Unit 1 Review
A female client has a 12-year history of ETOH abuse. The client is injured in a motor vehicle accident and requires surgery with general anesthesia. What would the nurse expect for this client?
a larger-than-normal dose of the general anesthetic Drug tolerance occurs when the body becomes accustomed to a particular drug over time, so that larger doses must be given to produce the same effects. Tolerance may be acquired to the pharmacologic action of many drugs, especially opioid analgesics, alcohol, and other CNS depressants. Tolerance to pharmacologically related drugs is called cross-tolerance. For example, a person who regularly drinks large amounts of alcohol becomes able to ingest even larger amounts before becoming intoxicated; this is tolerance to alcohol. If the person is then given sedative-type drugs or a general anesthetic, larger-than-usual doses are required to produce a pharmacologic effect. This is cross-tolerance.
Young's rule
a method for determining pediatric drug dose based on the child's age and the usual adult dose; it states Childs dose (age 1-12 y) = child's age (y) / (Childs age (y) + 12 x average adult dose)
Fried's rule
a method of determining a pediatric drug dose for a child younger than 1 year of age, based on the child's age and the usual adult dose (assumes that an adult dose would be appropriate for a 12.5-year-old child); it states Childs dose (age 1 y) = (weight of child (lb) / 150 (lb) ) x average adult dose
Clark's rule
a method of determining the correct drug dose for a child based on the known adult dose (assumes that the adult dose is based on a 150-pound person); it states Childs dose = (weight of child (its) / 150 lbs) x average adult dose
first-pass effect
a phenomenon in which drugs given orally are carried directly to the liver after absorption, where they may be largely inactivated by liver enzymes before they can enter the general circulation; oral drugs frequently are given in higher doses than drugs given by other routes because of this early breakdown
apothecary system
a very old system of measure that was specifically developed for use by apothecaries or pharmacists; it uses the minim as the basic unit of liquid measure and the grain as the basic unit of solid measure
A patient is taking a drug that is known to be toxic to the liver. The patient is being discharged to home. What teaching points related to liver toxicity and the drug should the nurse teach the patient to report to the physician? a. Fever; changes in the color of urine b. Changes in the color of stool; malaise c. Rapid, deep respirations; increased sweating d. Dizziness; drowsiness; dry mouth e. Rash, black or hairy tongue; white spots in the mouth or throat f. Yellowing of the skin or the whites of the eyes
a. Fever; changes in the color of urine b. Changes in the color of stool; malaise f. Yellowing of the skin or the whites of the eyes
A client is experiencing a reaction to the penicillin injection that the nurse administered approximately ½ hour ago. The nurse is concerned that it might be an anaphylactic reaction. What signs and symptoms would validate her suspicion? a. Rapid heart rate b. Diaphoresis c. Constricted pupils d. Hypotension e. Rash f. Client report of a panicky feeling
a. Rapid heart rate b. Diaphoresis e. Rash f. Client report of a panicky feeling
The nurse should have basic knowledge of drug classifications in order to administer medications safely to clients. What drug information is instrumental in determining nursing actions following drug administration?
adverse effects Becoming familiar with classifications of medications helps the nurse to recognize possible adverse effects clients may experience, providing a basis for implementing appropriate nursing actions should undesirable effects occur. The route of administration, body system involved, and protocols are more important to know before medication administration.
ratio and proportion
an equation in which a ratio containing two known equivalent amounts is on one side and a ratio containing the amount desired to convert and its unknown equivalent is on the other side
The nurse is called to a client's room 15 minutes after the client has received a new medication. The client reports pruritus as well as nausea. The nurse notes that the client appears pale, is sweating, and has begun to cough and wheeze. The nurse determines that the client is experiencing what type of reaction related to the new medication?
anaphylactic shock Anaphylactic shock occurs shortly after administration of a drug to which the client is sensitive. It may be life-threatening and must be treated immediately. The client may experience respiratory, cardiovascular, integumentary, and gastrointestinal symptoms.
Which system of measurement uses the minim as the basic unit of liquid measure?
apothecary The apothecary system uses the minim as the basic unit of liquid measure and the grain as the basic unit of solid measure.
The nurse is assessing a new client who states being allergic to nonsteroidal anti-inflammatories (NSAIDs. What subsequent assessment should the nurse prioritize?
asking the client what the client's response is to taking NSAIDs The nurse should ask additional questions of clients who state that they have a drug allergy to ascertain the exact nature of the response and whether or not it is a true drug allergy. This would be a priority over exploring alternatives or determining the client's pain tolerance.
A client is experiencing a serum sickness reaction to a recent rubella vaccination. Which of the following interventions would be appropriate when caring for this client? a. Administration of epinephrine b. Cool environment c. Positioning to provide comfort d. Ice to joints as needed e. Administration of anti-inflammatory agents f. Administration of topical corticosteroids
b. Cool environment c. Positioning to provide comfort d. Ice to joints as needed e. Administration of anti-inflammatory agents
A patient with a severe infection is given gentamicin, the only antibiotic shown to be effective in culture and sensitivity tests. A few hours after the drug is started intravenously the patient becomes very restless and develops edema. Blood tests reveal abnormal electrolytes and elevated blood urea nitrogen. This reaction was most likely caused by a. an anaphylactic reaction. b. renal toxicity associated with gentamicin. c. superinfection related to the antibiotic. d. hypoglycemia.
b. renal toxicity associated with gentamicin.
A woman has had repeated bouts of bronchitis throughout the fall and has been taking antibiotics. She calls the clinic with complaints of vaginal pain and itching. When she is seen, it is discovered that she has developed a yeast infection. You understand that a. her bronchitis has moved to the vaginal area. b. she has developed a superinfection, because the antibiotics kill bacteria that normally provide protection. c. she probably has developed a sexually transmitted disease related to her lifestyle. d. she will need to take even more antibiotics to treat this new infection.
b. she has developed a superinfection, because the antibiotics kill bacteria that normally provide protection.
D/H * V = X
basic formula used for simple step dosage calculations D: equal to the desired drug or the dose ordered H: is the dose on hand or the amount available V: is the vehicle (table, capsule, vial of medication)
A client with a serious Escherichia coli infection is being treated with gentamicin. When monitoring for potential adverse effects, the nurse should prioritize:
blood urea nitrogen and creatinine levels. Gentamicin is an example of a drug that holds the potential for renal toxicity. This drug is not associated with hepatic damage, electrolyte disturbances or disruptions of skin integrity.
