toxic effects of drugs ch3

The patient with diabetes is also taking ephedrine to treat asthma that causes her blood sugar to increase. The patient asks the nurse, "Why does this medication make my blood sugar go up?" What is the nurse's best response?

"Stored glycogen is broken down by ephedrine, which is causing higher blood sugar levels."

A nurse is providing teaching to a group of patients who are beginning drug therapy for acquired immunodeficiency syndrome (AIDS). What should be included in her instructions to the group?

"Take your medications as directed. Poisoning occurs with overdosage causing damage to more than one body system."

Before administering a macrolide antibiotic the nurse would question the order for what patient?

A 12-year-old boy with hearing loss

A patient with Parkinson's disease is taking an anticholinergic drug to decrease the tremors and drooling caused by the disease process. The patient complains that he is having trouble voiding. The nurse would explain that this is what?

A secondary action of the drug

A patient presents at the clinic complaining of vaginal itching and a clear discharge. The patient reports to the nurse that she has been taking an oral antibiotic for 10 days. The nurse is aware that the patient is experiencing what?

A superinfection caused by the antibiotic, which has destroyed normal flora

A patient with seasonal allergies is taking an antihistamine to relieve itchy, watery eyes, and a runny nose. When planning teaching for this patient, the nurse would include what teaching point?

Advise the patient to avoid driving or operating machinery.

The nurse administers erythromycin, a drug that is known to irritate mucosa in the stomach lining. When the patient reports abdominal discomfort after taking the medication, the nurse would classify this discomfort as what type of adverse effect?

Allergic reaction

What cardiac effect would the nurse be prepared to see in the patient with an extremely high potassium level?

Arrhythmia

The nurse is assessing a patient new to the clinic. The patient says she is allergic to penicillin. What would be the nurse's appropriate next action?

Ascertain the exact nature of the patient's response to the drug.

A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to Mexico. The nurse will encourage the patient to do what?

Avoid sightseeing during the hottest part of the day.

A patient is taking chloroquine (Aralen) for rheumatoid arthritis. What problem reported by the patient would the nurse suspect may be an adverse reaction of the medication? A) "I have to urinate all the time." B) "Sometimes I have blurred vision." C) "I have tingling in my arms and legs." D) "Sometimes I feel like I am off balance."

B

The nurse is caring for a patient receiving an antineoplastic medication who reports fever, chills, sore throat, weakness, and back pain. What type of adverse effect does the nurse suspect this patient is experiencing?

Blood dyscrasia

A 42-year-old male patient is brought to the emergency department by ambulance. The patient is in distress. The nurse suspects an anaphylactic reaction resulting from taking oral penicillin. What assessment findings are important in making this diagnosis?

Blood pressure (BP): 186/100, difficulty breathing

The nurse administers a medication to the patient that induces the secondary action of hypoglycemia. What organ will be most acutely impacted by inadequate circulating glucose?

Brain

A patient is admitted to the intensive care unit with hyperkalemia. The nurse caring for the patient knows that the most severe adverse effect of hyperkalemia is what?

Cardiac emergency

Oral antidiabetic drugs can cause alterations in glucose metabolism. Patients who are taking these drugs would need to be observed for what?

Confusion and lack of coordination

The home health nurse is caring for an elderly patient with benign prostatic hypertrophy. An anticholinergic drug has been prescribed. What would be the nurse's priority teaching point for this patient?

Empty the bladder before taking the drug.

The pharmacology instructor is discussing the adrenergic drug ephedrine with the nursing students and lists an adverse reaction of this drug as what?

Hyperglycemia

A nurse is planning patient teaching about a newly prescribed drug. What is a priority teaching point included by the nurse to improve compliance and safety?

Measures to alleviate any discomfort associated with adverse effects

The nurse administers antipsychotic medications to the patient who has taken these same drugs for many years. What signs and symptoms would the nurse attribute to secondary actions of the drug? (Select all that apply.)

Muscular tremors Drooling Yellow discoloration of skin and sclera

The nurse administers an anticholinergic medication to the patient. When assessing this patient, what finding will the nurse consider a secondary effect of the drug?

Nasal congestion

The post-anesthesia care unit nurse is serving a patient after a right knee arthroscopy. As the patient begins to wake up from anesthesia, the nurse assesses rigidity, involuntary movements, hyperthermia, and tachycardia. What would the nurse suspect is causing these effects?

Neuroleptic malignant syndrome

The nurse is acting as the triage nurse in the emergency department when a 16-year-old boy is brought in by his friends. The patient is in respiratory distress, he is vomiting, and blood is noted in the vomitus. He is somnolent and his electrocardiogram shows an arrhythmia. The boy's friends tell you he was taking a "bunch of little green pills" he got from the cupboard at his grandparent's house. The nurse suspects what?

Poisoning

The nurse is caring for a patient who experienced a severe headache. When the prescribed number of over-the-counter pain relievers did not work the patient said she took double the dosage an hour later. The nurse recognizes this patient is at greatest risk for what?

Poisoning

The nurse administers a loop diuretic to the patient. In addition to sodium and water, what other electrolyte would the nurse expect to be excreted in significant amounts?

Potassium

The pharmacology instructor is talking to the nursing students about potassium-sparing diuretics and how they can lead to hyperkalemia, indicated by what assessment finding?

Potassium level of 5.9 mEq/L

The pharmacology instructor explains to students that adverse effects can be extensions of what?

Primary action of a drug

An 80-year-old patient presents at the clinic for a follow-up appointment. She is taking a macrolide antibiotic and is experiencing tinnitus. The nurse is talking with family members about home care for the patient. What should the nurse include in her instructions regarding home care?

Provide protective measures to prevent falling or injury.

The nurse is writing a plan of care for a patient who is exhibiting Parkinson-like syndrome. What would be an appropriate intervention if, on assessing the patient, the nurse finds the patient is having difficulty swallowing?

Provide small, frequent meals.

A 77-year-old man is brought to the clinic by his daughter for a routine follow-up appointment. The daughter tells the nurse that her father is only taking half the prescribed dosage of several of his medications. What effect would the nurse explain could result from this behavior?

Reduced therapeutic effect

What classification of drug allergy would be described as an immune system reaction to injected proteins used to treat immune conditions?

Serum sickness

A student nurse asks her study group how to define a drug allergy. What would be the peer group's best response?

The formation of antibodies to a drug protein causing an immune response when the person is next exposed to that drug.

The Kardex record of a male patient who is prescribed antihistamines for treating an allergy reads as follows: Age: 32; Profession: Carpenter; Lifestyle & diet: Lives alone, average smoker, nonalcoholic, no food preferences, practices yoga; Medical history: Suffers from hay fever, recent urinary tract infection that has been treated successfully. What information from the Kardex is likely to have the greatest implication in educating the patient about antihistamine administration?

The patient's profession

Why does the nurse need to be alert for any indication of an allergic reaction in patients?

To maintain the patient's safety during drug therapy

The nurse needs to consider teratogenic effects of medications when caring for what population of patients?

Young adult women