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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?

  • Fluticasone
  • Albuterol (correct)
  • Salmeterol
  • Cromolyn
  • What should the nurse say in response to a client concerned about a prescription for verapamil?

  • Verapamil is used to treat both high blood pressure and angina. (correct)
  • Your provider has prescribed verapamil so that you will not develop high blood pressure.
  • Are you concerned that you might have high blood pressure?
  • You should talk to your provider to make sure the prescription is correct for you.
  • Which statement should the nurse include in teaching about Omeprazole for a client with a bleeding duodenal ulcer?

    <p>You should take this medication before breakfast every day.</p> Signup and view all the answers

    The nurse should administer _____ mL of codeine for pain.

    <p>10</p> Signup and view all the answers

    Which laboratory value should the nurse report for a client receiving methotrexate?

    <p>Platelets 78,000/mm3</p> Signup and view all the answers

    The nurse should administer _____ mL of ampicillin per dose.

    <p>7.5</p> Signup and view all the answers

    What action should the nurse take when administering iron dextran IV?

    <p>Administer a small test dose before giving the full dose.</p> Signup and view all the answers

    Which statement indicates understanding of Digoxin and Furosemide teaching?

    <p>I will eat fruits and veggies that have high potassium content every day.</p> Signup and view all the answers

    What data should the nurse review before administering Epoetin alfa?

    <p>Blood pressure</p> Signup and view all the answers

    Why are both Ciprofloxacin and Phenazopyridine prescribed for a severe urinary tract infection?

    <p>Ciprofloxacin treats the infection, and Phenazopyridine treats pain.</p> Signup and view all the answers

    What statement indicates understanding of lithium toxicity teaching?

    <p>I can develop lithium toxicity if I experience vomiting or diarrhea.</p> Signup and view all the answers

    Which statement indicates understanding of teaching regarding metoprolol?

    <p>I might have difficulty recognizing when my blood sugar is low.</p> Signup and view all the answers

    What finding indicates toxicity to Theophylline?

    <p>Tremors</p> Signup and view all the answers

    Which statement indicates understanding of teaching regarding Spironolactone?

    <p>I will watch for increased breast tissue growth while taking this medication.</p> Signup and view all the answers

    Which instruction should the nurse include for a client prescribed warfarin?

    <p>Carry a medic alert ID card.</p> Signup and view all the answers

    For which of the following adverse effects should the nurse assess the client who has been administered Lorazepam?

    <p>Sedation</p> Signup and view all the answers

    How many mL should the nurse administer for Digoxin 0.2 mg if the available dose is 0.25 mg/1ml?

    <p>0.8 mL</p> Signup and view all the answers

    Which statement indicates an understanding of teaching about oral cyclosporine for a kidney transplant client?

    <p>I am likely to develop higher blood pressure while taking this medication</p> Signup and view all the answers

    How does Nifedipine help clients who are pregnant and experiencing preterm labor?

    <p>It inhibits uterine contractions by blocking the entry of calcium into uterine cells</p> Signup and view all the answers

    For which finding should the nurse assess a client during administration of Adenosine?

    <p>Dyspnea</p> Signup and view all the answers

    Which adverse effect should the nurse instruct the client to expect when administering Hydroxyzine?

    <p>Dry mouth</p> Signup and view all the answers

    Which food is safe for a client taking Phenelzine?

    <p>Broiled beef steak</p> Signup and view all the answers

    For which adverse effect should a client on Furosemide be taught to monitor?

    <p>Tinnitus</p> Signup and view all the answers

    Which action should the nurse take when administering Diphenhydramine to a client with an incompatible IV medication?

    <p>Aspirate to check IV patency before administering</p> Signup and view all the answers

    What should the nurse check first for a client who reports nausea and has taken Digoxin?

    <p>Check the client's apical pulse</p> Signup and view all the answers

    Which laboratory values should be monitored for a client taking Isoniazid?

    <p>Aspartate aminotransferase</p> Signup and view all the answers

    What instruction should be included in the teaching plan for a client taking long-term Prednisone?

