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175 Cards in this Set

  • Front
  • Back

a health care professional obtaining a patient's health history discovers that the patient takes loratadine (Claritin), an over the counter drug. What information about OTC drugs is true?

- they do not require supervison of a healthcare professional


-they can interact with other drugs


-they should be included in the drug hx



A health care professional is talking about drugs that have a small margin of safety to a patient who is taking phenytoin (Dilantin). the health care professional should include which information?

-periodic laboratory tests are essential to measure serum drug levels


-monitoring for indications of toxicity is important


-taking the smallest effective drug dose is crucial



A health care professional is obtaining a patient's health history. The pt stats that he has no allergies but developed some mild itching while taking amoxicillin (Amoxil). What information should the health care professional explain to the pt?

Itching can indicate a hypersensitivity to amoxicillin

A health care professional administers 2 units of regular insulin (Humulin R) to a pt by subQ injection at 0700. the package insert included w/ R insulin bottle states that the onset of action is 30 - 60 min, the peak effect is 1 to 5 hr, and the duration of action is 6 - 10 hr. the health care professional should advise the pt to expect the lowest blood glucose level at what time?

0900

A health care professional is caring for a pt who is hospitalized w/ chest pain. Pt instructions and discharge planning should begin when?

as soon as possible

A health care professional is preparing to explain how to take care of a newly created colostomy to a pt. The health care professional should recognize that what can decrease the pt's ability to learn?

-cognitive level


-language


-comfort level


-readiness to learn

A health care professional is caring for a pt who is taking acetaminophen (Tylenol), a nonopiod analgesic, and codeine, an opiod agonist, for pain relief. These drugs interact together causing an additive effect. What are the characteristics of additive drug interactions?

-pt can achieve desired effects with lower dosages


-both drugs have similar actions

What information should health care professionals consider when calculating drug dosages for infants and children compared w/ adults?

older children (1 to 12) have a higher reate of metabolism than adults and can metabolize certain drugs faster.



An older adult pt who has hypertension is prescribed enalapril (Vasotec), a drug that is eliminated by the kidneys. Before the pt begins the drug, the health care professional should assess which blood value?

Creatinine clearance. Used to check liver and kidney function.

pregnancy category D are drugs that....

-require the use of contraception by women of childbearing age to avoid becoming pregnant on the medication


- can cause fetal malformation


- can pass through the umbilical cord or the placenta to the fetus


- require weighing potential benefits against possible risks

A health care professional is caring for a pt who is having cardiac dysrhythmias ans is taking digoxin (Lanoxin). The health care professional should recognize that what route of admin. has the fastest rate of absorption?

IV

A health care professional is caring for a pt who is reciving nitroglycerin (Nitrostat) IV and is changing to the oral form of the drug. The health care professional should recognize that the oral dose will be high than the IV dose because...

of the first - pass effect by the liver, which reduces the bio-availability of the drug. Enzymes in the liver metabolize drugs, making less of he drug available for use by the body

A pt is having difficulty remembering to take a prescribed drug three times a day. What form of the drug should the health care professional recommend to increase adherence?

Extended - release tablet

A health care professional is talking w/ a F pt who is taking captopril (Capoten), and ACE inhibitor, for hyper tension. the health care professional informs the pt that captopril is a teratogenic drug. Teratogenic drugs can cause what?

Fatal malformation

You are caring for a pt who arrived at an urgent care center following a bee sting. What findings would indicate an anaphylactic reaction?

-Low blood pressure


- wheezing


- swallowing difficulty

Infants are at risk for drug toxicity due to...

- Decreased liver enzymes due to an immature liver. this affects the metabolize of drugs.


- Reduced kidney perfusion resulting in reduced excretion of certain drugs.


- Reduced liver perfusion

A pt who is postpartum and is breastfeeding asks you about what effects taking OTC drugs will have on her newborn. What should you consider when recommending a drug for the pt?

- the newborns weight. the lower the wight the greater the effects of the drug


- How much breast mil the newborn consumes each day. ( more likely the drug will be absorbed by the baby)


- whether or not the benefits to the mother outweigh the risks of the newborn.


- the properties of the drug (some drugs can transfer more easily into breast milk)

A pt who reports chronic pain states that his fentanyl (Duragesic) topical patch is no longer effective for pain relief. You should suspect that what caused this?

