phram test 2
The patient's serum phenytoin level is 31 mcg/mL. What is the appropriate nursing action?
Hold the medication
The primary health care provider prescribed vitamin B 6 and antiparkisonian drugs to a patient with Parkinson's disease. What instructions does the primary health care provider give the nurse to prevent drug interactions in the patient?
"Administer vitamin B 6 with levodopa and carbidopa."
A patient is prescribed demeclocycline for the treatment of a respiratory infection. What instruction does the nurse give to the patient to ensure safe and effective administration of the drug?
"Avoid the consumption of dairy products."
The nurse is educating a patient who has gout. Which statements by the patient indicate effective learning? Select all that apply.
"I should adhere to the complete medical regimen.", "I should avoid consuming alcohol while on antigout drugs." & "I should avoid taking cold relief products with antigout drugs." - The patient should take special precautions while taking antigout drugs. The patient should adhere to the complete medical regimen for successful treatment. Alcohol interferes with antigout drug absorption, so the patient should avoid alcohol consumption. Most cold relief products contain alcohol, so the patient should avoid administering cold relief products with antigout drugs.
A patient with gout(arthritis w/ uric crystal formation) asks the nurse about the mechanism of action of the antigout drugs. What should the nurse tell the patient?
"It decreases the serum uric acid level."
A patient at risk for stroke tells the nurse that the doctor "told me to take aspirin every day." The patient states that he or she is on nabumetone daily, so he or she does not need to take the aspirin too. What is the nurse's best response to the patient?
"Take an aspirin every day even though you are on nabumetone."' -Nabumetone is a COX-2 inhibitor and does not inhibit platelet aggregation
A patient is prescribed celecoxib for the treatment of rheumatoid arthritis. Which instruction does the nurse give to the patient for safe administration of the drug?
"Take the drug after a meal."
The patient has been ordered azithromycin and asks the nurse why the medication does not have to be taken as often as other antibiotics that have previously been ordered. What is the nurse's best response?
"This drug has a longer duration of action than some of the other antibiotics."
The nurse is caring for a patient who states, "I can't take aspirin. It makes my stomach hurt." What is the nurse's best response to the patient?
"You can try enteric-coated aspirin." -Gastric distress is a common problem with uncoated aspirin. Enteric-coated tablets are designed to protect the stomach mucosa by dissolving in the duodenum.
A 7-year-old child is highly impulsive and has not been attentive in school for the last 2 months. The child's parents are worried about the child's behavior. What will the nurse inform the child's parents?
"You should continue to observe the child's behavior for 4 months."
While interviewing a pregnant patient, the nurse learns that the patient takes aspirin for pain relief. What appropriate suggestion does the nurse give to the patient?
"You should stop taking aspirin after delivery while breastfeeding." -The nurse should check the medications taken by the patient and give appropriate suggestions to prevent adverse effects. NSAIDs like aspirin cause increased bleeding and neonatal toxicity, so they must not be administered during breastfeeding. They are passed into the breast milk from the capillaries and reach the neonate. Aspirin must be avoided during the third trimester to prevent teratogenic effects. Aspirin must not be administered for 1 week prior to any surgery or delivery, because it causes increased bleeding. NSAIDs are categorized as C/D, so they can be administered with caution during the first two trimesters.
A patient is prescribed enteric-coated aspirin for joint pain management. What does the nurse tell the patient while administering enteric-coated aspirin?
"You should swallow the tablet with water."
The nurse is teaching a patient about therapy for a newly diagnosed seizure disorder. What statement should the nurse include?
"Your medication is chosen based on your type of seizure."
What dose of salicylate can cause severe toxicity in a patient?
300 to 500 mg/kg
What is the dose regimen of methylphenidate (Ritalin) for a 6-year-old child with attention deficit hyperactivity disorder (ADHD)?
5 mg before breakfast and lunch -Methylphenidate (Ritalin) is a central nervous system (CNS) stimulant prescribed for the treatment of ADHD. In a 6-year-old child, 5 mg dose is prescribed before breakfast and lunch. The dose prescribed to an adult is 20 mg after lunch.
The nurse is assessing a geriatric patient who has high blood pressure and prediabetes and was prescribed propranolol 10 mg. Which treatment can be given to the patient to reduce the risk of coronary artery disease?
81 mg of aspirin
Which nurse should not be assigned to treat a patient who is receiving ribavirin in an aerosol formulation?
A nurse who is pregnant -Ribavirin is a teratogenic (category X) drug and should be avoided in those who are pregnant or trying to conceive
Which of the following body systems manifests amantadine toxicity?
The central nervous system - with confusion, hallucinations, and severe mental or mood changes
The nurse is assessing a 3-year-old child who has a fever. After checking the laboratory reports, the nurse finds that the child has influenza B. Which medications should the nurse expect to be included in the care plan?
Acetaminophen
The nurse anticipates an order for vitamin supplementation for a patient who is receiving isoniazid therapy. What vitamin supplement is usually used with isoniazid?
Vitamin B 6
A patient with alcohol withdrawal is given carbamazepine. Which finding indicates a therapeutic effect?
Absence of seizures -Carbamazepine is an anti-epileptic and is used to decrease withdrawal symptoms and prevent seizures.
Which conditions predispose a patient to toxic effects from neuromuscular blocking drugs (NMBDs)? Select all that apply.
Acidosis,Poliomyelitis(viral infection that can cause temporary or permanent paralysis) & Myasthenia graves -NMBDs are the agents that prevent nerve transmission in the skeletal and smooth muscles. Some conditions such as acidosis, poliomyelitis, and myasthenia gravis increase the sensitivity of an individual to NMBDs and prolong their effects. Conditions such as hemiplegia and clostridial infections will oppose the effect of NMBDs, decreasing the patient's sensitivity to the toxic effects of NMBDs.
A patient has been diagnosed with genital herpes. What drug will be used to treat and manage this infection?
Acyclovir
Which agent is used to treat most infections caused by herpes simplex viruses and varicella-zoster virus?
Acyclovir
A nurse is caring for a patient who has been diagnosed with genital herpes. Which medication is the drug of choice for this patient?
Acyclovir is the drug of choice to treat herpes simplex infections.
How can the nurse determine whether a patient will tolerate an amphotericin B infusion?
Administer a test dose
Which intervention is most appropriate for a patient who needs treatment for acute postoperative pain?
Administer ketorolac IV every 4 hours PRN
A patient with respiratory depression secondary to opioid toxicity is being treated in the emergency department. What is the nurse's priority action?
