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Pharm Final

Terms in this set (92)

antibiotic for MRSA
vanco
antibiotic responsible for red man syndrome
vanco
teachings for bactrim
- take on empty stomach with at least 8 oz of water and drink at least 3L a day
- avoid direct sunlight and wear sunscreen
- the addition of trimethoprim to sulfa is to prevent bacterial resistance
if allergic to penicillin what order of meds should a nurse question
cephalosporins
tetracycline teaching
- avoid direct sunlight and tanning beds
- avoid milk
- drink a full glass of water with each dose
- do not take if pregnant or less than 8 years old
penicillin and warfarin interaction
penicillin will enhance anticoagulant effect of warfarin
which generation of cephalosporin is appropriate for a patient with a gram positive infection and pneumonia
1st
class of drug for UTIs
sulfonamides
the beta lactam antibiotic describes which classes
penicillins and cephalosporins
main reasons for loop diuretics like Lasix in CHF
- decrease BP and decrease edema
nursing interventions for furosemide (lasix)
- monitor urinary output
- check serum potassium levels
- tell pt to rise slowly
combination potassium wasting and potassium sparing diuretics are prescribed to control hypertension and edema and to prevent
hypokalemia
hypokalemia caused by lasix has what effect on digoxin
increases action of digoxin and may lead to toxicity
amoxacillin is for what type of bacteria
gram neg
adverse reactions of penicillins
N/V/D
important information for someone taking antibiotics
oral contraceptives dont work
what is ceftin
second generation cephalosporin PO form
what to watch for with azithromycin
QT prolonged intervals
macrolides like azithromycin are good for what condition
pneumonia
what is tetracycline most commonly used for
ance and lyme disease
tetracyclines can cause what
stained teeth
adverse reaction of ciprofloxacin
tendon rupture
what are fluroquinolones used for
travelers diarrhea
side effect of bactrim
hyperkalemia
c.diff drug
vanco
side effect of vanco
ototoxicity
A teenage patient is taking a tetracycline drug as part of treatment for severe acne. When
the nurse teaches this patient about drug-related precautions, which is the most important
information to convey?
a. When the acne clears up, the medication may be discontinued.
b. This medication needs to be taken with antacids to reduce GI upset.
c. The patient needs to use sunscreen or avoid exposure to sunlight, because this drug may
cause photosensitivity.
d. The teeth should be observed closely for signs of mottling or other color changes.
C
A newly admitted patient reports a penicillin allergy. The prescriber has ordered a second-
generation cephalosporin as part of the therapy. Which nursing action is appropriate?
a. Call the prescriber to clarify the order because of the patient's allergy.
b. Give the medication, and monitor for adverse effects.
c. Ask the pharmacy to change the order to a first-generation cephalosporin.
d. Administer the drug with a nonsteroidal antiinflammatory drug to reduce adverse
effects.
A
During patient education regarding an oral macrolide, such as erythromycin, the nurse
will include which information? (Select all that apply.)
a. Use another form of birth control if the patient is taking oral contraceptives.
b. If GI upset occurs, the drug will have to be stopped.
c. The drug needs to be taken with an antacid to avoid GI problems.
d. The patient needs to take each dose with a sip of water.
e. The patient may take the drug with a small snack to reduce GI irritation.
A and E
The nurse is reviewing the orders for a patient who has been admited for treatment of
pneumonia. The antibiotic orders include an order for doxycycline. However, when the
patient is asked about his allergies, he lists "doxycycline" as one of his allergies. What is
the nurse's first action at this time?
a. Call the prescriber to clarify the order because of the patient's allergy.
b. Ask the patient to explain what happened when he had the allergic reaction.
c. Ask the pharmacy to order a different antibiotic.
d. Administer the drug with an antihistamine to reduce adverse effects.
B
While assessing a woman who is receiving quinolone therapy for pneumonia, the nurse
notices that the patient has a history of heart problems. The nurse will monitor for which
potential cardiac effect of quinolone therapy?
a. Bradycardia
b. Dysrhythmias
c. Tachycardia
d. Prolonged QT interval
D
When administering vancomycin, the nurse knows that which of these is most important
to assess before giving the medication?
a. Renal function
b. WBC count
c. Liver function
d. Platelet count
A
When giving intravenous quinolones, the nurse needs to keep in mind that these drugs
may have serious interactions with which drugs?
