Pharmacology midterm Part 6
the nurse is teaching a pt about med treatment for depression. the pt asks how long it will take before sleep and appetite will begin to improve. which response by the nurse is most accurate?
1 week
which nursing action is most important when providing care to a pt diagnosed with a mood disorder
assess the pt for thoughts of suicide
what is included in the nursing management of the patient with generalized tonic-clonic seizure? -select all that apply
positioning the patient on the side once the relaxation stage is entered to allow oral secretions to drain, requesting additional assistance and/or necessary equipment in case the patient does not begin breathing spontaneously when the seizure is over, placing padding around or under the patients head
which is/are ectrapyramidal adverse effects of antipsychotic agents? all that apply
inability to sit in one place for an extended period, spasmodic movements of muscle groups, lip smacking, and masklike expression
the nurse transcribes an order for lorazepam for a patient experiencing nausea and vomiting as a result of alcohol withdraw. the most appropriate route of administration for lorazepam with the patient would be
intramuscularly
which is true regarding psychological drug dependence?
it requires medical intervention to treat
the outcome statement for a pt suffering from anxiety order reads," after 1 week on Xanax therapy patient will exhibit a manageable level of anxiety." which assessment finding validates that this outcome is met?
pt reports sleeping better and increased interest in activity
which pt is most likely to respond quickly to antianxiety therapy with benzo's
pt with recent anxiety reactions
what will the nurse caution a patient about when providing info about the prescribed azaspirone antidepressent?
risk of injury when using machinery
what is the recommended time over which antianxiety meds must be gradually tapered before discontinuation?
1 month
for which condition may carbamazepine(Tegretol) be used?
trigeminal neuralgia pain
the nurse is providing discharge teaching to a patient prescribed phenytoin (dilantin) for management of a seizure disorder. which patient statement indicates a need for further teaching?
"if I develop enlarged gums, I will stop taking the medication"
the nurse is developing a teaching plan for patients prescribed buspirone (Buspar). Which info about this medication should be included?
there is minimal potential for abuse
what is the major advantage of SSRI's over other types of antidepressant therapy?
they do not cause the anticholinergic and cardiovascular adverse effects
what is the drug of choice when treating a generalized tonic-clonic seizure?
valproic acid(depakene)
which condition would indicate to the nurse that a patient has phenytoin(Dilatin) toxicity?
Nystagmus
Which is a benzodiazepine of choice when treating anxiety associated with alcohol withdrawal?
Oxazepam(Serax)
a newly admitted psychiatric patient repetitively states, "I wish I were dead. I just want to kill myself." The priority nursing at this time is to
PROVIDE FOR PATIENT SAFETY
the nurse is providing education to a pt who has been prescribed bupopion (Wellbutrin) for smoking cesation. which statement by the pt would indicate the need for further teaching?
"If I have the urge to smoke, I will take more medication."
the nurse is educating a patient recently prescribed pregabalin(Lyrica). which statement by the patient indicates a need for further instruction?
"Once my pain improves, I will stop taking this medication"
what is a guideline for the nurse when administering phenytoin(Dilantin) intraveniously?
administer w/o mixing with other meds
what instruction is most important for the nurse to teach the pt who has recently been prescribed alprazolam (Xanax)?
"You may feel dizzy or unsteady when you rise to a standing position"
what dose is within the acceptable range for administering IV phenytoin(dylatin) to a patient with a seizure disorder?
30 mg/min
what is the most common cause of nonadherence to antipsychotic pharmacologic treatment?
EXTRAPYRAMIDAL EFFECTS
which is the drug of choice to treat a pt with OCD?
Fluvoxamine (Luvox)
lithium (eskalith) is the drug of choice for which of the following disorders?
bipolar disorder
the nurse is caring for a pt who is taking a newly prescribed drug, nefazadone for treatment of depression. which physical assessment finding is most important for the nurse to report to the health care provider immediately?
bradycardia
the pediatric nurse is caring for a pt diagnosed with refractory seizures. the physician orders a ketogenic diet. when the child receives his food tray, the nurse should remove any food containing high levels of
carbohydrates
a patient on anticonvulsant therapy confides to a nurse at an outpatient clinic that she suspects that she may be pregnant. the nurse should encourage the patient to take which actions? select all that apply
consult an OB, provide a list of seizure meds, care an ID
which areas should be addressed by the nurse when obtaining a history from a pt admitted with depression? select all that apply
current meds and medical history, family history of mood disorder, recent stressors and support system, and dietary patterns
a pt is admitted to a long-term psychiatric setting. the MAIO med previously prescribed is discontinued by the physician. New orders are obtained to initiate imipramine therapy. the nurse will provide the first dose of imipramine to the patient_______the MAIO drug
in 14 days following the last dose of
which premedication assessment by the nurse is most important prior to the inititation of carbamazepine (Tegratol) therapy?
determine pt's ancestry
a young male patient taking an antipsychotic is experiencing an oculogyric crisis. the nurse prepares to administer
diphenhydramine
...and significant other about antianxiety meds before the patients discharge. what is ...to be included in the teaching plan?
discuss, review, and validate the behavior monitoring system and interview flow sheet the patient and significant other will continue to use following discharge
what occurs with mania associated with bipolar disorder?
distinct episodes of elation
which assessment would the nurse expect to observe in a patient who has been prescribed trazadone for treatment anxiety?
drowsiness
which type of adverse effects are present when a patient displays prolong tonic contractions of the tongue, oculogyric crisis, and torticollis?
dystonic reactions
the prenatal nurse is educating a woman regarding preconception care. the pt informs the nurse that she is currently taking a benzo drug for management of anxiety. appropriate teaching to this patient about benzos include:
enter fetal circulation and readily cross into breast milk
dystonic reactions, pseudoparkinsonism, akathisia,and tardive dyskinesia are types of which effect?
extrapyramidal symptoms
a male patient becomes verbally aggressive and insists the nurse is poisoning him as she attempts to administer Haldol. Which action will the nurse take?
firmly redirect the patient to take the medication
a pt taking vilazodone has been vomiting persistently for 12 hrs. the priority nursing diagnosis for the pt is?
fluid volume deficet
the nurse assessing a pt who is complaining of hearing voices. what is the pt experiencing?
hallucincations
the nurse is preparing discharge instructions for a pt with a history of diabetes who has just been diagnosed with seizure disorder. The pt has been prescribed hydantoin therapy. what will the pt most likely experience?
hyperglycemia
which medication is used to control seizures or prevent migraine headaches?
Topiramate (Topamax)
which response by the nurse is accurate when a pt who has been on laotrigine (Lamictal) for seizure control reports a skin rash and urticaria?
advise the pt that this adverse effect usually resolves but should be reported to the health care provider
which signs and symptoms may occur in neurologic malignant syndrome? select all that apply
alterations in consciousness, fever, severe extrapyramidal symptoms, and hypertension
which is an appropriate nursing intervention for a pt who has recently been prescribed clozapine(Clozaril)?
measure the pt's waist circumference
what info would be most important for the nurse to provide to a pt when teaching about the adverse effects of succinimide therapy?
nausea, vomiting, and indegestion are common during the initiation of therapy
in addition to the relief of mild to moderate anxiety, hydroxyzine (Vistaril) had which additional therapeutic outcome? all that apply
reduce need for sedation and analgesia before and after surgery, control of vomiting, and control of itching in allergic reactions
which psychological manifestation of depression will improve in response to antidepressant therapy
social withdrawal