Administer naloxone. - Severe opioid toxicity causes respiratory depression. Naloxone is the best choice of treatment for the management of respiratory depression. Naloxone is an opioid antagonist, and it inhibits the action of opioids and improves the patient's respiratory status. Assessing blood gases and preparing for intubation would be interventions to implement if the naloxone does not reverse the respiratory depression. Calling the respiratory team would likewise be performed if the patient did not respond to the treatment.
Which drug is indicated for the treatment of gout because of its ability to inhibit the enzyme xanthine oxidase?
Allopurinol -Allopurinol is indicated for the treatment of gout because of its ability to inhibit the enzyme xanthine oxidase, thereby preventing uric acid production.
The nurse is assessing a patient who has pain in multiple joints and has been prescribed indomethacin. When reviewing the laboratory reports of the patient, the nurse finds that the patient has hyperuricemia and deposition of sodium urate crystals in the synovial fluid. Which drug does the nurse expect to be added to the patient's regimen?
Allopurinol -Pain in multiple joints, hyperuricemia, and deposition of sodium urate crystals in the synovial fluids indicate that the patient has gouty arthritis. Allopurinol is prescribed for this. It reduces the uric acid levels and prevents the formation of kidney stones. Indomethacin is a nonsteroidal antiinflammatory drug (NSAID) that is more effective than other NSAIDs for pain relief. It also reduces the inflammation in patients with gouty arthritis.
The nurse is caring for a patient who is taking antibiotics. The patient reports flushing, itching, hives, anxiety, and throat and tongue swelling. The nurse finds that the patient has a rapid, irregular pulse. Which condition may the patient have as a result of taking the antibiotic?
An allergic anaphylactic reaction
What are the properties of mefenamic acid? Select all that apply.
Analgesic, Antipyretic & Antiinflammatory -Mefenamic acid belongs to the category of nonsteroidal antiinflammatory drugs. It has analgesic, antipyretic, and antiinflammatory properties. It is prescribed for pain relief, for reducing temperature during fever, and for treating inflammation
While instructing a patient about antibiotic therapy, the nurse explains to the patient that bacterial resistance to antibiotics can occur when what happens? Select all that apply.
Antibiotics are prescribed to treat a viral infection & Patients stop taking an antibiotic after they feel better -
Which nonsteroidal antiinflammatory drug (NSAID) is prescribed for the patient with myocardial infarction?
Aspirin
Which nonsteroidal antiinflammatory drug (NSAID) may cause Reye's syndrome in children with viral illnesses or fever?
Aspirins
A patient with Parkinson disease is prescribed ropinirole. Upon reviewing the patient's prescriptions, the nurse notes that the patient has been prescribed ciprofloxacin for a urinary tract infection. What is the nurse's best action?
Assess the patient for toxicity and notify the health care provider. -
The nurse is assessing a patient who has a bone infection who has been prescribed clindamycin. The primary health care provider also has prescribed vecuronium for the patient's persistent pain. Which intervention will the nurse perform to ensure the patient's safety?
Assess the patient's respiratory rate.
Which condition listed in the patients' medical history could be a contraindication to administration of morphine sulfate?
Asthma -Morphine sulfate should be used with caution in patients with asthma, because naturally occurring opioids cause the release of histamine; a release of histamine in a patient with asthma can trigger bronchoconstriction. Because 20% to 35% of morphine sulfate binds to protein, cancer and anorexia are causes for concern, because both conditions can result in hypoproteinemia and a lack of protein-binding sites for morphine, which can alter the pharmacokinetics of the medication. The administration of morphine sulfate can help diminish diarrhea.
Which symptoms are likely to be found in patients having aspirin triad? Select all that apply.
Asthma, Rhinitis & Nasal polyps -Aspirin triad is characterized by asthma, rhinitis, and nasal polyps. Patients who have these symptoms should avoid aspirin, as it can be fatal. Seizures and vomiting are not symptoms of aspirin triad. They are the symptoms of Reye's syndrome, which is caused in children by the administration of aspirin.
A patient with gout is prescribed aspirin. Which conditions in the patient's medical history will cause the nurse to be concerned? Select all that apply.
Asthma, Wheezing & Respiratory problems -Before administering aspirin to a patient, the nurse should assess for a history of asthma, wheezing, and respiratory problems. With these conditions the patient is more susceptible to an allergic reaction associated with aspirin.
A patient is diagnosed with attention deficit hyperactivity disorder (ADHD). Which drug is suitable for treatment of this disorder?
Atomoxetine -Atomoxetine is a nonstimulant drug used to treat ADHD. It is prescribed to children older than 6 years and in adults Orlistat, doxapram, and sumatriptan are not used to treat ADHD. Orlistat is a drug that is used to treat obesity. Doxapram is an analeptic that is used to treat drug-induced respiratory depression. Sumatriptan is a serotonin receptor agonist and is indicated for acute migraine headache
The nurse is caring for a patient who has symptoms of acute toxicity due to an overdose of immediate-release ibuprofen, which was administered 1 hour earlier. What is the appropriate action in this situation?
activated charcoal
What are the common primary tissues that are affected by infection with the Trichophyton spp.? Select all that apply.
skin & slcap b/c it only effects superficial areas
Why is diazepam used for the treatment and prevention of alcohol withdrawal symptoms?
Because of the presence of benzodiazepine receptors adjacent to the receptors responsible for alcohol addiction
A patient with Parkinson disease takes carbidopa-levodopa but experiences disabling tremors. Which adjunct medications can be administered for alleviation of the patient's tremors? Select all that apply.
Benztropine & Trihexyphenidyl
Which assessment finding in a patient who is on nonsteroidal antiinflammatory drug (NSAID) therapy does the nurse report to the primary health care provider?
Black stools -Severe gastrointestinal bleeding results in black stools due to blood mixing with excretory waste. Therefore, the nurse reports this adverse effect immediately to the health care provider to prevent further damage.
A patient with multiple sclerosis participates in a rehabilitation program. The patient takes baclofen to help manage muscle spasticity. How will the baclofen interfere with the patient's rehabilitation activities?
By producing drowsiness, lethargy, and blurred vision (adverse effects)
Which is a long-acting nondepolarizing neuromuscular blocking drug?
Pancuronium
A patient has started on a fentanyl patch. After 3 hours, the patient continues to complain of pain of "8 on a scale of 0 to 10." What is the nurse's best action?
Call the primary health care provider. -takes 6 to 12 hours to reach steady-state pain control after the first patch is applied. The nurse should call the primary health care provider for a medication to control pain immediately until the full effect of the patch is realized. The nurse should not change the patch, because it would then take longer for the patient to achieve pain control.
Which neurodegenerative disorder is caused by a decrease in dopamine levels and an increase in acetylcholine levels in the brain?
