Nursing Medications Quiz

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Questions and Answers

What is an important nursing action to take if a client exhibits symptoms of serotonin syndrome?

Increase the dosage of the medication immediately

Discontinue the medication and monitor for bleeding (correct)

Encourage the client to continue with therapy despite symptoms

Administer the medication on an empty stomach

Which of the following symptoms is NOT typically associated with serotonin syndrome?

Bruxism (correct)

Diaphoresis

Tachycardia

Hyperreflexia

When can serotonin syndrome symptoms begin to appear after starting treatment?

Immediately after starting medication

After two weeks of medication use

Between 2 to 72 hours (correct)

Within 2 to 24 hours

What should be advised to a client experiencing bruxism while on medication?

Use a mouth guard during sleep Signup and view all the answers

What is a key consideration when administering medications to clients taking antiplatelet or anticoagulant drugs?

Monitor for bleeding and avoid concurrent use Signup and view all the answers

What should be avoided to prevent increased CNS depression when taking benzodiazepines?

Grapefruit juice Signup and view all the answers

Which of the following is a potential effect of IV benzodiazepine toxicity?

Cardiac arrest Signup and view all the answers

What should be administered to counteract benzodiazepine toxicity?

Flumazenil Signup and view all the answers

When should benzodiazepines ideally be administered to mitigate sedation effects?

At bedtime Signup and view all the answers

Which food type should be avoided to enhance benzodiazepine absorption?

High-fat meals Signup and view all the answers

What is a paradoxical response that can occur with benzodiazepines?

Insomnia Signup and view all the answers

Which is an important nursing action while administering benzodiazepines?

Maintain a patent airway Signup and view all the answers

What should patients be advised regarding the use of sustained-release benzodiazepine tablets?

Swallow them whole Signup and view all the answers

What is a common pattern regarding weight changes in treatment with paroxetine?

Weight loss may occur early but can be followed by weight gain long-term. Signup and view all the answers

What should clients do to minimize the risk of postural hypotension while on paroxetine?

Change positions slowly. Signup and view all the answers

Which of the following is a key nursing action regarding clients with a history of GI bleeding on paroxetine?

Monitor and report any manifestations of depression. Signup and view all the answers

What is a contraindication for prescribing paroxetine?

Concurrent use of St. John's wort. Signup and view all the answers

Which pregnancy risk category does paroxetine belong to?

Category D Signup and view all the answers

In older adult clients taking diuretics, which risk is more prevalent when using paroxetine?

Hyponatremia Signup and view all the answers

Which of the following manifestations might suggest serotonin syndrome in a client taking paroxetine?

Agitation and confusion Signup and view all the answers

What should be monitored periodically in clients using paroxetine, especially older adults?

Blood sodium levels Signup and view all the answers

Which statement by a client indicates understanding of escitalopram administration?

I need to discontinue this medication slowly. Signup and view all the answers

What is an appropriate intervention for managing bruxism in a client taking paroxetine?

Use of a mouth guard. Signup and view all the answers

What should a nurse emphasize to a client starting buspirone?

Take this medication on an empty stomach. Signup and view all the answers

When teaching about escitalopram, which dietary consideration is important for the client?

Limit caffeine intake. Signup and view all the answers

Why should a client be cautious about discontinuing escitalopram abruptly?

It can lead to increased anxiety symptoms. Signup and view all the answers

Which medication should be administered if a client experiences serious side effects from paroxetine?

Change to a different class of antidepressants. Signup and view all the answers

What early administration side effect should a nurse monitor for in a client taking buspirone?

Restlessness. Signup and view all the answers

What key point should be made regarding the administration of paroxetine?

It may take several weeks to see full effects. Signup and view all the answers

What is a significant risk associated with taking escitalopram?

Hyponatremia Signup and view all the answers

Why should escitalopram be tapered before discontinuation?

To prevent withdrawal syndrome Signup and view all the answers

Which adverse effect is NOT commonly associated with escitalopram?

Rapid hair growth Signup and view all the answers

What should a client avoid when discontinuing escitalopram?

Tapering the medication too quickly Signup and view all the answers

Which condition indicates a possible severe reaction to escitalopram?

Delirium Signup and view all the answers

Which symptom indicates possible overstimulation when on escitalopram?

Tremors Signup and view all the answers

Which statement about escitalopram administration is accurate?

It can be crushed before swallowing. Signup and view all the answers

What is a possible outcome of hyperreflexia in a patient taking escitalopram?

