Medication Toxicity and Patient Education
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Questions and Answers

What is the appropriate action for a nurse to take if a patient's heart rate decreases significantly?

  • Administer an additional medication
  • Withhold the medication (correct)
  • Contact the physician immediately
  • Increase the dosage of medication
  • Which liver function test is particularly important before starting atorvastatin?

  • ALT and AST levels (correct)
  • Albumin level
  • Alkaline phosphatase level
  • Bilirubin level
  • What should a patient taking warfarin understand about contraindicated herbal medications?

  • Echinacea can be taken without concern
  • Ginkgo biloba is safe to take
  • Saw palmetto is contraindicated (correct)
  • Garlic does not affect warfarin
  • What is a common adverse effect that a nurse should monitor in a patient taking clopidogrel?

    <p>Bloody or black stools (B)</p> Signup and view all the answers

    How is the effectiveness of sucralfate in treating a duodenal ulcer assessed?

    <p>Protection against acid erosion (B)</p> Signup and view all the answers

    Which method should be used for intramuscular injection of vitamin K in newborns?

    <p>Vastus lateralis muscle (B)</p> Signup and view all the answers

    What symptoms may indicate acute acetaminophen toxicity in a patient?

    <p>Vomiting (B)</p> Signup and view all the answers

    What is the most appropriate instruction for a patient taking ibuprofen for chronic pain management?

    <p>Have a regular eye exam done (C)</p> Signup and view all the answers

    Which of the following is the correct method to administer the hepatitis B vaccine into the deltoid muscle?

    <p>Place one finger across the acromion process and measure down three fingerbreadths (A)</p> Signup and view all the answers

    What essential information should be obtained from a client prior to administering a vaccine?

    <p>Any known allergies (C)</p> Signup and view all the answers

    If a patient presents with acute toxicity, what physical sign might you expect?

    <p>Pupillary dilatation (D)</p> Signup and view all the answers

    What is the recommended antidote for opioid toxicity caused by fentanyl overdose?

    <p>Naloxone (B)</p> Signup and view all the answers

    What abnormality should a nurse expect to find in a patient undergoing chemotherapy for squamous cell carcinoma?

    <p>Decreased leukocyte count (C)</p> Signup and view all the answers

    What is the correct time frame for the peak effect of NPH insulin after administration?

    <p>4 to 14 hours (C)</p> Signup and view all the answers

    When should a patient administer their insulin detemir injection if prescribed to take it once daily?

    <p>In the evening before bedtime (B)</p> Signup and view all the answers

    What sequence should a nurse follow when preparing to administer regular insulin and NPH insulin from the same vial?

    <p>Inspect vials, roll NPH, inject air into NPH, then regular insulin (A)</p> Signup and view all the answers

    What is an important instruction for a patient prescribed levothyroxine to manage hypothyroidism?

    <p>Take it in the morning on an empty stomach (B)</p> Signup and view all the answers

    What precaution should a nurse emphasize to a patient receiving radioactive iodine treatment?

    <p>Remain isolated from family members (C)</p> Signup and view all the answers

    What nursing intervention is essential for a patient taking propylthiouracil (PTU) for hyperthyroidism who presents with granulocytosis?

    <p>Watch for signs of infection (D)</p> Signup and view all the answers

    What should a nurse communicate to a patient with rheumatoid arthritis regarding the effectiveness of prednisone treatment?

    <p>They will have improved range of motion (A)</p> Signup and view all the answers

    What is the recommended duration for holding an albuterol metered dose inhaler after taking medication?

    <p>10 seconds (C)</p> Signup and view all the answers

    What is a primary benefit of using albuterol for patients with asthma?

    <p>Decreases coughing episodes (C)</p> Signup and view all the answers

    Which of the following instructions should be emphasized for a patient prescribed methotrexate?

    <p>Avoid people with infections (B)</p> Signup and view all the answers

    What is a known side effect of diphenhydramine (Benadryl)?

    <p>Dry mouth (D)</p> Signup and view all the answers

    Which condition contraindicates the use of lisinopril?

    <p>Pregnancy (D)</p> Signup and view all the answers

    What should be monitored if a patient on spironolactone has a potassium level of 6.8?

    <p>EKG (C)</p> Signup and view all the answers

    When taking verapamil, which food should patients avoid?

    <p>Grapefruit juice (B)</p> Signup and view all the answers

    What should a nurse do if a patient taking digoxin shows blurred vision?

