Study Kaplan Pharmacology Integrated
A client is to have timolol 0.25% 1 drop in each eye twice daily. The nurse instructs the client to self-administer the eye drops. Which client assessment indicates a need for further instruction?
"After I put the eye drops in my eye, I should put pressure on the outside corner of my eye."
The nurse instructs a client how to take oral iron supplements. Which client statement indicates the need for further teaching?
"I will stop taking this medication between meals."
The nurse instructs a client about taking 500 mg metformin PO daily. Which client statement indicates a need for further teaching ?
"I will take this medication on an empty stomach." Metformin is used to treat high blood sugar levels that are caused by a type of diabetes mellitus or sugar diabetes called type 2 diabetes. With this type of diabetes, insulin produced by the pancreas is not able to get sugar into the cells of the body where it can work properly. Using metformin alone, with a type of oral antidiabetic medicine called a sulfonylurea, or with insulin, will help to lower blood sugar when it is too high and help restore the way you use food to make energy. Many people can control type 2 diabetes with diet and exercise. Following a specially planned diet and exercise will always be important when you have diabetes, even when you are taking medicines. To work properly, the amount of metformin you take must be balanced against the amount and type of food you eat and the amount of exercise you do. If you change your diet or exercise, you will want to test your blood sugar to find out if it is too low. Your doctor will teach you what to do if this happens. Metformin does not help patients who have insulin-dependent or type 1 diabetes because they cannot produce insulin from their pancreas gland. Their blood glucose is best controlled by insulin injections. proper use Carefully follow the special meal plan your doctor gave you. This is a very important part of controlling your condition, and is necessary if the medicine is to work properly. Also, exercise regularly and test for sugar in your blood or urine as directed. Metformin should be taken with meals to help reduce stomach or bowel side effects that may occur during the first few weeks of treatment. Swallow the tablet or extended-release tablet whole with a full glass of water. Do not crush, break, or chew it. While taking the extended-release tablet, part of the tablet may pass into your stool after your body has absorbed the medicine. This is normal and nothing to worry about. Measure the oral liquid with a marked measuring spoon, oral syringe, or medicine cup. The average household teaspoon may not hold the right amount of liquid. Use the supplied dosing cup to measure the mixed extended-release oral suspension. Ask your pharmacist for a dosing cup if you do not have one. Use only the brand of this medicine that your doctor prescribed. Different brands may not work the same way. You may notice an improvement in your blood glucose control in 1 to 2 weeks, but the full effect of blood glucose control may take up to 2 to 3 months. Ask your doctor if you have any questions about this.
The nurse instructs instructs the client taking atenolol. The nurse includes which instructions?
"Report any wheezing or shortness of breath to the heath care provider." Atenolol is used alone or together with other medicines (such as hydrochlorothiazide) to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled . Atenolol is also used to help prevent chest pain and to decrease the severity of heart attacks . This medicine is a beta-blocker. It works by affecting the response to nerve impulses in certain parts of the body, like the heart. As a result, the heart beats slower and decreases the blood pressure. When the blood pressure is lowered, the amount of blood and oxygen is increased to the heart . Check with your doctor immediately if any of the following side effects occur: More common Blurred vision cold hands or feet confusion difficult or labored breathing dizziness, faintness, or lightheadedness when getting up from a lying or sitting position suddenly shortness of breath sweating tightness in chest unusual tiredness or weakness wheezing
The nurse monitors a client taking nifedipine. Which client statement requires immediate follow up by the nurse ?
"Since I started the medication, I feel a little stiff when I get out of bed." Nifedipine is a calcium channel blocker that treats and prevents chest pain. It works by relaxing your blood vessels to decrease the amount of work your heart does. The brand names of this medication are Adalat® and Procardia®. NIFEDIPINE (nye FED i peen) prevents and treats chest pain (angina). It works by relaxing blood vessels, which decreases the amount of work the heart has to do. It belongs to a group of medications called calcium channel blockers.
The healthcare provider prescribes levothyroxine for a client. Which statement requires immediate follow-up by the nurse?
"Sometimes I feel dizzy and my heart pounds." Levothyroxine is a thyroid medicine that replaces a hormone normally produced by your thyroid gland to regulate the body's energy and metabolism. Levothyroxine is used to treat hypothyroidism (low thyroid hormone). This medicine is given when your thyroid does not produce enough of this hormone on its own. Levothyroxine is also used to treat or prevent goiter (enlarged thyroid gland), which can be caused by hormone imbalances, radiation treatment, surgery, or cancer. Levothyroxine may cause serious side effects. Call your doctor at once if you have: fast or irregular heartbeats; chest pain, pain spreading to your jaw or shoulder; shortness of breath; fever, hot flashes, sweating; tremors, or if you feel unusually cold; weakness, tiredness, sleep problems (insomnia); memory problems, feeling depressed or irritable; headache, leg cramps, muscle aches; feeling nervous or irritable; dryness of your skin or hair, hair loss; irregular menstrual periods; or vomiting, diarrhea, appetite changes, weight changes.
The nurse instructs a client taking potassium chloride 40 mEq daily. Which statements indicate understanding of the instructions? Select all that apply.
-If my urine output decreases, I will notify my health care provider. -I will take the medication with a full glass of water. - I will need to have periodic blood test done while taking this medication.
The client takes oral ibandronate 150 mg once a month. The nurse includes which instructions in the teaching ?
