Podcast
Questions and Answers
Which adverse effect should the nurse monitor for in a client receiving care?
Which adverse effect should the nurse monitor for in a client receiving care?
- Orthostatic hypotension
- Atelectasis (correct)
- Photosensitivity
- Skin pressure point integrity
What initial drug groups may be ordered for a client with an average blood pressure reading of 164/92 mm Hg?
What initial drug groups may be ordered for a client with an average blood pressure reading of 164/92 mm Hg?
- Thiazide diuretics (correct)
- Calcium channel blockers
- Beta-blockers (correct)
- Direct-acting vasodilators (correct)
Which medication could interact with a new prescription for ACE inhibitors?
Which medication could interact with a new prescription for ACE inhibitors?
- A potassium supplement (correct)
- A nonsteroidal anti-inflammatory drug (correct)
- An oral anticoagulant
- A benzodiazepine
How does atenolol (Tenormin) primarily assist in managing angina?
How does atenolol (Tenormin) primarily assist in managing angina?
What adverse effect should be monitored in a patient receiving sublingual nitroglycerin?
What adverse effect should be monitored in a patient receiving sublingual nitroglycerin?
Angina occurs when which condition arises?
Angina occurs when which condition arises?
Which of these medications is an initial choice for managing hypertension?
Which of these medications is an initial choice for managing hypertension?
Which substance should be cautiously monitored when a patient is prescribed ACE inhibitors?
Which substance should be cautiously monitored when a patient is prescribed ACE inhibitors?
How many grams of mannitol will the patient receive from a 100ml vial of 20% mannitol?
How many grams of mannitol will the patient receive from a 100ml vial of 20% mannitol?
When using a combination of NPH and regular insulin, why is it critical for the client to know the peak times?
When using a combination of NPH and regular insulin, why is it critical for the client to know the peak times?
Before administering morning lispro insulin, which action is most critical for the nurse to perform?
Before administering morning lispro insulin, which action is most critical for the nurse to perform?
After an insulin overdose, if a client is waking up but still incoherent, what should the nurse advise?
After an insulin overdose, if a client is waking up but still incoherent, what should the nurse advise?
What should be the nurse's immediate concern if a client on Levothyroxine reports nervousness and palpitations?
What should be the nurse's immediate concern if a client on Levothyroxine reports nervousness and palpitations?
What is the appropriate volume to prepare for the infusion if 3.5g of mannitol is needed?
What is the appropriate volume to prepare for the infusion if 3.5g of mannitol is needed?
What action should a nurse avoid when a client is experiencing symptoms of hypoglycemia?
What action should a nurse avoid when a client is experiencing symptoms of hypoglycemia?
Why is it essential for a client with Type 1 diabetes to have knowledge of their insulin peak times?
Why is it essential for a client with Type 1 diabetes to have knowledge of their insulin peak times?
What is the best action for a nurse to take when an 11-year-old patient is struggling to use an inhaler correctly?
What is the best action for a nurse to take when an 11-year-old patient is struggling to use an inhaler correctly?
Which drug should be administered for a patient with bronchitis and a productive cough?
Which drug should be administered for a patient with bronchitis and a productive cough?
What therapeutic response can antihistamine-type drugs provide for upper respiratory issues?
What therapeutic response can antihistamine-type drugs provide for upper respiratory issues?
Before administering magnesium hydroxide for constipation, the nurse should first assess which factor?
Before administering magnesium hydroxide for constipation, the nurse should first assess which factor?
When considering the use of bismuth subsalicylate (Pepto-Bismol) for diarrhea, which factor is most important for the nurse to consider?
When considering the use of bismuth subsalicylate (Pepto-Bismol) for diarrhea, which factor is most important for the nurse to consider?
Before administering ondansetron (Zofran) prior to chemotherapy, which past medical history condition should be reviewed?
Before administering ondansetron (Zofran) prior to chemotherapy, which past medical history condition should be reviewed?
For a patient experiencing post-operative constipation, which drug would be least appropriate?
For a patient experiencing post-operative constipation, which drug would be least appropriate?
Which patient assessment is critical before administering an expectorant?
Which patient assessment is critical before administering an expectorant?
What is the most appropriate time for a client to receive proton pump inhibitors?
What is the most appropriate time for a client to receive proton pump inhibitors?
Which drug order should a nurse question when treating gastroesophageal reflux disease?
Which drug order should a nurse question when treating gastroesophageal reflux disease?
What should the nurse instruct a 21-year-old female patient taking ampicillin regarding oral contraceptives?
What should the nurse instruct a 21-year-old female patient taking ampicillin regarding oral contraceptives?