Parkinson disease
What is the advantage of COX-2 inhibitors over nonspecific nonsteroidal antiinflammatory (NSAID) drugs?
COX-2 inhibitors specifically inhibit cyclooxygenase-2, so they are not associated with adverse effects such as gastrointestinal ulcers.
Which drug is most commonly used for the treatment of a spinal headache?
Caffeine
Which class of drugs is administered to treat on-off phenomenon in a patient with Parkinson disease?
Catechol-ortho-methyltransferase
Which part of the brain regulates muscle coordination?
Cerebellum
The nurse is caring for a patient with tuberculosis and acquired immunodeficiency syndrome (AIDS). The patient's laboratory findings indicate the presence of Mycobacterium flavescens in the culture of the patient's sputum and stomach secretions. Which medication should be included in the treatment regimen for treating tuberculosis in this patient?
Clarithromycin
Which antibiotic can be used against several anaerobic organisms?
Clindamycin
A patient receiving antibiotics for chronic tonsillitis has been experiencing abdominal pain and cramps associated with frequent watery stools. Which infection does the nurse suspect?
Clostridium infection
Which medication causes leukopenia by inhibiting cell mitosis?
Colchicine -
Orlistat is a drug used in the treatment of obesity. A common adverse effect of orlistat is gastrointestinal distress, which causes fecal incontinence and oily stools.
Combination of ropinirole and carbidopa-levodopa -The patient has severe dyskinesia and tremors in the fingers, which indicate that the patient has Parkinson disease. The patient reports sleep disturbed by uneven leg movements. This condition is called restless leg syndrome. Carbidopa-levodopa is used to treat Parkinson disease, and ropinirole is used to treat restless leg syndrome.
The patient has been started on a medication regimen that includes sulfamethoxazole/trimethoprim. The nurse notes that the source of the patient's infection has been determined to be viral in origin. What is the nurse's highest priority action?
Contact the health care provider to discuss the medication.
The nurse is caring for a patient with a phenytoin level of 12 mcg/mL. What is the nurse's best action?
Continue to monitor the patient on this medication.
Which category of medications increases the ulcerogenic effect of nonsteroidal antiinflammatory drugs (NSAIDs)?
Corticosteroids inhibit the synthesis of prostaglandins. Simultaneous administration of nonsteroidal antiinflammatory drugs (NSAIDs) and corticosteroids should be avoided, because this can cause ulcerogenic effects.
Which patient group should receive the Zostavax vaccine?
Patient 50 years of age and older -Zostavax is a herpes zoster vaccination given to older patients to prevent zoster lesions known as shingles. It is prescribed for patients who are 50 years of age or older.
The primary health care provider has asked the nurse to administer diazepam to a patient who has symptoms of alcohol withdrawal. Why does the primary health care provider select this drug for the patient?
The drug acts on benzodiazepine receptors that play a role in alcohol addiction.
When planning care for a patient receiving a sulfonamide antibiotic, which is a primary intervention?
Force fluids to at least 2000 mL/day.
The nurse is caring for a patient taking foscarnet. What will the nurse monitor to identify potential side effects of this medication?
Foscarnet can cause kidney damage. Blood urea nitrogen and creatinine should be closely monitored.
What is the result of a potential drug interaction between benzodiazepines and rifampin?
Decreased benzodiazepine effects
The nurse is teaching a group of nursing students about the stages of non-rapid eye movement (non-REM) sleep. Which is the third stage of sleep?
Deep sleep -Deep sleep is the third stage of sleep. The person finds it difficult to wake, and the respiratory rate, pulse rate, and blood pressure may decrease. Dozing is the first stage of sleep. The person has feelings of drifting off to sleep. Relaxation is the second stage of sleep. The person can easily be awakened. In the fourth stage of sleep, it is very difficult to wake the person up, and sleepwalking may occur during this stage.
What are the clinical applications of the infiltration method of anesthesia? Select all that apply.
Dental surgery & Wound suturing -Infiltration is a local anesthetic technique that involves injecting small amounts of anesthetic drug into the tissue that surrounds the operative site. Dental surgery and wound suturing are the common clinical applications of infiltration.
Which drug is used to treat attention deficit hyperactivity disorder (ADHD)?
Dextroamphetamine -Dextroamphetamine is the drug used in the treatment of ADHD because it stimulates the central nervous system and increases alertness. Orlistat is used for treating obesity. Modafinil is the drug used for the treatment of narcolepsy. Sumatriptan is used in the treatment of acute migraine headache attack.
In which conditions are nonsteroidal antiinflammatory drugs (NSAIDs) prescribed? Select all that apply.
Diabetic neuropathy, Rheumatoid arthritis & Ankylosing spondylitis -Nonsteroidal antiinflammatory drugs (NSAIDs) have analgesic and antiinflammatory properties, so they can be prescribed for the treatment of diabetic neuropathy, rheumatoid arthritis, and ankylosing spondylitis. They help to relieve pain and inflammation.
Which inhibitory neurotransmitter is involved in Parkinson disease?
Dopamine
Which substance, if out of balance with acetylcholine, leads to Parkinson disease?
Dopamine
Which analeptic may cause gasping syndrome in a newborn?
Doxapram -Doxapram is an analeptic that is used as a respiratory stimulant. It is contraindicated for newborns because it causes gasping syndrome as a result of the presence of benzyl alcohol. Caffeine is contraindicated in patients who have a history of peptic ulcers. Theophylline causes a delay gastric emptying, not gasping syndrome, in newborns. Aminophylline is used to treat apnea in newborns and does not cause gasping syndrome.
Which condition contraindicates barbiturates?
Drug allergy -Barbiturates can be used as hypnotics, sedatives, and anticonvulsants and for anesthesia. This class of drugs is contraindicated in patients with known drug allergy, pregnancy, or severe kidney or liver disease. Valerian (Valeriana officinalis) is an herbal product that is contraindicated in patients with cardiac disease. Barbiturates are indicated for the treatment of epileptic disease because of their anticonvulsant properties. Narrow-angle glaucoma contraindicates benzodiazepines.
The nurse is assessing a patient who has just had a myocardial infarction and who also has a history of peptic ulcer disease. While reviewing the prescription, the nurse finds that the patient is prescribed aspirin 35 mg. Which drug should be used as an alternative to aspirin to prevent the recurrence of peptic ulcers?
Enteric-coated aspirin -Enteric-coated tablets of aspirin can be prescribed to the patient to prevent the recurrence of peptic ulcers. These tablets dissolve in the duodenum and do not damage the mucosal layer of the stomach.
The nurse is caring for a patient who experienced lacerations in a minor automobile accident. The patient was administered lidocaine before suturing of the lacerations. The nurse observes that the patient has excessive bleeding. Which medication would have prevented this complication?