-Take the medication the same day of each month. -Sit or stand 60 minutes after taking the medications. Ibandronate is used to treat and prevent osteoporosis (thinning of the bone) in women after menopause. Make sure your doctor knows if you are on any special diet, such as a low-sodium or low-sugar diet. Your doctor may recommend that you eat a balanced diet with an adequate amount of calcium and vitamin D (found in milk or other dairy products). Take ibandronate with a full glass (6 to 8 ounces) of plain water on an empty stomach. It should be taken first thing in the morning at least 60 minutes before any food, beverage, or other medicines. Food and beverages (eg, mineral water, coffee, tea, milk, or juice) will decrease the amount of ibandronate absorbed by the body. Waiting longer than 60 minutes will allow more of the drug to be absorbed. Medicines such as antacids, calcium or vitamin supplements will also decrease the absorption of ibandronate. Swallow the tablet whole. Do not suck or chew on the tablet because it may cause throat irritation. Do not lie down for 60 minutes after taking ibandronate. This will help ibandronate reach your stomach faster. It will also help prevent irritation to your esophagus. It is important that you eat a well-balanced diet with an adequate amount of calcium and vitamin D (found in milk or other dairy products). However, do not take any food, beverages, or calcium or vitamin supplements within 60 minutes or longer after taking ibandronate. To do so may keep this medicine from working properly. Follow the dosing instructions given to you by your doctor closely. It may affect the way this medicine works if you do not. Do not stop using this medicine suddenly without asking your doctor
A school-aged child is to receive 1.2 million units of penicillin G potassium IV daily. The medication is divided and given every 6 hours. The medication vial contains 300,000 units/mL. How many mL does the nurse minister per dose?
1 mL Penicillins are used to treat infections caused by bacteria. They work by killing bacteria or preventing their growth. There are several different kinds of penicillins. Each is used to treat different kinds of infections. Penicillin is commonly used to treat a variety of bacterial infections, including meningitis, pneumonia, gonorrhea, syphilis, and endocarditis.
A 14-month-old toddler receives 250 mg of a liquid mediation. The nurse instructs the parent about administration using a syringe without a needle. The label on the medication bottle reads: 2 teaspoons = 250 mg. How many mL of the medication is drawn into the syringe?
10 mL
The nurse administers an IV infusion of a medication at 10 units/kg/hour. The client weighs 50 kilograms. The medication concentration is 50,000 units per 1000 mL. The infusion pump is set at how many mL/hr?
10 mL/hr
The nurse sets an infusion pump to deliver 4 mcg/kg/min of a medication. The client weighs 50 kg. How many micrograms does the client receive in one hour?
12000 mcg
A client is to receive 4.5 ounces of a liquid medication. How many milliliters (mL) does the nurse administer ?
135 mL
A client receives 2 mg of a medication every 2 hours. The medication is available in 250 mg capsules. The client takes the medication every 6 hours. How many capsules does the client take for each dose?
2 capsules
Sodium polystyrene sulfonate 15 g PO BID is ordered for a client. The medication comes in a 1.25 g/5 mL suspension. How many mL does the nurse administer ?
60 mL.
A client is to receive 1000 mL of 5% dextrose in 0.9% saline over a 4 hour period. The infusion set delivers 15 drops per milliliter. The nurse sets the IV to administer how many drops per minute?
63 drops per minute
The nurse administers an angiotensin converting enzyme inhibitor to a client. Which assessment data indicates an adverse effect of he medication ?
A dry, annoying cough
A client is diagnosed with thrombophlebitis. The client receives heparin sodium IV. Which is the most appropriate laboratory test for the nurse to monitor?
Activated partial thromboplastin time
The nurse instructs a client to apply a 25 mcg/hr fentanyl transdermal patch every 72 hours. Which statement is included in the teaching ?
After your remove a patch, flush it down the toilet immediately.
A health care provider's prescription reads, "Diphenhydramine 25 mg at hour of sleep." Which is the most appropriate action for the nurse to take?
Ask the health care provider for clarification of the prescription Diphenhydramine is marketed under the brand name Benadryl, store brands, and generics. Diphenhydramine is an antihistamine that reduces the effects of the natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose. Diphenhydramine is used to treat sneezing, runny nose, watery eyes, hives, skin rash, itching, and other cold or allergy symptoms. Diphenhydramine is also used to treat motion sickness, to induce (bring about) sleep, and to treat certain symptoms of Parkinson's disease. About diphenhydramine It's known as a drowsy (sedating) antihistamine and is more likely to make you feel sleepy than other antihistamines. It's used for: short-term sleep problems (insomnia), including when a cough, cold or itching is keeping you awake at night. cough and cold symptoms.
An adult client receives chemotherapy. The client asks the nurse if all the hair will be lost. Which action does the nurse take first?
Assesses the client's understanding of the adverse effects of the medication.
The nurse cares for a client who has been taking prednisone for several months. Which finding indicates a complication of the medication?
Black, tarry stools.
A client is admitted to a psychiatric unit. The client has symptoms of depression, anorexia., low self esteem, and suicidal idealization. Th nurse expects to administer which medication?
Bupropion
The nurse provides care for a client diagnosed with severe preeclampsia. The client receives magnesium sulfate IV. Which medication must be available for the treatment of magnesium toxicity ?
Calcium gluconate Calcium gluconate is an ingredient found in a variety of supplements and vitamins, and is used to lower potassium in the blood or treat magnesium poisoning. Oral calcium salts are used as dietary supplemental therapy for person who may not get enough calcium in their regular diet. Calcium gluconate is used as a cardioprotective agent in high blood potassium. Calcium gluconate is the antidote for magnesium sulfate toxicity. Preeclampsia is a complication of pregnancy. With preeclampsia, you might have high blood pressure, high levels of protein in urine that indicate kidney damage (proteinuria), or other signs of organ damage. Preeclampsia usually begins after 20 weeks of pregnancy in women whose blood pressure had previously been in the standard range. Left untreated, preeclampsia can lead to serious — even fatal — complications for both the mother and baby. Early delivery of the baby is often recommended. The timing of delivery depends on how severe the preeclampsia is and how many weeks pregnant you are. Before delivery, preeclampsia treatment includes careful monitoring and medications to lower blood pressure and manage complications.
A client developed wheezing when given ampicillin and co-trimoxazole. Which additional order does the nurse question?
Cefaclor 500 mg q 8 hours. If you are allergic to Penicillins then you are more likely to be allergic to a group of antibiotics called Cephalosporins of which Cephalexin is a member. Cephalexin should be avoided in a penicillin allergic patient. Antibiotics such as clarithromycin, doxycycline and erthyromycin may be safe alternatives for you Cefoxitin is a cephalosporin (SEF a low spor in) antibiotic. It works by fighting bacteria in your body. Cefaclor is used to treat many kinds of bacterial infections, such as bladder infection, ear infection, skin infection, or infection of the respiratory tract. Ampicillin is a penicillin antibiotic that is used to treat or prevent many different types of infections such as bladder infections, pneumonia, gonorrhea, meningitis, or infections of the stomach or intestines. Co-trimoxazole is used to treat certain bacterial infections, such as pneumonia (a lung infection), bronchitis (infection of the tubes leading to the lungs), and infections of the urinary tract, ears, and intestines. It also is used to treat 'travelers' diarrhea.
