Questions and Answers
The client should expect to have a slower heart rate while taking alosetron.
True
Which of the following medications should the nurse instruct the parents to use to relieve an acute asthma attack?
What should the nurse say in response to a client concerned about a prescription for verapamil?
Which statement should the nurse include in teaching about Omeprazole for a client with a bleeding duodenal ulcer?
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The nurse should administer _____ mL of codeine for pain.
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Which laboratory value should the nurse report for a client receiving methotrexate?
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The nurse should administer _____ mL of ampicillin per dose.
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What action should the nurse take when administering iron dextran IV?
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Which statement indicates understanding of Digoxin and Furosemide teaching?
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What data should the nurse review before administering Epoetin alfa?
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Why are both Ciprofloxacin and Phenazopyridine prescribed for a severe urinary tract infection?
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What statement indicates understanding of lithium toxicity teaching?
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Which statement indicates understanding of teaching regarding metoprolol?
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What finding indicates toxicity to Theophylline?
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Which statement indicates understanding of teaching regarding Spironolactone?
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Which instruction should the nurse include for a client prescribed warfarin?
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For which of the following adverse effects should the nurse assess the client who has been administered Lorazepam?
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How many mL should the nurse administer for Digoxin 0.2 mg if the available dose is 0.25 mg/1ml?
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Which statement indicates an understanding of teaching about oral cyclosporine for a kidney transplant client?
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How does Nifedipine help clients who are pregnant and experiencing preterm labor?
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For which finding should the nurse assess a client during administration of Adenosine?
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Which adverse effect should the nurse instruct the client to expect when administering Hydroxyzine?
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Which food is safe for a client taking Phenelzine?
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For which adverse effect should a client on Furosemide be taught to monitor?
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Which action should the nurse take when administering Diphenhydramine to a client with an incompatible IV medication?
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What should the nurse check first for a client who reports nausea and has taken Digoxin?
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Which laboratory values should be monitored for a client taking Isoniazid?
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What instruction should be included in the teaching plan for a client taking long-term Prednisone?
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Which medication should be administered first to a client experiencing alcohol withdrawal?
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After administering the wrong dose of Digoxin, which action should the nurse take first?
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What is a contraindication for administering Diltiazem to a client?
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What finding should the nurse expect in a client who has overdosed on heroin?
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How many mL should the nurse administer for Chlorothiazide if the toddler weighs 28.6 lb?
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What is the IV flow rate for 400 mL to be administered over 8 hours?
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Which instruction should be included for a client taking Oral Clonidine?
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How many gtt/min should the nurse set for administering 50 mL of Ampicillin over 15 minutes with a drop factor of 10 gtt/mL?
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Which finding indicates acute Levothyroxine overdose?
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What is the IV flow rate for administering 1 L of 0.9% sodium chloride over 2 hours?
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At what time should the nurse anticipate the onset of action for Insulin Glulisine administered at 0720?
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Which statement indicates understanding of teaching for a client prescribed Amitriptyline?
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What is the addition to the medication regimen for a client in hospice care managing pain with Naproxen and Gabapentin?
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What should the nurse include in the plan of care for a client taking Alosetron?
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Saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects?
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Aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects?
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Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching?
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Which of the following medications should the nurse plan to administer to a client who has peptic ulcer disease and reports a headache?
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The nurse should monitor the client for which of the following adverse effects when caring for a client with a prescription for clopidogrel?
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Which of the following medications should the nurse include as a contraindication to ceftriaxone?
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Which of the following conditions is a contraindication to metoclopramide according to the teaching?
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Which of the following medications should the nurse anticipate administering to a client experiencing involuntary movements and tremors induced by chlorpromazine?
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Which adverse effect should the nurse monitor for when administering subQ epinephrine for a client experiencing anaphylaxis?
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Which statement by the client indicates the need for further teaching regarding phenazopyridine and ciprofloxacin?
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Which adverse effect should the nurse monitor for an older adult client prescribed zolpidem at bedtime to promote sleep?
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The nurse should anticipate a prescription for which medication for a client with an increased thyroid-stimulating hormone (TSH) level and decreased T3 and T4 levels?
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Which instruction should the nurse include when teaching a client prescribed hydrochlorothiazide for hypertension?
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Which medication should the nurse plan to administer to a client experiencing preterm labor?
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What therapeutic effect should the nurse instruct the client regarding lactulose?
