Medications and Antidotes

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Questions and Answers

A nurse is caring for a client who is experiencing respiratory depression after taking an excessive dose of oxycodone. Which of the following medications should the nurse expect to administer?

  • Bisacodyl
  • Naloxone (correct)
  • Pentazocine
  • Flumazenil

A nurse is assessing a client who has heart failure and is taking digoxin. Which of the following manifestations should the nurse report to the provider as an indication of digoxin toxicity?

  • Vomiting (correct)
  • Dilated pupils
  • Peripheral edema
  • Bruising

A nurse is caring for a client who is at risk for alcohol withdrawal delirium. Which of the following medications should the nurse expect the provider to prescribe?

  • Naloxone
  • Chlordiazepoxide (correct)
  • Bupropion
  • Methadone

A nurse is caring for a client who is receiving morphine. Which of the following assessments should the nurse perform first?

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

A nurse is providing discharge instructions to a client who has a new prescription for omeprazole for the treatment of GERD. Which of the following statements by the client indicates an understanding of the teaching?

<p>This medication reduces stomach acid. (A)</p> Signup and view all the answers

The nurse is developing a teaching plan for an elderly patient who will begin taking an antihypertensive drug that causes dizziness and orthostatic hypotension. Which nursing diagnosis is appropriate for this patient?

<p>Risk for injury related to side effects of the medication (B)</p> Signup and view all the answers

A 70-year-old patient has just received a drug that can cause sedation. What would be the priority nursing diagnosis for this patient?

<p>Risk for injury: Related to adverse effects of the drug (A)</p> Signup and view all the answers

A nurse is providing an in-service on the complications of overdosing on morphine, such as the opioid toxicity triad. Which of the following signs and symptoms should the nurse include in her in-service about opioid toxicity triad?

<p>Pinpoint pupils, respiratory depression, and coma. (A)</p> Signup and view all the answers

A nurse is providing an in-service on the complications of naloxone (Narcan), such as abstinence syndrome. Which of the following signs and symptoms should the nurse include in her in-service about abstinence syndrome?

<p>Fever, hypertension, vomiting, anxiety, and abdominal cramping (C)</p> Signup and view all the answers

A nurse is teaching diabetic clients about the use of insulin. For which of the following types of insulin should the nurse tell the clients to expect an onset of 15 to 30 minutes?

<p>Insulin lispro (Humalog) (D)</p> Signup and view all the answers

A nurse is preparing to administer naloxone (Narcan). The nurse understands that this medication has a rapid first-pass inactivation. The nurse understands that naloxone (Narcan) be administered in all of the following routes EXCEPT for:

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

A nurse is caring for a client that is newly prescribed with omeprazole (Prilosec). Which of the following options is a correct indication for omeprazole Prilosec)?

<p>Prevention of stress ulcers for at-risk clients experiencing acute events (A)</p> Signup and view all the answers

You are caring for a new client that got admitted to the unit for abdominal pain. The client takes levothyroxine (Synthroid) at home. The nurse understands that the client is taking levothyroxine (Synthroid) to treat which of the following conditions?

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

The nurse is caring for a client who received a high amount of fentanyl three hours ago. The nurse understands that she should anticipate a prescription for naloxone (Narcan). Which of the following signs is suggestive of opioid toxicity triad?

<p>Respiration rate of 7 breaths per minute (D)</p> Signup and view all the answers

A nurse is caring for a client who is on warfarin therapy for atrial fibrillation. The client's INR is 5.2. Which of the following medications should the nurse prepare to administer?

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

A nurse is caring for a client who has heart failure and a prescription for digoxin. Which of the following statements by the client indicates an adverse effect of the medication?

<p>&quot;I feel nauseated and have no appetite.&quot; (A)</p> Signup and view all the answers

A nurse is assessing a client who is taking lisinopril to treat hypertension. Which of the following findings is a priority to report?

<p>Swelling of the tongue (A)</p> Signup and view all the answers

A nurse is reviewing the health history for a client who has angina pectoris and a prescription for propranolol hydrochloride PO 40 mg twice daily. Which of the following findings in the history should the nurse report to the provider?

<p>The client has a history of bronchial asthma. (A)</p> Signup and view all the answers

A nurse is teaching a client who has a new prescription for transdermal nitroglycerin to treat angina pectoris. Which of the following instructions should the nurse include in the teaching?