The nurse instructs a client who is to take captopril daily. Which statement is included in the instructions?
Change the positions slowly. Orthostatic hypotension — also called postural hypotension — is a form of low blood pressure that happens when standing after sitting or lying down. Orthostatic hypotension can cause dizziness or lightheadedness and possibly fainting. Orthostatic hypotension can be mild. Episodes might be brief. Captopril is used to treat high blood pressure (hypertension). Lowering high blood pressure helps prevent strokes, heart attacks, and kidney problems. It is also used to treat heart failure, protect the kidneys from harm due to diabetes, and to improve survival after a heart attack.Captopril is an ACE inhibitor and works by relaxing blood vessels so that blood can flow more easily.
A client receives cimetidine. The client asks the nurse how the medication works. Which nurse's response is best?
Cimetidine decreases acid secretion. Cimetidine is a medication that reduces the amount of acid in your stomach. It treats heartburn, stomach ulcers and reflux disease. This medication comes in a tablet form that you can take by mouth with a drink of water as directed. Follow the instructions on the label and take this medication before you to go bed.
The nurse administers morphine sulfate 4 mg intravenously every 4 hours PRN to a client. The nurse monitors for which adverse reactions? Select all that apply .
Constipation Decreased urinary frequency Nausea and vomiting Morphine is an opioid medication. An opioid is sometimes called a narcotic. Morphine works by blocking pain signals from travelling along the nerves to the brain. Morphine is used to treat moderate to severe pain. The extended-release form of morphine is for around-the-clock treatment of pain. Short-acting formulations are taken as needed for pain. Get emergency medical help if you have signs of an allergic reaction to morphine: hives; difficult breathing; swelling of your face, lips, tongue, or throat. Opioid medicine can slow or stop your breathing, and death may occur. A person caring for you should seek emergency medical attention if you have slow breathing with long pauses, blue colored lips, or if you are hard to wake up. slow heart rate, sighing, weak or shallow breathing, breathing that stops; chest pain, fast or pounding heartbeats; extreme drowsiness, feeling like you might pass out; serotonin syndrome - agitation, hallucinations, fever, fast heart rate, muscle stiffness, twitching, loss of coordination, nausea, diarrhea; or low cortisol levels - nausea, vomiting, loss of appetite, dizziness, worsening tiredness or weakness. Serious breathing problems may be more likely in older adults and people who are debilitated or have wasting syndrome or chronic breathing disorders. Common morphine side effects may include: drowsiness, dizziness, tiredness; constipation, stomach pain, nausea, vomiting; sweating; or feelings of extreme happiness or sadness.
The nurse instructs the client who is to take risperidone daily. Which adverse effects are included in the teaching?
Diarrhea (questionable) and increased salivation Drug class: Atypical antipsychotics Risperidone is used to treat schizophrenia, bipolar disorder, or irritability associated with autistic disorder. This medicine should not be used to treat behavioral problems in older adults who have dementia. Common risperidone side effects include nausea, constipation, and dry mouth. More serious side effects include movement problems, hyperprolactinemia, and a greater risk of falls. What are the adverse effects of antipsychotics? These effects include: antimuscarinic effects bed-wetting blood disorders body temperature problems emotional effects eye problems heart problems liver disorders metabolic syndrome neuroleptic malignant syndrome (NMS) neuromuscular side effects sedation (sleepiness) seizures (fits) sexual and hormonal problems skin problems suicidal feelings and behaviour tardive dyskinesia (TD) tardive psychosis weight gain
The nurse provides care for a client who takes carbamazepine daily. Which assessment indicates an adverse reaction?
Diplopia Diplopia is the medical term for double vision or seeing double. Diplopia is defined as seeing two images of a single object when you're looking at it. Carbamazepine is an anticonvulsant. It works by decreasing nerve impulses that cause seizures and nerve pain, such as trigeminal neuralgia and diabetic neuropathy. Carbamazepine is also used to treat bipolar disorder. Check with your doctor immediately if any of the following side effects occur: More common Blurred vision or double vision continuous back-and-forth eye movements
The nurse cares for a client diagnosed with acute salicylate poisoning. Which signs and symptoms does the nurse expect to observe?
Disorientation or increased pulse rate What is acute salicylate toxicity? Definition. Salicylate poisoning is the result of ingestion of, or (rarely) topical exposure to, chemicals metabolized to salicylate. Poisoning may occur due to acute or chronic salicylate exposure and is characterized by acid-base disturbances, electrolyte abnormalities, and central nervous system effects. With acute overdose, early symptoms include nausea, vomiting, tinnitus, and hyperventilation. Later symptoms include hyperactivity, fever, confusion, and seizures. Rhabdomyolysis, acute renal failure, and respiratory failure may eventually develop. Hyperactivity may quickly turn to lethargy; hyperventilation (with respiratory alkalosis) progresses to hypoventilation (with mixed respiratory and metabolic acidosis) and respiratory failure. With chronic overdose, symptoms and signs tend to be nonspecific, vary greatly, and may suggest sepsis. They include subtle confusion, changes in mental status, fever, hypoxia, noncardiogenic pulmonary edema, dehydration, lactic acidosis, and hypotension. treatment is with activated charcoal and alkaline diuresis or hemodialysis.
The nurse cares for an older client who is confused. The nurse notes the client charges the settings on the IV infusion pup. The client received 250 ml of IV fluid in one hour. The nurse makes which priority assessment ?