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Which diagnostic test should the nurse plan to perform before starting a client on amitriptyline to treat depression?
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The nurse should instruct the client taking allopurinol for gout to discontinue the medication for which of the following adverse effects?
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Which finding indicates that the client is experiencing an adverse effect of IV gentamicin?
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Which lab tests should the nurse instruct to monitor for a client on gemfibrozil?
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Ergotamine is administered to treat which condition?
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If a client receiving a continuous IV heparin infusion has an aPTT of 90 seconds, which action should the nurse prepare to take?
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What adverse effect should the nurse instruct the client on long-term prednisone therapy to monitor for?
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Tamoxifen has which therapeutic effect?
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The nurse should plan to monitor the client for which adverse effect when administering amphotericin B?
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Which action should the nurse take when administering subQ heparin to prevent DVT?
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An increase in which lab value indicates a therapeutic effect of filgrastim?
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Which adverse effect should the nurse instruct the client on sulfasalazine to monitor for?
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Which lab values should the nurse plan to monitor for a client on valproic acid?
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Candidiasis is a manifestation of which adverse effect after taking tetracycline for 7 days?
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What is the nurse monitoring for in a client on chlorothiazide for hypertension?
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Which action should the nurse prioritize when administering alendronate for an older adult client with Paget's disease?
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Which statement indicates understanding regarding rifampin and urine discoloration?
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The nurse should monitor which adverse effect when caring for a client prescribed enalapril?
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Which intervention should the nurse include in the discharge teaching plan for a 6-year-old client using MDIs?
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Which statement indicates understanding about administering intranasal calcitonin-salmon?
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Which finding should indicate to the nurse that a client is dehydrated after taking furosemide?
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How many mL/hr should the nurse set the IV pump to deliver heparin 900 units/hr?
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Identify the sequence of instructions to use if a client experiences chest pain associated with stable angina.
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Study Notes
Herbal and Vitamin Supplements
- Saw palmetto is commonly used for urinary health promotion and benign prostatic hypertrophy (BPH).
- Effectiveness of saw palmetto is not scientifically proven; advise clients to consult providers about medication interactions.
Pediatric Considerations
- Aspirin is contraindicated in children with viral infections due to the risk of Reye's syndrome, a serious condition that can lead to liver damage.
Anemia Treatment
- Epoetin alfa is prescribed to promote red blood cell (RBC) production in patients with chronic kidney failure.
Pain Management
- Acetaminophen is recommended for clients with peptic ulcer disease to manage headaches, as NSAIDs can exacerbate ulcers.
Monitoring Medications
- Clopidogrel necessitates monitoring for bleeding as a significant adverse effect.
- Severe allergy to piperacillin is a contraindication for ceftriaxone use.
Medication Contraindications
- Metoclopramide is contraindicated in patients with intestinal obstruction.
- Amantadine may be administered to manage extrapyramidal side effects from antipsychotic medications like chlorpromazine.
Anaphylaxis Management
- After administering subcutaneous epinephrine, monitor for tachycardia as a potential adverse effect.
Urinary Tract Infections
- Clients on phenazopyridine should be informed that urine turning orange is a normal effect, not a reason to notify their provider.
Geriatric Care
- Monitor older adults taking zolpidem for dizziness, a common side effect that can increase fall risk.
Thyroid Dysfunction
- Increased TSH with decreased T3 and T4 indicates hypothyroidism; levothyroxine is the expected medication.
Hypertension Treatment
- Hydrochlorothiazide should be taken in the morning, and patients should be advised to hydrate adequately.
Preterm Labor Management
- Nifedipine is indicated for the management of preterm labor, helping to relax uterine muscles.
Liver Health
- Lactulose is used to reduce ammonia levels in clients with liver disease.
Cardiac Monitoring
- An electrocardiogram is essential before starting amitriptyline due to potential adverse cardiovascular effects.
Gout Management
- Allopurinol requires discontinuation if fever develops, indicating a potential serious adverse effect.
Antibiotic Monitoring
- Proteinuria is a key indicator of gentamicin adverse effects.
Lipid Management
- Liver function tests are crucial when a client is prescribed gemfibrozil for managing hyperlipidemia.
Headache Management
- Ergotamine is specifically used to treat migraine headaches.
Coagulation Monitoring
- In clients on IV heparin, a prolonged aPTT requires a reduction in the infusion rate to prevent bleeding risks.
