Pharmacology final

A client receiving morphine is being monitored by the nurse for adverse effects of the medication. Which clinical finding warrants immediate action by the nurse?

-CNS depressant effect of morphine can cause bradycardia and bradypnea -morphine causes constriction of pupils -sever side effect can be unconsouness

What should you avoid when taking MAOIs?

-MAOIs can cause hypertensive crisis if foods or beverages high in tyramine are consumed including: -fermented foods, aged cheese, yogurt, cured meats, draft beer, sauerkraut

What are PPIs used for?

-PPIs are effective at decreasing secretions of gastric acid, helping alleviate symptoms of GERD

A client with hypertension is prescribed an angiotensin II receptor blocker (ARB). Which instruction will the nurse provide about this medication?

-risk for hypotension is increased with ARBs -pt. should be educated on signs and symptoms of low BP. -pt. must monitor BP often -stop medication and notify provider if angioedema occurs -electrolyte levels should be monitored 2 weeks and periodically after -ARBs may increase the effect of other medications -dry cough may occur but it is not necessary to stop meds. -report light headedness or dizziness on standing to provider

Which newborn characteristic associated with renal excretion will the nurse consider to ensure safe medication administration?

-medications are excreted slower because of slower renal blood flow -glomerular filtration rate is slower -glomerular and tubular development is incomplete

What are thrombocytopenic effects that develop bone marrow suppression from chemotherapy?

-melena -purpura -hematuria

What is the highest priority for a pt. taking nitroglycerine for treatment of angina?

-nitroglycerine is a potent antihypertensive and antianginal medication -pt. should be instructed to sit and stand slowly to avoid orthostatic hypotension -after insuring safety urine output should be monitored

A child undergoing prolonged steroid therapy takes on a cushingoid appearance. The nurse would expect to find which manifestation during further assessment?

-obesity -truncal obesity due to increase appetite -thin extremities due to muscle wasting -slow linear growth due to calcium excretion -virilization and hirsutism due to excess androgens -hypertension and hypernatremia due to increase waster and salt -easy bruising due to fragile skin

what would the nurse monitor for on a pt. taking a neuromuscular blocking agent before electro convulsive therapy?

-respiration depression -succinylcholine, a neuromuscular blocking agent produced respiratory depression because it inhibits contractions of respiratory muscles

Which information would be included in the teaching plan for the older adult client with peptic ulcer disease who is taking an antacid and sucralfate?

-sucralfate works best at low pH, should be taken 1hr before or 2hrs after meal -should not be administered sooner than 30 min before or after antacid -when both are prescribed they work best if sucralfate is taken 1hr before and antacids after meal -sucralfate is short term treatment for peptic ulcer disease, limited 4-8 weeks

Which clinical manifestation that would require the client to stop taking an oral contraceptive and notify the provider would the nurse include in the teaching plan?

-sudden or persistent headaches; may indicate hypertension or a CV event -visual disturbances; may indicate neuro ocular lesion -sever leg pain pain; may indicate abnormal clotting -shortness of breath; if a clot traveled to the heart or lungs -liver or gallbladder problems would manifest as abd. pain

what type of medication would put a pt. at risk if they were exposed to the varicella virus?

-systemic corticosteroids -individuals taking steroids have reduced resistance to infection and may become fatally ill if they are exposed to the varicella virus

The nurse is caring for an 8-year-old child with acute poststreptococcal glomerulonephritis (APSGN). Which medication would the nurse anticipate incorporating into the plan of care?

-the child would be hypertensive; an antihypertensive would be prescribed -a diuretic such as furosemide would be prescribed due to oliguria

What teaching would you give a pt. on metformin who is scheduled to get a ct. with contrast?

-the iodine in the contrast my react with the metformin can cause lactic acidosis -discontinue metformin 1 day before the procedure and up to 48hrs after

What are some common teratogenic effects caused by medications?

-tooth and bone anomalies are caused by tetracyclines -short limbs and internal organ defects result from maternal thalidomide exposure -facial malformations result from HMG-CoA reductase inhibitors such as atorvastatin and simvastatin -CNS malformations may result from maternal exposure to methotrexate or cyclophosphamide

prednisone

-administered to treat adrenal gland HYPOfunction -pts should be monitored for fever -dosing needs modification if pt develops infection or illness -pt. should report any occurrence of diarrhea or watery stools

A health care provider prescribes aspirin therapy for a client with arthritis. The nurse will advise the client to report which adverse effect immediately?

-aspirin/salicylates are a GI irritant that can cause N/V/D -salicylates decrease platelet aggregation causing easy bruising and GI bleed -tinnitus and hearing loss can occur -salicylates may increase heart rate -sour stomach, trouble sleeping and dry mouth are all SE

Metformin

-carries a BBW for possibility of lactic acidosis -advantage is that it does not cause weight gain, but may result in weight loss -when used without other antidiabetic medication will not cause hypoglycemia

Which medications are useful to relieve pain associated with muscle spasms?

-central and peripheral muscle relaxants are used -carisoprodol -methocarbamol -cyclobenzaprine

A pt. is prescribed cholestyramine for treatment of type II hyperlipoproteinemia, which vitamin would the nurse anticipate become deficient because of this therapy?

-cholestyramine= bile acid sequestrant, bind to bile acid to form an insoluble compound that is excreted in the feces -these medications decrease the absorption of fat-soluble vitamins (A, D, E, K)

What are clinical manifestations of digoxin toxicity?

-confusion -headache -nausea -bradycardia -blurred/yellow vision/vision problems -dizziness -irregular pulse ECG findings -heart block -atrial tachycardia with block -ventricular dysrhythmias

Which client response is indicative of a hypoglycemic reaction?

-confusion is typically the first sign of hypoglycemia -tremors and anxiety are SNS responses to low glucose to the brain -hunger, diaphoresis, and paresthesia are cholinergic responses caused by too much insulin -hypoglycemia causes hunger

What THC medications can help with nausea and vomiting from cancer chemotherapy?

-dronabinol and nabilone are THC based medications used as antiemetics for cancer chemotherapy

Which intervention would a nurse suggest to the client who is prescribed hormonal therapy for the treatment of low estrogen levels?

-encourage physical activity to reduce weight gain -take oral forma of estradiol with food to reduce GI upset -provide instructions on how to self administer -educate on symptoms to report immediately such as vaginal bleed -educate on smoking cessation as it may cause risks -avoid ibuprofen/NSAIDs as they cay interact with estradiol -DO NOT recommend long term use -take medication same time each day to maintain serum levels effective

Which medication would be contraindicated for a pt. recovering from osteomyelitis and ruptured tendon?

-fluoroquinolones (ciprofloxacin, levofloxacin) can cause tendon rupture, especially achilles

Which medications are used to treat cerebral edema or decrease free water in clients with submersion injuries in the emergency department?

-furosemide (Lasix -mannitol (Osmitrol)

Which information is important for the nurse to obtain during the assessment of a female who has been prescribed combined oral contraceptives (COCs)?

-hx of thromboembolic disorders, they may increase risk of estrogen therapy -full med. reconciliation to check for potential interactions -treatment of TB; rifampin is CI -migraines with auras are CI

A child with nephrotic syndrome has been receiving prednisone for 1 week. Which information in the child's record indicates to the nurse that the medication has been effective?

-increase urine output (diuresis) -lethargy decreases -activity level increases -nephrotic syndrome causes the liver to produce large levels of cholesterol, with effective treatment lipid levels would normalize

What medication can be used to prevent signs and symptoms of alcohol withdrawal?

-lorazepam is most effective at preventing signs and symptoms of alcohol withdrawal