Pharm new info for final- EAQ

A mother of a 1-month-old infant calls the clinic and asks the nurse if the medication she is taking can be passed to her infant during breast-feeding. What is the appropriate response for this patient?

"Drugs can cross from mother to infant in breast milk, so it will depend on the drug you are taking."

Which statements should the nurse include when educating a breast-feeding patient about her medications? Select all that apply.

-"Drugs taken by lactating women can be excreted in breast milk." -"Most drugs can be detected in milk, but concentrations are usually too low to cause harm." -"If drug concentrations in milk are high enough, a pharmacologic effect can occur in the infant."

Which statements by a student nurse about the effect of pregnancy on medication action indicate effective learning? Select all that apply.

-"There is a more rapid renal excretion of medications during pregnancy." -"The serum and tissue concentrations of the medications decrease during pregnancy." (The serum and tissue concentrations of medications decrease during pregnancy because of an alteration in the clearance of the medications. There is also a more rapid excretion of medications during pregnancy due to an increased glomerular filtration rate and an increase in renal perfusion. The expanded maternal circulating blood volume during pregnancy results in the dilution of medications. There is reduced gastrointestinal motility due to the hormonal changes during pregnancy. For some drugs, hepatic metabolism increases during pregnancy.)

Which instructions should the nurse give a patient who is prescribed a topical glucocorticoid for a dermatologic disorder? Select all that apply.

-"Topical glucocorticoids pose a risk of local infection." -"Apply in a thin film and gently rub into the affected area." -"You may note some local irritation when using this product." -"Avoid using any tight-fitting bandages or dressings after applying."

The nurse assesses a patient who has been prescribed beta-adrenergic blockers for the treatment of ocular hypertension. Which adverse effects should the nurse monitor in the patient? Select all that apply.

-Bradycardia -Hypotension

Which factors affect the placental transfer of medications between the mother and the fetus? Select all that apply.

-Degree of protein binding -Metabolic activity of the placenta -Molecular weight of the substance -Degree of ionization of the medication molecule

A pregnant woman has taken a drug that is a known teratogen. What steps should the nurse take to identify risks for malformation? Select all that apply.

-Determine exactly when the drug was taken. -Determine exactly when the pregnancy began.

Which interventions should the nurse implement for a patient who is receiving oxytocin [Pitocin] therapy to induce labor? Select all that apply.

-Monitor uterine contractions. -Monitor fetal heart rate (FHR). -Assess maternal blood pressure.

Which fetal side effects may be observed if a patient is taking terbutaline [Brethine] for preterm labor? Select all that apply.

-Tachycardia -Hypoglycemia -Hyperbilirubinemia (Terbutaline [Brethine] can cause tachycardia and hypoglycemia because of fetal hyperinsulinemia. Hyperbilirubinemia also occurs. Diarrhea can occur in the fetus with indomethacin [Indocin]. Hypokalemia is a maternal side effect, while hypocalcemia is a fetal effect.)

For a drug to be a proven teratogen, which criteria must be met? Select all that apply.

-The drug must cause a characteristic set of malformations. -The drug must act only during a specific window of vulnerability. -The incidence of malformations should increase with increasing dosage and duration of drug exposure.

The nurse assesses the urine output of a patient receiving oxytocin [Pitocin]. Which finding would require immediate follow-up by the nurse?

80 mL in the past 4 hours

The nurse is caring for a child who is experiencing severe discomfort and high fever. The provider diagnoses acute otitis media. Which first-line drug will be included as a part of the treatment plan?

Amoxicillin [Moxatag]

In which condition is the intraocular pressure increased due to accumulation of aqueous humor?

Angle-closure glaucoma

The nurse prepares to administer timolol [Timoptic] eye drops to a patient who has asthma. Which action should the nurse take when applying the eye drops?

Apply pressure to the inner aspects of the eye during and after administration.

The nurse prepares to administer a newly prescribed medication to a 22-year-old woman. The insert in the medication package states, "Pregnancy Category X." Select the nurse's best action.

Ask the patient, "When was your last menstrual period?"

The safety or potential harm of drug therapy during pregnancy relates to which factor?

Drug properties

According to the FDA Pregnancy Risk categories, which category represents the greatest risk for fetal harm?

D (Drugs in Category D are the most dangerous; these drugs are known to cause human fetal harm. Drugs in Categories B and C are progressively more dangerous than drugs in Category A and less dangerous than drugs in Category D.)

The nurse develops a plan of care for a pregnant patient receiving nifedipine [Procardia]. Which outcome should be included?

Delivery is postponed for at least 24 hours.

The nurse prepares a patient for an intraocular examination by administering a topical anticholinergic agent intended to achieve which outcome?

Dilation of the pupil

In which gestational period is drug therapy associated with a greater incidence of drug-induced developmental defects in the newborn?

First trimester

When teaching a pregnant patient about the effects of medication on the fetus, the nurse should recognize that the greatest harm from maternally ingested medications occurs during which time period?

First trimester

The nurse is planning care for a patient in preterm labor who is receiving magnesium sulfate. Which nursing action is most important for this patient?

Obtaining deep tendon reflexes

Which statement regarding adverse reactions during pregnancy is false?

One in five children is born with a malformation related to drug use during pregnancy. (Fewer than 1% of all birth defects are caused by drugs.)

A patient has uterine atony. Which medication will most likely be added to the patient's prescriptions first?

Oxytocin [Pitocin]

The dosage of a certain drug is reduced when administered to a pregnant woman with liver impairment. Which other clinical situation requires reduction in the dosage of most drugs administered during pregnancy?

Renal impairment

A patient who is near term gestation is receiving oxytocin [Pitocin]. Which response should the nurse expect if the medication is having the desired therapeutic effect?

Stimulation of uterine smooth muscle

A pregnant woman admits taking a friend's left-over antibiotics for a sore throat. The nurse will need to verify that the antibiotic is void of what kind of effects?

Teratogenic effects

During which gestational period is drug transfer to the fetus more likely to happen?

Third trimester

Which type of medication will the nurse expect to administer to a patient in preterm labor?

Tocolytics

Which finding in a patient receiving an oxytocin [Pitocin] infusion should be reported to the physician immediately?

Uterine contractions lasting longer than 1 minute