Corticosteroid Therapy
- Long-term prednisone use necessitates monitoring for stress fractures due to increased osteoporosis risk.
Cancer Treatment
- Tamoxifen functions as an antiestrogenic agent in breast cancer treatment.
Nephrotoxicity Awareness
- Amphotericin B treatment requires careful monitoring for nephrotoxicity.
Heparin Administration
- Subcutaneous heparin should be administered in the abdomen to reduce the risk of bleeding.
Neutrophil Count
- In patients on filgrastim, an increase in neutrophil count indicates therapeutic effectiveness.
Clinical Signs of Drug Reactions
- Jaundice in clients on sulfasalazine requires monitoring for drug-related adverse effects.
Seizure Management
- Monitor PTT, AST, and ALT in patients on valproic acid for effective seizure control.
Oral Candidiasis
- Occurrence following tetracycline indicates a superinfection, a common complication.
Thiazide Diuretics
- Muscle weakness in clients on chlorothiazide signals potential electrolyte imbalances.
Bisphosphonate Administration
- Prioritize ambulating the client before administering alendronate for best outcomes in treating Paget's disease.
Medication Discoloration
- Orange discoloration of urine from rifampin is normal and does not require medication discontinuation.
Blood Pressure Monitoring
- Enalapril can lead to hypotension; clients must be monitored accordingly.
Metered Dose Inhalers
- Using a spacer with MDIs improves medication delivery for pediatric asthma patients.
Cromolyn Sodium Usage
- Cromolyn sodium should not be used as a rescue medication; it’s preventive, indicating the need for further teaching if misused.
IV Morphine Administration
- Respiratory depression can occur as quickly as seven minutes post-administration; monitoring is critical.
Furosemide and Dehydration
- A urine specific gravity of 1.035 indicates dehydration, especially in clients taking furosemide inappropriately.
Cyclosporine Effects
- Increased blood pressure is a common side effect of cyclosporine therapy following organ transplant.
Preterm Labor Treatment
- Nifedipine acts as a calcium channel blocker to manage contractions during pregnancy.### Uterine Contractions and Medications
- Nifedipine is a calcium channel blocker that inhibits uterine contractions by blocking calcium entry into myometrial cells, decreasing the risk of bacterial vaginosis and associated uterine contractions.
Adenosine Administration
- During the IV administration of adenosine for paroxysmal atrial tachycardia, watch for dyspnea due to potential bronchoconstriction, though effects are transient due to the drug's short half-life (about 10 seconds).
Hydroxyzine Side Effects
- Common side effect of hydroxyzine, an antihistamine with anticholinergic properties, is dry mouth; clients should be advised to sip water or use hard candies for relief.
Phenelzine Dietary Precautions
- Fresh meats like broiled beef steak are safe to consume while on phenelzine, an MAOI, which requires avoidance of tyramine-rich foods to prevent hypertensive crises.
Monitoring Furosemide Effects
- Patients on furosemide should monitor for tinnitus as a sign of ototoxicity, as loop diuretics can cause this hearing issue.
Diphenhydramine Administration Protocol
- When administering diphenhydramine IV, confirm IV patency to prevent severe tissue damage from possible extravasation before bolus injection.
Digoxin Toxicity Assessment
- In clients on digoxin who exhibit nausea and poor appetite, the nurse's first action should be to check the client's apical pulse to assess for potential toxicity.
Isoniazid Monitoring
- Clients starting isoniazid must have liver enzymes, specifically aspartate aminotransferase (AST), closely monitored due to hepatotoxicity risk.
Long-term Prednisone Therapy
- Advise patients on long-term prednisone to use alternate-day dosing to minimize side effects like adrenal suppression.
Acute Alcohol Withdrawal Management
- Chlordiazepoxide, a long-acting benzodiazepine, is first-line treatment for acute alcohol withdrawal symptoms such as restlessness and tremors.
Digoxin Administration Error
- In the event of administering an incorrect dose of digoxin, the nurse's initial response should be to assess the client’s apical pulse for any abnormalities.
Diltiazem Contraindications
- Hypotension is a contraindication for diltiazem use, as it may exacerbate low blood pressure in patients with existing hypotension.
Opioid Toxicity Indicators
- Pinpoint pupils are a classic sign of opioid toxicity such as in a heroin overdose, contrasting with increased pupil size during withdrawal.
Chlorothiazide Dosage Calculation
- For a toddler weighing 28.6 lbs, the prescribed dosage of Chlorothiazide is calculated to be 2.6 mL per dose, based on the available concentration.