Tolerance to the drug

When talking to a pt about taking vancomycin (Vancocin), you explain the need to check periodic blood levels of the drug to monitor serum peak and trough. Peak and trough drug levels help monitor for what?

- Minimum effective dose


- Drug toxicity


-constant therapeutic level

What are adverse reactions to digoxin (Lanoxin)?

- cardiac dysrhythmias

when talking to a pt about taking naproxed (EC - naprosyn), enteric - coated tablets, what should you include..

Do not crush or chew the tablet

you are talking to a pt about giving the correct dose of acetaminophen (Tylenol) to the pt's infant. you explain that infants can absorb certain drugs at different rates than adults. what physiologic characteristic of infants can alter drug absorption?

Delayed gastric emptying. infants have less gastric acidity. reduced gastric acidity can alter the absorption of certain drugs.

You are caring for a pt who has a hx of renal insuffciency and is taking lithium carbonate (Lithobid). You should monitor for what?

Drug toxicity



You are preparing to administer a parenteral drug to a pt. How will you give this drug?

via injection

You are speaking to a pt who is taking carbamazepine (Tegretol) and who reports drinking grapefruit juice. You explain that grapefruit juice inhibits an enzyme in the liver that is used to metabolized certain drugs such as carbamazepine. What is the pt at risk for?

Drug toxicity

You are caring for a pt who is about to begin iron dextran (INFeD) therapy. When administering the drug IM, you should take what actions?

- Administer a test dose; iron dextran can cause hypersensitivity reaction so a test dose should be administered 1 hr before real dose




- Monitor BP; Iron dextran can cause hyoptension




- Have epinephrine available; epinephrine can help with hypersensitive reactions




- use the z - track technique

You are caring for a pt who is about to begin taking clopidogrel (Plavix) to prevent thrombus formation. You should question the use of clopidogrel by a pt who has what?

Peptic ulcer disease. Clopidogrel is a blood thinner and can cause gastric bleeding.

You are caring for a pt who is about to being taking clopidogrel (Plavix) to prevent stent stenosis. You should monitor the pt for what adverse reactions?

Thrombocytopenia.




Clpidorgel is an antiplatelet drug.




You should look for decreased platelet count, bruising, bleeding gums, and petechiae

Youare caring for a pt who is about to begin taking alteplase (Activase) to treat acute myocardial infraction. You should understand the drug is most effective when the pt receives it....

within 3 hr of symptom onset

You should assess a pt who has megalobalastic anemia for indications of what vitamin deficiencies?

Vitamin B12

You are caring for a pt who is about to begin taking oprelvekin (Neumega) to treat thrombocytopenia. You should tell the pt to report what indications of adverse reaction?

- Conjunctivitits (thrombopoietic growth factor can cause conjunctivitis, blurred vision, and papilledema. Report eye rednees or blurred vision)




- Swollen ankles ( can cause fluid retention. need to monitor I&O's and report edema or difficulty breathing)




- Jaundice




- palpitations ( can cause cardiac dysrhythmias. report palpitations or dizziness)

You are caring for a pt who is about to begin taking filgrastim (Neupogen) to treat neutropenia. you should assess the pt for what adverse reactions?

Enlarged spleen; report abdominal pain or fullness

You are caring for a pt who has mild hemophilia A and is about to begin taking desmopressin (DDAVP) to prevent bleeding. YOu should monitor for what adverse reactions?

Edema; desmopressin (antidiuretic) can cause fluid retention and edema

You are caring for a pt who is about to begin taking folic acid to treat megaloblastic anemia. You should monitor what laboratory values?

Reticulocyte count

You are caring for a pt who is about to begin factor VIII (Advate) therapy to treat hemophilia A. When administering factor VIII, what actions should you take?

Have emergency equipment ready.


factor VIII can cause anaphylaxis; monitor for hives, fever, wheezing, and difficulty breathing.

You are caring for a pt who is about to begin alteplase (Activase) therapy to treat pulmonary embolism. What drugs should you have available in the event of a severe adverse reaction?

Aminocaproic acid (Amicar) (coagulator) inhibits fibrinolysis ans stops fibrinolytiv bleeding

a pt is about to begin therapy with recombinant factor IX (BeneFix) to treat hemophilia B. The pt asks you about the risk of disease transmission with recombinant factor IX , as compared with plasma - derived factor IX. You should explain that recombinant factor IX eliminates the risk for what?

