Terms in this set (101)
Taking a client history, you must assess all OTCs, because?
Drug interactions and ADRs
You should teach clients to keep their medications
Avoid extreme heat, moisture, temperature extremes
When administering medications through a gastrostomy tube, the precautions are
Never crush XR's and enteric coated liquid form if possible
Flush before and after
Crush as fine as possible
G tubes are long-term, NG tubes are short term
Inhalers are the best option for bronchodilation over IM, PO, etc because
Your client's protein bound drug will last....
Longer in the blood
Longer duration because slowly released
Tell your client not to drink grapefruit juice with a drug because...
Acts on CYP450
Inhibits the enzyme
So increases the blood level of drug/ increase toxicity
If a client is a fast metabolizer, then drugs affected by this action will...
Have a shorter duration
Histamine-2 blockers affect...
Parietal cells to decrease acid
You tell a client on warfarin to decrease the intake of...
Green leafy vegetables
A client has four healthcare providers in different offices. This contributes to the risk of medication errors because...
Multiple providers in different locations = multiple pharmacies = duplicate prescriptions
Medication errors can have what outcomes?
Legal effects on the nurse
Increased cost for hospital
A high alert drug is...
Immediate deleterious outcome
Oral are not high-alert
A client's pain is...
Whatever they say it is
If you take it away from them they will go through physical/psychological withdrawal
If a client who is an alcoholic has surgery, this might happen with the amount of anesthesia,
They need more
Because they have a cross-tolerance
Your alcoholic client is now needing less alcohol to get drunk... this is important since...
They've gone into liver failure/ their liver is shutting down
Check labs increased ALT, AST, itchy, yellow, increased ammonia
Your pregnant client has high estrogen levels that may affect...
Increases acidity which Decreases absorption
If a female pregnant client is using drugs, what can you tell her?
Get off any medications that aren't necessary (i.e., acne) but can stay on those for chronic conditions
Illicit drugs will affect the baby birth defects
Drugs can cross the placenta
Even drugs that don't cross the placenta can affect the baby
The symptoms of nephrotoxicity include...
Proteinuria Cloudy urine
Hematuria Bloody urine
Oliguria Decreased urine output
Tells you that the tissue is dying fever and increased WBC
Childhood poisonings from medications is extremely common during the toddler stage because...
They put everything in their mouth
Flavor medications to make them taste better = drink/want more of it
they call it candy
Older people synthesize less albumin; when is this important?
Decreases the amount of protein binding which increases the amount of free drug.
How the drug effects the body
Your client has a fluid imbalance... the most important thing to do is...
Find out what the problem is and fix it
Clients with HTN need to take their medications continually to prevent...
Weight gain that needs to be reported
2lbs a day or 5lbs a week.
A sodium channel anti-dysrhytmic is prescribed, but is contraindicated if the patient has a cardiac history of...
A client on Lovenox(anticoagulant) needs to be taught...
Don't get rid of the bubble
Why they're getting it: to prevent clot, check for DVT Increase in diameter of the calf and pain in the calf
No Homan's test (can dislodge emboli)
Unilateral swelling of the limb
For CSF (colony stimulating drugs) drugs to work, this needs to be functioning...
Epogen is given to...
Increases RBC to increase the oxygen-carrying capacity of the blood
A client with aspirin overdose could have symptoms of...
Hyperventilation to blow off acid
Metabolic acidosis symptoms
Before administering an antibiotic, the nurse should...
We don't give a pregnant woman aminoglycosides because...
Kills the babies kidneys
Ototoxic as well
A client on cephalosporins might experience side effects of...
Renal effects in older adults = nephrotoxic
Diarrhea in children
A client is on gentamicin (Garamycin), the nurse would monitor lab tests, including...
A breast feeding mother is prescribed ciprofloxacin (Cipro), so the nurse...
Not supposed to breastfeed with Cipro
Change the antibiotics.
Would not be put on tetracycline because it hits the teeth.
A toddler girl is prescribed TMP-SMP for...
A client has been prescribed acyclovir (Zovirax) and the nurse giving report says the client has hepatitis B, so...
Question the order
This is given for Herpes which attacks neural cells
Zovirax = nerve
Hepatitis affects liver cells
Systemic fungal infections would be treated with...
Before we give it we will give them Tylenol/aspirin and Benadryl
A client with TB needs taught to take their medication for...
6 months to a year
HIV = 2 years
A client on immune therapy needs to be observed for what S/S of infection?
Fever - 101
SSRIs are used for narcolepsy and cataplexy to relieve...
Narcolepsy = sleep
Cataplexy = loss of muscle tone
To decrease the symptoms of the above & slurred speech and saggy jaw
Danger with airway obstruction
When teaching a client who cannot sleep about non-pharmacologic approaches, you tell him...
Decrease all stimulation
Avoid caffeine later in the day
Avoid alcohol and nicotine
Exercise during the day
Meditation, deep breathing, relaxation technique
A client on phenelzine (Nardil Antidepressant) needs instructed to avoid these...
Processed meats and cheese
Treatment for bipolar disorders continues
An abrupt discontinuance of ziprasidone (Geodon) for bipolar disorder may result in...
Acute mania = bizarre behavior to the point of seizures
When administering Lasix to a client with SIADH, you expect...