A 2-year-old client is diagnosed with stomach flu and is suffering from vomiting and diarrhea. What is the most important factor in determining the correct dosage for his infection?
body surface area A drug dose for a child can be determined by using the standard formula for finding the body surface area of the child. The ratio of the body surface area to weight is inversely proportional to its length. Body surface area also can be determined by using a nomogram. Drug dosages cannot be based on age or memorized because child weights may vary considerably. Child dosage cannot be based on adult dosage, because a child's body is small and immature.
blood dyscrasia
bone marrow depression caused by drug effects on the rapidly multiplying cells of the bone marrow; lower-than-normal levels of blood components can be seen
An example of a drug allergy is a. dry mouth occurring with use of an antihistamine. b. increased urination occurring with use of a thiazide diuretic. c. breathing difficulty after an injection of penicillin. d. urinary retention associated with atropine use.
c. breathing difficulty after an injection of penicillin.
Knowing that a patient is taking a loop diuretic and is at risk for developing hypokalemia the nurse would assess the patient for a. hypertension, headache, and cold and clammy skin. b. decreased urinary output and yellowing of the sclera. c. weak pulse, low blood d. pressure, and muscle cramping. diarrhea and flatulence.
c. weak pulse, low blood
A client is receiving a drug to lower blood glucose level. What would lead the nurse to suspect that the client's blood glucose level was too low?
cold, clammy skin Signs of hypoglycemia, or low blood glucose level, include fatigue; drowsiness; hunger; anxiety; headache; cold, clammy skin; shaking and lack of coordination (tremulousness); increased heart rate; increased blood pressure; numbness and tingling of the mouth, tongue, and/or lips; confusion; and rapid and shallow respirations. In severe cases, seizures and/or coma may occur. Increased urination, fruity breath odor, and increased hunger are signs of hyperglycemia.
Patients receiving antineoplastic drugs that disrupt cell function often have adverse effects involving cells that turn over rapidly in the body. These cells include a. ovarian cells. b. liver cells. c. cardiac cells. d. bone marrow cells.
d. bone marrow cells.
A patient taking glyburide (an antidiabetic drug) has his morning dose and then does not have a chance to eat for several hours. An adverse effect that might be expected from this would be a. a teratogenic effect. b. a skin rash. c. an anticholinergic effect. d. hypoglycemia
d. hypoglycemia
What changes due to aging in the geriatric client may affect excretion and promote accumulation of drugs in the body?
decreased glomerular filtration rate. In older adults (65 years and older), physiologic changes may alter all pharmacokinetic processes. Changes in the gastrointestinal tract include decreased gastric acidity, decreased blood flow, and decreased motility. Despite these changes, however, there is little difference in drug absorption. Changes in the cardiovascular system include decreased cardiac output, and therefore slower distribution of drug molecules to their sites of action, metabolism, and excretion. In the liver, blood flow and metabolizing enzymes are decreased. Therefore, many drugs are metabolized more slowly, have a longer action, and are more likely to accumulate with chronic administration. In the kidneys, there is decreased blood flow, decreased glomerular filtration rate, and decreased tubular secretion of drugs; all of these changes tend to slow excretion and promote accumulation of drugs in the body. Impaired kidney and liver function greatly increases the risks of adverse drug effects. In addition, older adults are more likely to have acute and chronic illnesses that require the use of multiple drugs or long-term drug therapy. Therefore, possibilities for interactions among drugs and between drugs and diseased organs are greatly multiplied.
placebo effect
documented effect of the mind on drug therapy; if a person perceives that a drug will be effective, the drug is much more likely to actually be effective
Which units of measure would a nurse expect to find when using the apothecary system?
drams The apothecary system includes units such as grain, dram, ounce, minim, fluidram, and fluid ounce. Liters and kilograms are units in the metric system. Pound is a unit in the household system.
Which prescribed medications should the nurse administer to an adult having an anaphylactic reaction?
epinephrine Epinephrine, 0.3 mL of a 1:1,000 solution, subcutaneously should be given to adults having an anaphylactic reaction.
hypersensitivity
excessive responsiveness to either the primary or the secondary effects of a drug; may be caused by a pathological condition or, in the absence of one, by a particular patient's individual response
conversion
finding the equivalent values between two systems of measure
drug allergy
formation of antibodies to a drug or drug protein; causes an immune response when the person is next exposed to that drug
Which laboratory test should the nurse monitor to assess the status of drug elimination that is expected in neonates?
glomerular filtration rate Excretion of most drugs occurs via the kidneys, and elimination in the urine follows. Young children have immature kidneys, a reduced glomerular filtration rate, and slower renal clearance. Neonates are especially prone to increased levels of drugs that are eliminated primarily by the kidneys. CK, albumin, and C-reactive protein levels do not directly relate to this physiological characteristic.
A nurse should recognize what as a metric system unit? (Select all that apply.)
gram milliliter kilogram The metric system uses the gram, liter, and meter. Gram, milliliter, and kilogram are metric units.
A client is diagnosed with hypercholesterolemia and is prescribed a statin. As part of client education, the nurse should teach the client to avoid eating:
grapefruit. Grapefruit contains a substance that strongly inhibits the metabolism of drugs normally metabolized by the cytochrome P450 CYP3A4 enzyme. This effect greatly increases the blood levels of some drugs (e.g., the widely used "statin" group of cholesterol-lowering drugs), and the effect lasts for several days. Clients who take medications metabolized by the CYP3A4 enzyme should be advised against eating grapefruit or drinking grapefruit juice.
The student nurse is studying common fractions as they apply to the healthcare setting. What is true about common fractions?
he numerator is part of the whole number and is the top number The numerator refers to a part of the whole and is the top number. The denominator refers to the total number of parts and is the number on the bottom. Decimal fractions are fractions in which 10 is always the denominator
When reviewing the medication list of a client being seen in the clinic, the nurse notes that the client is receiving glipizide. Based on the nurse's understanding, this drug is used to treat:
hyperglycemia. Glipizide (Glucotrol) is an antidiabetic agent with the desired action of lowering the blood glucose level. Glipizide does not elevate glucose levels (hyperglycemia), lower potassium levels (hypokalemia), or increase potassium levels (hyperkalemia).
A nurse who provides care on a pediatric unit of a hospital is aware that the potential for harm as a result of drug errors is higher among infants and children than adults. This fact is primarily due to:
immature liver and kidney function in infants and children. Children are more at risk of the deleterious effects of drug errors because they have not physiologically matured. Immature liver or renal function, for example, can increase the circulating level of a drug beyond what would be expected in adults. This characteristic supersedes differences in body surface area, cardiac function, and ability to verbalize discomfort.