IV Fluid Administration Rate
- A nurse administering IV fluids at 400 mL over 8 hours should set the pump to deliver 50 mL/hr.
Clonidine Precautions
- Teach clients on clonidine to avoid driving until they know how the medication affects them, due to potential drowsiness and sedation.
Ampicillin Infusion Parameters
- A dosage of 500 mg of ampicillin should be infused over 15 minutes using a drop factor of 10 gtt/mL, resulting in a rate of 33 gtt/min.
Levothyroxine Overdose Symptoms
- Symptoms of acute levothyroxine overdose include tremors and anxiety, as they resemble hyperthyroid manifestations.
IV Sodium Chloride Administration
- When administering 1 L of 0.9% sodium chloride IV over 2 hours, set the pump to deliver at a rate of 500 mL/hr.
Insulin Glulisine Action Timing
- Expect the onset of action for insulin glulisine around 15 minutes after administration, urging clients to eat breakfast quickly.
Amitriptyline Safety Measures
- Clients on amitriptyline should be instructed about the risk of orthostatic hypotension and to take precautions to prevent falls.
Pain Management in Hospice Care
- For clients on naproxen and gabapentin who need additional pain relief, oral oxycodone is the next appropriate addition per WHO pain management guidelines.
Metformin Adverse Effects
- Myalgia is a significant sign to monitor for in patients taking metformin, indicating a rare but serious condition known as lactic acidosis.
Oxytocin Administration for Ineffective Labor
- Increase the dose of oxytocin to ensure uterine contractions occur every 2 to 3 minutes for effective labor induction.
Alosetron Risk Management
- Clients prescribed alosetron for severe IBS must sign a patient-provider agreement due to the associated risk of severe gastrointestinal complications.
Albuterol for Asthma Attacks
- Albuterol is the recommended rescue inhaler during acute asthma attacks due to its fast-acting beta2-agonist properties.
Verapamil Uses and Queries
- Verapamil effectively treats both hypertension and angina; thus, concerns about its appropriateness should be discussed with the provider for clarification.
Omeprazole Administration Guidance
- Omeprazole should be taken once daily before breakfast to maximize its effectiveness in treating ulcers or gastric reflux.
Codeine Dosage Calculation
- For administering codeine, 30 mg requires 10 mL of the oral solution, based on the available concentration.
Monitoring for Methotrexate Side Effects
- A platelet count under 100,000/mm3, such as 78,000, is critically low and necessitates immediate reporting when on methotrexate therapy.### Iron Dextran Administration
- Administer a small test dose before the full dose over 5 minutes to monitor for hypersensitivity reactions.
- Anaphylaxis is a serious risk associated with iron dextran infusion.
Digoxin and Furosemide Teaching
- Maintain potassium levels (3.5 to 5.0 mg/dL) to prevent digoxin toxicity, as hypokalemia can occur with diuretic therapy.
- Consuming fruits and vegetables high in potassium is essential for clients taking digoxin and furosemide.
Epoetin Alfa Administration
- Monitor blood pressure prior to administering epoetin alfa; it can cause hypertension, increasing stroke risk.
- Notify healthcare providers about any significant increases in blood pressure.
Ciprofloxacin and Phenazopyridine Indication
- Ciprofloxacin treats the bacterial infection, while phenazopyridine alleviates bladder pain and discomfort.
Lithium Toxicity Awareness
- Electrolyte imbalances from vomiting or diarrhea increase the risk of lithium retention and toxicity.
- Clients need to avoid sodium fluctuations to maintain lithium balance.
Metoprolol and Diabetes Management
- Metoprolol can mask signs of hypoglycemia; clients should learn alternative symptoms like hunger and nausea.
- Awareness of potential blood sugar level changes is crucial for clients with diabetes.
Theophylline Toxicity Signs
- Tremors are an early indicator of Theophylline toxicity, which may progress to seizures with increased levels.
Spironolactone and Side Effects
- Gynecomastia and menstrual irregularities can occur with spironolactone due to its steroid-like properties.
- Monitoring for breast tissue growth is essential for clients on this medication.
Warfarin Safety Precautions
- Clients on warfarin should carry a medic alert ID to inform emergency staff of their increased bleeding risk.
- Regular laboratory tests are needed to monitor clotting levels; aPTT is not the appropriate test for warfarin.
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