    <p>Withhold the medication and report (B)</p> Signup and view all the answers

    What is the significance of a heart rate of 54 in a patient taking digoxin?

    <p>It indicates bradycardia, which may require intervention (B)</p> Signup and view all the answers

    What side effect is associated with fluconazole for patients with asthma?

    <p>Oral candidiasis (C)</p> Signup and view all the answers

    Flashcards

    Acetaminophen Toxicity Symptoms

    Vomiting is a potential symptom of acute acetaminophen (Tylenol) overdose.

    Priority data before Morphine admin

    Respiratory rate is a critical factor to assess before administering morphine.

    Fentanyl antidote

    Naloxone is the antidote for fentanyl overdose.

    Acute Toxicity pupil effect

    Pupillary dilation (wide pupils) might indicate acute toxicity.

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    Gardasil vaccine purpose

    The Gardasil vaccine protects against human papillomavirus (HPV).

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    Hepatitis B Vaccine Injection Site

    Inject the Hepatitis B vaccine in the deltoid muscle, 3 fingerbreadths below the acromion process, Centered laterally.

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    NPH Insulin Peak Time

    NPH insulin typically peaks 4 to 14 hours after injection.

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    Insulin Injection Sequence

    Draw regular (clear) insulin first, then NPH (cloudy) insulin to avoid contamination.

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    Levothyroxine Timing

    Take levothyroxine before a meal or several hours after a meal.

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    Side Effect of Radioactive Iodine Treatment

    Patients should isolate from family members due to the radioactive nature of the treatment.

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    Granulocytosis Monitoring

    When a patient has granulocytosis, monitor for increased infection risk, especially with PTU treatment.

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    Prednisone Effectiveness

    Effective prednisone treatment shows improved range of motion for patients with rheumatoid arthritis.

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    Insulin Administration Time (Regular)

    Regular insulin should be administered before breakfast, after checking blood glucose.

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    Chemo for Skin Cancer

    Chemotherapy for squamous cell carcinomas involves topical treatments.

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    Atorvastatin Baseline Test

    Before starting atorvastatin, a patient needs a liver function test to assess their baseline liver health.

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    Atorvastatin Side Effect to Report

    Patients taking atorvastatin should report muscle weakness to their healthcare provider immediately.

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    Heparin Antidote

    Protamine sulfate is the antidote for heparin overdose.

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    Warfarin Antidote

    Vitamin K is the antidote for warfarin overdose.

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    Warfarin Interactions

    Patients taking warfarin should avoid saw palmetto, glucosamine, and glycosylation as they can interfere with the medication's effectiveness.

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    Clopidogrel Adverse Effect

    Patients taking clopidogrel (Plavix) may experience bloody or black stools, which is a sign of potential bleeding.

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    Albuterol use in asthma

    Albuterol helps in asthma by decreasing coughing, opening airways, and preventing wheezing.

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    Methotrexate precautions

    Patients taking methotrexate should avoid close contact with people who have infections, report any bruising, and avoid alcohol.

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    Albuterol side effect

    Albuterol can cause tachycardia (fast heart rate).

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    Montelukast schedule

    Montelukast is taken once daily in the evening.

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    Diphenhydramine side effect

    Diphenhydramine (Benadryl) can cause a dry mouth.

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    Fluconazole side effect

    Fluconazole can cause oral candidiasis (thrush).

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    Lisinopril pregnancy risk

    Lisinopril is contraindicated during pregnancy due to potential fetal harm.

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    Lisinopril discharge instructions

    Discharge instructions for lisinopril patients should include notifying the provider of immediate pregnancies, regular blood pressure monitoring, and reporting persistent coughs.

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    Spironolactone adverse effect (Potassium)

    Spironolactone can increase potassium levels, potentially to dangerous levels.

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    High potassium action

    If potassium levels are dangerously high, an electrocardiogram (EKG) is needed to monitor the patient's heart.

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    Study Notes

    Medication Toxicity and Patient Education

    • Acetaminophen (Tylenol) Toxicity: Symptoms include vomiting.
    • Naproxen: Patients taking enteric-coated naproxen should not crush or swallow the medication.
    • Ibuprofen: Patients taking ibuprofen should have regular eye exams.
    • Morphine: Nurses should report suspicions of another nurse improperly administering morphine to the charge nurse.
    • Priority Data for Morphine Administration: The nurse needs to recognize respiratory rate as a priority data point before administering the medication.
    • Fentanyl Antidote: Naloxone is the antidote for fentanyl.