Distended hand veins, elevated blood pressure, and moist lung crackles. Document baseline data. Before infusion, assess the patient's vital signs, edema status, lung sounds, and heart sounds. Continue monitoring during and after the infusion. Observe for signs of fluid overload. Look for signs of hypervolemia such as hypertension, bounding pulse, pulmonary crackles, dyspnea, shortness of breath, peripheral edema, jugular venous distention, and extra heart sounds. Monitor manifestations of continued hypovolemia. Look for signs that indicate continued hypovolemia such as, decreased urine output, poor skin turgor, tachycardia, weak pulse, and hypotension. Prevent hypervolemia. Patients being treated for hypovolemia can quickly develop fluid overload following rapid or over infusion of isotonic IV fluids. Elevate the head of the bed to 35 to 45 degrees. Unless contraindicated, position the client in semi-Fowler's position. Elevate the patient's legs. If edema is present, elevate the legs of the patient to promote venous return. Educate patients and families. Teach patients and families to recognize signs and symptoms of fluid volume overload. Instruct patients to notify their nurse if they have trouble breathing or notice any swelling. Close monitoring for patients with heart failure. Because isotonic fluids expand the intravascular space, patients with hypertension and heart failure should be carefully monitored for signs of fluid overload
The nurse prepares to administer 18 units of intermediate-acting and 10 units of short-acting insulin to a client. The nurse takes which action first?
Draws up to 10 units of air into the syringe
A client is to self-administer enoxaparin. The nurse instructs the client to avoid herbal preparation.
Ginkgo biloba Enoxaparin injection is used to prevent deep venous thrombosis, a condition in which harmful blood clots form in the blood vessels of the legs. These blood clots can travel to the lungs and can become lodged in the blood vessels of the lungs, causing a condition called pulmonary embolism. This medicine is used for several days after hip or knee replacement surgery, and in some cases following abdominal or stomach surgery, while you are unable to walk. It is during this time that blood clots are most likely to form. It is also used if you are unable to get out of bed because of a serious illness. In addition, enoxaparin is used to prevent blood clots from forming in the arteries of the heart during certain types of chest pain and heart attacks. Enoxaparin injection is used together with warfarin to treat acute deep vein thrombosis with or without pulmonary embolism. It is also used to treat certain types of acute heart attacks. Common herbal supplements with the potential to interfere with blood clotting Aloe. Aloe (Aloe vera) has been widely used as a medicinal plant for centuries. ... Cranberry. ... Feverfew. ... Garlic. ... Ginger. ... Ginkgo. ... Meadowsweet. ... Turmeric.
The nurse administers 5000 units of heparin subcutaneously to a client. Which action is most important for the nurse to take?
Give the injection in the abdomen.
The nurse cares for a client who takes lorazepam daily. The nurse expects the client to make which statement?
I am feeling less anxious Lorazepam is used to treat anxiety disorders. It is also used for short-term relief of the symptoms of anxiety or anxiety caused by depression. Lorazepam is a benzodiazepine that works in the brain to relieve symptoms of anxiety. Benzodiazepines are central nervous system (CNS) depressants, which are medicines that slow down the nervous system. More common side effects Drowsiness relaxed and calm sleepiness
A client is diagnosed with Parkinson disease. The nurse teaches about benztropine. Which client statement requires additional teaching?
I can expect to have increased sweating and diarrhea while taking benzotropine. Parkinson's disease is a progressive disorder that affects the nervous system and the parts of the body controlled by the nerves. Symptoms start slowly. The first symptom may be a barely noticeable tremor in just one hand. Tremors are common, but the disorder may also cause stiffness or slowing of movement. In the early stages of Parkinson's disease, your face may show little or no expression. Your arms may not swing when you walk. Your speech may become soft or slurred. Parkinson's disease symptoms worsen as your condition progresses over time. Although Parkinson's disease can't be cured, medications might significantly improve your symptoms. Occasionally, your health care provider may suggest surgery to regulate certain regions of your brain and improve your symptoms. Benztropine is used with other medicines to treat Parkinson's disease. By improving muscle control and reducing stiffness, this medicine allows more normal movements of the body as the disease symptoms are reduced. It is also used to control severe reactions to certain medicines that are used to treat nervous, mental, and emotional conditions (e.g., phenothiazine medicine such as prochlorperazine, Compazine®, Mellaril®, Phenergan®, Thorazine®, Trilafon®). Benztropine is in a class of medications called anticholinergics. It works by blocking a certain natural substance (acetylcholine) to help to decrease symptoms in people with Parkinson's disease.J side effects: https://www.mayoclinic.org/drugs-supplements/benztropine-oral-route/side-effects/drg-20072652?p=1
A client takes atorvastatin daily. Which client statement most concerns the the nurse?
I have muscle aches that seems to be getting worse.
The nurse cares for a client diagnosed with type 1 Diabetes mellitus. The nurse instructs the client to administer rapid-acting insulin. Which client statements indicate understanding of the teaching ?
I know that insulin is most rapidly absorbed from my abdominal tissue. I will inject the insulin within 15 minutes of eating. I will monitor my blood glucose levels when I am sick. I will keep my insulin in the refrigerator after I open the vial.
The nurse instructs the parents of a 6-year-old child taking phenytoin. Which parental statement indicates the the teaching is effective ?
I will give the medication to my child at the same time every day.
The nurse teaches a client about isoniazid. Which client statement indicates the need for further teaching?
I will stop the medication if I have fatigue and nausea. Isoniazid is an antibiotic that fights bacteria. Isoniazid is used to treat and to prevent tuberculosis (TB). You may need to take other TB medicines in combination with isoniazid. When treating active TB, isoniazid must be used with other TB medicines. Tuberculosis can become resistant to treatment if isoniazid is used alone. Take all your medicines as prescribed by your doctor. You should not use isoniazid if you have active liver disease, or if you have taken isoniazid in the past and it caused liver problems, fever, chills, joint pain, or severe allergic reaction. Side Effects Clumsiness or unsteadiness. nausea or vomiting. numbness, tingling, burning, or pain in hands and feet. yellow eyes or skin.
The nurse teaches the client about sublingual nitroglycerin administration. Which client statement indicates further teaching is necessary?
I will swallow frequently until the tablet completely dissolves. Nitroglycerin is used to prevent angina (chest pain) caused by coronary artery disease. This medicine is also used to relieve an angina attack that is already occurring. Nitroglycerin belongs to the group of medicines called nitrates. It works by relaxing the blood vessels and increasing the supply of blood and oxygen to the heart while reducing its work load. When used regularly on a long-term basis, or just before exercise or a stressful event, this helps prevent angina attacks from occurring. What happens if you swallow a nitroglycerin tablet? If you accidentally swallow the tablet, take another. The medicine won't work if you swallow it. For between-cheek-and-gum (buccal) tablets, place the tablet between your cheek and gum. Leave it there until it dissolves. Nitroglycerin sublingual tablets should not be chewed, crushed, or swallowed. They work much faster when absorbed through the lining of the mouth.
