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Pharm ATI 2017

Terms in this set (43)

Heparin
Monitor activated partial thromboplastin time (aPTT)
Vitamin K
Warfarin antidote
Warfarin
Monitor prothrombin (PT) and INR- International Normalized Ratio
Protamine sulfate
Heparin antidote
MOA for Osmotic diretics
Reduce intracranial pressure and intraocular pressure by raising serum osmolality and drawing fluid back into the vascular and extravascular space.
MOA for Loop diuretics
Work on the ascending limb of the loop of Henle to block reabsorption of sodium and chloride and to prevent reabsorption of water
MOA for Thiazide diuretics
Work in the early distal convoluted tubule to block the reabsorption of sodium and chloride and prevent the reabsorption of water that this site
MOA for Potassium sparing diuretics
Work in the early distal convoluted tubule to block the reabsorption of sodium and chloride and prevent the reabsorption of water that this site
A nurse is caring for a client prescribed hydromorphone for severe pain. The client's respiratory rate has decreased from 16 breaths per minute to 6. Which if the following medications should the nurse prepare to administer?
Naloxone
A client has been prescribed lisinopril. Which of the following medication interactions should the nurse instruct this client about?
Potassium supplements
A client has been prescribed vasopressin for the treatment of diabetes insipidus. What is the expected pharmacological action of this medication?
To increase re-absorption of water in the renal tubules- The expected pharmacological action is to promote reabsorption of water within the kidney.
A nurse is reviewing the medication class, benzodiazepines. The nurse would use caution when administering benzodiazepines to which of the below clients?
A client with glaucoma.
A client is prescribed propranolol. Which of the following client history findings would require the nurse to clarify this medication prescription?
Asthma
A nurse is caring for a client newly prescribed doxazosin mesylate. Which of the following instructions should the nurse include in client education regarding taking the first dose of this medication?
Change positions slowly and lie down if dizziness occurs. First-dose orthostatic hypotension can occur with Cardura. The nurse should instruct clients to change positions slowly and to lie down if feeling dizzy, lightheaded or faint.
Which of the following are contraindications to aspirin therapy?
Thrombocytopenia, 3rd trimester pregnancy, Adolescents with chickenpox
A 45-year-old client is taking methylprednisolone. What pharmacological action should the nurse expect with this therapy?
Suppression of airway mucus production
A nurse is caring for a client receiving a dopamine infusion via a peripheral IV. Which of the following actions should the nurse take if the IV site appears infiltrated?
Stop the infusion.
A nurse is to instill ear drops to a 2 year-old child. To straighten the ear canal, the nurse should pull the auricle of the ear:
down & back
A nurse is preparing to administer an intramuscular injection to an adult client. At what angle should the nurse administer the medication using the ventrogluteal site?
90 degree angle
A client has been prescribed isosorbide mononitrate. Which of the following should the nurse include in this client's education related to this medication?
This medication is prescribed for long-term prophylaxis against anginal attacks.
A nurse is caring for a client prescribed ferrous sulfate for the treatment of anemia. Which of the following instructions should be included in client teaching about this medication?
Take the medication on an empty stomach to maximize absorption.
A nurse is caring for a client prescribed montelukast. Which of the following should the nurse include in teaching related to this medication?
Advise client to take the medication once daily at bedtime.
A nurse is preparing to administer enoxaparin to a client. Which of the following actions should the nurse take when administering this medication?
Advise client to take the medication once daily at bedtime.
A nurse has just administered a wrong medication to a client. Which of the following actions should the nurse take next?
Report error to the provider.
A nurse is preparing to administer a measles, mumps, and rubella vaccine (MMR) to an adult client. Which of the following is a contraindication to this vaccine?
The possibility of pregnancy within 4 weeks
A 52-year-old client with a history of angina has been prescribed transdermal nitroglycerin. Which of the following adverse effects is not seen with this therapy?
Productive Cough
A client with osteoporosis is prescribed alendronate. What client education should the nurse provide to ensure optimal absorption of the medication?
Advise the client to take the medication on an empty stomach with at least 8 oz of water.
A nurse is caring for a client receiving patient-controlled analgesia (PCA). Which of the following interventions should the nurse take while caring for this client?
Encourage the client to use the PCA before dressing changes.
A client has been prescribed metoclopramide. Which of the following should the nurse include in client education regarding this medication?
Notify your provider if you experience restlessness or spasms of the face or neck.
A nurse is caring for a client prescribed the HMG CoA reductase inhibitor, atorvastatin. Which of the following should be monitored while this medication is prescribed?
Liver function test. Statins (HMG CoA reductase inhibitors) like atorvastatin (Lipitor) can cause hepatotoxicity. Prior to initiating therapy the client's baseline liver function should be determined then liver function tests should be checked after 12 weeks of therapy and then every 6 months. The nurse should advise the client to observe for symptoms of liver dysfunction (anorexia, vomiting, nausea, jaundice) and to notify the provider if these occur.
A nurse have provided education to a client regarding prescribed levothyroxene sodium. What of the following client statements demonstrates understanding of medication administration?
"I should take the medication in the morning to prevent insomnia."
A nurse is providing care to a client with staphylococcus epidermidis, who is prescribed vancomycin. Identify the adverse effect associate with this antibiotic therapy?
Infusion reaction- Red Man Syndrome or an infusion reaction that results in rashes, flushing, tachycardia and hypotension can occur as an adverse reaction. For this reason, vancomycin should be administered over a 60 minute period.
A nurse is caring for a client prescribed digoxin. Which the following should alert the nurse to possible digitalis toxicity?
anorexia and weakness
A client diagnosed with Parkinson's disease is prescribed levodopa. The nurse should instruct the client not to take over the counter pyridoxine supplements while taking this medication.

