Week 2 meds
A client is being discharged following an allergic reaction after ingesting aspirin. When providing client education about the allergy, the nurse would provide the client with what information?
''Do not take any NSAIDs.'' because cross-hypersensitivity reactions may occur with any drugs that inhibit prostaglandin synthesis.
A client diagnosed with iron deficiency has been taking oral ferrous sulfate for the past several days. When the nurse is assessing for therapeutic effects, what question is most warranted?
''How is your energy level compared with a few days ago?'' The nurse should assess for increased energy, vigor, and feeling of well-being
An adult client has asked the nurse about the potential need for calcium supplements. What should the nurse identify as the daily upper intake level for this mineral?
2500 mg
What drug groups are considered teratogenic?
A teratogen is an agent that can disturb the development of the embryo or fetus. Classes of teratogens include antiepileptic drugs, ''statin'' cholesterol-lowering drugs, antidepressant drugs, and nonopioid analgesics.
Acetaminophen antidote
Acetylcysteine (Oral or IV) Most beneficial if given 8 to 10 hours after ingestion, may be helpful within 36 hours Does NOT reverse damage already sustained
The ability of older adults to adequately distribute drugs that are ingested is highly dependent on serum levels of what factor?
Albumin
The nurse knows, that as a COX-1 inhibitor, indomethacin inhibits prostaglandins associated with which tissues?
All tissues and cell types
Which drug would be avoided for a client with a high risk for bleeding?
Aspirin, Ibuprofen, Naproxen, Indomethacin
water soluble vitamins
B and C and folic acid
Which characteristic allows for a drug to be stored in the body and released as needed?
Being protein bound
What unique characteristic is present in lipid-soluble drugs?
Can cross the blood-brain barrier
Lab test for anemia
Check the complete blood count for decreased red blood cells, hemoglobin, and hematocrit. Reduced values may indicate iron deficiency
What factors contribute to the decrease in absorption that accompanies aging?
Decreased blood flow in the GI tract, Decreased surface area of the GI tract, Decreased gastric emptying
The process that largely determines serum drug levels, adverse effects, and other important aspects of drug therapy is known by what term?
Drug clearance
The nurse's discussion of the role of cytochrome P-450 (CYP) enzymes is focusing on what aspect of pharmacokinetics?
Drug metabolism that takes place in the liver
The nurse is caring for an older adult client who has been prescribed multiple medications. How can the nurse best work with the care team to prevent polypharmacy-related issues?
Ensure that each of the client's medications is genuinely necessary and discontinue those that are not.
The nurse administers ibuprofen to adult clients experiencing a variety of health disorders. Following administration, the nurse should assess for therapeutic effects related to what symptoms?
Fever, Inflammation, Moderate pain
A client has just presented for care after a positive over-the-counter pregnancy test. When performing health education with this client, the nurse should emphasize the need for supplementation with what nutrient?
Folic acid Women who are pregnant or who may become pregnant should increase their intake of folic acid.
When conducting health promotion education with older adults, the nurse should encourage what intervention to help reduce their risks of altered drug responses?
Frequent physical activity
Which medication being taken regularly by a client may create a need for oral potassium supplementation?
Furosemide (potassium-depleting diuretics)
Vitamin K
Green leafy vegetables, cauliflower, tomatoes, wheat bran, cheese, egg yolk, liver
Excess Vitamin A
High doses of vitamin A can result in headaches; diarrhea; nausea; loss of appetite; dry, itching skin; and elevated blood calcium, anorexia, pain in muscles, bones, joints
Ibuprofen parm action
Inhibits prostaglandin synthesis in both the central and peripheral nervous systems
During a routine visit to the clinic, a client reports taking a daily vitamin and mineral supplement. What important fact should the nurse teach the client to promote safe use?
Large doses of any mineral are potentially toxic.
An adult client is brought to the emergency department after deliberately overdosing on acetaminophen. The care team should prioritize interventions based on the client's risk for which adverse reaction?
Liver failure
Race is a variable that is known to influence what aspect of pharmacokinetics in older adults?
Metabolism Clients of Asian descent can metabolize and excrete medications more quickly than White or Black clients.
Nursing interventions for patient's getting parenteral nutrition?
Monitor weight, fluid intake, urine output, vital signs, blood glucose, serum electrolytes, and complete blood count
Which characteristic may allow a drug to cross the blood-brain barrier?
Only drugs that are lipid soluble or have a transport system can cross the blood-brain barrier and reach therapeutic concentrations in brain tissue
A client has been prescribed supplemental iron tablets. What instruction is most appropriate for the nurse to include in teaching to maximize absorption?
Oral iron preparations are better absorbed if taken on an empty stomach
What substance is necessary to facilitate absorption of fat-soluble vitamins? Select all that apply.
Pancreatic lipase, Bile salts
Tube feeding supplements:
Patient in sitting position, solution at room temp ( cold will cause abdominal cramping), no more than 5oomL per feeding (vomiting) , should take 30-60 mins, tubes should be rinsed after each use and replaced ever 24h. DO NOT mix meds.
Acetaminophen Toxicity
Prevention: maximum daily dose is 4 g from all sources. Overdose causes hepatotoxicity. 24 to 48 hours after overdose, liver function tests begin to show increased levels. Gastric lavage and activated charcoal (If overdose detected within 4 hours after ingestion)
Aspirin
Reduce fever by acting on the hypothalamus Diminish inflammation Suppress platelet aggregation Low dose for Ischemic stroke, transient ischemic attack, angina, and acute myocardial infarction
The nurse is educating a client regarding a newly prescribed oral prescription with a name that includes initials SR. What information should the nurse provide concerning the drug's delivery system
Slow-release (SR) dosage forms absorb more slowly and maintain concentrations within an acceptable therapeutic range over a long period of time It provides for a more consistent serum level. It allows for less frequent dosing.