The nurse instructs the client to take diphenhydramine daily. Which statement by the client indicates a need for further instructions?
I will take the diphenhydramine in the morning before I drive to work. Drug classes: Anticholinergic antiemetics, Anticholinergic antiparkinson agents, Antihistamines, Miscellaneous anxiolytics, sedatives and hypnotics Diphenhydramine is an antihistamine that reduces the effects of natural chemical histamine in the body. Histamine can produce symptoms of sneezing, itching, watery eyes, and runny nose. Diphenhydramine is used to treat sneezing, runny nose, watery eyes, hives, skin rash, itching, and other cold or allergy symptoms. How should I take diphenhydramine? Use diphenhydramine exactly as directed on the label, or as prescribed by your doctor. Do not use in larger or smaller amounts or for longer than recommended. Cold or allergy medicine is usually taken only for a short time until your symptoms clear up. Do not give diphenhydramine to a child younger than 2 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. You should not use diphenhydramine to make a child sleepy. Measure liquid medicine with a special dose-measuring spoon or medicine cup. If you do not have a dose-measuring device, ask your pharmacist for one. For motion sickness, take diphenhydramine 30 minutes before you will be in a situation that causes you motion sickness (such as a long car ride, airplane or boat travel, amusement park rides, etc). Continue taking diphenhydramine with meals and at bedtime, for the rest of the time you will be in a motion-sickness situation. As a sleep aid, take diphenhydramine within 30 minutes before bedtime Warnings When taking diphenhydramine, use caution driving, operating machinery, or performing other hazardous activities. Diphenhydramine may cause dizziness or drowsiness. If you experience dizziness or drowsiness, avoid these activities. Use alcohol cautiously. Alcohol may increase drowsiness and dizziness while taking diphenhydramine. Do not give this medication to a child younger than 2 years old. Always ask a doctor before giving a cough or cold medicine to a child. Death can occur from the misuse of cough and cold medicines in very young children. You should not use diphenhydramine to make a child sleepy.
The nurse instructs a client about taking aluminum hydroxide. Which client statement indicates understanding of the instructions?
I will take the medication between meals and at bedtime.
The nurse administers warfarin to a client. The nurse informs the client it will be necessary to monitor which laboratory test regularly?
International normalized ratio.
The nurse instructs a client to take oral baclofen daily. Which is the most appropriate statement for the nurse to make?
It is common to experience some drowsiness and dizziness.
Th nurse reviews laboratory reports for a client receiving digoxin and furosemide. Which laboratory values most concern the nurse?
K= 3.2 mEq/L (3.2 mmol) ; digoxin level= 2.2 ng/mL (2.8 n mmol/L) Digoxin is a type of medicine called a cardiac glycoside. It's used to control some heart problems, such as irregular heartbeats (arrhythmias) including atrial fibrillation. It can also help to manage the symptoms of heart failure, usually with other medicines. More common side effects Dizziness fainting fast, pounding, or irregular heartbeat or pulse slow heartbeat A normal Digoxin level should be 0.5 - 2 ng/mL. Any levels greater than 2 ng/mL is considered toxic. Furosemide belongs to a group of medicines called loop diuretics (also known as water pills). Furosemide is given to help treat fluid retention (edema) and swelling that is caused by congestive heart failure, liver disease, kidney disease, or other medical conditions. It works by acting on the kidneys to increase the flow of urine. Furosemide is also used alone or together with other medicines to treat high blood pressure (hypertension). High blood pressure adds to the workload of the heart and arteries. If it continues for a long time, the heart and arteries may not function properly. This can damage the blood vessels of the brain, heart, and kidneys, resulting in a stroke, heart failure, or kidney failure. High blood pressure may also increase the risk of heart attacks. These problems may be less likely to occur if blood pressure is controlled.
The nurse prepares to administer medications. Which order does the nurse question?
Metoprolol to a client with a blood pressure 118/78.
A client starts chemotherapy for treatment of colon cancer. The client returns four days later. It is most important for the nurse to take which action?
Observe the skin You may develop sores that become painful, wet, and infected. This is called a moist reaction. Some types of chemotherapy can cause your skin to become dry, itchy, red or darker, or peel. You may develop a minor rash or sunburn easily; this is called photosensitivity.
The nurse instructs a client who is to take rifampin. The nursing informs the client that which adverse effect may occur?
Orange-colored urine Rifampin is used together with other medicines to treat tuberculosis (TB) in many different parts of the body. It is also used by patients who have meningitis bacteria in their nose or throat who do not show symptoms of the infection to prevent the spread of the bacteria to other patients. Rifampin is in a class of medications called antimycobacterials. It works by killing the bacteria that cause infection. Antibiotics such as rifampin will not work for colds, flu, or other viral infections. What is the major adverse effect of Rifampin? Rifampin will cause urine, saliva, sputum, sweat, teeth, and tears to turn a reddish-orange to reddish-brown color. This is to be expected while you are using this medicine. This effect may also cause soft contact lenses to become permanently discolored.
The nurse provides care for a client diagnosed with Hodgkin's disease. The client received cyclophosphamide. Which laboratory value does the nurse report to the healthcare provider?
Platelets 40,000 mm3 (40x10^9/L) A normal platelet count in adults ranges from 150,000 to 450,000 platelets per microliter of blood. Hodgkin's lymphoma is a type of cancer that affects the lymphatic system, which is part of the body's germ-fighting immune system. In Hodgkin's lymphoma, white blood cells called lymphocytes grow out of control, causing swollen lymph nodes and growths throughout the body. Cyclophosphamide is used to treat cancer of the ovaries, breast, blood and lymph system, and nerves (mainly in children). Cyclophosphamide is also used for retinoblastoma (a type of eye cancer mainly in children), multiple myeloma (cancer in the bone marrow), and mycosis fungoides (tumors on the skin). It belongs to the group of cancer medicines called alkylating agents. Cyclophosphamide is also used for some kinds of kidney disease. Cyclophosphamide interferes with the growth of cancer cells, which are then destroyed by the body. Since the growth of normal body cells may also be affected by cyclophosphamide, other effects will also occur. Some of these may be serious and must be reported to your doctor. Other effects, like hair loss, may not be serious but may cause concern. Some effects may not occur for months or years after the medicine is used.