Epinephrine -Lidocaine is a local anesthetic. Sometimes excessive bleeding may occur during the surgical process. It can be prevented with the administration of vasoconstrictors such as epinephrine along with a local anesthetic. Epinephrine reduces local blood loss during minor surgical procedures. Dantrolene is a muscle relaxant; it is not useful to prevent excessive bleeding. It is used in the treatment of malignant hyperthermia. Doxacurium and pancuronium are long-acting nondepolarizing neuromuscular blocking drugs. These drugs are used for maintaining skeletal muscle paralysis to facilitate controlled ventilation during surgical procedures.
A patient questions the use of epinephrine for repair of a laceration, stating, "I thought that was the drug they use in the emergency room when patients have cardiac arrest." Select the nurse's best response.
Epinephrine enhances the duration of action for lidocaine and minimizes bleeding at the laceration site." -Epinephrine causes localized vasoconstriction, not only allowing for a bloodless field to suture but also delaying absorption of the lidocaine and thus enhancing its numbing effect. It does not help the anesthetic effect wear off more quickly. Epinephrine is used to prevent adverse effects, but more specifically it helps to minimize toxicity caused by local anesthetics. Epinephrine is often coadministered with the local anesthetic to maintain localized drug activity, but it does not help with the systemic absorption of lidocaine.
A patient reports unusual sleep patterns and lack of sleep. What is the best nonpharmacologic patient teaching the nurse can provide to reset the patient's internal clock?
Establishing a set sleep pattern
Which is an adverse effect of orlistat therapy?
Fecal incontinence -Orlistat is a drug used in the treatment of obesity. A common adverse effect of orlistat is gastrointestinal distress, which causes fecal incontinence and oily stools.
The nurse erroneously administers a high dose of a benzodiazepine to a patient who has insomnia. What drug will the nurse expect the primary health care provider to prescribe to treat this potential overdose?
Flumazenil - a benzodiazepine antidote, antagonizes the action of benzodiazepine by blocking the central nervous system for benzodiazepines.
Which drug is used as an antidote for overdose of oral benzodiazepine or excessive intravenous sedation?
Flumazenil -An antidote is a medication given to reduce the symptoms of drug overdose or toxicity. Flumazenil slightly reverses the adverse effects of benzodiazepines. Olanzapine may interact with benzodiazepines when administered simultaneously. However, olanzapine is not an antidote for benzodiazepines. Furosemide is commonly used to eliminate barbiturates by promoting diuresis. Activated charcoal is administered for an overdose of barbiturates. It prevents liver damage by quickly eliminating the barbiturates from the body.
Which adverse effect should be predicted if the patient is administered bisphosphonates and nonsteroidal antiinflammatory drugs (NSAIDs) together?
Gastric bleeding - Bisphosphonates and nonsteroidal antiinflammatory drugs (NSAIDs), if administered together, may interact and cause gastrointestinal toxicity. This can result in increased risk of gastric bleeding
Which dietary supplement can be given to a patient for treatment of osteoarthritis?
Glucosamine -Glucosamine is a dietary supplement derived from glucose. It is prescribed to patients with osteoarthritis for joint pain relief
The patient taking carbamazepine should be instructed to avoid taking her dose with which beverage?
Grapefruit juice
The nurse is caring for a patient who is intubated. The nurse observes that the patient was administered succinylcholine. Which parameter will the nurse assess in the patient to ensure safe drug administration?
Hand grasp strength The neuromuscular drugs act on the skeletal and smooth muscles, causing paralysis.
A patient develops black stools, bleeding around the gums, and very small red-brown spots on the body after taking a nonsteroidal antiinflammatory drug to relieve joint pain. The nurse will contact the provider to request which tests? Select all that apply.
Hematocrit test, Hemoglobin test, & Total blood count test -Many nonsteroidal antiinflammatory drugs can cause drug-induced gastrointestinal bleeding. The patient's symptoms indicate that he or she may have drug-induced gastrointestinal bleeding. As a result, the patient's hematocrit level, hemoglobin level, and red blood cell count will drop due to the drug interaction and blood loss. Therefore, the nurse should advise the patient to have the hematocrit test, hemoglobin test, and total blood count test. These help identify drug-induced gastrointestinal bleeding.
The nurse observes that a patient has cold sores around the mouth. Which virus would have caused this condition?
Herpes simplex type 1
Which microorganism is directly affected by acyclovir?
Herpes zoster
What is an expected therapeutic outcome assessment for a patient who has Parkinson's disease and dementia and is prescribed rivastigmine?
Improvement in memory
The nurse will advise a patient receiving opioid analgesics for chronic pain to perform which action to minimize the gastrointestinal (GI) side effects?
Increase fluid and fiber in the diet. -Opioid analgesics decrease intestinal motility, leading to constipation. Increasing fluid and fiber in the diet can prevent constipation. The nurse should advise the patient to take the opioid with meals, not on an empty stomach, to decrease GI side effects. Diphenoxylate/ atropine is an antidiarrheal preparation that will further decrease GI motility.
Why is a patient advised to drink at least 48 oz of liquids every day while taking indinavir?
To prevent nephrolithiasis - Indinavir may cause nephrolithiasis, or the presence of calculi in the kidney; the patient is advised to drink at least 48 oz of liquids every day to prevent this.
The nurse is assessing an older adult who has rheumatoid arthritis and has been prescribed cyclosporine. While obtaining a medical history, the nurse learns that the patient is taking ibuprofen for pain relief. Which side effect does the nurse anticipate in the patient?
Increased risk of nephrotoxicity -Ibuprofen is a nonsteroidal antiinflammatory drug (NSAID). The administration of cyclosporine and ibuprofen in the patient causes an increased risk of nephrotoxicity and renal failure. NSAIDs increase the nephrotoxic effects of cyclosporine, and can lead to renal failure due to the inhibition of renal prostaglandin analogs.
Which medication is prescribed to promote the closure of the patent ductus arteriosus in premature infants?
Indomethacin -Patent ductus arteriosus is a congenital disorder in which the ductus arteriosus of the infant's heart fails to close after birth. It is most commonly seen in premature infants. Prostaglandins prevent the closure of the ductus arteriosus, so prostaglandin synthesis inhibitors like indomethacin are prescribed to treat infants with patent ductus arteriosus. Indomethacin is an approved medication for this indication. It can be administered intravenously to infants
A patient who is treated with zidovudine develops blistering rashes, fever, and myalgia. What should the nurse do first?
Inform the primary health care provider
A patient has been prescribed tenofovir. After taking the drug for 3 days, the patient contacts the nurse to report experiencing muscle pain and weakness. What is the nurse's highest priority action?