Increased urine output
A diabetic is prescribed a beta blocker, you should...
Monitor blood sugar
Change the prescription because it will mask hypoglycemia and affect blood sugar
For most medications, clients should avoid...
You are teaching a client about insulin, so you should include:
How to check sugar
How to administer
S/S of hypo and hyperglycemia
Sick day rules
Have snack with them
Should wear alert band
A client with hyperthyroidism would most likely be treated with...
SSKI Lugol's solution, Tapazole
A women should stop taking atorvastatin (Lipitor) when she...
Pregnant/thinking of becoming pregnant
The major difference between ACEI's and ARBs is...
ACEI's cause more angioedema
Dry cough with ACEI's
Medications that can cause ulcers primarily include...
A client being treated spironolactone (aldactone)should watch intake of
Early S/S of hypokalemia are...
Muscle cramps and weakness
A client on hydrochlorothiazide needs taught about...
Monitor BP and weight daily
Avoid the sun/photosensitivity
Report hearing problems
Check their blood sugar
Take in the morning
High potassium diet
Can cause hyperglycemic = monitor blood sugars more frequently
report 2 lbs in a day, 5 lbs in a week
A bedridden client is prescribed risedronate for osteoporosis. The nurse needs to assess for the ability to...
Sit up for 30 minutes.
A client with gout is prescribed colchicine for gout needs to report which S/S that indicate an ADR?
Hits the GI tract distention, diarrhea, vomiting, nausea, abdominal pain
Major health problems that can occur while taking Provera include...
increase in Thromboembolic disorders
Head : any changes to the brain
Lungs: respiratory emboli
Cardiac: MI, change in cardiac enzymes
Lower extremities= DVT / swelling in one limb, weakness on one side
Indications for interruption of terbutaline (Brethine a beta 2 agonist) therapy for premature labor include...
Increased respiratory rate = dyspnea, hyperventilation
Low Potassium level < 3
To treat metabolic acidosis, the nurse would administer
A client needs to return for depot method of contraception every...
Androgens are used in women to treat...
The lab that would indicate a positive response after testerone therapy is...
A client toxic from IV mag would receive...
Anti-parkinsonism drugs don't contain dopamine because...
It does not cross the BBB
The important information to give a spouse about drug treatment for Alzheimer's disease is...
Not a cure
Will only take for a short time
The client treated with tacrine (Cognex) for Alzheimer's disease would need the nurse to monitor....
Liver function studies
The diuretic contraindicated for a client with renal failure is...
Aldactone (potassium will build up)
The OTC medication a patient being treated with levodopa/carbidopa (for parkinsons) should avoid
If a client being treated with phenytoin (Dilantin for seizures) suddenly stops taking the med could result in
IV diazepam (Valium) could cause
A woman planning to get pregnant is taking (Tegretol) for seizure control should...
Dantrolene sodium (Dantrium for muscle relaxant) should monitor
A client is prescribed Robaxin most likely due to...
Sleepy side effect = shouldn't drive or operate heavy machinery
A nurse prepares to administer Kayexelate(electroyltes) to a client by...
Give with rectal tube and then clamp the rectal tube for 20-30 minutes
Pilocarpine (Isopto Carpine) affects the pupil of the eye resulting in...
Causes induced myopia
Given for glaucoma
To examine an injury to the cornea, the drug specific for this is...
The nurse would administer ear drops to an adult client by...
Side lying with bad ear up
Pull pinna up and back
Stay in side lying position for at least 5 minutes up to 10 minutes
The drug of choice to treat anthrax is...
Have a patient in DI and they're on Desmopressin (antidiuretic), what are you going to be looking for to see if it's working?
Normal specific gravity
What is the adverse effect of furosemide?
Mannitol (Osmotic diuretic):
Works by pulling water from the interstitium into the vascular system so that your kidneys can excrete it.
Adverse effect: cerebral edema because it can increase ICP in high doses and cross the BBB.
When you have a patient that is in renal failure, what can you expect the physician to do with their medications?
Decrease the dosage
What can lasix cause?
Deafness through an IV in an instant. It is ototoxic. Push slowly and monitor hearing. Monitor potassium levels. (potassium loss occurs)
What should be used f lasix doesn't work?
Bumex. It is 40x stronger.
Thiazides are not good for patients who?
Are allergic to sulfa drugs.
What do you give to patients ho have metabolic alkalosis?
What are the most verse affects of procrit?
Which is worse acidosis or alkalosis?
Who should albuterol (ventolin) not be given to?
Tachy, prolonged qt, HtN, CAD. No PO for babies.
What needs to be monitored when administering cardizem?
Monitor bp if lower than 90 systolic than hold.
What do you check before administering dig (lanoxin)
Check apical pulse for 1 min. Hold if pulse is <60.
What do you not give with tetracycline?
Milk, dairy, yogurt, etc.
When should you question the order of tetracycline?
If order is for a pt that is under 8 yo.
When should you take a azithromycin?
Take it on an empty stomach.
What would you use to stop bleeding after a surgery?
Systematic antacids should?
Always be given IV
Safe use of desmopressin.
HAsn not been established during pregnancy n lactation
edecrin acid ?
cause most severe hearing loss.
annitol decreases what?
THe effects of lithium, imipramine, salicylates.