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ATI pharm1 final study
Terms in this set (203)
Tobramycin Sulfate contraindicated in:
Metformin (Glucophage) and glipizide (Glucotrol) for diabete mellitus. Nurse check what lab:
HbA1c of below 7% for diabetics/ give med
Pancrelipase (Pancrease) teaching plan:
Take at each meal and snack.
Levothyroxine (Synthroid) effective if:
TSH 0.5-2 mircounits/mL
T3 and T4 Value
t3: 75-220 ng/dL
t4: 4-11 mcg/dL
Prazosin (Minipress) teaching:
Move slowly from sitting to standing.
Phenytoin (Dilantin) teaching:
Hirsutism, avoid alcohol and antihistamines, double vision
Enalapril (Vasotec) and spironolactone (Aldactone) adverse effects:
Hyperkalemia because its a ACE-inhibitor and K-sparing diuretic.
Methotrexate (Rheumatrex) for Rheumatoid arthritis teaching:
Report sores in mouth, take once a week [oral or injection], 4-6 weeks to work.
Mannitol (Osmitrol) effective:
Urine output increases
Morphine Sulfate following thoracic procedure. What indicates client pain being managed:
Client able to breathe deeply and cough.
Amitriptyline (Elavil) adverse effects:
Magnesium Sulfate toxicity signs:
Decrease level of consciousness, CNS depression
Ferrous Sulfate enhance absorption:
Sotalol Hydrochloride (Betapace) teaching plan:
Decrease heart rate.
Patient on Insulin Lispro and prescribed Metoprolol (Lopressor) for HTN. Nurse should observe what signs for hypoglycemia:
Nitroglycerin SL teaching:
Lie down, check BP, relief in 1-3 mins, monitor for headache.
Allopurinol (Zyloprim) contraindications:
Atovastain (Lipitor) nurse should monitor:
Exercise induced asthma:
Cromolyn sodium (Intal)
Furosemide (Lasix) withhold:
Insulin glargine (Lantus) type 1 diabetes mellitus teaching plan:
DON'T MIX in syringe, adminster at bedtime, clear, don't need to shake
Colesevelam (WelChol) teaching plan:
Other medication 1 hour or 4 hours after, taken with food or water, high fiber diet.
Levothyroxine (Synthroid) breastfeeding:
Take after breast feeding.
Fluoxetine (Prozac) teaching plan:
Don't take St. John's Wort, may get rash, Acetaminophen instead of Ibuprofen.
Digoxin (Lanoxin) patient experiences Dysrhythmias:
Furosemide (Lasix) lead to hyperkalemia causes dysrhythmias.
Ceftriaxone (Rocephin) postop and notices Uticardia and dyspnea:
Ketorolac (Toradol) teaching plan:
Check for bruising, Take with food.
Risedronate (Actonel) for osteoporosis teaching plan:
Sit up 30 mins, don't take with milk, take in morning, take on empty stomach.
Albuterol (Proventil) for asthma with montelukast (Singular) teaching:
Take montelukast at night
Pilocarpine (Pilocar) eye drops teaching:
Don't drive until vision clears, cause brow pain, take for rest of life, messes with the rest of the body
Required Digoxin measurements:
Peak and trough
Naloxone (Nacar) Antidote:
Observe for bleeding, Assess client for nausea and vomiting, check pain frequently, tachycardia, repeat dose every 2-3 minutes.
Fluticasone propionate (Flovent) adverse:
Candidasies of the mouth, dysphonia.
Trimethropim/sulfamethoxazole (Barctim DS) teaching:
Drinking 8-10 glasses of water
Gentamicin (Garamycin) side effect:
Telephone prescription from provider. The Nurse:
Reads the prescription back to the provider.
Seizure disorder. Patient should:
Keep a seizure chart.
Potassium level less then 3.5 mEq/L:
Cardiac monitor for cardiac dysrhythmias.
Penicillin allergy requires incident report with what symptom:
Phenytoin (Dilantin) decreases effectiveness of:
Ethinyl/desogestrel (Oral contraceptive)
Ergotamine (Ergostat) SL for migraine headache:
1 SL tablet at onset of headache.
1.0-2.0 ng/mL. Digoxin is toxic at 2.4 give Digoxin immune fab (Diggibind)
Avoid during metronidazole (Flagyl):
Beer can cause disulfiram-reaction (Hypotension, vomiting, weakness)
Captopril (Capoten) cannot be used:
With salt substitue with meal or potassium.
Mannitol (Osmitrol) achieving therapeutic effect:
Decrease intraocular pressure for acute closure glaucoma.
Simvastatin (Zocor) teaching plan:
Report muscle pain, do not take med with grapefruit juice, minimize alcohol intake, life long therapy, take in the evening.