Instruct the patient to hold doses of the medication until further notice. - The patient should not take any more doses of the medication until the health care provider can evaluate the patient.
Which type of anesthetic agent is administered into the subarachnoid space?
Intrathecal anesthesia
A patient reports swelling at the site of infusion of intravenous (IV) pentobarbital. Which event does the nurse suspect as the cause of swelling?
Intravenous infiltration -he site may become swollen, erythematous, and tender. IV drugs such as amphotericin B, hydrocortisone, and hydromorphone are incompatible with pentobarbital. However, they may not cause swelling at the IV site. Too rapid an infusion may produce profound hypotension and marked respiratory depression. Infusing pentobarbital without dilution is not safe. However, it may not necessarily cause swelling.
Which is the first-line antitubercular drug?
Isoniazid
How does penicillin work to destroy bacteria?
It interferes with cell wall synthesis.
Why is levodopa the mainstay of treatment for a patient with Parkinson disease?
It provides a dopamine precursor.
A patient enters the emergency department with suspected influenza. Before administering the prescribed oseltamivir, what should the nurse determine?
Length of time since onset of symptoms -Oseltamivir phosphate inhibits the replication and spread of influenza if given within 48 hours of symptoms.
Which class of drugs is prescribed for a patient who is obese to promote weight reduction?
Lipase inhibitors -Lipase is the enzyme helpful in the digestion of fats. Lipase inhibitors are a class of drugs that help in inhibiting the enzyme, causing excretion of excess fats from the body and resulting in weight reduction. Ergot alkaloids are useful drugs in the case of chronic migraine headache treatment. Serotonin receptor agonists are the class of the drugs used in the treatment of migraine headache. Phosphodiesterase inhibitors are the drugs useful in the treatment of respiratory depression and related disorders.
Which enzyme plays an important role in the conversion of arachidonic acid to leukotrienes?
Lipoxygenase -Various enzymes play important roles in the inflammation process. In the leukotriene pathway, lipoxygenase is an enzyme that converts arachidonic acid into leukotrienes.
Which category of phenobarbital is most commonly used in the treatment of epilepsy?
Long-acting barbiturates
Which category of phenobarbital is most commonly used in the treatment of epilepsy?
Long-acting barbiturates -Phenobarbital is a generic barbiturate. This drug is categorized as long acting based on potency, time to onset of action, and duration of action. Phenobarbital is used as an epileptic seizure prophylaxis. Pentobarbital and secobarbital are examples of short-acting barbiturates. Methohexital and thiopental are examples of ultrashort-acting barbiturates. Butabarbital is an example of an intermediate-acting barbiturate.
Which is the most common site of infection caused by Mycobacterium tuberculosis?
Lung
What is appropriate information for the nurse to give the patient who is taking an antiepileptic drug with a narrow therapeutic index?
Make certain the drug is taken at the same time daily.
A patient about to undergo surgery states that a family member has a history of difficulty with surgery. Which subjective information about a family member contraindicates the use of succinylcholine in this patient?
Malignant hyperthermia -Succinylcholine is contraindicated in patients with a personal or familial history of malignant hyperthermia or conditions that can lead to hyperkalemia, including denervation of skeletal muscles, upper motor neuron disease, or a personal history of major burns or multiple traumas. None of the remaining family information represents a high risk in connection with the use of succinylcholine.
A patient who is resistant to several antiretroviral therapies is prescribed maraviroc. What substance in the patient's history would decrease the therapeutic effect of the drug?
Maraviroc is a new class of antiviral drugs that is used to treat patients who have developed resistance to antiretroviral therapies. Maraviroc has a reduced effect when given in combination with St. John's wort, which is an herbal medication that is used for depression. St. John's wort quickly processes maraviroc, reducing its absorption time and thereby reducing its effect.
A patient has undergone a minor procedure in an ambulatory surgery center. At the time of discharge, the nurse instructs the patient to avoid driving for at least 24 hours. Which drug was included in the patient's treatment plan?
Midazolam -A patient who has undergone a minor surgery has typically been given a sedative during the procedure. These drugs cause moderate sedation, so driving within 24 hours of administration of these drugs may cause accidents. Midazolam is a local anesthetic that was administered to the patient. Sevoflurane, pancuronium, and succinylcholine would not have been administered to the patient, because they are general anesthetics. They cause a prolonged sedative effect and the patient needs a longer recovery time for reversal.
Which medication is beneficial for reducing presurgery anxiety and decreasing the patient's ability to remember an uncomfortable medical procedure?
Midazolam -Midazolam has the ability to induce amnesia, which temporarily reduces the patient's memory. Ramelteon and eszopiclone are nonbenzodiazepine drugs that correct irregular sleep patterns but do not cause amnesia. Alprazolam is a benzodiazepine that reduces sleep irregularities but does not cause amnesia.
A patient is diagnosed with fibromyalgia. Which drug does the nurse expect to administer?
Milnacipran -Fibromyalgia is a condition in which the level of norepinephrine is reduced in the brain. Milnacipran is used for the treatment of fibromyalgia. Milnacipran is a selective serotonin and norepinephrine reuptake inhibitor. Milnacipran increases norepinephrine levels and reduces pain associated with the fibromyalgia.
The nurse is caring for a patient who has juvenile arthritis. The patient is prescribed ibuprofen. Long-term use of ibuprofen may cause severe gastrointestinal ulcers. Which other drug to prevent gastrointestinal ulcers does the nurse expect in the prescription?
Misoprostol -Ibuprofen is a nonsteroidal antiinflammatory drug and is a propionic acid derivative. Nonsteroidal antiinflammatory drugs are acidic in nature, and they suppress antiinflammatory prostaglandin synthesis, which causes gastrointestinal ulcers. Misoprostol is helpful in preventing gastrointestinal ulcers. Misoprostol is a synthetic prostaglandin E 1 analog that inhibits gastric acid secretion and also has a cytoprotective component.
Which drug has abortifacient properties and is avoided in pregnant women?
Misoprostol -Misoprostol is a synthetic prostaglandin E 1 analog and has abortifacient properties. It is prescribed with nonsteroidal antiinflammatory drugs to prevent gastrointestinal ulcers.
Which drug is indicated for the improvement of wakefulness in patients who have excessive daytime sleepiness?
Modafinil -is a psychostimulant that enhances the memory and brightens the mood. It is indicated for the improvement of wakefulness in patients who have excessive daytime sleepiness.
A nurse is administering intravenous (IV) acyclovir to a patient. What should the nurse remember to ensure safe administration of the drug?