    Emergency Room Management

    • Acute Toxicity: Patients presenting to the emergency room with acute toxicity may experience pupillary dilation.

    Patient Teaching

    • Codeine: Patients taking codeine should be instructed to change positions slowly.

    Vaccination Administration

    • Hepatitis B Vaccine: When administering the Hepatitis B vaccine in the deltoid muscle, place one finger over the acromion process and measure 3 finger-breadths below for injection site.
    • Gardasil Vaccine: The vaccine protects against HPV.
    • Vaccine Safety: Before administering a vaccine, the nurse should ask the patient about any allergies.

    Laboratory Values and Abnormalties

    • Acute Leukemia and Chemotherapy: A client with acute leukemia and recent aggressive chemotherapy will likely exhibit decreased platelet counts, white blood cell and red blood cell counts.
    • Squamous Cell Carcinoma Chemotherapy: Chemotherapy for squamous cell carcinoma is typically administered topically because the target area is skin.
    • Insulin Peak Time: NPH insulin peaks in 4-14 hours after administration.

    Medication Administration and Side Effects

    • Insulin Administration: Regular insulin should be administered before breakfast at 7:30 if a client is getting regular insulin prior to 8:30 breakfast.
    • NPH/Regular Insulin Sequence: Regular insulin, then NPH insulin administration is the correct sequence.
    • Levothyroxine (Hypothyroidism): Clients with hypothyroidism should take their levothyroxine before a meal or several hours after a meal.
    • Radioactive Iodine: Patients undergoing radioactive iodine therapy need to avoid close contact with others for a period of time.
    • Lisinopril Contraindication: Pregnant women should not take lisinopril as it can cause congenital defects.
    • Granulocytosis: Granulocytosis, a condition related to high white blood cell counts, may require treatment with medication such as propylthiouracil.
    • Prednisone (Rheumatoid Arthritis): Clients taking prednisone should inform nurses/doctors if improvement in symptoms occurs.
    • Albuterol: Albuterol helps decrease coughing episodes, open airways, prevent wheezing.
    • Fluconazole: Fluconazole can cause oral thrush or oral candidiasis.
    • Omeprazole: Effectiveness of Omeprazole is demonstrated by a decrease in stomach acid symptoms.
    • Sucralfate: It protects against stomach acid erosion.
    • Metoclopramide: Monitor patients for sedation.
    • Buspirone: Patients taking this drug may experience headaches.
    • Iron Supplement Interaction: Best absorbed with citrus (orange) juice.
    • Vitamin K Injection Site: The Vastus lateralis is the recommended site for vitamin K injection in newborns.
    • Hypomagnesemia Management Symptoms include mood changes, mobility challenges and visual problems.
    • Magnesium Toxicity: Prolonged PR interval on an EKG can indicate magnesium toxicity
    • Omeprazole Effectiveness: The effectiveness of Omeprazole is judged by self-report of reduced stomach acid symptoms.
    • Digoxin Administration: Hold digoxin and report to a provider if there are blurred visions or lowered heart rates.
    • Warfarin Antidote: Vitamin K is the antidote for warfarin.
    • Herbal Medications: Avoid saw palmetto, glucosamine, and glycosylation while taking warfarin.
    • Clopidogrel (Plavix) Adverse Effect: Bloody or black stools can be an adverse effect.
    • Potassuim Levels: Monitor potassium levels of patients taking spironolactone closely.
    • Intravenous Potassium Replacement: Important to maintain a urine output of 1 mL/kg per hour.
    • Cephalexin and Anaphylaxis: A patient with a history of anaphylaxis to penicillin and prescribed Cephalexin requires a different antibiotic.
    • Azithromycin: Patients taking azithromycin should inform their providers of any sore throat or fever.
    • Alendronate and Milk: Alendronate should not be taken with milk.
    • Sulphamethoxazole/Trimethoprim: Patients taking this medication may experience photosensitivity.

    Other Important Information

    • Patient Education: Patient education should occur to ensure patients understand their medications and potential side effects, as well as steps to take during times of illness, injury, infection, or concern.

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    Final Pharm Exam

    Description

    This quiz covers essential information related to medication toxicity, including specific medications like acetaminophen, naproxen, and morphine. It emphasizes patient education and nursing responsibilities in monitoring and administering these drugs for safety. Assess your knowledge on emergency management and proper teaching protocols for various medications.

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