Pharm adaptive quizzing
Client Teaching for Simvastatin
Avoid prolonged exposure to the sun, schedule regular opthalmic examinations, contact provider if skin becomes gray-bronze
What should the nurse include in a teaching plan for a client taking calcium channel blockers such as Nifedipine (Procardia)? Select all that apply.
Changing positions slowly helps reduce orthostatic hypotension. Peripheral edema may occur as a result of heart failure and must be reported. Grapefruit juice affects the metabolism of calcium channel blockers and should be avoided. Reducing calcium intake is unnecessary because calcium levels are not affected. Hair loss does not occur.
Most common side effect of Vincristine that it does not have in common with other chemo agents?
Constipation
Oxytocin (Pitocin) augmentation by way of intravenous piggyback is prescribed for a client in labor after a period of ineffective uterine contractions. What nursing interventions are most important if strong contractions that last 90 seconds or longer occur? Select all that apply.
Discontinuing the oxytocin (Pitocin) infusion lessens uterine stimulation and eases intrauterine pressure; continuing the oxytocin may lead to fetal hypoxia, placental separation, or uterine rupture. Turning the client on her side increases oxygen perfusion to the fetus. The health care provider should be notified to obtain additional prescriptions. Contractions lasting longer than 90 seconds warrant stopping the oxytocin infusion to prevent uterine rupture. Oxygen administration by way of facemask, not nasal cannula, will increase oxygen supply to the placenta and fetus.
The nurse provides teaching to a client diagnosed with pulmonary tuberculosis that will begin taking pyrazinamide (PZA). The nurse concludes that the teaching is effective when the client says, "I will:
Drink at least 2Q a day; The response "Drink at least 2 quarts of fluid a day" causes hyperuricemia, leading to joint swelling and pain; fluids dilute the urine and help remove the uric acid. Changes in vision are not a side effect of this medication. This medication causes gastrointestinal irritation and should be taken with food. Discoloration of urine, sweat, and tears is a side effect of rifampin (RIF), not PZA.
What should the nurse explain to a newly pregnant client with cardiac disease
During the second and third trimesters blood volume and cardiac output increase, placing a greater workload on the heart. Women with preexisting heart disease may require larger doses of cardiac medication to prevent cardiac decompensation.
A 6-month-old infant is to receive scheduled immunizations. The parents ask why two influenza vaccines are given: Haemophilus influenzae type B (Hib) and pneumococcal conjugate vaccine (PCV). How should the nurse respond?
Hib and PCV prevent different bacterial diseases.
To minimize the side effects of the vincristine (Oncovin) that a client is receiving, what does the nurse expect the dietary plan to include?
High in Fluids to reduce constipation
A client who is receiving hydrochlorothiazide (Hydrodiuril) asks what this drug actually does. What information about the drug's therapeutic action should the nurse consider when formulating a response?
Hydrochlorothiazide inhibits sodium reabsorption in the nephrons, causing increased excretion of sodium and chloride
A health care provider prescribes a vitamin tablet that contains vitamin B complex. What should the nurse teach the client?
It may turn the urine bright yellow
Clinical manifestations to stop haldol immediately
Jaundice, Tachycardia
A nurse is caring for a client in labor whose cervix is dilated 6 cm. The client is receiving epidural analgesia. What common response to regional anesthesia does the nurse anticipate?
Lightheadedness may indicate hypotension resulting from the vasodilation commonly associated with epidural analgesia.
While receiving betamimetic (tocolytic) therapy for preterm labor the client begins to experience muscle tremors and exhibit signs of nervousness. She reports, "My heart is racing." The nurse identifies that the client's pulse rate is 110 beats/min and regular. What should the nurse do next?
Reassure the client that these are expected side effects of the medication.
A client is admitted to the hospital for an adrenalectomy. When the nurse teaches the client about the prescribed medications, the nurse emphasizes that:
Salt intake may have to be restricted while taking the medications; Administration of adrenocortical hormones causes sodium retention
Bupropion (Wellbutrin) has a unique side effect not shared by most other drugs of its class. The nurse should assess the client for which unique possible side effect of this drug?
Seizures; inhibits the reuptake of dopamine, serotonin, and norepinephrine and may cause seizures that can be life threatening; also, it may cause headaches, agitation, sedation, tremors, and confusion.
A nurse on a mental health unit administers a variety of antipsychotic medications. The nurse concludes that olanzapine (Zyprexa, Zydis) has a distinct advantage over other antipsychotics because:
Tablets disintegrate immediately in the mouth, preventing tablet "cheeking."
A client is receiving an epidural anesthetic during labor. For which side effect should the nurse monitor the client?
Urine retention
Most common physical manifestation of MS?
Vision loss; Steroid therapy will decrease episodes of vision loss by decreasing the inflammatory process around the optic nerve
A client on prolonged cortisone therapy for adrenal insufficiency is being discharged. Which side effects should the nurse teach the client and family to expect? Select all that apply.
Weakness, moon face, weight gain
he most effective method for the nurse to evaluate a client's response to ongoing serum albumin therapy for biliary cirrhosis is to monitor the client's:
Weight daily
Contraindications to eardrops
allergy to the medication, drainage from the ear canal, and tympanic membrane rupture
Pseudoparkinsonism
develops within several days to 1 month after the start of therapy with a conventional antipsychotic
Tardive Dyskinesia
involuntary repetitious tonic muscular spasms that involve the face, tongue, lips, limbs, and trunk. Tardive dyskinesia takes several months to years to develop after the start of therapy with a conventional antipsychotic.