The health care provider orders pilocarpine eye drops for a client. The nurse is aware the client has which disorder ?
Primary open-angle glaucoma Pilocarpine is a muscarinic cholinergic agonist used on the eye to treat elevated intraocular pressure, various types of glaucoma, and to induce miosis. Also available orally to treat symptoms of dry mouth associated with Sjogren's syndrome and radiotherapy. Pilocarpine tablets are used to treat dryness of the mouth and throat caused by a decrease in the amount of saliva that may occur after radiation treatment for cancer of the head and neck or in patients with Sjogren's syndrome. This medicine may help you speak without having to sip liquids. It may also help with chewing, tasting, and swallowing. This medicine may reduce your need for other oral comfort agents, such as hard candy, sugarless gum, or artificial saliva agents. Pilocarpine may also be used to treat dryness of the eyes caused by Sjogren's syndrome
The nurse questions the dosage of a pain medication prescription. The health care provider tells the nurse to give the medication. The nurse still has concerns about the safety of the dose. Which is the best action for the nurse to take?
Refuse to administer the medication.
The nurse instructs a client about the use of transdermal nitroglycerin patch. Which instruction is included?
Remove the patch 12 to 14 hours
The client is diagnosed with rheumatoid arthritis. The nurse instructs the client about taking methotrexate. The nurse includes which statement?
Report any temperature increases to your health care provider immediately. Rheumatoid arthritis is a chronic inflammatory disorder that can affect more than just your joints. In some people, the condition can damage a wide variety of body systems, including the skin, eyes, lungs, heart and blood vessels. An autoimmune disorder, rheumatoid arthritis occurs when your immune system mistakenly attacks your own body's tissues. Unlike the wear-and-tear damage of osteoarthritis, rheumatoid arthritis affects the lining of your joints, causing a painful swelling that can eventually result in bone erosion and joint deformity. The inflammation associated with rheumatoid arthritis is what can damage other parts of the body as well. While new types of medications have improved treatment options dramatically, severe rheumatoid arthritis can still cause physical disabilities. Signs and symptoms of rheumatoid arthritis may include: Tender, warm, swollen joints Joint stiffness that is usually worse in the mornings and after inactivity Fatigue, fever and loss of appetite How does methotrexate work? Methotrexate calms your immune system, to help stop it attacking your body's cells. This helps reduce the inflammation that causes swollen and stiff joints in rheumatoid arthritis, thickened skin in psoriasis or damage to your bowel in Crohn's disease (A chronic inflammatory bowel disease that affects the lining of the digestive tract.). Methotrexate is not a painkiller. Methotrexate may cause serious or life-threatening skin reactions. If you experience any of the following symptoms, call your doctor immediately: fever, rash, blisters, or peeling skin. Methotrexate may decrease the activity of your immune system, and you may develop serious infections.
The nurse instructs the client to take clonidine hydrochloride. It is most important for the nurse to include which statement in the teaching?
Rise slowly from the bed to the chair. Clonidine lowers blood pressure by decreasing the levels of certain chemicals in your blood. This allows your blood vessels to relax and your heart to beat more slowly and easily. Clonidine is used to treat hypertension (high blood pressure). Call your doctor at once if you have: severe chest pain, shortness of breath, irregular heartbeats; a very slow heart rate; or a light-headed feeling, like you might pass out. Common clonidine side effects may include: drowsiness, dizziness; feeling tired or irritable; dry mouth; constipation, loss of appetite; or sleep problems (insomnia), nightmares.
A client is diagnosed with bacterial pneumonia. The nurse prepares to administer 80 mg of gentamicin intravenously. Which laboratory test is the priority to review prior to the first dose?
Serum creatinine A creatinine test is a measure of how well your kidneys are performing their job of filtering waste from your blood. Creatinine is a chemical compound left over from energy-producing processes in your muscles. Healthy kidneys filter creatinine out of the blood. Creatinine exits your body as a waste product in urine. A measurement of creatinine in your blood or urine provides clues to help your doctor determine how well the kidneys are working. Bacterial pneumonia is an infection of your lungs caused by certain bacteria. The most common one is Streptococcus (pneumococcus), but other bacteria can cause it too. If you're young and basically healthy, these bacteria can live in your throat without causing any trouble. Gentamicin injection is used to treat serious bacterial infections in many different parts of the body. Gentamicin belongs to the class of medicines known as aminoglycoside antibiotics. It works by killing bacteria or preventing their growth. However, this medicine will not work for colds, flu, or other virus infections. Gentamicin injection is usually used for serious bacterial infections for which other medicines may not work. However, it may also cause some serious side effects, including damage to your kidneys and the part of your body that controls hearing. These side effects may be more likely to occur in elderly patients and newborn infants. You and your doctor should talk about the benefit of this medicine as well as the risks.
A client is diagnosed with osteoarthritis. The client takes naproxen sodium 250 mg PO twice a day. It is most important for the nurse to teach the client to report which symptom?
Stomach pain over a 3-day period. Osteoarthritis is the most common form of arthritis, affecting millions of people worldwide. It occurs when the protective cartilage that cushions the ends of the bones wears down over time. Although osteoarthritis can damage any joint, the disorder most commonly affects joints in your hands, knees, hips and spine. Osteoarthritis symptoms can usually be managed, although the damage to joints can't be reversed. Staying active, maintaining a healthy weight and receiving certain treatments might slow progression of the disease and help improve pain and joint function. Naproxen is a nonsteroidal anti-inflammatory drug (NSAID) used to relieve symptoms of arthritis (eg, osteoarthritis, rheumatoid arthritis, or juvenile arthritis) such as inflammation, swelling, stiffness, and joint pain. Naproxen also helps relieve symptoms of ankylosing spondylitis, which is a type of arthritis that affects the joints in the spine. However, this medicine does not cure arthritis and will help you only as long as you continue to take it. This medicine may also be used to treat mild to moderate pain, including acute gout and other painful conditions such as bursitis, tendinitis, or menstrual cramps. Check with your doctor immediately if any of the following side effects occur: More common Belching bruising chest tightness difficult or labored breathing feeling of indigestion headache itching skin large, flat, blue, or purplish patches in the skin pain in the chest below the breastbone skin eruptions stomach pain swelling
The nurse teaches a client to use the metered-dose inhaler. The client is to have 2 inhalation's of albuterol every 4 hours. Which action indaicates the teaching is effective?