    <p>Schedule the medication on alternate days to decrease adverse effects</p> Signup and view all the answers

    Which medication should be administered first to a client experiencing alcohol withdrawal?

    <p>Chlordiazepoxide</p> Signup and view all the answers

    After administering the wrong dose of Digoxin, which action should the nurse take first?

    <p>Assess the client's apical pulse</p> Signup and view all the answers

    What is a contraindication for administering Diltiazem to a client?

    <p>Hypotension</p> Signup and view all the answers

    What finding should the nurse expect in a client who has overdosed on heroin?

    <p>Pinpoint pupils</p> Signup and view all the answers

    How many mL should the nurse administer for Chlorothiazide if the toddler weighs 28.6 lb?

    <p>2.6 mL</p> Signup and view all the answers

    What is the IV flow rate for 400 mL to be administered over 8 hours?

    <p>50 mL/hr</p> Signup and view all the answers

    Which instruction should be included for a client taking Oral Clonidine?

    <p>Avoid driving until the client's reaction to the medication is known</p> Signup and view all the answers

    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?

    <p>33 gtt/min</p> Signup and view all the answers

    Which finding indicates acute Levothyroxine overdose?

    <p>Tremor</p> Signup and view all the answers

    What is the IV flow rate for administering 1 L of 0.9% sodium chloride over 2 hours?

    <p>500 mL/hr</p> Signup and view all the answers

    At what time should the nurse anticipate the onset of action for Insulin Glulisine administered at 0720?

    <p>0745</p> Signup and view all the answers

    Which statement indicates understanding of teaching for a client prescribed Amitriptyline?

    <p>I will move slowly when I stand up because amitriptyline can decrease my blood pressure</p> Signup and view all the answers

    What is the addition to the medication regimen for a client in hospice care managing pain with Naproxen and Gabapentin?

    <p>Oral oxycodone</p> Signup and view all the answers

    What should the nurse include in the plan of care for a client taking Alosetron?

    <p>The client must sign an agreement with the provider before beginning alosetron</p> Signup and view all the answers

    Saw palmetto is a supplement used by clients to elicit which of the following therapeutic effects?

    <p>Urinary health promotion</p> Signup and view all the answers

    Aspirin is contraindicated for children who have a viral infection due to the risk of developing which of the following adverse effects?

    <p>Reye's syndrome</p> Signup and view all the answers

    Which of the following therapeutic effects of epoetin alfa should the nurse include in the teaching?

    <p>Promotes RBC production</p> Signup and view all the answers

    Which of the following medications should the nurse plan to administer to a client who has peptic ulcer disease and reports a headache?

    <p>Acetaminophen (analgesics)</p> Signup and view all the answers

    The nurse should monitor the client for which of the following adverse effects when caring for a client with a prescription for clopidogrel?

    <p>Bleeding</p> Signup and view all the answers

    Which of the following medications should the nurse include as a contraindication to ceftriaxone?

    <p>Piperacillin</p> Signup and view all the answers

    Which of the following conditions is a contraindication to metoclopramide according to the teaching?

    <p>Intestinal obstruction</p> Signup and view all the answers

    Which of the following medications should the nurse anticipate administering to a client experiencing involuntary movements and tremors induced by chlorpromazine?

    <p>Amantadine</p> Signup and view all the answers

    Which adverse effect should the nurse monitor for when administering subQ epinephrine for a client experiencing anaphylaxis?

    <p>Tachycardia</p> Signup and view all the answers

    Which statement by the client indicates the need for further teaching regarding phenazopyridine and ciprofloxacin?

    <p>I should notify my provider immediately if my urine turns an orange color.</p> Signup and view all the answers

    Which adverse effect should the nurse monitor for an older adult client prescribed zolpidem at bedtime to promote sleep?

    <p>Dizziness</p> Signup and view all the answers

    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?

    <p>Levothyroxine</p> Signup and view all the answers

    Which instruction should the nurse include when teaching a client prescribed hydrochlorothiazide for hypertension?