<p>Apply the transdermal patch in the morning. (C)</p> Signup and view all the answers

A nurse is caring for a client who has difficulty swallowing medications and is prescribed enteric- coated aspirin PO once daily. The client asks if the medication can be crushed to make it easier to swallow. Which of the following responses should the nurse provide?

<p>&quot;Crushing the medication might cause you to have a stomachache or indigestion.&quot; (C)</p> Signup and view all the answers

A nurse in the emergency department is caring for a client who took 3 nitroglycerin tablets sublingually for chest pain. The client reports relief from the chest pain but now he is experiencing a headache. Which of the following statements should the nurse make?

<p>&quot;A headache is an expected adverse effect of the medication.&quot; (B)</p> Signup and view all the answers

A nurse is caring for a client who is taking lisinopril. Which of the following outcomes indicates a therapeutic effect of the medication?

<p>Decreased blood pressure (A)</p> Signup and view all the answers

A nurse is providing teaching to a client who has hypertension and a new prescription for hydrochlorothiazide. Which of the following instructions should the nurse provide?

<p>Take the medication early in the day. (B)</p> Signup and view all the answers

A nurse is caring for a client who has atrial fibrillation and receives digoxin daily. Before administering this medication, which of the following actions should the nurse take?

<p>Measure the client's apical pulse. (B)</p> Signup and view all the answers

A nurse is caring for a client that is newly diagnosed with hypertension. The client noted that the provider will prescribe a medication to treat angina and hypertension. Which of the following medications should the nurse expect the provider to prescribe?

<p>Nifedipine. (A)</p> Signup and view all the answers

A nurse is caring for a client who is prescribed warfarin via oral (PO) route. Two hours after the administration of warfarin, the client reports having dark tarry stools and petechiae. Based on the client's presenting symptoms, which of the following options is an antidote for warfarin toxicity?

<p>Vitamin K1. (D)</p> Signup and view all the answers

The nurse is caring for a new client that got admitted to the unit for abdominal discomfort. The nurse notes that the client takes levothyroxine (Synthroid) at home. The nurse understands that the client is taking levothyroxine (Synthroid) to treat which of the following conditions?

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

A nurse is caring for a client with a new prescription for digoxin for one week. The client reported having blurred vision, vomiting, and weight loss of 4 pounds in one week. Which of the following medications should the nurse anticipate to give to the client based on the presenting symptoms?

<p>Digoxin immune fab (Digibind). (C)</p> Signup and view all the answers

A client has a new prescription for naloxone (Narcan). Which of the following statements indicates the correct therapeutic use of this medication?

<p>This medication is used as a reversal of the effects of opioids. (A)</p> Signup and view all the answers

A nurse is preparing to educate a patient who has newly been prescribed sucralfate (Carafate) for the management of peptic ulcer disease (PUD). What is the mechanism of action for this medication?

<p>Creates a protective barrier that adheres to an ulcer, which can stick to the ulcer for up to 6 hours. (B)</p> Signup and view all the answers

Which of the following options is a correct indication for omeprazole (Prilosec)?

<p>Prevention of gastric ulcers caused by NSAIDs. (D)</p> Signup and view all the answers

A nurse is caring for a client with hypertension.Which of the following medications is a vasodilator and is indicated for a hypertensive crisis?

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

A nurse is caring for a client that is newly diagnosed with hypertension.Which of the following medications is a beta-adrenergic blocker that has a mechanism of action to decrease heart rate, myocardial contractility, and cardiac output, and is also used to treat hypertension?

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

A nurse is caring for a client who has a new prescription for warfarin.Which of the following is a therapeutic use of this medication?

<p>This medication prevents venous thrombosis. (A)</p> Signup and view all the answers

A home care nurse administers oral morphine to the patient with cancer pain. When will the nurse expect the medication to reach peak activity?

<p>60 minutes. (D)</p> Signup and view all the answers

What assessment finding would indicate the patient's left-sided heart failure is worsening?

<p>Increased crackles in lung fields (B)</p> Signup and view all the answers

The nurse is preparing to assist with blood collection on a newly admitted patient who has been taking phenytoin for several years. The provider has ordered a complete blood count and liver function tests. Which other blood test will the nurse discuss with the provider?