Absorption of a drug administered orally will take place primarily in what anatomical location?
Small intestine
COX-1 inhibitor has known protective effects on what organ?
Stomach, Kidneys
An adult client has told the nurse that vitamin supplements should be avoided because ''natural foods are the only good source of vitamins.'' What information about synthetic vitamins should be the basis of the nurse's response?
Synthetic vitamins are less expensive than some natural sources., Natural and synthetic sources of vitamins are equivalent in function.
VItamin K supplement
Take this vitamin only as directed by a health care provider. Keep intake of vitamin K-containing foods constant. Avoid sudden increases or decreases in the amounts of these foods. If taking warfarin, report any use of vitamin K to your health care provider. During warfarin therapy, intake of vitamin K-containing foods should remain constant.
How is pharmacodynamics best defined?
The action that the drug has on body cells
The client's admission blood work indicates a low creatinine clearance rate (CrCl). A low CrCl may have what implication for the client's pharmacotherapy?
The client may require lower-than-normal doses of a drug.
How should the nurse best describe prostaglandins when asked to do so?
They are chemical mediators that participate in the inflammatory response and that are found in most body tissues.
The nurse is providing education to the caregiver of a client who is receiving a commercially prepared enteral formula. The nurse should indicate that, when given in sufficient amounts, these products can meet all nutritional needs except for what?
Water
Tube feeding and drug absorption
administer med 30 mins before
B3 (niacin) sources
all protein foods and whole grain and enriched breads and cereals.
Person should avoid potassium supplements and foods if taking which meds for BP?
angiotensin converting enzyme inhibitor
Iron sources
beef liver, red meats, fish, poultry, clams, tofu, oysters, lentils, dried peas and beans, fortified cereals, bread, and dried fruit
Iron therapeutic effect check
check for reticulocyte count (immature RBC)
Vitamin C sources
citrus fruits and juices, red and green peppers, broccoli, cauliflower, brussels sprouts, cantaloupe, kiwi fruit, mustard greens, strawberries, and tomatoes.
Vitamin E overdose
fatigue, headache, blurred vision, nausea, diarrhea
Patient with dehydration symptoms include
fever
Loss of minerals and electrolytes
gastric suction, polyuria, diarrhea, excessive perspiration, and other conditions.
Pottasium
helps to maintain electrolyte balance, nerve impulse transmission
Potassium deficiency and surplus
hypokalemia and hyperkalemia.
Well balanced diet can lack what nutrients?
iron and calcium (mostly in women and children)
Succimer chelates
lead to form water-soluble complexes that are excreted in the urine
lithium with meloxicam (osteoarthritis)
lithium toxicity results
The nurse assesses the function of what organ to evaluate the client's ability to effectively absorb medications prescribed in tablet and capsule forms?
liver
Folic acid sources
liver, okra, spinach, asparagus, dried peas and beans, seeds, and orange juice. Breads, cereals, and other grains are fortified with folic acid.
B6 (pyridoxine) sources
meats, fish, poultry, fruits, green leafy vegetables, whole grains, and dried peas and beans.
Signs and symptoms of hyperkalemia
muscle weakness, palpitations, slow pulse, fatigue, shortness of breath
Vitamin A deficiency
night blindness, change in skin and mucus membranes
Acetaminophen
not an NSAID Does not cause nausea, vomiting, GI bleeding, or interfere with blood clotting Equal to ASA in analgesic and antipyretic effects Lacks anti-inflammatory activity Metabolized in the liver; small amount remains in the body as toxic metabolite Usual therapeutic doses may cause/increase liver damage in those who abuse alcohol. Available in tablet, liquid, rectal suppository
ASA (aspirin) risk for children
not used with children because of risk of Reye's syndrome
Vitamin B12 sources
occurs in meat, fish, poultry, shellfish, milk, dairy products, eggs, and some fortified foods. Vitamin B12 does not occur in plant sources.
Vitamin B1 sources (thymine)
occurs in whole grain and enriched breads and cereals, liver, nuts, wheat germ, pork, and dried peas and beans.
Signs and symptoms of hypokalemia
palpitations, confusion, dizziness, muscle weakness, abdominal distension, frequent voiding of large amounts of urine
Vitamin A sources
retinols: liver, milk, butter, cheese, cream, egg yolk, fortified milk, margarine, and ready-to-eat cereals. Beta-carotenes occur in spinach, collard greens, kale, mango, broccoli, carrots, peaches, pumpkin, red peppers, sweet potatoes, winter squash, watermelon, apricots
Salicylates toxicity sign
ringing in the ears
Anemia and vitamin B
should be administer IM bcuz. is not absorbed orally in case of anemia
Aspirin take with food or no
take after meal to reduce gastric irritation
Pregnancy and vitamin A
teratogenic
Penicillamine chelates
vcopper, zinc, mercury, and lead to form soluble complexes that are excreted in the urine.
vitamin E sources
vegetable oils, margarine, salad dressing, other foods made with vegetable oil, nuts, seeds, wheat germ, dark green vegetables, whole grains, and fortified cereals.
A history of liver disease and vitamins
vit deficiency
Vitamin C and iron
vitamin C improves the absorption of iron.