Creutzfeldt - Jakob disease

You are caring for a pt who has a known sensitivity to Escherichia coli- derived proteins. This sensitivity is a contraindication for what drug?

filgrastim (Neupogen)

You are caring for a pt who is about to begin taking aspirin (Ecotrin) to reduce the risk of a cardiovascular event/ You should understand that the drug inhibits platelet aggregation by what mechanism?

Inhibiting cyclooxygenase action in platelets

You are preparing to administer the prescribed dose of filgrastim (Neupogen) to a pt. The pt's laboratory results indicate that the pt has a WBC count of 12,000/mm. What actions should you take?

Clarify the prescription with the provider.




Leukocytosis can occur with filgrastim therapy. CBC nees to be monitored twice a week and the dosage needs to be reduced or stopped if the WBC is about 10,000/mm.

You are caring for a pt who is about to begin taking oprelvekin (Neumega). You should explain to the pt that the drug has what effect?

Increases platelet production.




Oprelvekin (Neumega) (thrombopoietic growth factor) used to treast thrombocytopenia that is associated with myelosuppression.

You are caring for a pt who is about to begin taking ferrous sulfate (Feosol) to treat iron- deficiency anemia. When taking with the pt about the drug, you should include what instructions?

- Eat iron enriched food




- spread the dosage across each day (maximizes the production of RBC's)




- Take the drug on an empty stomach (food reduces the absorption of ferrous sulfate)




- Expect dark green or black stools




- Increase dietary fiber intake (counteracts constipation caused by the ferrous sulfate)

A pt who is taking warfarin (Coumadin) arrives at the emergency department and reports rectal bleeding. what drug shuld teh health care profeesional have available?

Vitamin K. It reverses the effects of warfarin by promoting the synthesis of coagulation factors VI, IX, X and prothrombin.

A pt who is taking ferrous sulfate (Feosol) to treat iron deficiency anemia develops severe nausea and vomiting due to iron toxicity. What drug should the health care professional use to treat this complication?

Deferoxamine (Desferal).




nausea, vomiting, and diarrhea are indications of iron toxicity, deferoxamine binds to the iron to reduce toxicity.

You are administering epoetin alfa (Epogen) subcutaneously to a pt who has renal failure. You shoud take what actions?

Insert the needle into the vial once.





YOu are caring fora pt who is about to begin alteplase (Activase) therapy. You should monitor the pt for which of the following incications of possible adverse effect?

Headache.




alteplase (throbolytic drug) can cause intracranial bleeding. Monitor pts receiving the drg for changes in level of consciousness, headache, and one - sided weakness

You are caring for a pt who is about to begin taking warfarin (Coumadin). You should caution the pt about taking what OTC drugs?

Ibuprofen (Motrin)




NSAIDs can increase the risk of bleeding for pts taking warfarin (anticoagulent)

You are caring for a pt who is about to begin taking epoetin alfa (Epogen). What laboratory values should increase with effective therapy?

Hgb




epoetin alfa (erythropietic growth factor) increases the production of RBCs for pts with anemia and renal failure. Hgb and Hct shoud increase with effective therapy.

You administer epoetin alfa (Epogen) subcutaneoulsly to a pt who has renal failure. You should monitor the pt for which of the following adverse effects?

Hypertension.





You are caring for a pt who is undergoing bone marrow transplantation following high - dose chemotherapy. which of the following drugs should you expect the primary care provider to prescribe to reduce the pt's risk of infection?

Filgrastim (neupogen)




stimulates production of neutrophils in the bone marrow

A pt who takes low-dose aspirin to prevent cardiovascular events asks you about taking ibuprofen (advil) to treat rheumatoid arthritics. You should respond with what statement?

Ibuprofen will reduce the antiplatelet effects of low - dose aspirin.

You should advise pts to take acetaminophen (Tylenol) for what?

- to reduce fever




- to relieve mild pain




*does not relieve inflammation*

You are caring for a pt who has osteoarthritis and is about to begin taking aspirin. You should tell the pt to report what possible indications of salicylism?

- Tinnitus




- Diaphoresis




- thrombophlebitis




- dizziness

You should question the use of acetaminophen (Tylenol) for pt's who have what?