<p>Serum electrolytes. (D)</p> Signup and view all the answers

A nurse is caring for a newly admitted patient who will receive Digoxin to treat cardiac dysrhythmia. The patient takes hydrochlorothiazide and reports regular use of OTC laxatives. Before administering the first dose of Digoxin, the nurse will review the patient’s electrolyte levels with careful attention to which electrolytes?

<p>Potassium and chloride. (C)</p> Signup and view all the answers

The nurse is preparing to administer digoxin (Lanoxin) to a client experiencing atrial fibrillation. Which of the following electrolyte imbalances would the nurse assess to reduce the incidence of toxicity with digoxin?

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

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

<p>&quot;I'll be glad when I can stop taking this medicine.&quot; (A)</p> Signup and view all the answers

A patient in a rehabilitation center is beginning to experience opioid withdrawal symptoms. The nurse expects to administer which drug as part of the treatment?

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

The nurse has given medication instructions to a patient receiving phenytoin. Which statement by the patient indicates that the patient has an adequate understanding of the instructions?

<p>&quot;I will need to take extra care of my teeth and gums while on this medication.&quot; (D)</p> Signup and view all the answers

The nurse is caring for a 64-year-old male client with diabetes who is being treated with a nonselective beta-blocker. What health education should the nurse prioritize with this client?

<p>Perform more frequent blood glucose checks due to effects of the drug (C)</p> Signup and view all the answers

A nurse is preparing regular and NPH insulin in the same syringe for a client who has diabetes mellitus. Which of the following actions should the nurse take?

<p>Draw up the regular insulin first, then the NPH insulin. (B)</p> Signup and view all the answers

Flashcards

Naloxone

Reverses the effects of opioid overdose by blocking opioid receptors.

Vomiting

A common sign of digoxin toxicity affecting the gastrointestinal system.

Chlordiazepoxide

A benzodiazepine used to manage alcohol withdrawal symptoms.

Respiratory Rate

Monitor this vital sign first when administering morphine due to risk of respiratory depression.

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Omeprazole Action

Omeprazole reduces acid production in the stomach.

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Risk for Injury

Patients are more likely to fall with orthostatic hypotension and dizziness.

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Risk for Injury

Sedatives increase risk of falls

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Opioid Toxicity Triad

Pinpoint pupils, respiratory depression, and coma indicate opioid overdose.

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Opioid Abstinence Syndrome Signs

Symptoms of opioid withdrawal.

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Insulin Lispro Onset

Rapid-acting insulin

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Naloxone Route

Naloxone is inactivated during the first-pass effect and it cannot be administered via this route.

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Omeprazole Use

Omeprazole decreases acid secretion.

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Levothyroxine Use

Treats hypothyroidism.

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Fentanyl overdose

Respiratory rate is a sign of opioid toxicity.

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Vitamin K

Antidote for warfarin.

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Nausea

Adverse effect of digoxin that may be a sign of toxicity.

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Angioedema

A potentially serious side effect of lisinopril. Prioritize assessment.

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Propranolol Contraindication

Asthma is a contraindication.

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Nitroglycerin Patch

Apply once daily and remove each night.

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Enteric-Coated Aspirin

The coating protects the stomach. Crushing defeats the purpose.

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Nitroglycerin Headache

A common side effect related to vasodilation.

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Lisinopril Effect

Lisinopril lowers blood pressure.

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Hydrochlorothiazide Timing

To prevent nocturia, take in AM.

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Digoxin Administration

Assess heart rate to confirm the HR is within normal limits to hold or give the prescribed medication.

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Nifedipine

A calcium channel blocker that vasodialates to treat hypertension and angina.

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Vitamin K1

Vitamin K is an antidote for warfarin (Coumadin) because it helps reverse the anticoagulant effects and promotes blood clotting.

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Levothyroxine Use

Treats hypothyroidism.

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Digoxin Immune Fab

Antidote for digoxin toxicity.

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Naloxone Use

Naloxone reverses effects of opioids such as respiratory depression.

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Sucralfate Mechanism

Sucralfate creates a protective layer.

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Omeprazole Use

Omeprazole decreases gastric acid secretion.

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Nitroglycerin

Treats hypertensive crisis.

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Metoprolol Use

Lowers HR and BP.

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Warfarin Use

Warfarin prevents clot formation.

