Pharm study guide ch 50-54

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Gastro

A patient who has been on antibiotic therapy for 2 weeks has developed persistent diarrhea. The nurse expects which medication to be ordered to treat this diarrhea?

Intestinal flora modifiers such as Lactinex

A laxative has been ordered for a patient. The nurse checks the patient's medical history, knowing that this medication is contraindicated with which condition?

Abdominal pain of unknown origin

The nurse is preparing to administer medications to a patient who is receiving a gastric tube feeding. When reviewing the patient's medication list, the nurse notes a potential concern about a food-drug interaction if this medication is listed?

phenytoin (Dilantin)

A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control his diarrhea. When reviewing the patient's other ordered medication, the nurse recognizes that which medication will interact significantly with the Pepto-Bismol?

digoxin (Lanoxin)

The nurse is preparing a plan of care for a patient undergoing therapy with vitamin A. Which nursing diagnosis is appropriate for this patient?

Disturbed sensory perception (visual) related to night blindness caused by vitamin deficiency

The nurse is reviewing the mechanism of action of antidiarrheal drugs. What type of antidiarrheal medication works by decreasing the intestinal muscle tone and peristalsis of the intestines?

Anticholinergics such as belladonna alkaloids.

The nurse will monitor for which signs of toxicity when a patient is on vitamin D supplemental therapy?

Anorexia

When administering mineral oil, the nurse recognizes that it can interfere with the absorption of which substance?

Vitamin A

A patient is taking chemotherapy with a drug that has a high potential for causing nausea and vomiting. The nurse is preparing to administer an antiemetic drug. Which class of antiemetic drugs has proven most effective in preventing nausea and vomiting for patients receiving chemotherapy?

Serotonin blockers.

An elderly patient needs to take an enteral supplement to improve her overal nutrition status. When considering enteral supplements, the nurse notes that which formulation provides complex nutrients?

Ensure

The nurse is giving oral mineral oil as an ordered laxative dose. The nurse will take measures to prevent which potential problem that may occur with mineral oil?

Lipid pneumonia

Niacin is prescribed for a patient who has hyperlipidemia. The nurse checks the patient's medical history, knowing this medication is contraindicated in which disorder?

Liver disease

A patient with a history of alcohol abuse has been admitted for severe weakness and malnutrition. The nurse will prepare to administer which vitamin preparation to prevent Wernicke's encephalopathy?

vitamin B1 (thiamine)

A mother calls the pediatrician's office to report that her 18-month-old child has eaten half a bottle of baby aspirin. She says, "I have a bottle of syrup of ipecac. Should I give it to him? He seems fine right now. What should I do?" What is the nurse's best response?

"Don't give him the ipecac, but call the Poison Control number immediately for instructions."

The nurse notes that a patient is taking tegaserod (Zelnorm) to treat irritable bowel syndrom (IBS). The nurse will monitor the patient for which adverse effect?

Chest pain

When giving nutrition supplements, the nurse keeps in mind that the most common adverse effect is:

diarrhea

While recovering from surgery, a 74-year old woman started taking a stimulant laxative, senna (Senokot), to relieve constipation caused by the pain medications. She tells the nurse that she likes how "regular" her bowel movements are now that she is taking the laxative. Which teaching principle is appropriate for this patient?

Long-term use of laxatives often results in decreased bowel tone and may lead to dependancy.

A patient is severely constipated and needs immediate relief. The nurse knows that which type of laxative will provide the most rapid results?

Magnesium hydroxide (MOM)

The nurse is reviewing conditions caused by nutrient deficiencies. Conditions such as infantile rickets, tetany, and osteomalacia are caused by a deficiency in which vitamin or mineral?

Vitamin D

A patient is receiving a tube feeding through a gastrostomy. The nurse expects that which type of drug will be used to promote gastric emptying for this patient?

Prokinetic drugs

The patient asks advice about which type of laxative is safe to use while at home so as to prevent problems with constipation. The nurse explains that which class of laxative is considered safe to use on a long term basis?

Bulk-forming laxatives

The nurse is considering the use of oral laxatives. All the conditions below are contraindicated in or require caution with the use of oral laxatives except:

GERD

A woman who is in the first trimester of pregnancy has been experiencing severe morning sickness. She asks, "I've heard that ginger tablets may be a natural way to ease nausea and vomiting. Is it okay to try them?" What is the nurse's best response?

"Some health care providers do not recommend ginger during pregnancy. Let's check with your doctor."

A patient has been receiving total parenteral nutrition (TPN). Upon assessment, the nurse notes that his blood pressure is elevated, his pulse is weak and elevated, he seems confused, and he has new pitting edema around his ankles. Which condition does the nurse suspect the patient is experiencing?

Fluid overload

When counseling a patient about calcium supplements, the nurse should include which dietary information?

Foods high in calcium include dairy products and salmon.

During the night shift, a patient's total parenteral nutrition (TPN) infusion ran out, and there was no TPN solution on hand to continue the infusion. The nurse will have to implement measures to prevent what consequences of abruptly discontinuing TPN infusions?

Rebound hypoglycemia

A patient with motion sickness is planning a cross-country car trip to attend a family reunion. He has a prescription for a scopolamine transdermal patch. The nurse should instruct the patient that the patch should be changed:

Every 3 days

Which one of the following interventions is correct regarding the pharmacologic management of nausea and vomiting?