If a client reports abnormal vaginal discharge after taking cefotaxime, what condition might they be exhibiting symptoms of?
If a client reports abnormal vaginal discharge after taking cefotaxime, what condition might they be exhibiting symptoms of?
In what order should a nurse administer blood cultures, sputum cultures, and an ampicillin dose for a patient with a fever and productive cough?
In what order should a nurse administer blood cultures, sputum cultures, and an ampicillin dose for a patient with a fever and productive cough?
Which instruction should be given to a patient prescribed a proton pump inhibitor?
Which instruction should be given to a patient prescribed a proton pump inhibitor?
What is the priority assessment related to a Central Venous Access Device (CVAD) infusion?
What is the priority assessment related to a Central Venous Access Device (CVAD) infusion?
Which patient would be a candidate for insertion of a central line?
Which patient would be a candidate for insertion of a central line?
What is a common misconception about the interaction between antibiotics and oral contraceptives?
What is a common misconception about the interaction between antibiotics and oral contraceptives?
What influence does a drug that stimulates gastric peristalsis have on additional oral medications?
What influence does a drug that stimulates gastric peristalsis have on additional oral medications?
What is the primary reason for questioning an order of antibiotics in a patient with gastroesophageal reflux disease?
What is the primary reason for questioning an order of antibiotics in a patient with gastroesophageal reflux disease?
In a patient with hepatitis and hepatic impairment, what is expected regarding the duration of action of medications?
In a patient with hepatitis and hepatic impairment, what is expected regarding the duration of action of medications?
What is the correct order of the phases of pharmacokinetics?
What is the correct order of the phases of pharmacokinetics?
If a drug delivers 500 mg and has a half-life of 4 hours, how many milligrams will remain after 1 half-life?
If a drug delivers 500 mg and has a half-life of 4 hours, how many milligrams will remain after 1 half-life?
Which pharmacodynamic principle is most closely associated with a drug's affinity for receptors?
Which pharmacodynamic principle is most closely associated with a drug's affinity for receptors?
In the context of a patient receiving a medication with a high first-pass effect, what is the expected impact on oral bioavailability?
In the context of a patient receiving a medication with a high first-pass effect, what is the expected impact on oral bioavailability?
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Study Notes
Central Venous Access Device (CVAD)
- Priority assessment for a patient with a CVAD includes chest assessment to monitor for complications.
- Candidates for central line insertion include those with septicemia and chemotherapy-related immunocompromise.
Medication Interactions
- Drug stimulating gastric peristalsis can decrease absorption of additional oral medications.
- Hepatic impairment increases the duration of action for most medications.
Pharmacokinetics Phases
- Phase 1: Drug moves from the intestinal lumen into mesenteric blood.
- Phase 2: Drug binds to plasma protein albumin.
- Phase 3: Liver enzymes transform the drug into inactive metabolites.
- Phase 4: Drug metabolites are excreted via renal tubules.
Drug Half-Life and Affinity
- A drug at 500mg with a half-life of 4 hours will have 250mg remaining after one half-life.
- Drugs with high receptor affinity are closely associated with potency.
Hypertension Management
- Initial drug groups for hypertension may include beta-blockers, calcium channel blockers, and thiazide diuretics.
- ACE inhibitors may interact with nonsteroidal anti-inflammatory drugs and potassium supplements.
Angina Management
- Atenolol acts by slowing the heart rate and reducing contractility to help manage angina.
- Sublingual nitroglycerin can cause decreased blood pressure, requiring monitoring for this adverse effect.
Insulin Management
- NPH and regular insulin require knowledge of peak times due to hypoglycemia risk during peak action.
- Before administering lispro insulin, ensure breakfast availability and check blood glucose levels.
Insulin Overdose Response
- If a patient regains consciousness after glucagon administration but remains groggy, wait for further recovery before offering food.
Pediatric Inhaler Use
- Providing a spacer can help facilitate proper inhaler technique in a child unable to demonstrate correct usage.
OTC Medications
- Recommendations for bismuth subsalicylate depend on the cause of diarrhea and age of the child.
Chemotherapy and Drug Review
- Ondansetron should be reviewed for allergies to egg or soy before chemotherapy administration.
Proton Pump Inhibitors
- Proton pump inhibitors should be taken half an hour before meals for optimal effectiveness.
Antibiotic Counseling
- Ampicillin may decrease the effectiveness of oral contraceptives; patients should use contraception as prescribed.
- Abnormal vaginal discharge after cefotaxime may indicate superinfection.
Blood Culture Protocol
- Correct sequence for a patient with fever and respiratory signs is to perform blood and sputum cultures before antibiotic administration.
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