Questions and Answers
The client is likely experiencing ______ as evidenced by the client's blood thyroxine level.
hyperthyroidism
Which of the following instructions should the nurse include in the teaching for the client starting treatment for asthma with beclomethasone and albuterol inhalers?
The nurse should hold the next dose of gentamicin if which of the following findings are observed?
The nurse should administer heparin subcutaneously in the 5 cm (2 in) radius of the umbilicus.
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The nurse should identify which of the following as a contraindication for administering ciprofloxacin?
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What should the nurse instruct the client taking allopurinol for gout to do?
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A client who is taking nitroglycerin should leave the patch on after their evening meal.
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What is an expected finding following the administration of atropine eye drops?
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What action should the nurse take for a medication error involving propranolol?
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The nurse should monitor for ____________ as a sign of digoxin toxicity.
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How should the nurse respond to a client refusing to take their fluid pill?
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What lab value should the nurse monitor for a client prescribed spironolactone?
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What is the correct administration route for filgrastim?
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What should the nurse expect to administer to a client with magnesium level of 3.1 mEq/L?
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For a client with a gastric ulcer prescribed famotidine, what symptom should the nurse instruct the client to report?
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How many mL should the nurse administer for a dose of amoxicillin 250 mg?
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Which of the following findings should the nurse monitor?
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Which action should the nurse take when contacting a provider for a prescription for pain medication?
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Which of the following adverse effects should the nurse include in the teaching for oxybutynin?
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What adverse effect should a nurse monitor for in a client receiving mannitol?
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What should a client do before discontinuing cyclobenzaprine?
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What daily routine should a client on fentanyl patches follow to manage side effects?
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What is the purpose of administering chlordiazepoxide during acute alcohol withdrawal?
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What adverse effect should a nurse identify when a client is receiving haloperidol?
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What should a client do after taking risedronate?
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What action should a nurse take if an antibiotic is found to be missing during scheduled administration?
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What should a client do before taking diltiazem?
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What should the nurse include in teaching about medication reconciliation?
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What lab result should be reported by a nurse for a client taking digoxin?
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What is the mechanism of action of docusate sodium?
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What laboratory test should a nurse review before administering clozapine?
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What ECG finding could indicate hypokalemia in a client receiving IV furosemide?
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CVAD is difficult to flush. The nurse should first address the client's ______.
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Study Notes
Card 1: Hyperthyroidism Assessment
- Elevated heart rate (110/min) and low TSH (0.1 mU/L) suggest hyperthyroidism.
- Symptoms include nervousness, irritability, hyperactive bowel sounds, and loose stools.
Card 2: Asthma Inhaler Teaching
- Rinse mouth after using beclomethasone to prevent oropharyngeal candidiasis and hoarseness.
Card 3: Gentamicin Administration
- Hold next gentamicin dose if BUN (48 mg/dL), creatinine (2.7 mg/dL), and dark amber urine indicate nephrotoxicity.
Card 4: Heparin Administration Technique
- Administer heparin subcutaneously at least 5 cm away from the umbilicus, in the abdomen above the iliac crest.
Card 5: Neuroleptic Malignant Syndrome Actions
- Administer dantrolene and bromocriptine, use a cooling blanket, discontinue fluphenazine in NMS cases.
Card 6: Isotretinoin Pre-Refill Requirement
- Require two negative pregnancy tests for initial isotretinoin prescription and one before monthly refills due to teratogenic effects.
Card 7: Nitroglycerin Patch Usage
- Patch should be removed after 12 to 14 hours to prevent tolerance.
Card 8: Oral Contraceptive Interaction
- Carbamazepine interferes with the effectiveness of oral contraceptives due to accelerated hepatic metabolism.
Card 9: Hydrochlorothiazide Adverse Effects
- Monitor for orthostatic hypotension when administering hydrochlorothiazide, a thiazide diuretic.
Card 10: Aspirin Usage Monitoring
- Notify provider if the client exhibits hyperventilation, indicating possible acute salicylate poisoning.
Card 11: Allopurinol Patient Instruction
- Advise to drink at least 2 L of water daily to prevent renal stones and injury when taking allopurinol.
Card 12: Blood Pressure Check
- Obtain blood pressure before administering hydrochlorothiazide to assess readiness for treatment.
Card 13: Managing Nitroglycerin Side Effect
- Assist client into bed and elevate legs if faintness occurs after nitroglycerin administration; check blood pressure afterward.
Card 14: Cholinergic Crisis Treatment
- Administer atropine for managing cholinergic crisis due to excess cholinesterase inhibitors.
Card 15: Ciprofloxacin Contraindication
- Tendonitis indicates a contraindication for ciprofloxacin due to risk of tendon rupture.
Card 16: Neuroleptic Malignant Syndrome Indication
- Report elevated temperature (39.7°C) as an indicator of NMS when patient is on haloperidol.
Card 17: Incident Report Details
- Include precise details of medication error, such as administering 80 mg propranolol without a prescription.
Card 18: Tamoxifen Adverse Effects
- Hot flashes are a common adverse effect when taking tamoxifen due to its estrogen receptor blocking action.
Card 19: Morphine Effectiveness Assessment
- Client reporting pain level as 3 out of 10 indicates effective pain management post-morphine administration.
Card 20: IV Dopamine Effectiveness
- Increased cardiac output signifies effective administration of dopamine in heart failure treatment.
Card 21: Atropine Adverse Effect
- Blurred vision is a common side effect following the application of atropine eye drops.