Medicate only when nausea is severe

When monitoring a patient who has been on peripheral parenteral nutrition (TPN) for more than three weeks, the nurse monitors for which possible complication?

Phlebitis

A patient who has severe nausea and vomiting following a case of fool poisoning comes to the clinic. When reviewing his medication history, the nurse notes that he has an allergy to procainamide. The nurse would question an order for which antiemetic drug if ordered for this patient?

promethazine (Phenergan)

A patient with type 2 diabetes will be receiving a nasogastric tube feeding for a few days. The nurse expects which type of formula to be used?

Glucerna

A patient will be taking bismuth subsalicylate (Pepto-Bismol) to control his diarrhea. When reviewing the patient's other ordered medications, the nurse recognizes that which medication will interact significantly with the Pepto-Bismol?

warfarin (Coumadin)

A patient on chemotherapy is using ondansetron (Zofran) for treatment of nausea. The nurse will instruct the patient to watch for which adverse effect of this drug?

Headache

A patient is receiving lactulose (Chronulac) three times a day. The nurse knows that the patient is not constipated and is receiving this drug for what reason?

High ammonia levels due to liver failure

A patient who has been newly diagnoses with vertigo will be taking an antihistamine antiemetic drug. The nurse will include which information when teaching the patient about this drug?

The patient should avoid driving because of possible drowsiness.

A patient who has AIDS has lost weight and is easily fatigued because of his malnourished state. The nurse anticipates using which antinausea drug to stimulate his appetite?

dronabinal (Marinol), a tetrahydrocannabinoid

The nurse will prepare to give which preparation to a newborn upon arrival in the nursery after delivery?

vitamin K (AquaMEPHYTON)

A patient will be starting vitamin D supplements. The nurse reviews his medical record for contraindications, which include:

renal disease

The nurse is providing teaching to a patient who will be taking the laxative docusate (Bisocodyl). Which statement by the nurse is appropriate during this teaching session?

"The tablets should be taken with water."

When administering a bulk-forming laxative, the nurse instructs the patient to drink the medication mixed in a full 8-ounce glass of water. Which statement best explains the rationale for this instruction?

These laxatives may cause esophageal obstruction if taken with insufficient water.

A woman has been receiving both radiation and chemotherapy for her cancer. Lately, she has developed anorexia caused by the treatments, so she needs short-term nutrition supplementation. The nurse anticipates that the physician will initiate which therapy?

Peripheral parenteral nutrition (PPN)

A patient is about to undergo a diagnostic bowel procedure. The nurse expects which drug to be used to induce total cleansing of the bowel?

polyethylene glycol (GoLYTELY)

A nurse is discussing the use of adsorbents such as bismuth subsalicylate (Pepto-Bismol) with a patient who has diarrhea. The nurse should warn the patient about which possible adverse effect?

Darkened stools

The peripheral parenteral nutrition bag that has been infusing into an assigned patient has run dry before a new bag has been ordered. The nurse should immediately hang with of the following available solutions until the new bag arrives?

10% dextrose in water

A patient has received an overdose of the anticoagulant warfarin (Coumadin) and the nurse is preparing to administer vitamin K as an antidote. Which statement about vitamin K is true?

The vitamin K dose will be given intramuscularly

The nurse is administering intravenous calcium and will administer it slowly to avoid which adverse effect?

Cardiac arrest

The nurse knows that the major difference between diphenoxylate with atropine (Lomotil) and the over-the-counter drug loperamide (Imodium) is that

Imodium does not cause physical dependence

A patient is on a chemotherapy regimen in an outpatient clinic and is receiving a drug that is known to be highly emetogenic. The nurse will implement which interventions regaring the pharmacologic management of nausea and vomiting?

- Administering antinausea drugs 30 to 60 minutes before chemotherapy is started
- Instructing the patient that the antinausea drugs may cause extreme drowsiness
- Instructing the patient to rise slowly from a sitting or lying position because of possible orthostatic hypotension

The nurse is monitoring a patient who is receiving a parenteral nutrition infusion. What measures are appropriate to prevent infection?

- Change the intravenous tubing set every time a new bag is added to the infusion
- Use a 1.2 micron filter with each tubing set
- Report any increase in the patient's temperature over 101 F

A patient asks the nurse about taking megadoses of vitamin C to improve her immunity to colds. "It's just a vitamin, right? What can happen?" Which responses by the nurse are correct?

- "Megadoses of vitamin C can cause nausea, vomiting, headache, and abdominal cramps."
- "Keep in mind that if you suddenly stop taking these megadoses, you might experience symptoms similar to scurvy."
-"Studies have shown that vitamin C has little value as prophylaxis for the common cold."
- "Vitamin C acidifies the urine, which can lead to the formation of renal stones."

The nurse is considering the uses of oral laxatives. Which conditions are general contraindications to or cautions about the use of oral laxatives?

- Abdominal pain of unknown orgin
- Nausea and vomiting
- Fecal impactions
- Acute surgical abdomen

The nurse is reviewing vitamin therapy. Which statements are true regarding vitamin C?

- Vitamin C is important for the maintenance of bone, teeth, and capillaries
- Vitamin C is important for tissue repair
- Vitamin C is found in citrus fruits, tomatoes, strawberries, and broccoli.
- Vitamin C deficiency is known as scurvy.

During an intravenous infusion of calcium, the nurse monitors the patient for symptoms of hypercalcemia. Which are symptoms of hypercalcemia?

-anorexia
- nausea and vomiting
- constipation
- cardiac irregularities

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