The client exhales completely before closing mouth around the spacer mouthpiece.
A client is diagnosed with schizophrenia. The nurse administers haloperidol. Which assessment indicates a therapeutic response to the medication ?
The client has become more quiet and unobtrusive.
A client is receiving 5% dextrose in 0.45% saline IV at 150 mL per hour in the forearm. Which finding best indicates to the nurse the IV is infiltrated?
The client reports the arm is painful. What are signs of an infiltration/extravasation? Redness around the site. Swelling, puffy or hard skin around the site. Blanching (lighter skin around the IV site) Pain or tenderness around the site. IV not working. Cool skin temperature around the IV site or of the scalp, hand, arm, leg or foot near the site. What is dextrose 5% IV used for? Dextrose injection is a sterile solution used to provide your body with extra water and carbohydrates (calories from sugar). It is used when a patient is not able to drink enough liquids or when additional fluids are needed. Dextrose 5 in .9 Sodium Chloride is a prescription medicine used to treat the symptoms of Hypoglycemia. Dextrose 5 in .9 Sodium Chloride may be used alone or with other medications.
A client has labor induced with oxytocin. The client's cervix is 7 cm dilated. Which assessment causes the nurse to stop the oxytocin infusion?
The client's contractions last 90 to 110 seconds.
The nurse is to administer a medication that is classified by the Federal Drug Administration (FDA) as a schedule II drug. What does this mean?
The medication has high potential for abuse.
The nurse administers albuterol 2 puffs every 4 to 6 hours PRN to the client. The client is carefully assessed for which adverse reaction?
Tremors
A client is diagnosed with systemic lupus erythematosus (SLE). The client has taken corticosteroid therapy for several years. The nurse knows the client is at high risk to develop which clinical manifestations?
Truncal obesity and purple striations on the skin What side effects can corticosteroids cause? A buildup of fluid, causing swelling in your lower legs. High blood pressure. Problems with mood swings, memory, behavior, and other psychological effects, such as confusion or delirium. Upset stomach. Weight gain in the belly, face and back of the neck. Lupus is a disease that occurs when your body's immune system attacks your own tissues and organs (autoimmune disease). Inflammation caused by lupus can affect many different body systems — including your joints, skin, kidneys, blood cells, brain, heart and lungs. Lupus can be difficult to diagnose because its signs and symptoms often mimic those of other ailments. The most distinctive sign of lupus — a facial rash that resembles the wings of a butterfly unfolding across both cheeks — occurs in many but not all cases of lupus. Some people are born with a tendency toward developing lupus, which may be triggered by infections, certain drugs or even sunlight. While there's no cure for lupus, treatments can help control symptoms. treatment may include: Nonsteroidal anti-inflammatory drugs (NSAIDs). Over-the-counter NSAIDs, such as naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others), may be used to treat pain, swelling and fever associated with lupus. Stronger NSAIDs are available by prescription. Side effects of NSAIDs may include stomach bleeding, kidney problems and an increased risk of heart problems. Antimalarial drugs. Medications commonly used to treat malaria, such as hydroxychloroquine (Plaquenil), affect the immune system and can help decrease the risk of lupus flares. Side effects can include stomach upset and, very rarely, damage to the retina of the eye. Regular eye exams are recommended when taking these medications. Corticosteroids. Prednisone and other types of corticosteroids can counter the inflammation of lupus. High doses of steroids such as methylprednisolone (Medrol) are often used to control serious disease that involves the kidneys and brain. Side effects include weight gain, easy bruising, thinning bones, high blood pressure, diabetes and increased risk of infection. The risk of side effects increases with higher doses and longer term therapy. Immunosuppressants. Drugs that suppress the immune system may be helpful in serious cases of lupus. Examples include azathioprine (Imuran, Azasan), mycophenolate (Cellcept), methotrexate (Trexall, Xatmep, others), cyclosporine (Sandimmune, Neoral, Gengraf) and leflunomide (Arava). Potential side effects may include an increased risk of infection, liver damage, decreased fertility and an increased risk of cancer. Biologics. A different type of medication, belimumab (Benlysta) administered intravenously, also reduces lupus symptoms in some people. Side effects include nausea, diarrhea and infections. Rarely, worsening of depression can occur. Rituximab (Rituxan, Truxima) may be beneficial for some people in whom other medications haven't helped. Side effects include allergic reaction to the intravenous infusion and infections.
The nurse provides care for a client diagnosed with bipolar disorder. The client receives lithium. Which sign or symptom indicates lithium toxicity?
Unsteady gait Lithium is used to treat mania which is part of bipolar disorder (manic-depressive illness). It is also used on a daily basis to reduce the frequency and severity of manic episodes. Manic-depressive patients experience severe mood changes, ranging from an excited or manic state (eg, unusual anger or irritability or a false sense of well-being) to depression or sadness. What are the symptoms of too much lithium in your body? Call your doctor right away if you have diarrhea, vomiting, drowsiness, muscle weakness, tremors, unsteadiness, or other problems with muscle control or coordination. These may be symptoms of lithium toxicity. Make sure your doctor knows if you have a heart disorder called Brugada syndrome. Treatment varies https://www.healthline.com/health/lithium-toxicity#treatment Moderate to severe toxicity Moderate to severe lithium toxicity usually requires additional treatment, such as: Stomach pumping. This procedure may be an option if you've taken lithium within the last hour. Whole bowel irrigation. You'll swallow a solution or be given one through a tube to help flush the extra lithium out of your intestines. IV fluids. You may need these to restore your electrolyte balance. Hemodialysis. This procedure uses an artificial kidney, called a hemodialyzer, to remove waste from your blood. Medication. If you start to have seizures, your doctor might prescribe an anticonvulsant medication. Vital sign monitoring. Your doctor may choose to keep you under supervision while they monitor your vital signs, including your blood pressure and heart rate, for any unusual signs.