Card 22: Insulin Storage Instructions
- Store unopened insulin vials in the refrigerator; opened vials can remain at room temperature for 1 month.
Card 23: IV Infusion Rate Calculation
- Set manual IV infusion to 100 gtt/min for administering D5W at 400 mL over 1 hour.
Card 24: Transdermal Medication Usage
- Remove nitroglycerin patch after 12 to 14 hours to avoid tolerance.
Card 25: Digoxin Toxicity Monitoring
- Instruct client to be alert for yellow-tinged vision as a symptom of digoxin toxicity.
Card 26: Responding to Medication Error
- Check the client's blood glucose first after administering metformin instead of metoclopramide.
Card 27: Fluoxetine Teaching
- Advise taking acetaminophen for headaches to reduce bleeding risk while on fluoxetine.
Card 28: High Magnesium Level Management
- Administer calcium gluconate for treating a magnesium level of 3.1 mEq/L to prevent severe complications.
Card 29: Anaphylactic Reaction Intervention
- Discontinue ceftriaxone infusion immediately if urticaria and dyspnea occur, indicating potential anaphylaxis.
Card 30: Calcium Gluconate Interaction
- Monitor for digoxin toxicity due to calcium gluconate's potential to cause hypercalcemia.
Card 31: Filgrastim Therapy Effectiveness
- Document increased neutrophil count as evidence of the effectiveness of filgrastim therapy.
Card 32: Spironolactone Monitoring
- Monitor potassium levels closely as spironolactone can cause hyperkalemia; evaluate lab results regularly.
Card 33: Medication Refusal Protocol
- Document and inform the provider of the client's refusal to take medication after ensuring understanding of risks.
Card 34: Opioid Use Disorder Treatment
- Expect to administer methadone for treatment and maintenance of opioid use disorder.
Card 35: Amoxicillin Dosage Calculation
- Administer 6.3 mL of amoxicillin oral suspension (200 mg/5 mL) to deliver 250 mg.
Card 36: Famotidine Monitoring
- Instruct to report any yellowing of the skin as it may indicate hepatotoxicity when on famotidine.
Card 37: Epoetin Alfa Effect Monitoring
- Monitor blood pressure as an increase in hematocrit from epoetin alfa can lead to hypertension.
Card 38: Medication Name Clarity
- Ask providers to spell unfamiliar medication names for clarity during telephone prescriptions.
Card 39: Oxybutynin Adverse Effects
- Monitor for dry mouth, blurred vision, and dry eyes, common adverse effects of oxybutynin.
Card 40: Mannitol Adverse Effects
- Monitor for bibasilar crackles indicating potential heart failure or pulmonary edema during mannitol administration.
Card 41: Cyclobenzaprine Teaching Effectiveness
- Assess client understanding through appropriate responses to instructions regarding cyclobenzaprine use and effects.### Medication Management
- Tapering off medications like cyclobenzaprine is crucial to prevent withdrawal symptoms such as abstinence syndrome or rebound insomnia.
- Constipation is a common adverse effect of opioids like fentanyl; using a stool softener daily can help mitigate this issue.
Alcohol Withdrawal Management
- Chlordiazepoxide is administered during acute alcohol withdrawal primarily to prevent delirium tremens, a severe complication.
Antipsychotic Treatment
- Haloperidol can cause extrapyramidal side effects, including akathisia, dystonia, and pseudoparkinsonism.
Osteoporosis Treatment
- Patients taking risedronate should remain upright for at least 30 minutes post-ingestion to minimize gastrointestinal irritation and adverse effects like esophagitis.
Safe Medication Storage
- Oral transmucosal fentanyl lozenges must be stored properly; unused medication sticks should be kept in a designated storage container provided in the kit.
Asthma Management
- Cromolyn sodium should be used 10 to 15 minutes before exercise to prevent bronchospasms in patients diagnosed with exercise-induced asthma.
Antibiotic Administration Timing
- Scheduled antibiotics can be given 30 minutes before or after the designated time without necessitating an incident report, ensuring effective therapeutic levels.
Monitoring Heart Rate
- Patients prescribed diltiazem should check their heart rate prior to administration due to its potential to cause bradycardia; they must inform healthcare providers of any rates below the expected range.
Medication Reconciliation
- Medication reconciliation is necessary during transitions in care, such as admissions, transfers, or discharges, ensuring a comprehensive review of all medications.
Digoxin Toxicity Risk
- Hypokalemia significantly increases the risk of digoxin toxicity; it is imperative to report low potassium levels before administering the medication.
Stool Softener Mechanism
- Docusate sodium, a surfactant, acts by reducing stool surface tension, facilitating easier water penetration and resulting in softer stools.
Schizophrenia Treatment Monitoring
- Clozapine can induce hyperlipidemia; therefore, monitoring the client's total cholesterol is essential prior to administration.
ECG Changes and Potassium Levels
- The presence of U waves on an ECG can indicate hypokalemia, a potential adverse effect of diuretics like furosemide.
Prioritization in Nursing Care
- When managing patients, prioritize addressing hypoglycemia over complications with central venous access devices (CVAD), as hypoglycemia may result from abruptly stopping total parenteral nutrition (TPN).
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Description
This quiz focuses on the nursing considerations when administering epoetin alfa, particularly the necessity of monitoring blood pressure due to potential increases in hematocrit levels. It's essential for nurses to understand the risks of hypertension and seizures associated with rapid rises in hematocrit. Test your knowledge on this crucial aspect of patient management!