Monitor the IV site -intravenous acyclovir can cause venous irritation and phlebitis. Therefore, the nurse should monitor the IV site for redness, heat, pain, swelling, or red streaks.
Which is the most important nursing intervention while caring for a teenage patient who is on benzodiazepine therapy?
Monitoring for suicidal tendencies -Because of the prolonged effects of benzodiazepines on the central nervous system (CNS), the patient may develop suicidal tendencies. Therefore, the nurse should closely monitor the teenage patient for this. Older adults may have an increased risk of falling because of excessive drowsiness. The nurse should assess the risk for injury or falls if the patient is elderly. The nurse encourages the patient to increase the intake of fluids for complete excretion of the drug from the body, which helps to reduce its adverse effects, but this is not the most important intervention. The nurse should monitor renal and hepatic function to prevent potential toxicity or complications resulting from decreased excretion or metabolism, but monitoring for suicidal tendencies is the priority.
Which enzyme is inhibited by the antiparkinson drug selegiline?
Monoamine oxidase
The nurse prepares to administer 5 mg of intravenous (IV) morphine sulfate to a patient who underwent surgery 30 minutes earlier. What is the most important reason for the nurse to record baseline vital signs before administering this drug?
Morphine sulfate depresses the respiratory center.
Which statement by a patient makes the nurse aware of a need for further education about drug resistance in antimicrobial therapy?
My body has become resistant to the antibiotic." -The patient needs further education when he or she states, "My body has become resistant to the antibiotic" because it is the microbe that becomes resistant, not the patient.
Which is the most common organism that causes pulmonary infection characterized b granuloma in the lungs?
Mycobacterium tuberculosis
A patient with cancer is receiving an opioid analgesic for pain relief. The nurse understands that opioid analgesics are preferred over nonsteroidal antiinflammatory drugs (NSAIDs) for cancer-related pain relief for what reason?
NSAIDs are ineffective for treating chronic severe pain, because they have rapid ceiling effects. -NSAIDs have ceiling effects that limit their effectiveness. Any increase in the dose of the NSAID beyond a certain level does not increase the therapeutic effect of the drug, but doing so increases the adverse and toxic effects, so NSAIDs are not effective during severe pain.
Which drug causes fewer gastrointestinal adverse effects and is derived from enolic acid?
Nabumetone -Nabumetone is an enolic acid derivative. It is tolerated better than some of the other NSAID drugs in terms of gastrointestinal adverse effects. Nabumetone is relatively nonacidic compared with most of the other NSAIDs and thus has fewer gastrointestinal side effects
Which medication is used to treat a patient experiencing severe adverse effects of an opioid analgesic?
Naloxone -is the opioid antagonist that will reverse the effects, both adverse and therapeutic, of opioid analgesics. Flumazenil, a benzodiazepine antidote, can be used to acutely reverse the sedative effects of benzodiazepines. Acetylcysteine is the antidote for acetaminophen overdose.
The nurse is assessing a patient who has severe joint pain. The patient takes angiotensin-converting enzyme inhibitors for hypertension. Which medicine does the nurse expect to be added in the prescription for pain relief?
Naproxen -Nonsteroidal antiinflammatory drugs (NSAIDs) are prescribed to treat severe joint pain. Naproxen can be prescribed to the patient who is administering angiotensin-converting enzyme inhibitors for hypertension. It has fewer side effects than other NSAIDs
While caring for a patient, the nurse learns that the patient has dysfunctional rapid eye movement (REM) sleep. This finding is a symptom of which condition?
Narcolepsy - The patient may have "sleep attacks" due to this condition.
The health care provider is considering prescribing a patient ritonavir. The patient tells the nurse about recently being diagnosed with type 2 diabetes mellitus. What is the nurse's highest priority action?
Notify the health care provider of the new information.
A patient has been taking aspirin for chronic pain. The patient states that the pain is not relieved with 650 mg of aspirin every 4 hours. What is the best instruction for the nurse to give the patient?
Notify your health care provider that the medication is not effective." -Unlike opioids, NSAIDs show a ceiling effect that limits their effectiveness; that is, any further increase in the dosage beyond a certain level increases the risk for adverse effects without a corresponding increase in the therapeutic effect.
Which antifungal drug is applied topically for the treatment of candidal diaper rash?
Nystatin
Which patient conditions are contraindicated for administration of aspirin? Select all that apply.
Patient with rhinitis, Patient with severe peptic ulcer & Patient with vitamin K deficiency - Administration of aspirin is contraindicated in the patient who has rhinitis, because aspirin increases the risk of bleeding and may cause epistaxis. Aspirin increases the risk of gastrointestinal ulceration and should not be administered to patients with severe peptic ulcer disease. Vitamin K deficiency increases the risk of bleeding, so if aspirin is administered to a patient who has a vitamin K deficiency, it may cause bleeding
During the assessment of a pregnant patient, a nurse finds that the patient has active genital herpes lesions. What is the best strategy to prevent the spread of infection to the newborn?
Performing a cesarean section for the patient during labor
Which drug delays the renal excretion of penicillin?
Probenecid -Probenecid delays the renal excretion of penicillin. It increases the serum levels of penicillin and prolongs its effect. Therefore, the dose of penicillin should be reduced while administering probenecid
While completing preoperative patient teaching, which information should the nurse explain about general anesthesia?
Produces deep muscle relaxation and loss of consciousness -General anesthesia produces deep muscle relaxation (both visceral and skeletal) as well as loss of consciousness. Balanced anesthesia is the practice of using combinations of different drug classes rather than a single drug to produce anesthesia. Local anesthesia provides anesthesia to a specific region of the body and generalized sedation. Conscious sedation (also called moderate sedation) results in moderate sedation in which the patient can follow commands but will not remember anything after the procedure.
A patient who is about to undergo an open cholecystectomy is administered intravenous ceftriaxone. What antibiotic treatment is the patient most likely getting?
Prophylactic
The nurse is assessing a patient who was administered pancuronium. The nurse finds that the patient has an allergic reaction. Which symptoms associated with an allergic reaction to pancuronium might the nurse observe in the patient? Select all that apply.
Pruritus(itching), rash & fever -Pancuronium is a neuromuscular blocking drug. Rash, fever, and pruritus are the symptoms associated with this allergic reaction. It also causes respiratory distress
A patient who has been administered a neuromuscular drug has severe muscle paralysis. Which medication does the nurse expect the primary health care provider to prescribe for this condition?
Pyridostigmine
Which drug is contraindicated in patients with chronic obstructive pulmonary disease (COPD)?