Alcohol use disorder




acetaminophen can cause liver toxicity. pts who have a history of alcohol use disorder should not take the drug.

What drug can increase the risk of Reye's syndrome in children who have viral infections?

Asprin

You are caring for a pt who is taking naloxone to treat a morphine overdose. You should monitor for what adverse effects?

- Tachypnea




- increased pain




- tachycardia




- hypertension





You should advise a pt who has which of the following to stop taking ibuprofen (Advil) to treat an occasional headache or muscle strain?

Peptic ulcer disease





You are caring for a pt who is opioid-dependent and is about to begin taking butorphanoll (Stadol). You should recognize the pt is at risk for developing a syndrome that causes what?

- vomiting, nausea, and anorexia


- abdominal cramps


-hypertension


-tremors


-fever

You are caring for a pt who takes furosemide (Lasix) and is about to begin taking prednisone to treat inflammatory bowel disease. You should monitor the pt for what results of concurrent use of the two drugs?

Hypokalemia




Furosemide (diuretic)

You should understand that naloxone can reverse the effects of excessive dosage of what drug?

Morphine, methadone, levorphanol, remifentanil, and heroin (opioids)

You are caring for an older adult pt who is about to begin taking prednisone for long-term treatment of rheumatoid arthritis. You should monitor the pt for what adverse effects?

bone loss (osteoporosis)

You are caring for a pt who is recieving morphine to relieve severe pain. You should monitor the pt for what adverse effects?

-Urinary retention


-Respiratory depression


-Sedation


-Orthostatic hypotension

You should question the use of tramadol (Ultram) for pts who have what?

seizure disorder as tramadol can cause seizure activity

You are caring for an older adult pt who is about to begin taking aspirin to treat an ankle sprain. You should tell the pt to report what adverse reaction?

Weight Gain.




Aspirin can cause renal dysfunction

A pt recovering from a total knee arthroplasty has been prescribed acetaminophen (Tylenol) for mild discomfort that does not require an opioid. You should tell the pt to report what early indications of acetaminophen overdose?

-Diaphoresis


-nausea


-Vomiting


-Confusion


-Diarrhea


-liver tenderness


-Hypotension


-cardiac arrhythmias


-Jaundice

You should question the use of celecoxib (Celebrex) for a pt who has which of the following?

An allergy to sulfonamides.

You are caring for a pt who is about to begin taking celecoxib (Celebrex) to treat rheumatoid arthritis. You should tell the pt to report what adverse reactions?

Chest pain, shortness of breath, headache, numbness, weakness, or confusion.

You should question the use of morphine for a pt who is taking what drug?

Phenobarbital (Luminal) for a seizure disorder.




together they can cause increased CNS depression

You are caring for a pt who is about to begin taking allopurinol (Zyloprim) to prevent hyperuricemia. You should advise the pt to report what adverse effects?

-sore throat


-fever


-vertigo


-Drowsiness


-Bruising


-bleeding


-vision changes (cloudiness or halos around lights)

You are caring for a pt who is about to begin taking allopurinol (Zyloprim) to treat gout. You should monitor the pt for hypersensitivity syndrome, which causes what clinical manifestations?

Fever, rash, and itching

You are caring for a pt who is about to begin taking butorphanol for pain control. You should monitor the pt for what adverse reactions?

-Nausea


-Dizziness


-Drowsiness


-Headache

You are caring for a pt who is about to begin taking tramadol (Ultram) to treat moderate acute pain from a shoulder injury. When talking with the pt about the drug, you should inculde what instructions?

-Increase Fiber and fluid intake


-Take the drug with food


Avoid driving after taking the drug


-change positions gradually


-Increase exercise as tolerated

You are caring for a pt who is about to begin taking prednisone to treat systemic lupus erythematosus. when talking with the pt about the drug, you should include what instructions?

-Discontinue the drug gradually


-report illness or infection


-increase intake of calcium and vitamin D


Monitor for signs of gastric bleeding

You should question the use of morphine for a pt who is recovering from what procedure?

Cholecystectomy




Morphine can cause biliary colic and is inappropriate for pts who have had biliary tract surgery

You are preparing to administer butorphanol (Stadol) to a pt for pain control. During administration, you should take what action?

withhold the drug for respiratory rates below 12/min.

You are caring for a pt who is aobut to begin taking isoniazid (INH) to treat tuberculosis. You should tell the pt to report what adverse effects?