Heparin and warfarin client with 4 times aPPT and INR of 2:
Decrease the heparin.
aPPT (Activated partial thromboplastin time) plasma value:
1.5-2 times the normal
INR (International Normalized Ratio) value:
2.0-3.0. Target of 2.5. Higher the number bleeding disorder. Lower the number clotting disorder.
Oxytocin (Pitocin) by continuious IV, piggy backed into maintenance IV solution. FHR indicates late decelerations. The nurse first:
Discontinue client's IV to reduce contractions.
Bupropion (Zyban) side effects:
Risedronate (Actonel) to treat osteoporosis. Client teaching:
Take in the morning, sit up 30 mins after taking, take with food, swallow whole.
Haloperidol (Haldol) adverse effects (Used for treating vomiting):
Oprelvekin (Interleukin 11-WBC) effectiveness:
Increase platelet count in chemotherapy patients.
Baclofen (Lioresal) therapeutic outcome:
Decrease the frequency and severity of muscle spasms (MS).
Epoetin Alfa (Procrit) to treat anemia. Nurse should monitor:
Increased blood pressure and seizures if hematocrit rises too quickly.
Tranylcpromine (Parnate) for depression. Client teaching:
Move slowly when changing position because orthrostatic hypotension can result as a side effect.
Exenatide (Byetta) for type 2 diabetes mellitus. Nurse needs to monitor immediately:
Abdominal pain due to pancreatitis.
Secondary symptom for hyperglycemia: Increased thirst
Diaphoresis and Irritability.
Prednisone (Deltasone) for chronic asthma. Nurse monitors:
Blood glucose because steroid increase blood sugar.
NHP insulin and Regular insulin in a single syringe: Clear before cloudy.
1. NPH (Cloudy) insert air
2. Regular (Clear) insert air
3. Draw up regular (Clear)
4. Draw up NPH (Cloudy)
Zidovudine (Retrovir) nurse should monitor:
Hemoglobin level because it can cause anemia.
Timolol (Timoptic) for glaucoma. Client history concern:
Its a Beta Blocker that can worsen bradycardia.
Newborn DTaP injection timeframe:
6 months- 3rd
12-15 months- 4th
Newborn Hep B vaccine:
Warfain for AFIB. Nurse needs to check what prior to injection:
Hydroxyurea (Droxia) for sickle cell anemia. Nurse reports what to provider:
Hemoglobin, platelets, neutrophils.
Acetaminophen/oxycodone (Percocet) for breakthrough pain PRN and Acetaminophen every 4 hours. The nurse should:
Notify the provider due to possible overdose.
Sucralfate (Carafate) for PUD:
Form protective barrier around ulcer (mucosal protectant).
Client teaching for Warfain:
Limit green leafy veggies, get blood drawn regularly, notify doctor if you bleed of bruise easily, and do not take Aspirin or Tylenol.
Pregnant with Pneumonia contraindication:
Deoxycycline (Doxycin), Tetracycline due to adverse effects on bones.
Lisinopril (Zestril) for HTN. The client should monitor:
Dry cough due to build up of bradykinin.
Nitroglycerin (Nitro-Bid IV) for blood pressure:
Lower systolic blood pressure.
Procainamide (Pronestyl) with acute MI and premature ventricular beats. The nurse should withhold if:
QRS (Contraction) widening of more then 50% and long QT intervals (Rest period) indicates cardiotoxictiy.
Tamoxifen (Nolvadex) for breast cancer adverse side effects:
Menstrual irregularity, hot flashes, vaginal discharge.
Beclomenthasone (QVAR) for chronic asthma teaching plan:
Rinse your mouth.
HX of HTN uses OTC oral decongestants for nasal congestion. The nurse advises patient that decongestants:
Constricts blood vessels (Sympathomimetics)
Phenazopyridine HCL (Pyridium) for acute cystitis will:
Urine will turn a red-orange color.
Trimethoprim/sulfamethoxazole (Bactrim DS) side effects:
Vesicular, crusty rash is a sign of Stevens-Johnson syndrome.
(Photosensitivity-Limited sun exposure)
Propylthiouracil (PTU) outcomes:
Decrease T4, decrease heart rate, decrease body temp, weight gain.
Transdermal Nitroglycerin (Minitran) teaching plan:
Take patch each evening for medication free time of 12-14 before each new patch.
Amoxicillin/calavulaic acid (Augmentin) allergy to penicillin. The nurse should first:
Hold the medication.
Morphine and discharge teaching:
Increase fiber due to possible constipation.
Ampotericin B (Fungizone) for histoplasmosis (Skin) adverse effects:
Fever and chills are signs of infusion reaction.
Aspirin for arthritis. Signs of salicylism:
Tinnitus, sweating headache, dizziness.
Breakthrough pain. 8 of 10 on scale.
Hydromorphone (Dilaudid) pure opioid for sever pain.