An infant's antiseizure medication has been prescribed after careful consideration of the unique pharmacokinetics among this population. What characteristic of neonates has the greatest bearing on drug metabolism?
immaturity of the infant's liver The enzyme cytochrome P-450 (CYP450) in the liver metabolizes most drugs. In neonates, the ability to metabolize drugs is very low because of the immaturity of the liver and the resultant inability to break down drugs. Characteristics of the kidneys, the blood-brain barrier, and GI function do not primarily affect metabolism.
superinfections
infections caused by the destruction of normal flora bacteria by certain drugs, which allow other bacteria to enter the body and cause infection; may occur during the course of antibiotic therapy
stomatitis
inflammation of the mucous membranes related to drug effects; can lead to alterations in nutrition and dental problems
hepatic microsomal system
liver enzymes tightly packed together in the hepatic intracellular structure, responsible for the biotransformation of chemicals, including drugs
A nurse is instructing a client concerning a newly prescribed drug. What should be included to help improve client compliance and safety?
measures to alleviate any discomfort associated with adverse effects If clients are aware of certain adverse effects and how to alleviate or decrease the discomfort, they are more likely to continue taking the medication and providing for safe administration. A list of pharmacies can be useful information, but will not improve safety or compliance. Knowing the cost of the brand versus the generic could also be helpful to the client. However, a substitution may not be allowed, and the cost of a drug does not improve client safety. Most clients are not concerned with statistics regarding drug testing, and the testing is usually not discussed with clients.
A neonate's highly immature liver and resulting low levels of the enzyme cytochrome P-450 (CYP450) affects what aspect of pharmacokinetics?
metabolism The enzyme cytochrome P450 (CYP450) metabolizes drugs in the liver. This characteristic does not affect any of the other aspects of medication therapy.
The nursing student is studying drug dosage and has learned that there are three systems of measurement associated with drug dosing. What are these systems? (Select all that apply.)
metric system apothecary system household measurement system There are three systems of measurement associated with drug dosing: the metric system, apothecary system, and household measurements. The Mercalli system is a scale used to measure the intensity of earthquakes. The Avoirdupois system is a system of weights based on a pound of 16 ounces or 7,000 grains, widely used in English-speaking countries.
A nurse in a nutrition clinic is to give 2 cups of organic prune juice to a client every night. The nurse is to document this on the nursing chart. What unit will the nurse use to document the amount of juice according to the metric system of measurement?
milliliter The nurse should document the amount of prune juice in milliliters or increments of milliliters. The measure of liquid volume in the metric system is based on the milliliter. Gram is a measurement of weight. An ounce is an apothecary term used formerly; it is equivalent to 30 mL. The term unit does not belong to the metric system of measurement.
distribution
movement of a drug to body tissues; the places where a drug may be distributed depend on the drug's solubility, perfusion of the area, cardiac output, and binding of the drug to plasma proteins
passive diffusion
movement of substances across a semipermeable membrane with the concentration gradient; this process does not require energy
A 4-year-old boy is postoperative day 1 following surgery for trauma suffered in a motor vehicle accident. The boy is in pain, and the nurse is preparing to administer a dose of hydromorphone syrup as ordered. To administer this drug, the nurse should use a(n):
oral syringe. The nurse should administer oral medications only in oral syringes. Other methods have the potential to be inaccurate.
A client comes to the clinic reporting of a ringing sound in the ears and dizziness. When the nurse takes the client's history, the nurse discovers that the client has been taking several ibuprofen every day for various discomforts. What does the nurse understand has occurred with this client?
ototoxicity from the ibuprofen Ototoxicity is damage to the eighth cranial nerve. It may or may not be reversible. Signs and symptoms of ototoxicity include tinnitus, which is a buzzing or ringing sound in the ear, and sensorineural hearing loss. Other signs and symptoms, particularly of vestibular toxicity, include light-headedness, vertigo, a spinning sensation from a seated position, and nausea and vomiting.
poisoning
overdose of a drug that causes damage to multiple body systems and has the potential for fatal reactions
determine correct dose we consider
patients sex, weight, age, and physical condition and other drugs currently on
The nurse is assessing a client whose debilitating headache did not respond to the recommended dose of an OTC analgesic. In response, the client took another dose 30 minutes later and then a double dose one hour after that. The nurse's assessment should focus on the possibility of:
poisoning. Poisoning occurs when an overdose of a drug damages multiple body systems, leading to the potential for fatal reactions. Hypersensitivity, allergies, and anaphylaxis would not be indicated by an overdosage of the medication.
The nurse is caring for a client with hypertension who was prescribed a loop diuretic one week ago. The client reports malaise and weakness and the nurse's assessment reveals an irregular heart rate. The nurse should prioritize assessment of the client's:
potassium levels. The fact that the client began taking a loop diuretic recently coupled with the client's presentation suggests hypokalemia. Consequently, the client's liver and kidney function would not be the immediate priorities. The client's cognition may be affected but as a result of hypokalemia.
enzyme induction
process by which the presence of a chemical that is biotransformed by a particular enzyme system in the liver causes increased activity of that enzyme system
selective toxicity
property of a chemotherapeutic agent that affects only systems found in foreign cells without affecting healthy human cells (e.g., specific antibiotics can affect certain proteins or enzyme systems used by bacteria but not by human cells)
The nurse has begun the intravenous infusion of the first dose of a client's prescribed antibiotic. A few minutes later, the client is diaphoretic, gasping for breath and has a heart rate of 145 beats per minute. After calling for help, what is the nurse's priority action?
protecting and maintaining the patency of the client's airway This client's presentation is suggestive of anaphylaxis. In the care team's immediate treatment, maintaining the airway is a priority. Epinephrine is administered in the short term, not antihistamines. The nurse should reassure the client, if possible, but the patency of the airway is the highest priority. Similarly, this would supersede the need for vital signs monitoring, even though this should be done.
Here is an example of a doctors order for an antibiotic. Calculate the number of tablets the pt will receive. Order: ciprofloxacin (Cipro) 0.5 g, po, q12h Available: Cipro 250 mg tablet
pt will receive 2 tablets How to find answer: Change 0.5 g to 500 mg by moving decimal 3 spaces to right OR H : V :: D x unknown amount 250x =500 x=2
excretion
removal of a drug from the body; primarily occurs in the kidneys, but can also occur through the skin, lungs, bile, or feces
The nurse is reviewing the laboratory test results of a client receiving drug therapy. What would the nurse suspect if the results reveal an elevation in the blood urea nitrogen level and creatinine concentration?
renal injury Renal injury is reflected by elevated blood urea nitrogen and creatinine concentration. Liver injury would be reflected by elevated liver enzymes such as aspartate aminotransferase (AST) and alanine aminotransferase (ALT). Hypoglycemia would be indicated by decreased blood glucose levels. Hyperkalemia would be reflected by elevated potassium levels (greater than 5.0 mEq/L).