-Jaundice


-abdominal pain


-fatigue


-numbness, pain, or tingling in hands or feet


-Visual disturbances


-suprainfection and dry mouth

You are caring for a pt who is taking ciprofloxacin (Cipro) to treat a urinary tract infection and has rheumatoid arthritis, for which he takes prednisolone (Prelone). Recognizing the adverse effects of ciprofloxacin, you should tell the patient to report what?

Tendon pain



You are caring for a pt who takes an oral contraceptive and is about to begin rifampin (Rifadin) therapy to treat tuberculosis. You should include what instructions?

Use additional contraception




rifadin increases metabolism and decreases contraceptives

A primary care provider should prescribe a lower dose of aztreonam (Azactam) for a pt who has a respiratory tract infection and also has what?

Renal Impairment





You are caring for a pt who is about to begin taking cephalexin (Keflex) to treat bacterial meningitis. You should explain to the pt the need to monitor what laboratory tests?

Creatinine




cephalexin (first generation cephalosporin) is excreted by the kidneys. Renal function should before and during treatment.

A primary care provider is prescribing drug therapy for a pt whose sputum culture results indicate methicillin-resistant Staphylococcus aureus (MRSA). what drug should be administered?

Vancomcin (Vancocin)

You are caring for a pt who is about to begin taking nitrofurantoin (Macrodantin) to treat a UTI. You should tell the pt to report what adverse effects of the drug?

Cough, shortness of breath, chest pain, and fever

You are caring for a pt who is about to begin gentamicin therapy to treat an infection. You should monitor the pt for what?

Urine output, BUN, and creatinine levels

a pt who is taking amoxicillin (Amoxil) to treat a respiratory infection contracts you to report a rash and wheezing. What instructions should you provide?

Call emergency services immediately

you are caring for a pt who is about to begin using nystatin (Mycostatin) to treat oral Candida albicans that resulted from tetracycline therapy. what instructions should you include about using the antifungal preparation?

Swish the suspension in the mouth before swallowing it.

You are caring for a pt who is about to begin taking ketoconazole to treat a fungal infection. You should tell the pt to report what adverse effect of the drug?

Gynecomastia (reduced libido)

a pt who is taking ciprofloxacin (Cipro) to treat a tespiratoru tract infection contacts the health care professional to report dyspepsia. You should recommend what instructions?

take an antacid at least 2 hr after taking the drug

a pt who is taking tetracycline orally to treat a chlamydia infection contacts you to report severe blood-tinged diarrhea. recognizing the adverse effects of tetracycline, you should suspect what?

pseudomembranous enterocolitis




treatment includes stopping the drug and replacing fluids and elecrolytes

what drug should a provider prescribe for a pt who has streptococcal pharyngitis and is allergic to penicillin?

Erythromycin

a pt who is taking imipenem (Primaxin) to treat a bacterial infection contats you to report an inability to eat becaus of mouth pain. Recognizing the adverse effects of imipenem, you should suspect what?

Suprainfection

When administering erythromycin to a pt who has pneumococcal pneumonia, you should monitor for what adverse effects of the drug?

Cardiac dysrhythmias

you are caring for a pt who is about to begin taking acyclovir (Zovirax) to treat a herpes simplex infection. you should monitor what lab values for the pt?

BUN

You are preparing to administer amphotericin B IV to a pt who has a systemic fungal infection. What drug should you administer prior to the infusion to prevent or minimize adverse reactions during amphotericin B administration

-Acetaminophen




-Diphenhydramine



you are caring for a pt who is about to begin taking metronidazole (Flagyl) to treat an anaerobic intra-abdominal bacterial infection. You should recognize that cautious use of the drug is indicated if the pt has what?

Seizure disorder

you are caring for a pt who is about to receive gentamicin to treat a systemic infection. you should question the use of the drug for a pt who is also taking what?

Furosemide (Lasix)




taking both drugs increases the pt's risk for hearing loss

you are caring for a pt who is taking warfarin (Coumadin) and is about to begin taking trimethoprim/sulfamethoxazole (Bactrim) to treat a UTI. You should question the drug regimen because taking these two drugs concurrently can increase the pt's risk for what?

Bleeding

you are caring for a pt who is about to begin taking chloroquine (Aralen) to prevent malaria. When talking to the pt about taking the drug, you should include what instructions?