T/F
True. Pyridoxine (vitamin B6) decreases the effects of levodopa. Clients should not take over the counter supplements without consulting their provider.
A 55-year-old client has levothyroxine ordered. Which of the below past medical history concerns may contraindicate with her medication management of hypothyroidism?
Osteoporosis. Caution should be used to prevent overtreatment with levothyroxine and monitor drug levels. Chronic overtreatment can cause atrial fibrillation and an increased risk of fractures from bone loss, especially in older adults.
Which of the following agents is used for motion sickness?
Scopolamine (Hyoscine). Scopolamine is an anticholingeric that interferes with the transmission of nerve impulses traveling from the vestibular apparatus of the inner ear to the vomiting center of the brain. Misoprostol prevents gastic ulcers from forming by promoting submucosal blood flow. Raberprazole is a proton pump inhibitor that reduces gastric acid secretion to prevent erosion and ulcers of the gut. Oprelvekin is a thrombopoietic growth factor agent to increase platelet production.
Methotrexate blood levels are monitored to determine therapeutic dosing. The nurse knows that high-dose levels of methotrexate therapy can lead to __________ damage.
Liver. Acetaminophen, methotrexate, tetracyclines, and tamoxifen increase levels of mipomersen and can increase risk for liver damage.
A client with peptic ulcer disease takes cimetidine. Which of the below outcomes can occur if H2-receptor antagonists, such as cimetidine are taken long term?
Pneumonia. H2-receptor antagonists decrease gastric acidity, which promotes bacterial colonization of the stomach and the respiratory tract, which can lead to the outcome of pneumonia. Paralytic Ileus, fluid retention, and hyperkalemia are not expected outcomes with long term use of H2-receptor antagonists.
Disulfiram is taken by a client daily for abstinence maintenance. What is an adverse effect of this therapy?
Hepatoxicity.
A client taking lithium should be cautioned about drug interactions with which below medication?
Fluoxetine. Both lithium and fluoxetine drug-drug interaction can lead to serotonin syndrome which may include symptoms such as confusion, hallucination, seizure and increase in heart rate and blood pressure.
Before administering blood products, which action should be taken?
Asses pt's temperature. When administering blood products, assess the client's vital signs, obtain consent for the procedure and ensure compatibility. Prime the IV tubing with 0.9% sodium chloride. The nurse would not document client response or administer epinephrine prior to starting the transfusion.
The nurse knows that a client with renal insufficiency should be reevaluated for best diabetic management, when it is noted the client is on metformin. What is the reason metformin is contraindicated for clients who have renal insufficiency?
The medication increases the risk of lactic acidosis.
A client prescribed the tricyclic antidepressant, amitriptyline has been on the medication for three weeks. The client vocalizes increased mood, but complains of anticholinergic effects. What is an example of an anticholingeric adverse effect?
Urinary retention. Anticholinergic effects include dry mouth, blurred vision, photophobia, urinary retention, constipation and tachycardia.
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