When instructing a client who is taking an antibiotic about the possibility of nausea and diarrhea, the nurse understands that these effects are examples of:
secondary actions. Secondary actions are effects that are inevitable and undesired but not related to the desired pharmacologic effects. Nausea and diarrhea are examples of secondary actions due to an antibiotic's effect on the gastrointestinal tract. Primary actions are those associated with the therapeutic effect. Drug allergy involves the formation of antibodies to a particular drug. Hypersensitivity refers to an excessive response to either primary or secondary effects of a drug.
A client, prescribed a drug that has an exceptionally narrow margin of safety, should be educated about the need for what intervention?
serum drug level monitoring Measuring serum drug levels is useful when drugs with a narrow margin of safety are given because their therapeutic doses are close to their toxic doses. None of the other options are relevant to client safety regarding this drug characteristic.
The nurse is assessing a client who is distress and may be experiencing an anaphylactic reaction. What assessment finding is most consistent with this diagnosis?
shortness of breath Difficulty breathing, increased blood pressure, dilated pupils, diaphoresis, and a panicky feeling are associated with an anaphylactic reaction. Somnolence does not occur. Swollen lymph nodes are associated with a serum sickness reaction. Swollen joints are associated with a delayed allergic reaction.
Many drugs that reach the developing fetus or embryo can cause death or congenital defects. What are examples of congenital defects? Select all that apply.
skeletal and limb abnormalities central nervous system alterations heart defects Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. Birth at 40 weeks' gestation is a normal pregnancy outcome.
dermatological reactions
skin reactions commonly seen as adverse effects of drugs; can range from simple rash to potentially fatal exfoliative dermatitis
receptor sites
specific areas on cell membranes that react with certain chemicals to cause an effect within the cell
chemotherapeutic agents
synthetic chemicals used to interfere with the functioning of foreign cell populations, causing cell death; this term is frequently used to refer to the drug therapy of neoplasms, but it also refers to drug therapy affecting any foreign cell
critical concentration
the concentration a drug must reach in the tissues that respond to the particular drug to cause the desired therapeutic effect
metric system
the most widely used system of measure, based on the decimal system; all units in the system are determined as multiples of 10
active transport
the movement of substances across a cell membrane against the concentration gradient; this process requires the use of energy
glomerular filtration
the passage of water and water-soluble components from the plasma into the renal tubule
pharmacogenomics
the study of genetically determined variations in the response to drugs
pharmacodynamics
the study of the interactions between the chemical components of living systems and the foreign chemicals, including drugs, that enter living organisms; the way a drug affects a body
half-life
the time it takes for the amount of drug in the body to decrease to one half of the peak level it previously achieved
pharmacokinetics
the way the body deals with a drug, including absorption, distribution, biotransformation, and excretion
What would lead the nurse to suspect that a client has developed a blood dyscrasia related to drug therapy? (Select all that apply.)
thrombocytopenia anemia sore throat Manifestations of blood dyscrasia include anemia, thrombocytopenia, sore throat, fever, chills, back pain, dark urine, leukopenia, and a reduction of all cellular elements of the complete blood count.
loading dose
use of a higher dose than what is usually used for treatment to allow the drug to reach the critical concentration sooner
absorption
what happens to a drug from the time it enters the body until it enters the circulating fluid; intravenous administration causes the drug to directly enter the circulating blood, bypassing the many complications of absorption from other routes
A client with recurrent urinary tract infections was prescribed sulfamethoxazole-trimethoprim and experienced an allergic reaction. The client states, "I don't understand. I had a two-day course of the same drug last year with no problems." What is the nurse's best response?
"Allergic reactions happen after your body has been sensitized to a drug in the past." Allergies generally take place after antibody formation from an initial exposure. For this reason, the client's experience is not likely the result of the brevity of treatment, the dose, or the severity of the underlying illness.
The nurse is assessing a client who is being admitted to the healthcare facility. When asked about allergies, the client states, "I'm allergic to penicillin." What is the nurse's best initial response?
"Do you remember what happened the last time you received penicillin?" Any report of an allergy should be documented and communicated clearly. However, the nurse also has a responsibility to gather as much data as possible, especially since clients may classify a wide range of adverse effects as allergies. It would be premature for the nurse to state which antibiotics the client may or may not receive.
The nursing student is learning about the metric system and how it is the most commonly used system of measurement in medicine. The student demonstrates an understanding of the metric system when stating which?
"In the metric system, the liter is a unit of volume." In the metric system, the unit of weight is the gram. The unit of volume is the liter, and the unit of length is the meter. The metric system uses meters for height as well.
A pregnant client asks the nurse about what medications are safe during pregnancy. Which statement is correct?
"It is safe to take any medication in the pregnancy risk category A." During pregnancy, many drugs cross the placenta and may harm the fetus. The possible teratogenic risk is coded for each medication as a pregnancy risk category from A to X, with A being the safest and X known to be dangerous or "do not use." The nurse should instruct the client to ask the provider about the risk category for any medication prescribed, including over-the-counters.
A client with insomnia was put on eszopiclone (Lunesta) 2 mg orally before bedtime. The nurse was ordered to increase the dose by 250 mg weekly at 2- to 4-week intervals. How many milligrams more will the nurse give to increase the dose by 250 mg?
0.25 mg The nurse should increase the dose of Lunesta by 0.25 mg weekly. The nurse must be proficient in metric conversions for proper dosage calculation. To convert micrograms to milligrams, the nurse should move the decimal point three places to the left or divide by 1,000. Thus, 250 mg divided by 1,000 becomes 0.25 and not 0.025, 2.50, or 25.0 mg.
29s A client has been prescribed a one-time dose of 4 mg morphine IV. The medication is available in ampules of 10 mg/mL. What volume of morphine should the nurse draw up?
0.4 The client requires 4 mg of the 10 mg that are available in one mL. Dividing 4 by 10 yields a volume of 0.4 mL.
A client has been prescribed a one-time dose of 4 mg morphine IV. The medication is available in ampules of 10 mg/mL. What volume of morphine should the nurse draw up?