-Wear sunglasses outdoors


-Avoid driving


-Take the drug with food

While administering IV Cefotetan to a pt to treat bacterial meningitis, you find the IV insertion site warm and reddened. what actions should you take?

stop the cefotetan infusion, remove the IV catheter, assess for tissue damage, and treat it accordingly. Then initiate IV access via another site

you are caring for a pt who is about to begin receiving acyclovir (Zovirax) IV to treat a viral infection. you should recognize that cautious use of the drug is essential if the pt also has what?

Dehydration

A primary care provider is considering the various pharmazologic options for a pt who has a gynecologic infection and a history of alcohol use disorder. what medications can cause reaction similar to disulfiram (Antabuse) if the pt drinks alcohol while taking it?

-Cefotetan


-Metronidazole

You are caring for a pt who is about to being taking amphetamine sulfate (Adderall). You should monitor the pt for what adverse effect?

Tachycardia




Amphetamine sulfate is a stimulant that can cause tachycardia and dysrhythmias. report chest pain or palpitations

You are taking to a pt and her family about how methylphenidate (Ritalin) will help manage ADHD. what therapeutic effects should they expect

Increased focus, calmness, reduced hyperactivity

You are talking to a pt about beginning sumatriptan (Imitrex) therapy to treat migraine headaches. You should advise the pt to watch for what adverse effect?

vasospasm and chest pain.




report any pressure, pain or tightness in the jaw, chest, or back.




not appropriate for pts with CAD

You are reviewing the medical record of a pt who has a newly diagnosed seizure disorder. the pt is to begin taking both valproic acid (Depakote and phenytoin (Dilantin). You should recognize that what can occur as a result of a drug interaction between valproic acid and phenytoin?

Phenytoin toxicity





you are caring for a pt to begin taking dantrolene (Dantrium) for skeletal muscle spasms. You should recognize that what laboratory tests requires monitoring?

Liver function




report jaundice and abdominal pain

Because of the potential for adverse effects, what should you recommend for a pts who begin taking carbamazepine (Tegretol)?

begin taking the drug at low doses

For what should you monitor a pt who is taking donepezil (Aricept) for alzheimer's disease?

nausea, vomiting, and diarrhea

What information should you include when talking to a pt about taking baclofen (Lioresal)?

avoid driving until the drug's effects are evident

a pt is taking selegiline (Eldepryl) to treat parkinson's disease. the provider is considering the use of analgesics for the pt but should be aware that a drug interaction between selegiline and meperidine (Demerol) can result in what?

Muscle rigidity

You are caring for a pt who is about to begin taking pramipexole (Mirapex) to treat parkinson's disease. You should recognize that what laboratory tests require monitoring?

Creatine phosphokinase (CPK)

What finding should alert you that a pt is developing a potentially serious adverse reaction to interferon beta-1b (Betaseron)?

Fatigue

You are caring for a pt who is about to begin taking dantrolene (Dantrium) for skeletal muscle spasms. You should tell the pt tor report what?

Diarrhea

you are caring for a pt who is receiveing thiopental (Penthothal). What should you monitor?

Respiratory depression

anesthetists often administer midazolam (Versed) during induction of anesthesia because of what pharmacological actions?

causes amnesia

you are caring for a pt who is taking zolpidem (Ambien). the pt has a history of benzodiazepine abuse and reports insomnia. you should caution the pt that the drug can cause...

memory impairment

you are talking to a pt who is newly diagnosed with parkinson's disease about how levodopa/carbidopa (sinemet) will help control her symptoms. with what mechanism is the drug effective in treating the disorder?

increases available dopamine in the brain

you should include which of the following instructions when talking with a pt about taking levodopa/carbidopa (sinemet) to treat parkinson's disease?

change position slowly to prevent orthostatic hypotension

you are talking to a pt who is about to begin taking valproic acid (Depakote) for a newly diagnosed seizure disorder. you should tell the pt to watch for what adverse effects?

-drowsiness


-rash



you are talking with a pt who is beginning to take valproic acid (Depakote) to treat a seizure disorder. You should advise the pt to monitor for what adverse effects?

Jaundice

you administer fentanyl (sublimaze) to a pt to reduce pain. what drugs should they have available to reveres the effects of fentanyl?