A client receives 20 mEq of potassium chloride added to 1000 mL of 0.9% saline. Which assessment does the nurse make first?
Urine output Potassium chloride is a potassium salt used to treat hypokalemia. A white crystal or crystalline powder used as an electrolyte replenisher, in the treatment of hypokalemia, in buffer solutions, and in fertilizers and explosives.
A client chives vitamin B1 for the treatment of acute alcohol withdrawal. The client's adult child asks the nurse why. Which response by the nurse is best?
Vitamin B1 reduces the neurological symptoms your parent may experience.
A client takes isoniazid and vitamin B6. The client asks why vitamin B6 (pyridoxine) is also given. Which is the most appropriate response by the nurse ?
Vitamin B6 prevents inflammation of the nerves caused by isoniazid. Isoniazid is an antibiotic used to treat mycobacterial infections; most commonly use in combination with other antimycobacterial agents for the treatment of active or latent tuberculosis. Get emergency medical help if you have signs of an allergic reaction (hives, difficult breathing, swelling in your face or throat) or a severe skin reaction (fever, sore throat, burning in your eyes, skin pain, red or purple skin rash that spreads and causes blistering and peeling). Seek medical treatment if you have a serious drug reaction that can affect many parts of your body. Symptoms may include: skin rash, fever, swollen glands, flu-like symptoms, muscle aches, severe weakness, unusual bruising, or yellowing of your skin or eyes. This reaction may occur several weeks after you began using isoniazid. Isoniazid may cause serious side effects. Call your doctor at once if you have: sudden weakness or ill feeling, or fever for 3 days or longer; pain in your upper stomach (may spread to your back), nausea, loss of appetite; dark urine, clay-colored stools, jaundice (yellowing of the skin or eyes); vision changes, pain behind your eyes; confusion, memory problems, unusual thoughts or behavior; a seizure (convulsions); or pale skin, easy bruising or bleeding (nosebleeds, bleeding gums). Do you have to take B6 with isoniazid? Your doctor may also want you to take pyridoxine (eg, Hexa-Betalin, vitamin B6) every day to help prevent or lessen some of the side effects of isoniazid. Prevent the development of peripheral neuropathy.
A client receives warfarin. The client asked why am I taking this medication? Which is the best response by the nurse?
Warfarin blocks the formation of clotting factors in your blood.
The nurse cares for a client receiving a blood transfusion. The client develops circulatory overload. Which signs and symptoms does the nurse expect to observe?
Wheezing, chest pain, and fever.
The nurse prepares to administer digoxin 0.01 mg/kg PO to a 2-month-old infant. The infant weighs 5 kg.The sleeping infant's apical pulse is 70 bpm. The nurse takes which most appropriate action?
Withholds the medication and notifies the health care provider immediately. Digoxin belongs to the class of medicines called digitalis glycosides. It is used to improve the strength and efficiency of the heart, or to control the rate and rhythm of the heartbeat. This leads to better blood circulation and reduced swelling of the hands and ankles in patients with heart problems.. It is used to treat congestive heart failure, usually in combination with a diuretic (water pill) and an angiotensin-converting enzyme (ACE) inhibitor. It is also used to treat a heart rhythm problem called atrial fibrillation. What is a normal apical pulse for an infant? newborn: 100-170 bpm. 6 months to 1 year: 90-130 bpm. 2 to 3 years: 80-120 bpm. 4 to 5 years: 70-110 bpm.
The first time parent asks the nurse why the newborn was given a vitamin K injection. Which statement by the nurse is best?
Your baby needs Vitamin K to manufacture clotting factors.
The nurse cares for a pregnant client. The client is HIV positive. Which medication taken during pregnancy decreases transmission of HIV infection from the mother to the fetus?
Zidovudine Zidovudine (also known as AZT) is used together with other medicines for the treatment of human immunodeficiency virus (HIV) infection. HIV is the virus that causes acquired immune deficiency syndrome (AIDS). Zidovudine is used to slow the progression of disease in patients infected with HIV who have advanced symptoms, early symptoms, or no symptoms at all. This medicine is also used to help prevent pregnant women who have HIV from passing the virus to their babies during pregnancy and at birth. Zidovudine will not cure or prevent HIV infection or AIDS, however, it helps keep HIV from reproducing and appears to slow down the destruction of the immune system. This may help delay the development of problems that usually result from AIDS or HIV disease. Zidovudine will not keep you from spreading HIV to other people. People who receive this medicine may continue to have the problems usually related to AIDS or HIV disease.
A toddler is diagnosed with cystic fibrosis. The nurse instructs the family about pancreatic enzymes. At which time is the medication to be given?
immediately before meals. Cystic fibrosis (CF) is an inherited disorder that causes severe damage to the lungs, digestive system and other organs in the body. Cystic fibrosis affects the cells that produce mucus, sweat and digestive juices. These secreted fluids are normally thin and slippery. But in people with CF, a defective gene causes the secretions to become sticky and thick. Instead of acting as lubricants, the secretions plug up tubes, ducts and passageways, especially in the lungs and pancreas. The thick and sticky mucus associated with cystic fibrosis clogs the tubes that carry air in and out of your lungs. This can cause signs and symptoms such as: A persistent cough that produces thick mucus (sputum) Wheezing Exercise intolerance Repeated lung infections Inflamed nasal passages or a stuffy nose Recurrent sinusitis Your pancreas creates natural juices called pancreatic enzymes to break down foods. These juices travel through your pancreas via ducts. They empty into the upper part of your small intestine called the duodenum. Each day, your pancreas makes about 8 ounces of digestive juice filled with enzymes. How does cystic fibrosis affect pancreatic enzymes? In digestion in people with CF, the small tubes that transport these enzymes out of the pancreas become blocked with mucus. The enzymes build up in the pancreas instead of reaching the digestive system (specifically, the lumen of the gut), causing the pancreas to become inflamed.