0.4 The client requires 4 mg of the 10 mg that are available in one mL. Dividing 4 by 10 yields a volume of 0.4 mL.
A client is prescribed a 12.5-mg dose of metoprolol for the treatment of high blood pressure. The nurse should administer how many 25-mg tablets?
0.5 12.5 (desired dose) ÷ 25 (available dose) = 0.5 tablets.
After teaching a group of nursing students about using zeros, the instructor determines that the teaching was successful when they identify which as the correct placement of a zero in a decimal?
0.75 When there is no number to the left of the decimal, a zero is written; for example, 0.75 shows correct placement of the zero in a decimal. Without a number such as a "0" in front of the decimal, the decimal may not be seen causing massive overdose of medication to be given. All decimal points should be clearly written and seen.
A drug label reads 1 tablet equals 60 milligrams. How many grains would this be?
1 grain 60 milligrams is equivalent to 1 grain.
Medication doses given to children are usually smaller than those given to adults. Doses for children can also be calculated based on the child's weight. Which would be correct when calculating a dose based on weight?
1 kg equals 2.2 pounds The dosage of a drug may be based on the client's weight. In many instances, references give the dosage based on the weight in kilograms rather than pounds. There are 2.2 lbs in 1 kg.
The nurse must use the metric system in dosage calculations. Which conversions are correct? (Select all that apply.)
1 kilogram = 1000 grams 1 gram = 1000 milligrams 1 milligram = 1000 micrograms In the metric system the unit of weight is the gram. The following indicates the correct conversions: 1 kilogram = 1000 grams; 1 gram = 1000 milligrams; 1 milligram = 1000 micrograms. The conversion that 1 gram equals 100 miligrams is incorrect, as is that 1 gram equals 10 milligrams.
The nurse must use the metric system in dosage calculations. Which conversions are correct? (Select all that apply.)
1 kilogram = 1000 grams 1 gram = 1000 milligrams 1 milligram = 1000 micrograms n the metric system the unit of weight is the gram. The following indicates the correct conversions: 1 kilogram = 1000 grams; 1 gram = 1000 milligrams; 1 milligram = 1000 micrograms. The conversion that 1 gram equals 100 miligrams is incorrect, as is that 1 gram equals 10 milligrams.
When the nurse uses ratio and proportion to complete drug calculations, which formula would have the most potential for error?
1 mg.: 1,0000 mcg = X mg: 0.620 mcg Errors are a frequent problem when zeros (0) are involved. The trailing zero in 0.620 may cause an error if it is misinterpreted as another figure. It should correctly be written as 0.62.
4 ways drugs usually work
1. to replace or act as substitutes for missing chemicals 2. to increase or stimulate certain cellular activities 3. to depress or slow cellular activities 4. to interfere with the functioning of foreign cells, such as invading microorganisms or neoplasms leading to cell death
The nurse is preparing to administer 80 mg of Solu-medrol intravenously (IV) to a client with pneumonia. The vial states that it has 120 mg per 2 mL. The nurse would correctly draw up which amount?
1.3 mL The ordered amount is 80 mg and is supplied in 120mg/2 mL. In order to calculate you can divide what is needed (80mg) by what you have (120 mg) times the concentration of 2 mL. The nurse would administer 1.3 mL of Solu-medrol to the client.
A nurse is to administer 175 mg of a medication intramuscularly. The label on the multidose vial states that the concentration is 100 mg/mL. What volume of the drug should the nurse administer? (Record your answer using two decimal places.)
1.75 To determine the amount to give, the nurse would set up the following ratio and proportion: 100 mg/1 mL = 175 mg/X mL. Cross multiplying and solving for X: 100X = 175; X = 1.75 mL.
The primary care provider orders cimetadine 100 mg P.O. daily. The medication is available as cimetadine 200 mg tablets. How much will the nurse give?
1/2 tablet Cimetadine comes in 200 mg tablets; the prescriber has ordered the client to have 100 mg daily. This is one-half of the dose of the available tablet, so the nurse will give 1/2 tablet. Two tablets would be an overdose, as would 3 tablets. One tablet would also be an overdose because it would give double of what the PCP ordered.
A newly admitted client has orders to receive 1,000 mL of normal saline IV over 8 hours. If the IV infusion set is a microdrip set that delivers 60 drops per mL, how many drops per minute should the nurse administer to the client?
125 If a client was to receive 1,000 mL in 8 hours, dividing 1000 by 8 would mean that the client would receive 125 mL in 1 hour, or 60 minutes. Setting up the equation, 60 drops/mL ÷ X = 125 mL/60 minutes; cross-multiplying, the answer is 125 drops/min.
A child with a urinary tract infection who is prescribed cephalexin 25 mg/kg/day in 3 divided doses. Knowing that the child weighs 15 kilograms, the nurse should administer how many mg with each dose?
125 The nurse should begin by multiplying the child's weight by 25 mg: 15 kg X 25 mg = 375 mg. This yields the total daily dose. Dividing 375 mg by 3 yields each of the three individual doses.
Delatsone (prednisone) has been prescribed to a client with sarcoidosis. The client is to take 20 mg/day for 1 week and then taper the dose. The medication is available in 10-mg tablets. If the client follows the drug regimen, how many tablets would be taken in the first week?
14 The tablets are in 10mg form, so the client will take two tablets per day for 7 days which is 14 total tablets before the client begins to taper off the drug. The options of 2, 7 and 9 are incorrect.
At 0700 (7 AM) the health care provider has ordered the nurse to begin an IV infusion and has ordered the client to receive 125 mL/hr of IV fluid. At what time will the nurse be prepared to hang the next liter of IV fluid?
1500 (3 PM) At 125 mL/hr, the client will need another liter (1000 mL) of IV fluid in 8 hours. The infusion was begun at 7 AM and the next liter will be hung at 3 PM.
A client is prescribed acetaminophen 1 g every 6 hours. The acetaminophen is supplied in a multidose container. The label reads 500-mg tablets. The nurse would administer how many tablets?
2 1 g is equivalent to 1000 mg. Each tablet is 500 mg. So the nurse would give the client 2 tablets
A client is being treated for congestive heart failure (CHF) and is to receive 0.5 milligrams of digoxin, which is available in 250-microgram tablets. The nurse would correctly administer how many tablets?
2 tablets The nurse would correctly administer 2 tablets, as 0.5 milligrams is equal to 500 micrograms and what is available is 250 microgram tablets, so double the tablet amount, so 2 tablets will have to be given.