Naloxone

while talking with a pt and their family about taking memantine (Namenda) for Alzheimer's disease, you should include what instructions?

notify you before taking OTC antacids

an anesthetist is about to administer lidocaine (Xylocaine) as part of the protocol for spinal anesthesia for a pt who is undergoing a surgical procedure. you should be aware that the pt could develop what potentially serious effects?

hypotension

when talking with a pt about taking temazepam (Restoril), what instructions should you include?

-avoid alcohol and other depressants


-take the drug 30 min before bedto prevent daytime drowsiness


-taper the drug slowly to prevent withdrawal symptoms

you are talking to a pt about the adverse effects of interferon beta01a (Avonex). to help minimize these effects, you should tell the pt to....

premedicate with acetaminophen (tylenol)

when talking to a pt aobut taking modafinil (provigil) to treat narcolepsy, what instructions should you include?

take the drug in the morning

you should expect what adverse effects for a pt who is taking betaxolol (Betoptic) eye drops to treat glaucoma?

bradycardia

you are collecting data from a pt who is taking bupropion hydrochloride (Wellbutrin) to treat depression. You not that the pt has a recent history of head injury. you should recognize that the drug is inappropriate for the pt because of the increased risk of what?

seizure activity

you are caring for a pt who si about to begin using betaxolol (Betopitc) eye drops to treat open-angle glaucoma. you shouldadvise the pt to expect what reaction?

ocular stinging

during and immediately following IV administration of chlorpromazine to a pt who has schizoaffectiove disorder, you should monitor for what?

Blood pressure

when reviewing the indications for various antidepressants, you should understand that bupropion hydrochloride (wellbutrin) is and appropriate choice for pts who have what?

-seasonal affective disorder


-nicotine addiction


-depression

you are obtaining a pts drug hx when you find that the pt is taking lithium carbonate (Lithobid) for bipolar disorder. what findings in the pts drug hx should alert you to monitor for lithium toxicity?

furosemide (Lasix)

you are talking to a pt who is taking lithium carbonate (Lithobid). what instructions should be included to reduce the risk of lithium toxicity?

avoid taking NSAIDs

what instructions should you include when advising a pt about instilling pilocarpine (Isopto carpine) for managing open-angle glaucoma?

-apply gentle pressure to the nasolacrimal duct for 1 min after instilling the drops


-do not touch the tip of the dropper


- wash hands before instilling eye drops


- avoid rubbing or touching eyes after instilling drops


-remove contact lenses prior to instilling drops

you are caring for a pt who is about to begin amitriptyline therapy to treat major depression. you should include what instructions when talking with the pt

-change position slowly form sitting or lying to standing


-do not stop taking the drug abruptly


-take the drug at bedtime to prevent daytime drowsiness


-increase fiber and fluid intake

you are caring for a pt who is taking lithium carbonate (Lithobid) to treat bipolar disorder. what diagnostic tests should you recommend periodically for the pt?

thyroid function tests

when talking to a pt about taking buspirone, you should include what instructions?

allow 2 to 4 weeks before expecting to feel better

soon after beginning fluoxetine (Prozac), a pt is admitted to the emergency department with agitation and confusion. You should suspect what?

serotonin syndrome

you should question the use of timolol (timoptic) for a pt who has what?

asthma

you are caring for a pt who is about to begin taking lithium carbonate (lithobid) to treat bipolar disorder. you should caution the pt to watch for what indication of lithium toxicity?

-tremors


-confusion


-nausea


-muscle weakness

when caring for a pt who is taking risperidone (Risperdal) for schizophrenia, you should monitor for what adverse effects of the drug?

Polyuria



you should question the us of alprazolam (xanax) for a pt who....

drinks two 8 oz glasses of wine each evening

you are caring for a pt who has been taking alprazolam (xanax) for an extended period of time to treat anxiety. you shold recognize that stopping alprazolam therapy suddenly can result in what?

withdrawal symptoms

a pt is admitted to the emergency department with spasms of his face and back. he has recently begun taking chlorpromazine to treat schizophrenia. what adverse reaction should you suspect?

acute dystonia

you should advise the pt who is taking phenelzine (nardil) to avoid tyramine-enriched foods because of an increased risk for what adverse reactions?

hypertensive crisis

you should monitor an older adult pt who is taking alprazolam (xanax) for which of the following adverse effects?