    <p>Take the hydrochlorothiazide in the morning</p> Signup and view all the answers

    Which medication should the nurse plan to administer to a client experiencing preterm labor?

    <p>Nifedipine</p> Signup and view all the answers

    What therapeutic effect should the nurse instruct the client regarding lactulose?

    <p>Reduces ammonia levels</p> Signup and view all the answers

    Which diagnostic test should the nurse plan to perform before starting a client on amitriptyline to treat depression?

    <p>Electrocardiogram</p> Signup and view all the answers

    The nurse should instruct the client taking allopurinol for gout to discontinue the medication for which of the following adverse effects?

    <p>Fever</p> Signup and view all the answers

    Which finding indicates that the client is experiencing an adverse effect of IV gentamicin?

    <p>Proteinuria</p> Signup and view all the answers

    Which lab tests should the nurse instruct to monitor for a client on gemfibrozil?

    <p>Liver function</p> Signup and view all the answers

    Ergotamine is administered to treat which condition?

    <p>Migraine headaches</p> Signup and view all the answers

    If a client receiving a continuous IV heparin infusion has an aPTT of 90 seconds, which action should the nurse prepare to take?

    <p>Reduce the infusion rate</p> Signup and view all the answers

    What adverse effect should the nurse instruct the client on long-term prednisone therapy to monitor for?

    <p>Stress fractures</p> Signup and view all the answers

    Tamoxifen has which therapeutic effect?

    <p>Antiestrogenic</p> Signup and view all the answers

    The nurse should plan to monitor the client for which adverse effect when administering amphotericin B?

    <p>Nephrotoxicity</p> Signup and view all the answers

    Which action should the nurse take when administering subQ heparin to prevent DVT?

    <p>Administer the medication into the client's abdomen</p> Signup and view all the answers

    An increase in which lab value indicates a therapeutic effect of filgrastim?

    <p>Neutrophil count</p> Signup and view all the answers

    Which adverse effect should the nurse instruct the client on sulfasalazine to monitor for?

    <p>Jaundice</p> Signup and view all the answers

    Which lab values should the nurse plan to monitor for a client on valproic acid?

    <p>Alanine aminotransferase (ALT)</p> Signup and view all the answers

    Candidiasis is a manifestation of which adverse effect after taking tetracycline for 7 days?

    <p>Superinfection</p> Signup and view all the answers

    What is the nurse monitoring for in a client on chlorothiazide for hypertension?

    <p>Muscle weakness</p> Signup and view all the answers

    Which action should the nurse prioritize when administering alendronate for an older adult client with Paget's disease?

    <p>Ambulate the client to a chair prior to administering the medication.</p> Signup and view all the answers

    Which statement indicates understanding regarding rifampin and urine discoloration?

    <p>Rifampin can turn body fluids orange.</p> Signup and view all the answers

    The nurse should monitor which adverse effect when caring for a client prescribed enalapril?

    <p>Hypotension</p> Signup and view all the answers

    Which intervention should the nurse include in the discharge teaching plan for a 6-year-old client using MDIs?

    <p>Add a spacer to each MDI.</p> Signup and view all the answers

    Which statement indicates understanding about administering intranasal calcitonin-salmon?

    <p>I will need to depress the side arms to activate the pump.</p> Signup and view all the answers

    Which finding should indicate to the nurse that a client is dehydrated after taking furosemide?

    <p>Urine specific gravity 1.035</p> Signup and view all the answers

    How many mL/hr should the nurse set the IV pump to deliver heparin 900 units/hr?

    <p>18 mL/hr</p> Signup and view all the answers

    Identify the sequence of instructions to use if a client experiences chest pain associated with stable angina.

    <p>Stop activity = First action is to cease all exertion. Place a tablet under the tongue = Administer a sublingual nitroglycerin tablet. Wait for 5 min = Monitor symptoms after initial medication. Call 911 if the pain is not relieved = Seek emergency help if no relief.</p> Signup and view all the answers

    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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