The doctor has ordered 1 mg of atropine. Your label reads as follows: Dose ordered: 1 mg Dose on hand: 400 mcg What do you give the pt?
2.5 mL First need to convert micrograms to milligrams 400 mcg = 0.4 mg 1mg/0.4mg = 2.5*1mL =2.5 mL
The nurse provides health education for a diverse group of clients. For which client should the nurse emphasize the risk of teratogenic drug effects?
20-year-old female client who has been diagnosed with a chlamydial infection The risk of teratogenicity is a priority consideration for female clients of child-bearing age, not for males or prepubescent girls.
A child weighs 22 kilograms. The physician orders a drug as follows: "1.1 mg/kg by intramuscular injection." The nurse determines the proper dose as:
24 mg Using the mg/kg method, the nurse would set up the problem as follows: 1.1 mg/1 kg = X mg/22 kg Cross multiplying: 1X = 24.2; solving for X: X = 24.2, which would be rounded down to 24 mg.
The nurse is converting grams to milligrams. How would the nurse move the decimal point?
3 places to the right To convert from large to small, the nurse would move the decimal point to the right. In this case 1 g = 1,000 mg; therefore, the decimal point would move three places to the right.
The nurse is determining the recommended dose of medication for a child. The nursing drug handbook reads "Recommended dose is 15 mg per kg." The child's weight is 25 kg. The recommended dose for this child is:
375 Using the ratio-proportion formula, the nurse multiplies 15 mg by 25 kg and divides by 1 kg. This is equal to 375 mg.
Order: 400 mg. Cefazolin I.V. Available: Cefazolin 500 mg powder to be diluted with 5 mL of sterile saline How many mL will the nurse administer?
4 To determine the number of mL, 500/5 = 100mg/1mL. 400mg/100mg = 4 mL FORMULA 5mL:500mg::XmL:400mg 5ml X 400mg 500mg XmL 5 X 400 500 2000 500 = 4ml
The client is to be given ascorbic acid 1 g daily by mouth. The medication comes in a container labeled, "Ascorbic Acid 250 mg tablets." How much will the nurse give?
4 tablets The medication comes in 250 mg tablets, and the health care provider has ordered 1 g or 1,000 mg to be given to the client. Therefore, 1000 mg divided by 250 mg equals 4 tablets.
The nursing student is studying drug dosing with liquids. The student knows that a specific amount of drug will be in a given volume. A particular drug label reads "Augmentin 125 mg/5 mL." Which is the correct volume?
5 mL In liquid drugs, a specific amount of drug is in a given volume of solution. In this example, there is 125 mg/5 mL, so 5 mL is the volume (quantity) in which there is 125 mg of drug. The other calculations are incorrect and if given would be a drug error.
Order: Ibuprofen 150 mg. orally Available: Ibuprofen 100mg/ 5ml How many mL will the nurse administer?
7.5 To determine the number of mL, 100/5 = 20 mg/mL. 150mg/20mg = 7.5 FORMULA: 5mL:100mg::XmL:150mg 5 mL X 150 mg 100 mg X 750/100 = 7.5 mL 7.5 mL
The health care provider orders a client to receive 1000 mL of intravenous fluid over the next 12 hours. The intravenous delivery system is a microdrip system. The nurse would set the infusion to run at which rate?
83 gtts/minute The nurse would set up the following ratio: X = 1000 mL/12 hours x 60 gtts/min 60 min/hour Solving for X equals: 83 gtts/min
According to protocol, a nursing student is required to complete metric conversions to ensure accurate administration of medication dosage. What does this indicate?
A nurse must possess a basic understanding of mathematics. The nurse should have a basic understanding of several mathematical principles in order to do metric conversions in the event that a drug is ordered in a unit of measurement that is different from what is available. Strictly following the medication order and having a good knowledge about pharmacology ensures proper administration of drugs but does not help in metric conversions. Safe administration of drug dosage is a primary nursing function and not the health care provider's function
The nurse is to administer an off-label medication to a premature infant. To check for an appropriate dose for this client, the nurse refers to
A pediatric drug reference For pediatric dosages, the nurse refers to a pediatric drug reference. The other references will provide only label dosage information for pediatric clients.
Pregnant women should be advised of the potential risk to the fetus any time they take a drug during pregnancy. What fetal problems can be related to drug exposure in utero? a. Fetal death b. Nervous system disruption c. Skeletal and limb abnormalities d. Cardiac defects e. Low-set ears f. Deafness
All of the above
The nurse is conducting an admission assessment of a new client. When asked about any food or drug allergies, the client states that the client is allergic to tetracycline. What action should the nurse next perform?
Ask the client, "What happens when you take a dose of tetracycline?" Clients often characterize a wide variety of medication reactions as "allergies." The nurse should assess further, not because of mistrust for the client but because there is a need for further detail. Documentation of the client's allergy status should occur at the completion of assessment. Education about alternatives would be premature.
What would the nurse include in the teaching plan for a client who is to receive a drug that is associated with anticholinergic effects?
Be sure to drink plenty of fluids to prevent dehydration. Drugs with anticholinergic effects often cause dry mouth, constipation, dehydration, and decreased sweating. The client should be instructed to drink fluids to prevent dehydration and to avoid overly warm or hot environments. Avoiding exercise to affect calorie intake is not necessary. A high-fiber diet would be indicated to prevent constipation. Diarrhea is an anticholinergic effect.
A nurse needs to calculate a safe dose of medication for a child. Which would be most appropriate for the nurse to use?
Body surface area Today, the body surface area (nomogram) is considered the most accurate way for determining dosages. The Clark, Fried, and Young rules are rarely used today.
A nurse is caring for client who states, "I dislike hospitals because people die in them." What is the cause of 1 in 10,000 hospital deaths that occur each year in the United States?
Calculating a medication dose One in 10,000 hospital deaths each year in the U.S. are due to mistakes made specifically when calculating a medication dosage. The miscalculations are because of human error. Bar coding systems and computerized order entry can detect errors made by health care providers. Administration of a medication is minimized using the 5 rights of medication administration.
The nurse is confirming the dosage of a prescribed medication ordered for a child. What assessment data should the nurse obtain to most accurately confirm that the dose is safe and effective?
Child's body surface area Body surface area is the most clinically accurate basis for determining pediatric drug doses: 0.40 m2 * 250 ------------- 173
A group of students are practicing pediatric dosage calculation using Clark's rule. Which information would the students need?