Methylphenidate (Ritalin) for ADHD intervention in adverse effects:
Maintain age-appropriate weight.
Sumatriptan (Imitrex) patient teaching:
Use medication upon first sign of headache. Should dissipate 30-50 mins.
*Up to 2 dose after 2 hours of initial dose.
Side effect: Tightness of chest
PCA of Morphine Sulfate, patient Resp. 10/min, unresponsive to touch. Nurse first:
Administer NarCan into patient IV.
Beginning Prednisone (Deltasone) therapy for acute bronchitis:
Wait until complete therapy due to glucocorticoids reducing antibody response of live vaccine. Increase risk on infection.
Ferrous Sulfate teaching plan:
Black stools are common, take on empty stomach for absorption, no bruising.
Phenytoin (Dilantin) teaching plan:
Tell dentist because drug can cause gingival hyperplasia, report eye movement.
Below 10- Seizures
Above 20- Toxic can cause Nystagmus (Eye movement)
Ranitidine (Zantac) for GERD adverse effects:
Green Sputum from low stomach PH (Pneumonia)
Effects oral contraceptives:
Carbamazepine (Tegretol) inactivates oral contraceptives
Isoniazid (INH) for TB adverse effects:
Yellow skin tones (Jaundice)
Male: 4.7-6.1 billion
Female: 4.2-5.4 billion
PT (Prothrombin Time):
54-62% of blood
0.5-5.0 milli unit/L
IV infusion of mannitol (Osmitrol), what adverse affects should be reported to Dr.
24 hr postop with morphine sulfate you should assess for what?
Patient taking acetazolmide (Diamox Sequels) for chronic open angle glaucoma. What adverse effects should you watch for.
Tingling of fingers
Patient wants to know why they are on a 4 medication regimen for TB?
The regimen will eliminate various combinations of resistant strains of TB.
A patient is on long term cortisone treatment for SLE what test should expect them to have?
Bone Density Scan
enalapril (Vasotec) side effect
Patient taking aspirin regimen for the last year if develops ________ you should notify provider immediately.
Hyperventilation due to sign of salicylate poisoning.
A patient taking propylthiouracil (PTU) for Graves disease what would indicate effectiveness of medication.
Increase in ability to focus
What should the nurse monitor for with treatment of benzitropine (Cogentin)?
If stomach upset occurs with tetracycline
Take with applesauce (food)
A side effects of digoxin
yellow tinged vision
ceftazidime (Fortaz) should not be given to persons with penicillin allergy
Could cause SOB
indomethacin (Indocin) evaluate what for effectiveness?
Ditropan can cause
To a patient that is given Aricept watch for what.
A patient taking baclofen (Lioresal) you would expect to see what as a therapeutic result.
Decrease in flexor and extensor spasicity.
What symptoms after giving Reglan should a nurse monitor for?
What would you expect a patient to report for improved symptoms after taking salmeterol (Serevent)?
What should you teach a patient who is starting a new prescription of verapamil (Calan)?
Change position slowly
For a patient taking Lipitor check what lab value?
A patient taking Neumega for chemotherapy reaction what would show effectiveness.
Platelet count 350,000/mm3
What medication interferes with contraception
A patient taking amphotericin B (Fungizone) infusion what adverse effects would you notify the provider.
Fever could indicate a reaction to the drug that requires immediate intervention.
Bactrim DS report vesicular, crusty rash
Steven Johnson's syndrome
Patient taking clindamycin what would you watch for?
Watery diarrhea which could indicate C-diff
valporic acid (Depakene) what should a nurse report to the provider?
What could indicate a reaction to Aspirin?
A patient taking neostigmine (Prostgmin) what would indicate a reaction?
What is one thing thing that causes infants to absorbs drugs differently?
Delayed gastric emptying
A patient taking lithium has renal insufficiency what should you monitor about the drug?
Things to consider when providing a drug to a breastfeeding mother of a newborn
The baby's weight
How much breast milk the baby consumes
If the benefits to the mother outweigh the risk to the new born
The properties of the drug
When giving a patient a drug that is a Pregnancy class D what should you consider?
Require use of contraception
Can cause fetal malformation
Can pass to the fetus
Require weighing potential benefits against risks
When administering medications to an infant or child you should remember that.
Older children (1-12 yr) can have faster metabolic rate than an adult.
Infants are at risk for drug toxicity due to
Decrease liver enzymes
Reduced kidney perfussion
Reduced liver perfussion
Education of a patient for drug toxicity should include
Periodic lab samples will be needed
Watch for indications of toxicity
Take smallest effective dose
Grapefruit juice can cause Tegretol ______?
Drug toxicity due to the fact that it can inhibit the production of enzymes by the liver that help metabolize some drugs.
digoxin can cause
Tegretol should be
Started at a low dose
When taking care of a patient that is taking valporic acid (Depakote) and phenytoin (Dilantin) what should the nurse be aware of?