Decreased motor coordination Signup and view all the answers

Study Notes

Serotonin Syndrome

Nursing Action: Stop the medication, closely monitor vital signs, and provide supportive care.
Symptom NOT Typically Associated: Hypotension (low blood pressure).
Onset Time: Symptoms may begin within hours to days after starting or increasing the dosage.

Bruxism

Advice: Advise the client to use a mouthguard, stress-reduction techniques, and consult with a dentist.

Medication Administration

Key Consideration: Careful monitoring of bruising, bleeding, and any other signs of bleeding when administering medications to clients taking antiplatelet or anticoagulant drugs.

Benzodiazepines

Avoiding CNS Depression: Avoid alcohol and other CNS depressants while taking benzodiazepines to prevent increased CNS depression.
IV Toxicity: Respiratory depression is a potential effect of IV benzodiazepine toxicity.
Counteract Toxicity: Flumazenil can be administered to counteract benzodiazepine toxicity.
Ideal Administration Time: Administer benzodiazepines ideally 30 minutes to an hour before bedtime to minimize sedation effects.
Avoid Food: Avoid grapefruit juice to enhance benzodiazepine absorption.
Paradoxical Response: Paradoxical responses may occur, including agitation, anxiety, and aggression.
Nursing Action: Closely monitor clients for signs of sedation, respiratory depression, and paradoxical effects.
Sustained-Release Tablets: Advise clients to swallow sustained-release tablets whole and not to crush or chew them.

Paroxetine

Weight Changes: Weight gain is a common pattern in the long-term use of paroxetine.
Minimizing Risk: Instruct clients to change positions slowly, avoid standing for long periods, and stay hydrated to minimize the risk of postural hypotension (low blood pressure).
GI Bleeding: Monitor closely for signs of GI bleeding in clients with a history of GI bleeding who are taking paroxetine.
Contraindication: Paroxetine is contraindicated in clients who are taking monoamine oxidase inhibitors (MAOIs) due to the risk of serotonin syndrome.
Pregnancy Category: Paroxetine belongs to pregnancy risk category D, meaning it is known to cause fetal harm.
Risk in Older Adults: Older adults taking diuretics have a higher risk of hyponatremia (low sodium levels in the blood) while on paroxetine.
Serotonin Syndrome Manifestations: Monitor for symptoms like hyperreflexia, myoclonus, and autonomic dysfunction.
Periodic Monitoring: Monitor periodically for signs of depression, suicidal thoughts, and other mental health issues, especially in older adults.

Escitalopram

Client Understanding: "I will take escitalopram at the same time each day to help me maintain consistent levels of the medication in my body."
Managing Bruxism: Advise clients to use a mouthguard, stress-reduction techniques, and consult with a dentist.
Dietary Consideration: Advise clients to limit or avoid alcohol when taking escitalopram, as alcohol can increase the risk of sedation and other side effects.

Buspirone

Key Point: Buspirone is a non-benzodiazepine medication that is used to treat anxiety. It does not have the same potential for abuse or addiction as benzodiazepines.

General Considerations

Discontinuing Abruptly: Warn clients about the risks of abruptly discontinuing escitalopram, as this can lead to withdrawal symptoms.
Serious Side Effects: In case of serious side effects from paroxetine, administer an appropriate counteragent such as cyproheptadine (a serotonin antagonist).
Early Administration Side Effect: Monitor for drowsiness, lightheadedness, and dizziness as early administration side effects in a client taking buspirone.
Paroxetine Administration: Paroxetine is generally administered once daily in the evening.
Risk of Escitalopram: Suicidal thoughts and behaviors are a significant risk associated with taking escitalopram, especially in young adults.
Tapering Escitalopram: Escitalopram should be tapered before discontinuation to minimize the risk of withdrawal symptoms.
Adverse Effect NOT Associated: Constipation is not commonly associated with escitalopram.
Discontinuation: Advise clients taking escitalopram to avoid alcohol and other CNS depressants, especially when discontinuing the medication.
Severe Reaction: Tachycardia, hypertension, and hyperthermia indicate a possible severe reaction to escitalopram.
Overstimulation: Restlessness and agitation may indicate possible overstimulation when on escitalopram.
Escitalopram Administration Accuracy: "Escitalopram is usually taken once a day, but my doctor may adjust the dosage based on my needs."
Hyperreflexia Outcome: Hyperreflexia can progress to seizures, especially if untreated.

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Description

Test your knowledge on key nursing actions related to serotonin syndrome, bruxism, and the administration of medications for clients on antiplatelet or anticoagulant drugs. This quiz covers important symptoms, timing of onset, and considerations for safe medication practices. Perfect for nursing students and professionals.