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Morphine Peak

Approximately one hour.

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Increased Crackles

Crackles are a sign of fluid backup into the lungs.

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Liver Function Test

Long-term use of phenytoin (Dilantin) may cause liver damage. The nurse should discuss with the provider if they want to add liver function tests for assessing the patient’s liver functions.

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Electrolyte levels

Low potassium increases risk of Digoxin toxicity.

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Hypokalemia

Hypokalemia increases the risk of digoxin toxicity.

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Phenytoin Teaching

Stopping phenytoin abruptly can cause status epilepticus.

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Study Notes

Medications and Antidotes

  • Naloxone is administered for respiratory depression caused by excessive oxycodone.
  • Digoxin toxicity is indicated by vomiting and should be reported to the provider.
  • Chlordiazepoxide is prescribed for clients at risk for alcohol withdrawal delirium.
  • Respiratory rate should be assessed first in a client receiving morphine.
  • Vitamin K is administered when a client's INR is 5.2 while on warfarin therapy.
  • Digoxin immune fab (Digibind) is the antidote for digoxin toxicity and should be anticipated if a patient reports blurred vision, vomiting, and weight loss while taking digoxin.
  • Naloxone (Narcan) is the reversal agent for the effects of opioids.

Medication Teaching and Understanding

  • Omeprazole reduces stomach acid, indicating the client's understanding of the teaching
  • A relevant nursing diagnosis for an elderly patient taking an antihypertensive drug causing dizziness and orthostatic hypotension is risk for injury related to side effects of the medication.
  • The priority nursing diagnosis for a 70-year-old patient receiving a sedating drug is risk for injury related to adverse effects of the drug.
  • A client prescribed transdermal nitroglycerin should apply the patch in the morning.
  • A client taking lisinopril that has swelling of the tongue is a priority to report.
  • Clients with a bronchial asthma history should not take propranolol hydrochloride.
  • The client should be told that crushing enteric-coated aspirin may cause a stomachache or indigestion
  • A headache is an expected adverse effect of nitroglycerin.
  • Hydrochlorothiazide should be taken early in the day.
  • A client should not stop taking Phenytoin even when seizures resolve
  • Clients on Phenytoin need to take extra care of their gums and teeth

Opioid Toxicity and Withdrawal

  • The opioid toxicity triad includes pinpoint pupils, respiratory depression, and coma.
  • Abstinence syndrome includes fever, hypertension, vomiting, anxiety, and abdominal cramping.

Insulin

  • Insulin lispro (Humalog) has an onset of 15 to 30 minutes.

Medication Routes

  • Naloxone (Narcan) should not be administered orally due to rapid first-pass inactivation.

Medication Indications

  • Omeprazole (Prilosec) is indicated for the prevention of stress ulcers for at-risk clients experiencing acute events, and to treat peptic ulcers and prevent gastric ulcers
  • Levothyroxine (Synthroid) treats hypothyroidism.
  • Nifedipine is prescribed to treat angina and hypertension.
  • Warfarin prevents venous thrombosis.

Assessments and Labs

  • Apical pulse should be measured before administering digoxin.
  • Serum electrolytes, with specific attention to potassium, need to be reviewed before administering Digoxin because Hypokalemia increases the risk of Digoxin toxicity.
  • Renal function tests will need to be discussed with the provider when assisting with blood collection on a patient who has been taking Phenytoin for several years.
  • In patients with left-sided heart failure, increased crackles in the lung fields would indicate the patient's condition is worsening.

Medication Effects

  • A therapeutic effect of lisinopril is decreased blood pressure.
  • A therapeutic use of naloxone (Narcan) is the reversal of opioid effects.
  • Metoprolol is a beta-adrenergic blocker that decreases heart rate, myocardial contractility, and cardiac output, and is used to treat hypertension.
  • The peak activity of oral morphine is expected at 60 minutes.

Other

  • Perform more frequent blood glucose checks due to effects of the drug in diabetic clients being treated with a nonselective beta-blocker
  • Methadone is administered as part of the treatment for opioid withdrawal symptoms.
  • Sucralfate (Carafate) a protective barrier that adheres to an ulcer for up to 6 hours.
  • To administer regular and NPH insulin: Inject air into NPH insulin first, then inject air into regular insulin, withdraw regular insulin, and then withdraw NPH insulin.

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