a. Selective serotonin reuptake inhibitor antidepressants
b. Nonsteroidal antiinflammatory drugs
c. Oral anticoagulants
d. Antihypertensives
C
Which is the correct action when the nurse is administering sucralfate? (Select all that
apply.)
a. Giving the drug with meals
b. Giving the drug on an empty stomach
c. Instructing the patient to restrict fluids
d. Waiting 30 minutes before administering other drugs
e. Giving other drugs 2 hours before giving the sulcrafate
B and E
A patient with a history of renal problems is asking for advice about which antacid he
should use. The nurse will make which recommendation?
a. "Patients with renal problems cannot use antacids."
b. "Aluminum-based antacids are the best choice for you."
c. "Calcium-based antacids are the best choice for you."
d. "Magnesium-based antacids are the best choice for you."
B
A patient who is taking oral tetracycline complains of heartburn and requests an antacid.
Which action by the nurse is correct?
a. Give the tetracycline, but delay the antacid for 1 to 2 hours.
b. Give the antacid, but delay the tetracycline for at least 4 hours.
c. Administer both medications together.
d. Explain that the antacid cannot be given while the patient is taking the tetracycline.
A
When the nurse is administering a proton pump inhibitor (PPI), which actions by the
nurse are correct? (Select all that apply.)
a. Giving the PPI on an empty stomach
b. Giving the PPI with meals
c. Making sure the patient does not crush or chew the capsules
d. Instructing the patient to open the capsule and chew the contents for best absorption
e. Administering the PPI only when the patient complains of heartburn
A and C
A parent calls to ask about giving a medication for diarrhea to his child, 15 years of age,
who is recovering from the flu. The nurse expects the prescriber to recommend which
medication?
a. bismuth subsalicylate (Pepto-Bismol)
b. Lactobacillus GG (Culturelle)
c. belladonna alkaloid/phenobarbital combination (Donnatal Elixir)
d. loperamide (Imodium A-D)
D
action of antacid
neutralize acidity of stomach contents
teachings for antacids
avoid 2 hours before or after taking any other med
what type of antacid is recommended for patients with renal compromise
aluminum
instructions for PPIs
- monitor magnesium levels
- take on empty stomach 30-60 mins before eating
action of H2 receptor antagonists
decrease secretion of gastric acid by blocking histamine
side effects of H2 receptor antagonists in older adults
confusion and dizziness
how do coating agents like sulcrafate work
they coat the ulcer to protect from stomach acid and promote healing
imodium is used for what
acute travelers diarrhea
most common nausea med
zofran
why is zofran better than phenergan
its less sedating
nursing intervention for phenergan
observe IV site frequently for patency
common side effects of zofran
headache and dizziness
what happens when zofran is combined with dexamethason
it is more effective
In monitoring laboratory test results for patients receiving loop and thiazide diuretics, the
nurse knows to look for which of these results?
a. Decreased serum levels of potassium
b. Increased serum levels of calcium
c. Decreased serum levels of glucose
d. Increased serum levels of sodium
A
When the nurse is checking the laboratory data for a patient taking spironolactone
(Aldactone), which result would be a potential concern?
a. Serum sodium level of 140 mEq/L
b. Serum calcium level of 10.2 mg/dL
c. Serum potassium level of 5.8 mEq/L
d. Serum magnesium level of 2.0 mg/dL
C
Which statement must be included when the nurse provides education for a patient with
heart failure who is taking daily doses of spironolactone (Aldactone)?
a. "Be sure to eat foods that are high in potassium."
b. "Avoid foods that are high in potassium."
c. "Avoid grapefruit juice while taking this medication."
d. "A low-fiber diet will help prevent adverse effects of this medication."
B
A patient with diabetes has a new prescription for a thiazide diuretic. Which statement
will the nurse include in teaching the patient about the thiazide drug?
a. "There is nothing for you to be concerned about when you are taking the thiazide
diuretic."
b. "Be sure to avoid foods that are high in potassium."
c. "You need to take the thiazide at night to avoid interactions with the diabetes
medicine."
d. "Monitor your blood glucose level closely because the thiazide diuretic may cause the
levels to increase."