Side Effects of incompatible blood transfusion
Chills, Fever, Backache, muscle cramps, hemoglobinemia, hemoglobinuria, & Oliguria
Naltrexone (Depade) is used to treat clients with substance abuse problems. In which situation does the nurse anticipate that naltrexone will be administered?
Decrease recovering alcoholics desire to drink alcohol
A nurse is teaching the parents of a child with attention deficit-hyperactivity disorder (ADHD) about the prescribed medication methylphenidate (Ritalin). When should the daily dose be administered?
Methylphenidate (Ritalin) is an appetite suppressant; it should be given after meals. Methylphenidate given before a meal or as soon as the child awakens may suppress the child's appetite.
What is given post MI to prevent shock and decrease pain?
Morphine
Labor inducing medications
Oxytocin (Pitocin),Misoprostol (Cytotec),Dinoprostone (Prepidil)
Torticollis
Acute Dystonia that involves muscle spasms of the head and neck; begins 1-5 days after beginning traditional therapy of antipsycotics
What is given IV to prevent fibrillation of the heart?
Lidocaine
How long after the last dose should a nurse schedule a blood draw to determine serum lithium levels?
Absorption and excretion of lithium occur 8 to 12 hours after the last dose.
What stage of labor should butorphanol (Stadol) be given?
Active phase
A nurse is administering intravenous aminophylline to a client with asthma. Which clinical findings support the conclusion that the client is experiencing an adverse reaction to aminophylline? Select all that apply.
Aminophylline acts as a vasodilator, and hypotension results when vessels are dilated. This is an adverse reaction. Cardiac dysrhythmias are an adverse effect of aminophylline as a result of central nervous system stimulation. Muscle hyperactivity is an adverse effect of aminophylline as a result of central nervous system stimulation. Tachycardia, not bradycardia, is a common side effect of aminophylline. Tachypnea, not hypoventilation, is a common side effect of aminophylline.
A nurse is teaching a client who is taking a loop diuretic (e.g., furosemide [Lasix]) about foods that are high in potassium. Which foods should the nurse emphasize? Select all that apply.
A banana, a serving of beef, and a baked potato contain over 400 mg of potassium. A serving of chicken and a serving of pasta and cheese contains less than 400 mg of potassium.
A client with systemic lupus erythematosus (SLE) is at 39 weeks' gestation. What does the nurse anticipate regarding this client?
A need to discontinue the client's salicylate therapy
A client has been admitted with severe edema and hypertension. Intravenous furosemide (Lasix) has been prescribed. Which subjective clinical manifestations lead the nurse to suspect that the furosemide is infusing too rapidly? Select all that apply.
Tinnitus is a central nervous system side effect of furosemide. Weakness and leg cramps result from hypokalemia caused by an overload of furosemide. Nausea and anorexia, not hunger, are side effects of dehydration that may occur with an overload of furosemide. Dry mouth, not salivation, results from dehydration caused by an overload of furosemide.
A client with human immunodeficiency virus (HIV)-associated Pneumocystis jiroveci pneumonia is to receive pentamidine (Pentam) intravenously (IV) once daily. What should the nurse do to ensure client safety? Select all that apply.
Tell the client to report any evidence of bleeding immediately; Assess blood glucose levels daily and several times after therapy is completed Any signs of bleeding (e.g., bleeding gums or blood in the urine, stool, or emesis), unusual bruising, or petechiae should be reported to the health care provider. Pentamidine may cause hypoglycemia or hyperglycemia even after therapy has been discontinued; therefore, blood glucose levels should be monitored. Pentamidine may increase, not decrease, serum potassium levels. Administering the drug over a period of 30 minutes is too quick; the drug should be given over at least 60 minutes. Clients should be monitored closely for sudden, severe hypotension; they should lie flat when receiving the drug.
A 19-year-old adolescent is admitted to the emergency department with multiple fractures and potential internal injuries. The client's history reveals multiple drug abuse for the past 8 months. When caring for this client, the nurse determines that the most serious life-threatening responses usually result from withdrawal from:
Barbiturates; Withdrawal from central nervous system depressants, such as barbiturates, is associated with more severe morbidity and mortality. Symptoms begin with anxiety, shakiness, and insomnia; within 24 hours convulsions, delirium, tachycardia, and death may occur. Withdrawal from heroin or methadone is rarely life threatening, but it does cause severe discomfort, including abdominal cramping and diarrhea. Withdrawal from amphetamines is rarely life threatening, but it causes severe exhaustion and depression.
Neuroleptic malignant syndrome
a severe, potentially fatal (10%) response to conventional antipsychotics. It is believed to be caused by an acute reduction in brain dopamine activity, precipitating hyperthermia, Diaphoresis and hyperpyrexia , tachypnea, unstable blood pressure, hypertonicity, dyskinesia, incontinence, decreased level of consciousness, and pulmonary congestion. Neuroleptic malignant syndrome can occur during the first week of therapy but often occurs later during therapy.