Child's weight in pounds Clark's rule requires knowledge of the child's weight in pounds, and the average adult dose. A child's height in centimeters is used to determine body surface area. Fried's rule requires that the infant's age in months be known. Child's body surface area is not used with Clark's rule.
A client develops a cytotoxic reaction to a drug. What would the nurse expect to do?
Discontinue the drug immediately as ordered. For a client experiencing a cytotoxic reaction, the prescriber is notified and the drug is discontinued. Subcutaneous epinephrine is used to treat an anaphylactic reaction. The client is also encouraged to wear some type of MedicAlert identification denoting the allergy. Antipyretics would be used to treat serum sickness reaction.
A client who is being treated for cancer developed a serum sickness reaction. The care team has been notified, and the client is being stabilized. What is the nurse's priority action?
Discontinue the drug immediately as ordered. If serum sickness occurs, the prescriber is notified and the drug is discontinued. Epinephrine is given for an anaphylactic reaction and requires a prescriber's order. A MedicAlert identification may be indicated, but is not the nurse's first concern. Topical corticosteroids may be used to treat dermatological symptoms such as rash, but would not be the nurse's first concern.
How does knowledge of a drug's adverse effects impact the care provided by the nurse? (Select all that apply.)
Drug teaching can address signs and symptoms the client should be alert for. Assessments include monitoring for expected or common adverse effects. Baseline can be established to help identify adverse effects that occur. This information will direct the nurse's assessment of the client, helping to focus on particular signs and symptoms that would alert you to adverse effects, and helping to establish a baseline for that client so that you will be able to identify adverse effects that occur. When teaching the client about a drug, it is important to list the adverse effects that should be anticipated, along with the appropriate actions that the client can take to alleviate any discomfort associated with these effects. Being alert to adverse effects, and knowing what to assess and how to intervene appropriately, can increase the effectiveness of a drug regimen, provide for client safety, and improve client compliance. Deciding to withhold a drug is outside the nurse's scope of practice. Adverse effects may not be avoided, but they can be minimized or quickly treated with awareness.
A recent nursing graduate is preparing to enter the workforce. What principle should guide the nurse's administration of medications?
Drugs can cause unexpected reactions even after thorough screening and testing. Even though drugs are carefully screened and tested in animals before being released to use on humans, drug products often cause unexpected or unacceptable reactions when given. Many effects can be seen when just one chemical factor is changed or altered. All drugs have the potential to cause adverse effects whether they are prescribed or over-the-counter. Today's potent and amazing drugs can cause a variety of reactions, many of which are more severe than ever seen before.
An instructor is preparing a class that describes the toxic effects of drugs. Which effect would the instructor expect to include?
Drugs cause unexpected or unacceptable reactions despite screening and testing. All drugs are potentially dangerous. Even though chemicals are carefully screened and tested in animals and in people before they are released as drugs, drug products often cause unexpected or unacceptable reactions when they are administered. Drugs are chemicals, and the human body operates by a vast series of chemical reactions. Consequently, many effects can be seen when just one chemical factor is altered. Today's potent drugs can cause a great variety of reactions, many of which are more severe than ever seen before.
The nurse is administering a drug metabolized in the liver to an infant. Because of the immaturity of the infant liver, what does the nurse determine should be done for dosing of this drug?
Ensure that lower drug dosages or an increased interval between doses is scheduled. The liver metabolizes most drugs; however, the immaturity of the neonatal and infant liver results in decreased or incomplete metabolism of many drugs, which may necessitate lower drug dosages or an increased interval between doses to achieve appropriate blood levels.
Route PO (oral)
Factors Affecting Absorption -acidity of stomach -length of time in stomach -blood flow to gastrointestinal tract -presence of interacting foods or drugs
Route topical (skin)
Factors Affecting Absorption -perfusion or blood flow to the area -integrity of skin
Route mucous membranes (sublingual, buccal)
Factors Affecting Absorption -perfusion or blood flow to the area -integrity of the mucous membranes -presence of food or smoking -length of time retained in area
Route PR (rectal)
Factors Affecting Absorption -perfusion or blood flow to the rectum -lesions in the rectum -length of the time retained for absorption
Route subcutaneous
Factors Affecting Absorption -perfusion or blood flow to the tissue - fat content of the tissue
Route Intravenous
Factors Affecting Absorption none: direct entry into the venous system
Route Intramuscular
Factors Affecting Absorption -perfusion or blog flow to the muscle -fat content of the muscle -temperature of the muscle: cold causes vasoconstriction and decreases absorption; heat causes vasodilation and increases absorption
The nurse is performing an assessment on a 7-year-old child in the clinic. The nurse observes the child's teeth are darkly stained. What information should the nurse obtain from the parent?
Has the child taken tetracycline for treatment? Tetracycline administered to a child between the ages of 4 months and 8 years will stain the permanent teeth.
The charge nurse is retiring from work after 25 years of service. The staff are bringing potluck for all to enjoy. When planning to make brownies for the party, which measurement system would a nurse use?
Household system The household system is the measuring system found in recipe books. This system uses the teaspoon as the basic unit of fluid measure and the pound as the basic unit of solid measure. The metric system is used for dosage calculations as well as engineering standards. The apothecary system was a unit of measurement based on weight, but was not fully accurate so is no longer used. The avoirdupois system is a system of weights based on a pound of 16 ounces or 7,000 grains, widely used in English-speaking countries.
Which best describes the manual redundancy system used to reduce potential error in medication administration by a nurse?
It is a process using the 5 rights and 3 checks. The best method of error detection is the manual redundancy system in which each person in the process of medication prescription and delivery checks the medication dosage for accuracy. Nurses use this system when they perform the "5 rights and 3 checks" to catch a potential error in medication administration.
A client with a diagnosis of bipolar disorder has begun lithium therapy. What is the primary rationale for the nurse's instructions regarding the need for regular monitoring of the client's serum drug levels?
It is necessary to ensure that the client's drug levels are therapeutic but not toxic. Measuring serum drug levels is useful when drugs with a narrow margin of safety are given, because their therapeutic doses are close to their toxic doses. This is the case during lithium therapy. Serum levels are not commonly taken to monitor adherence to treatment. Blood-drug incompatibilities are not a relevant consideration.
A nurse is using the metric system for dosage calculations. Which unit would the nurse use as the basic unit for measuring liquids?
Liter In the metric system, the basic unit of liquid measure is the liter; the basic unit of solid measure is the gram. The kilogram is another unit used for solid measure in the metric system. The minim is the basic unit of liquid measure in the apothecary system.