Ramelteon -Ramelteon is recommended for the treatment of insomnia. This drug is contraindicated for patients with COPD or sleep apnea. Zaleplon is a nonbenzodiazepine drug used for the treatment of insomnia. It is contraindicated in patients with drug allergy, glaucoma, or pregnancy. Diazepam is a benzodiazepine drug used for the treatment of sleep disorders. It is contraindicated in patients with drug allergy, glaucoma, or pregnancy. Pentobarbital is a barbiturate class of drug used as hypnotic, sedative, and anticonvulsant. It is contraindicated in patients with drug allergy, pregnancy, or severe kidney or liver disease.
The nurse is assessing a patient who has gout and and is prescribed indomethacin 650 mg and febuxostat 40 mg. The nurse reports to the primary health care provider that the patient has symptoms of mild nonsalicylate intoxication. Which prescription does the primary health care provider give to the patient?
Reduce the dose of indomethacin -A nonsalicylate intoxication is caused by an overdosage of indomethacin, which is a nonsalicylate, nonsteroidal antiinflammatory drug. The treatment for this nonsalicylate intoxication is similar to that for salicylate intoxication (except when conducting dialysis). The indomethacin dose must be reduced if the patient has a mild salicylate intoxication
Which symptoms are associated with Parkinson disease? Select all that apply.
Rigidity, Tremors & Bradykinesia
What are the possible effects of garlic when used concomitantly with an anesthetic? Select all that apply.
Risk of increased bleeding & Changes in blood pressure -Herbal and drug interactions are very common in clinical practice. The possible effects of garlic when used concomitantly with anesthetic drugs include the risk of increased bleeding and changes in blood pressure. Sedation is a common effect of ginger when used in combination with anesthetic drugs because of decreased blood supply to the central nervous system. Potential liver toxicity is a possible effect of using kava in combination with anesthetic drugs. Irritability and insomnia are possible adverse effects of combined use of ginseng and anesthetic drugs.
Which indirect-acting cholinergic drug is used to treat a patient with parkinsonism with dementia?
Rivastigmine [Exelon] -Rivastigmine [Exelon] is an indirect-acting cholinergic drug used to treat Alzheimer's disease. However, it is also effective in treating patients with parkinsonism who have dementia. Drugs such as donepezil [Aricept] and galantamine [Razadyne] are also indirect-acting cholinergics but are used for treating Alzheimer's disease only and are contraindicated in parkinsonism. Memantine [Namenda] is an N-methyl-d-aspartate (NMDA) receptor antagonist that is used for treating Alzheimer's disease.
What is the difference between carbidopa-levodopa and ropinirole?
Ropinirole is a dopamine agonist that has fewer side effects than carbidopa-levodopa.
What effects are exerted by promethazine when it is administered simultaneously with propofol? Select all that apply.
Sedation, Anxiety reduction & Prevention of nausea and vomiting -Promethazine is an antihistamine that induces sedation, reduces anxiety, and prevents nausea and vomiting when administered simultaneously with a general anesthetic drug. Atropine is an anticholinergic drug that will help dry excessive secretions. Opioid analgesics such as meperidine and morphine reduce pain and other sensations but induce nausea and vomiting.
Which antiparkinson drug causes an increase in the levels of dopaminergic stimulation in the central nervous system and therefore allows a decreased dose of other medications?
Selegiline
Which drug is used as an adjunct therapy with carbidopa-levodopa to treat Parkinson disease?
Selegiline
What possible effect will the nurse anticipate in a patient who has received amphotericin B along with thiazide diuretics?
Severe hypokalemia
A child has contracted chickenpox and is treated successfully. Which infection is the child prone to develop as an adult?
Shingles, or herpes zoster, is caused by reactivation of varicella-zoster virus, which causes chickenpox. The virus that causes chickenpox may lie dormant in the nerve cells of the person for many years, only to be reactivated by any trigger. When reactivated, it causes shingles.
A patient is diagnosed with narcolepsy. Which symptom does the nurse expect to find in the patient?
Skeletal muscle weakness -Cataplexy is a symptom associated with narcolepsy, and is characterized by skeletal muscle weakness. Hyperactivity is not a symptom of narcolepsy. It is seen in attention deficit hyperactivity disorder. Pulsating headache is a symptom of migraine headache. High BMI is not seen in narcolepsy; it is the symptom associated with obesity.
Which is a side effect of the nonbenzodiazepine drug zolpidem?
Sleepwalking -Benzodiazepines induce daytime sleeping in a few cases. To reduce the daytime sleep, these patients may be prescribed zolpidem, which is a nonbenzodiazepine drug. This drug is known to cause sleepwalking (somnambulation) as a side effect. Bedwetting is more related to neurologic problems and is not an effect of nonbenzodiazepines. Perspiration and body weight are not affected by nonbenzodiazepine therapy.
The nurse is caring for a patient who has undergone orthopedic surgery. The patient is prescribed ketorolac 40 mg and antibiotics. Which action will the nurse expect to perform while caring for the patient?
Stops administering ketorolac after 5 days. -Ketorolac has analgesic and antiinflammatory properties. It is prescribed for patients with orthopedic injuries and those who have undergone orthopedic surgery. Ketorolac should not be administered for more than 5 days, because it has potential adverse effects such as renal impairment and gastrointestinal pain.
What is the main anatomic area of the brain that is affected in a patient with Parkinson disease?
Substantia nigra
A patient with ulcers in the mouth is complaining of pain. How would the nurse most likely classify this pain?
Superficial pain -Pain is an unpleasant sensory and emotional experience that is associated with either actual or potential tissue damage. Superficial pain originates from the skin and mucous membranes. Deep pain occurs in tissues below the skin level. Somatic pain originates from skeletal muscles, ligaments, and joints. Visceral pain originates from organs and smooth muscles.
When instructing a patient about antibiotic therapy, the nurse explains that which condition occurs when the normal flora are disturbed during antibiotic therapy?
Superinfection
What are the symptoms of malignant hyperthermia? Select all that apply.
Tachypnea, Tachycardia & Muscular rigidity -Malignant hyperthermia is an uncommon, genetically linked adverse metabolic reaction to general anesthesia. The symptoms of malignant hyperthermia include tachypnea, tachycardia, and muscular rigidity. Blood in the urine and yellowness of the eyes are not symptoms of malignant hyperthermia. Blood in the urine is hematuria, which is associated with urinary tract infections. Yellowness of the eyes is a symptom of jaundice.
Which instruction is appropriate for a patient who is on nonsteroidal antiinflammatory drug (NSAID) therapy?
Take the NSAID with food, milk, or an antacid. - Gastrointestinal distress is the most common complication with NSAID therapy.
A patient is prescribed allopurinol to treat gout. The nurse is educating the patient about administration of the drug. Which intervention does the nurse suggest to the patient to ensure safe administration of the drug?
