nurse notes in a patient's medication history that the patient is taking terbinafine (Lamisil). Based on this finding, the nurse interprets that the patient has which disorder? a. Vaginal candidiasis b. Cryptococcal meningitis c. Invasive aspergillosis d. Onychomycosis
d. Onychomycosis
The nurse is reviewing the medication history of a patient who is taking hydroxychloroquine. However, the patient's chart does not reveal a history of malaria or travel out of the country. The patient is most likely taking this medication for a. Plasmodium. b. thyroid disorders. c. roundworms. d. rheumatoid arthritis.
d. RA
While monitoring a patient, the nurse knows that a therapeutic response to antitubercular drugs would be: a. The patient states that he or she is feeling much better. b. The patient's laboratory test results show a lower white blood cell count. c. The patient reports a decrease in cough and night sweats. d. There is a decrease in symptoms, along with improved chest x-ray and sputum culture results.
d. There is a decrease in symptoms, along with improved chest x-ray and sputum culture results.
When the nurse is teaching about antigout drugs, which statement by the nurse is accurate? a. "Drink only limited amounts of fluids with the drug." b. "This drug may cause limited movements of your joints." c. "There are very few drug interactions with these medications." d. "Colchicine is best taken on an empty stomach."
d. colchicine is best taken on an empty stomach
When administering antifungal drug therapy, the nurse knows that an issue that contributes to many of the drug interactions with antifungals is the patient's a. history of cardiac disease. b. history of gallbladder surgery. c. ethnic background. d. cytochrome P-450 enzyme system.
d. cytochrome P-450 enzyme system.
amphotericin B - Amphocin, Fungizone
polyene - antifungal tx of severe systemic mycosis contra: pts w/ severe bone marrow suppression or renal impairment adverse: dysrhythmias; neurotoxicity; tinnitus; visual disturbances; hand/feet numbness, tingling, or pain; convulsions, renal toxicity; potassium loss, hypomagnesemia; pulmonary infiltrates; fever, chills, headache, malaise, nausea, hypotension, GI upset, anemia premedicate w/ antimetics, antihistamines, antipyretics, and/or antiinflammatory drugs to offset adverse reactions Interaction: digitalis glycosides = amphotericin B-induced hypokalemia/may increase potential for dig tox IV pump only in most distal vein - only clear monitor closely for adverse reactions, systemic and local give over 2-6 hours to limit reactions lipid formulas have decreased adverse effects, but are much more expensive rpt to HCP: bleeding bruising and/or soft-tissue swelling listen to lungs before/during/after
Nystatin - mycostatin
polyene - antifungal tx of vaginal or oral thrush (candidiasis) adverse: N/V/D, cramps, rash, urticaria, local irritation lozenges/troches - not used in childres less than 5 yrs - slowly & completely dissolve in the mouth - do not chew or swallow whole - if vaginal troche: use appropriate applicator w/ gloved hand & insert high into vagina, then wash hands thoroughly suspension - swish thoroughly for as long as possible before swallowing Avoid commercial mouth washes during therapy
The nurse is administering probenecid (Benemid) to a client with recurrent strep throat. The nurse teaches the client that the MOST likely reason for taking this medication is for what drug effect? Increase uric acid excretion Prevent the occurrence of gout Inhibit bacterial growth and replication Prolong the effectiveness of penicillin therapy
prolong the effectiveness of penicillin therapy Besides its use for the treatment of the hyperuricemia associated with gout and gouty arthritis, probenecid also has the ability to delay the renal excretion of penicillin, thus increasing serum levels of penicillin and prolonging its effect.
The nurse would question a prescription for voriconazole (Vfend) if the client was taking which medication? Quinidine Prednisone (Deltasone) Captopril (Capoten) Clindamycin (Cleocin)
quinidine The nurse would question a prescription for quinidine because both voriconazole and quinidine are metabolized by the cytochrome P-450 enzyme system. The drugs will compete for the limited number of enzymes, and one of the drugs will end up accumulating.
An 82-year-old woman is taking ibuprofen (Motrin) 3200 mg divided three times daily as treatment for arthritis. She has had no other health problems. What is the most important assessment for the nurse to monitor while the patient is on this therapy? Blood sugar Liver function studies Assessment of hearing Renal function studies
renal function studies
aspirin - ASA
salicylate tx/prophylaxis for acute MI and other thromboembolic disorders, headach immediatley rpt black/tarry stools, bleeding around gums, petechiae, ecchymosis, or purpura contra: children w/flulike symptoms - strongly associated with Reye's syndrome - PUD, vit K deficiency do not crush enteric coated tablets give w/food, milk, or meals monitor for toxicity salicylism = increased HR, drowsiness, hyperventilation - tinnitus, hearing loss, dimness of vision, headache, dizziness, mental confusion, n/v/d, sweating, thirst, hypo- or hyperglycemia do not give in 3rd trimester = increase risk for excessive maternal bleeding & neonatal toxicity increase incidences of allergic reactions in pts w/ hx of asthma, wheezing, & other resp problems adverse: dyspepsia, heartburn, GI bleeding severe toxicity = acute renal failure
ethambutol - Myambutol
suppresses RNA synthesis, affects lipid synthesis - 1st line tb drug combined with INH to tx pregnant women and pts who take anticoags Contra: optic neuritis, chronic alcohol use, children younger than 13 yrs Adverse: retrobulbar neuritis, blindness monitor uric acid levels, rpt any symptoms of gout
A client visits the health care provider for treatment of tinea pedis (athlete's foot). Which medication would the nurse MOST likely instruct the client to take to treat this condition? Terbinafine (Lamisil) Voriconazole (Vfend) Caspofungin (Cancidas) Amphotericin B (Amphocin)
terbinfine (Lamisil) Terbinafine (Lamisil) is classified as an allylamine antifungal drug and is currently the only drug in its class. It is available in a topical cream, gel, and spray for treating superficial dermatologic infections, including tinea pedis (athlete's foot), tinea cruris (jock itch), and tinea corporis (ringworm).
A patient with a diagnosis of TB will be taking INH as part of the anti-TB therapy. When reviewing the patient's chart, the nurse finds documentation that the patient is a "slow acetylator." This means that: a. the dosage of INH may need to be lower to prevent INH accumulation. b. the dosage of INH may need to be higher because of the slow acetylation process. c. he should not take INH. d. he will need to take a combination of anti-TB drugs for successful therapy.
the dosage of INH may need to be lower to prevent ING accumulation
praziquantel - Biltricide
trematode anthelmitic tx of Fluke infections contra: pts w/ ocular cysticercosis (tapeworm in eye) Interaction: w/ dexamethasone may increase blood levels of albendazole - H2RBs may increase blood levels of praziquantel PO only adverse: dizziness, headache, drownsiness, abd pain, N, malaise dose: approx 20-35 mg/kg 3x/day for 1 day