A client is receiving an antineoplastic medication for treatment of breast cancer and begins having tonic-clonic seizure activity. What type of toxicity does the nurse recognize that this client is experiencing?
Neurotoxicity Neurotoxicity, sometimes referred to as central nervous system toxicity, is a drug's ability to harm or poison a nerve cell or nerve tissue. Signs and symptoms of neurotoxicity include drowsiness, auditory and visual disturbances, restlessness, nystagmus, and tonic-clonic seizures. Neurotoxicity can occur after exposure to drugs and other chemicals and gases.
A hospital client began taking a newly prescribed antihypertensive 12 hours ago and has developed a full body rash with edema and pruritis. What is the nurse's best action?
Promptly inform the prescriber of the client's status. There is no indication that the client is in acute distress, so it is unnecessary to call an emergency code. However, prompt action is necessary, beginning with informing the client's care provider. The provider is likely to discontinue the medication, but the nurse cannot independently do this. Administration of diphenhydramine should only be done on the basis of a prescription.
A client began a new medication four days ago and presents with a temperature of 38.2° C (100.8 °F), dependent edema, and swollen cervical lymph nodes. The nurse has informed the client's provider, who has discontinued the medication. What subsequent intervention should the nurse prioritize?
Provide supportive care to manage fever and inflammation. This client's presentation and history are suggestive of a serum sickness reaction. Interventions include discontinuing the drug and providing supportive care. Resuscitation is not justified by this client's presentation. Epinephrine is prescribed to clients experiencing anaphylaxis. Naloxone is used to treat narcotic overdoses, not serum sickness reactions.
A client receiving drug therapy develops numbness and tingling in the extremities and muscle cramps. What assessment should the nurse perform?
Review the client's most recent potassium level Hypokalemia is suggested by numbness and tingling in the extremities, muscle cramps, weakness, and irregular pulse. Fatigue, drowsiness, hunger, tremulousness, and cold clammy skin would suggest hypoglycemia. Renal injury would be manifested by elevated BUN and creatinine concentration, decreased hematocrit, and electrolyte imbalances, fatigue, malaise, decreased urine output and irritability. Neurologic dysfunction would most likely be manifested by confusion, delirium, insomnia, drowsiness, and changes in deep tendon reflexes
A client with lymphoma is scheduled to begin chemotherapy tomorrow. When providing health education for the client regarding the risk for stomatitis, what should the nurse teach the client?
Techniques for providing safe and effective mouth care Antineoplastic drugs commonly cause stomatitis because they are toxic to rapidly turning-over cells such as those in the mucous membranes of the mouth. Vigilant and appropriate mouth care, whether provided by the nurse or by the client, is an important intervention. Stomatitis is not prevented by sitting upright during eating. Antibiotics and probiotics cannot prevent stomatitis.
Many drugs that reach the developing fetus or embryo can cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. What is the name of the adverse reaction that can cause birth defects?
Teratogenicity Teratogenicity is when drugs that reach the developing fetus or embryo cause death or congenital defects, which can include skeletal and limb abnormalities, central nervous system alterations, heart defects, and the like. Stomatitis and blood dyscasia are examples of tissue and organ damage. Cytotoxic reaction is an example of an allergic reaction to a drug.
A client is on antibiotic therapy for an axillary abscess. The client has been outside working in the yard and observes a rash everywhere that is not covered by clothing. What should the client be told about this finding?
The client is having photosensitivity and this can occur even with brief exposure to the sun or UV rays. The client's environment may increase the likelihood that a certain adverse effect will occur. Some antibiotics can cause the adverse effect of photosensitivity. Even brief exposure to sunlight or strong ultraviolet light can cause severe sunburn, hives, or a rash.
The nurse is administering medications to a 2-year-old child with impaired renal function. What does the nurse understand about the dosage of medication for this child?
The dose should be adjusted to achieve and maintain therapeutic drug levels. Drug elimination requires a functioning renal system, and its effectiveness depends on glomerular filtration rate, tubular reabsorption, and maturity of the renal system. In children with impaired renal function, drug dosage should be altered to achieve and maintain therapeutic drug levels.
An 8-year-old is going home on medication for a chronic condition. The nurse preparing to review the discharge instructions with the mother should include what basic information and/or instructions to help minimize the child's risk for injury? (Select all that apply.)
The drugs' potential side effects Schedule and duration of administration Description of the intended therapeutic drug effect A crucial step in administering pediatric drug therapy is educating the parents and other family members or caregivers, especially when the child returns home. Providing honest and detailed explanations and rationales helps reassure those caring for the child. The nurse should also provide age-appropriate explanations related to side effects, administration schedules and expected results. Referring to books or discussing therapy cost will not help the mother take care of her child at home.
A 70-year-old man who enjoys good health began taking low-dose aspirin several months ago based on recommendations that he read in a magazine article. During the man's most recent visit to his care provider, routine blood work was ordered and the results indicated an unprecedented rise in the man's serum creatinine and blood urea nitrogen (BUN) levels. How should a nurse best interpret these findings?
The man may be experiencing nephrotoxic effects of aspirin Damage to the kidneys is called nephrotoxicity. Decreased urinary output, elevated blood urea nitrogen, increased serum creatinine, altered acid-base balance, and electrolyte imbalances can all occur with kidney damage.
A client taking a beta blocker for hypertension tells the nurse he will no longer take the medication because it is causing an inability for him to maintain an erection. What is the best explanation for this issue by the nurse?
This is an expected adverse effect of the medication, but it is very important that you continue to take it. We can talk about other methods for sexual expression An adverse effect of drug therapy is a usually undesirable effect other than the intended therapeutic effect. It may occur even with normal drug dosing. Adverse effects may also occur independently of the dose and be unpredictable. The term adverse effect encompasses all nontherapeutic responses to drug therapy.
An elderly client has been taking a new medication for 2 months. During a follow-up visit, the client's son tells the nurse that he feels his mother's memory is getting worse. What concerns should the nurse have at this time?
This may be coincidental, and the memory loss may be attributed to changes with aging. It is important for nurses and other health care professionals to be alert for adverse effects from drug therapy. Sometimes, determining whether an adverse effect has occurred as a result of drug therapy is difficult. Adverse effects may be mistaken for changes associated with aging or disease pathology.
All prescriptions are required to list the metric measure for quantity and strength of the drug
True In 1995 the U.S. Pharmacopeia Convention established standards requiring that all prescriptions, regardless of the system that was used in the drug dosing, include the metric measure for the quantity and strength of drug. It was also established that drugs may be dispensed only in the metric form.