Take the drug after a meal -The nurse should advise the patient to take the drug after meals to minimize gastrointestinal symptoms.
A nurse is caring for a patient who has been started on antiepileptic drug therapy for seizures. What information should be included in the teaching plan for the patient?
Take the medication at the same time each day.
A patient is diagnosed with an oral candida infection. Which intervention will the nurse expect to implement?
Teach the patient how to take nystatin.
A patient diagnosed with cholecystitis reports pain in the back and scapular areas. What does the nurse infer about the type of pain from the assessment?
The patient has referred pain. -Patients with cholecystitis may report back pain and scapular pain. The signal for pain that is sent from the gallbladder to the spinal cord can get mixed up with signals from the back and scapular areas. Therefore, the brain receives a signal about back pain and scapular pain because of misinterpretation of signals by the nervous system. This type of pain is called referred pain. Referred pain occurs when visceral nerve fibers synapse at a level in the spinal cord close to fibers that supply specific subcutaneous tissues in the body. Vascular pain originates from the vascular or perivascular tissues. Phantom pain is associated with the area of a body part that has been removed surgically or traumatically. Neuropathic pain results from damage to peripheral or central nervous system nerve fibers by disease or injury.
A patient is taking an antibiotic medication to treat a kidney infection. The patient reports abdominal discomfort, and the primary health care provider prescribes an antacid. After a week of treatment the patient shows no signs of improvement. What could be the most likely reason for this?
The patient is consuming the antacid and antibiotic together.
What are the most common symptoms of chronic salicylate intoxication in adults? Select all that apply.
Tinnitus & Hearing loss Increased intake or long-term use of salicylates results in chronic salicylate intoxication. This condition occurs in both adults and children, but the symptoms vary. Tinnitus and hearing loss are the most common symptoms of chronic salicylate intoxication in adults. Central nervous system (CNS) effects such as dizziness and drowsiness are the most common symptoms of chronic salicylate intoxication in children.
What is the primary aim of using local anesthesia while suturing a wound?
To eliminate pain -is used to reduce neurologic function locally to eliminate pain in a particular body part.
What is the use of the Done nomogram tool?
To estimate the severity of acute salicylate intoxication -The Done nomogram is a graphic plot of serum salicylate level as a function of time since salicylate ingestion. It was first published in a 1960 issue of the journal Pediatrics. The Done nomogram is used to estimate the severity of acute salicylate intoxications and helps to guide treatment.
A patient is prescribed levorphanol to treat chronic pain. Why does the nurse instruct the patient to increase fluid intake while taking levorphanol?
To prevent constipation
What is the primary indication for the administration of morphine?
To relieve acute and chronic pain -The principal indication for morphine is the relief of moderate to severe acute and chronic pain, including postoperative pain and cancer pain. In addition, morphine is used during acute myocardial infarction to relieve pain, anxiety, and dyspnea and to promote relaxation of vascular smooth muscle. Morphine may also be administered before surgery for sedation. Nitroglycerin is used to treat ischemic pain.
The nurse is assessing a patient who was recently diagnosed with Parkinson's disease. The patient's medical records show the presence of liver failure. Which drug is contraindicated in the patient?
Tolcapone [Tasmar] -gets metabolized in the liver
The primary health care provider has prescribed topical antibiotics instead of systemic antibiotics to prevent infection in a patient with burns. What is the reason for prescribing topical antibiotics to the patient?
Topical antibiotics reach the desired site of action faster.
What are the adverse effects of sulfonamide antibiotics? Select all that apply.
Urticaria, Pancreatitis & Hepatotoxicity
A patient is prescribed rifampin for the treatment of tuberculosis. While checking the patient's history, the nurse finds that the patient is on oral contraceptive therapy. What advice on the safe use of rifampin does the nurse give to the patient?
Use other forms of birth control.
The nurse prepares to collect the health history of a patient with narcolepsy. Which strategy should be used to complete this assessment?
Use short, focused interview sessions with active participation by the patient. -A patient with narcolepsy will be drowsy or fall asleep easily. To obtain accurate information, the nurse should keep the dialogue short and focused. Narcolepsy is an incurable neurologic condition in which patients unexpectedly fall asleep in the middle of normal daily activities. For this reason, it is difficult for patients to complete a structured form. Seeking information from significant others may not always work. Using the patient's past medical information may be helpful, but few critical factors may be missed if the patient is not interviewed.
How does superinfection occur in a patient?
When the antibiotic eliminates the normal bacterial flora
When is the risk for renal toxicity due to the administration of nonsteroidal antiinflammatory drugs (NSAIDs) increased? Select all that apply.
When the patient is dehydrated, When the patient has liver dysfunction, & When the patient is administering diuretics - Renal toxicity is one of the major side effects of nonsteroidal antiinflammatory drugs (NSAIDs). Renal toxicity may be caused by dehydration. Metabolism and hepatic excretion of NSAIDs is reduced in patients with impaired liver functioning. This leads to drug accumulation and can cause renal toxicity. The amount of fluid volume is reduced in patients taking diuretics, so this can cause renal toxicity due to deposition of uric acid.
A patient who has gouty arthritis is prescribed febuxostat. What does the nurse assess before administering the medication?
Whether the patient has cardiovascular disease -Febuxostat is an antigout medication that has potential cardiovascular side effects, such as increase in blood pressure and increased risk of heart attack. The nurse should assess whether the patient has a history of cardiovascular disease before prescribing febuxostat. The other side effects associated with febuxostat are hepatic and renal impairment.
What are examples of nonbenzodiazepine drugs? Select all that apply.
Zaleplon, Zolpidem & Eszopiclone -The name nonbenzodiazepine is given to a group of drugs that are similar to benzodiazepines but not benzodiazepines. Nonbenzodiazepine drugs include zaleplon, which is a short-acting hypnotic for insomnia; zolpidem, also a short-acting nonbenzodiazepine hypnotic; and eszopiclone, which was the first hypnotic with U.S. Food and Drug Administration approval for long-term use.
A patient is prescribed zidovudine. The nurse understands that the drug may cause esophageal ulceration if not taken properly. What instruction will the nurse give to the patient to prevent this adverse effect?
Zidovudine is an antiviral drug that may cause esophageal ulceration if regurgitated. Therefore, the patient should be instructed to sit upright or keep the head elevated when taking the drug. The patient should be instructed not to lie down immediately after taking the drug; the patient should sit upright for at least 30 minutes after taking the drug to prevent regurgitation. The drug can be taken with milk or food, because these do not interfere with absorption of the drug.
Which form of the antifungal drug terbinafine is used primarily to treat onychomycoses of the fingernails or toenails?
tablet