D
A patient is taking an aminoglycoside antibiotic for pneumonia and will also be taking the
loop diuretic furosemide (Lasix) due to fluid overload. The nurse will monitor carefully
for which potential effect from the interaction of these two drugs?
a. Nephrotoxicity
b. Ototoxicity
c. Pulmonary fibrosis
d. Hepatotoxicity
B
how to administer mannitol
IV through a filter
what does mannitol do
reduces ICP and cerebral edema
teachings for lasix
- change positions slowly
- no meat or dairy
nursing intervention for lasix
watch for hypokalemia
what is seen with hydrochlorothiazide
improved exercise tolerance
first line of treatment for hypertension
thiazodes
fasted acting diuretic
loop diuretics (lasix)
teachings for spironolactone
- no potassium supplements
- no salt substitutes
nursing intervention for K sparing diuretics
monitor for hyperkalemia
The nurse notes in a patient's medication history that the patient is taking benzonatate
(Tessalon Perles) as needed. Based on this finding, the nurse interprets that the patient has
which problem?
a. Cough
b. Seasonal allergies
c. Chronic rhinitis
d. Motion sickness
A
The nurse is giving an antihistamine and will observe the patient for which side effects?
(Select all that apply.)
a. Hypertension
b. Dizziness
c. "Hangover" effect
d. Drowsiness
e. Tachycardia
f. Dry mouth
B, C, D, E
The nurse is reviewing a patient's medication orders for prn (as necessary) medications
that can be given to a patient who has bronchitis with a productive cough. Which drug
will the nurse choose?
a. An antitussive
b. An expectorant
c. An antihistamine
d. A decongestant
B
After the patient takes a dose of an inhaled corticosteroid, such as fluticasone (Flovent),
what is the most important action the patient needs to do next?
a. Hold the breath for 60 seconds.
b. Rinse out the mouth with water.
c. Follow the corticosteroid with a bronchodilator inhaler, if ordered.
d. Repeat the dose in 15 minutes if the patient feels short of breath.
B
During a teaching session for a patient who will be receiving a new prescription for the
LTRA montelukast (Singulair), the nurse will tell the patient that the drug has which
therapeutic effect?
a. Improves the respiratory drive
b. Loosens and removes thickened secretions
c. Reduces inflammation in the airway
d. Stimulates immediate bronchodilation
C
A patient is receiving ipratropium via an inhaler. The nurse will assess the patient for
which of these adverse effects? (Select all that apply.)
a. CNS depression
b. Dry mouth or throat
c. Increased appetite
d. Nasal congestion
e. Headache
B, D, E
After a nebulizer treatment with the beta agonist albuterol, the patient complains of
feeling a little "shaky," with slight tremors of the hands. The patient's heart rate is 98
beats/min, increased from the pretreatment rate of 88 beats/min. The nurse knows that
this reaction is which of these?
a. An expected adverse effect of the medication.
b. An allergic reaction to the medication.
c. An indication that he has received an overdose of the medication.
d. An idiosyncratic reaction to the medication.
A
A patient who has a history of asthma is experiencing an acute episode of shortness of
breath and needs to take a medication for immediate relief. The nurse will choose which
medication that is appropriate for this situation?
a. A beta agonist, such as albuterol
b. A leukotriene receptor antagonist, such as montelukast
c. A corticosteroid, such as fluticasone
d. An anticholinergic, such as ipratropium
A
side effects of benadryl
- sedation
- urinary retention
what can benadryl be used for
a night time sleep aid
why is claritan good compared to benadryl
it causes less drowsiness and minimal dry mouth
what are antihistamines used for
to reduce gastric acid
only expectorant ingredient listed by FDA as having scientific evidence of safety and efficacy
mucinex
what is mucinex used for
- thick mucus
- it increases production of respiratory tract fluids
when should you not use a mucolytic like mucinex
for a cough with a high fever or lasting longer than 7 days
what do you need to watch for with mucolytics
secretions may become too liquid and predispose the patient to aspiration
how to take singulair
- on empty stomach
- daily to prevent leukotriene
- 2 hours before exercise
difference between detromethorphan and benzonate
D is liquid cough suppresant and B is a capsule
anticholinergics like ipratropium are for what
maintenance not acute symptoms
choice for long term drug use in asthma/COPD
inhaled steroids like betamethasone
teachings for inhaled steroids
- use daily
- rinse mouth after each use to prevent thrush
when should a spacer device be used
- if a child has difficulty timing the inhale
- to make it easier for med to reach lung and also mean less med gets deposited into mouth and throat where it could lead to irritation and infection
pro of xopenex
less tachycardia than albuterol
choice drug for pregnancy for COPD asthma
albuterol
adverse effect of albuterol
tachycardia
when should albuterol be prescribed
for acute symptomatic relief
how do beta adrenergic bronchodilators work
they maximize airflow by relaxing the airway smooth muscle
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