This combination can cause an increase in phenytoin level causing toxicity levels should be monitored closely.
Education for a patient starting valporic acid (Depakote) should include
That is may cause a Rash and Drowsiness
Education of a patient that is taking Restoril should inclued
Avoid alcohol and other depressants
Take 30 min before bedtime
Taper drug slowly to prevent withdrawal symptoms
Education of a patient taking levadopa (Dopar) should include?
Change positions slowly to prevent orthostatic hypotension.
Education of a patient taking memantine (Namenda) should include.
Notify health care professional before taking OTC antacids.
When administering lidocaine be aware that the patient could develop
Provigil for narcolepsy should be given?
In the morning
to reduce side affects of beta-1a (Avonex) you should?
Premedicate with Tylenol
levodopa (Dopar) acts by
Increases availability of dopamine to the brain
beta-1b (Betaseron) side effects include
Fatigue, unexplained bruising and bleeding due to bone marrow supression
Adderall monitor patient for
Monitor LFT for
When teaching a patient about instilling pilocarpine (Pilocar) eye drops include what?
Apply pressure to the nasolacrimal duct for 1 minute after
Do not touch the tip of the dropper
Remove contacts prior to instilling drops
Instruct patients taking chlorpromazine (Thorazine) to?
Wear sunscreen when exposed to sunlight
Teach a patient that is taking amitryptyline to?
Change positions slowly to prevent orthostatic hypotension
Do not stop taking abruptly
Take the drug at bedtime to prevent daytime drowsiness
A patient who is taking lithium carbonate to have what test checked frequently?
Thyroid function tests
A patient that is taking phenelzine (Nardil) should avoid tyramine containing food because it could cause?
A patient taking betaxolol (Betoptic) drops for glaucoma you would expect to see?
Bradycarida & ocular stinging
A patient who it taking echothiopate (Phospholine Iodide) what would the nurse watch for?
Wellbutrin is prescribed for what?
If a patient with asthma is prescribed _____ a nurse should question the order.
timolol (Timoptic) because it can cause broncospasms
A patient taking Thorazine begins to have spasms of his face and back the nurse would suspect?
Acute dystonia treatment is immediate administration of Benadryl.
A patient taking Xanax could suffer from what?
GI (Nausea, diarrhea, vomiting)
Anxiety (paradoxical effect)
lithium toxicity is manifested by
Xanax should not be taken with?
Patients taking lithium should not take?
Patients taking Risperdal should watch for?
Wellbutrin has an increased risk for?
BuSpar may take ____ to be effective.
After an IV administration of Thorazine the nurse should watch?
A common side effect of imipramine (Tofranil) is?
When a patient takes Effexor and Nardil together it can increase risk for what?
A patient was given succinylcholine (Anectine) during surgery what would a nurse watch for?
What are side effects to watch for with Fosamax?
raloxafene (Evista) therapeutic effect is?
mimic the effects of estrogen on bone tissue.
What should a nurse plane to administer to counter the adverse affects of neostigmine (Prostigmin)?
For bradycardia patient should monitor pulse
Fosomax is contraindicated in a patient that can not?
Sit or stand up for 30 minutes after administration.
Instruct patients who are taking 1500mg calcium and prednisone to.
Take them 1 hour apart
Drink 8 oz of water with calcium
Divide calcium into 3 doses of 500mg
Chew calcium tablets before swallowing them
Enbrel patient should watch for?
Skin rash (Steven Johnson's syndrome)
Patients taking methotrexate should watch for?
Black, tarry stools (signs of GI Bleeding)
Fosamax works by
Decreasing activity of osteoclats
Use succinylcholine (Anecitine) should be given cautiously to patient with what?
Patient education for methotrexate should include.
Avoid people that are sick
Periodic lab tests are essential (monitor for kidney and liver damage)
Report bruising and petechiae
Avoid drinking alcohol
What should you check with a patient prior to administering calcitonin-salmon (Calcimar) for the first time?
Check for allergies using skin testing.
Teaching for nasal administration
Prime pump, report rash or itching, & report nasal irritation
A patient that is taking raloxafene (Evista) should watch for?
Calf pain (DVT)
For malignant hyperthermia the nurse should?
provide cooling measures
Patients taking Enbrel should be watched for?
SOB as it could indicate heart failure
A patient that was given pancuronium (Pavulon) during surgery, the nurse should suspect prolonged paralysis from a drug interaction of what?
A patient taking a calcium supplement reports flank pain the nurse should suspect the patient has?
raloxifene (Evista) patient education should include?
Increase physical activity
Use contraceptive if risk of pregnancy
Increase calcium and vit D intake
Fosamax can cause
methorexate patients need to
Increase fluid to 2-3 L a day
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