-tolerance


-anxiety


-sedation


-respiratory depression

you are caring for a pt who is taking venlafaxine to treat major depression. you should recognize that which of the following drugs can cause serotonin syndrome when pts take it concurrently with venlafaxine?

phenelzine (nardil)

you are caring for a pt who is about to begin taking echothiophate (Phospholine Iodide) to treat glaucoma. You should monitor the pt for the development of what adverse effects?

cataracts

you are caring for a young adult pt who is taking fluoxetine (prozac) to treat depression. you should tell the pt and the pts family to report waht?

suicidal thoughts

while talking to a pt about taking chlorpromazine, what instructions should you include?

wear sunscreen when exposed to sunlight

when reviewing the adverse effects of drug therapy with a pt, you should explain that orthostatic hypotension is a common adverse reaction of what drug?

Imipramine (tofranil)

You should recognize that depolarizing muscle relaxants, such as succinylcholine (Anecitine), require cautions use with patients who have what?

-Hyperkalemia; monitor for cardiac dysrhythmias


-Myasthenia gravis


-Respiratory depression

You are caring for a pt who was given succinylcholine (Anectine), a depolarizing neuromuscular blocker, during a surgical procedure. The pt developes rigid muscles, tachycardia, and a sudden spike in temp. You should immediately suspect what?

Malignant hyperthermia

You are caring for a pt who is taking alendronate (Fosamax) to treat postmenopausal osteoporosis. You should explain to the pt that alendronate increases bone mass by what action?

-decreases activity of osteoclasts

You are preparing to administer neostigmine (Prostigmin) to a pt who has myasthenia gavis. Knowing the adverse effects of neostigmine, what drugs should you have ready to administer?

Atropine (AtroPen)

You are administering succinylcholine (Anectine) to a pt. What info is correct regarding depolarizing neuromuscular blocking agents?

Causes muscle paralysis by binding with cholinergic receptors at the neuromuscular junction

You are caring for a pt who is taking prdenisone and also takes 1,500 mg/day of calcium carbonate (Tums) to reduce the risk of osteoporosis. What info should you include?

-drink 8 oz of water with the calcium tablets


-chew calcium tablets before swallowingthem


-take the drugs 1 hr apart


-divide the daily dose into three 500-mg doses

You are caring for a pt who has myasthenia gravis and has been prescribed neotigmine (Prostigmin) to increase muscle strength. You should tell the pt to watch for what indication of a serious adverse reaction to the drug?

Bradycardia

You should question the use of etanercept (Enbrel) for a pt who has a hx of diabetes mellitus because of what risks?

infection

What is a therapeutic action of raloxifene (Evista)?

mimics the effect of estrogen on bone tissue

Alendronate (Fosamax) is contraindicated for pts who...

should remain flat on bed rest

You are preparing to administer neostigmine (Prostigmin) to a pt. What info in the pt's health hx should alert her to use caution when administering neostigmine?

asthma

You should tell a pt who is taking methotrexate to monitor for what?

Black, tarry stools

You are caring for a pt who a calcium supplement and reports flank pain. You should suspect the pt has what?

Renal calculi

You are caring for a pt who is to begin taking calcitonin-salmon (Miacalcin) intranasal spray to treat osteoporosis. What info should you include?

-report rash or itching


-prime the pump


-report nasal irritation

You are caring for a pt who is postoperative and who demonstrates weakness and needs mechanical ventilation. The pt received pancuronium during the surgery. You should suspect prolonged paralysis form a drug interaction with what?

Gentamicin

You should tell a pt who is taking alendronate (Fosamax) to monitor for what adverse effects?

-Jaw pain


-Blurred vision


-Muscle pain

You are preparing to administer alendronate (Fosamax) to a pt who has osteoporosis. You should recognize what as an adverse effect of alendronate?

joint pain



You are caring for a pt who is about to begin methotrexate therapy for rheumatoid arthritis. You should include what info?

-avoid people who are sick


-periodic laboratory tests are essential


-report bruising or petechiae


-avoid drinking alcohol

Prior to administering calcitonin-salmon (Miacalcin) for the first time to a pt who is diagnosed with postmenopausal osteoporosis, you should perform what tasks?

check for allergies using skin testing

When treating a pt who has malignanat hyperthermia, you should do what?

-provide cooling measures


-administer dantrolene (Dantrium)


-discontinue anesthesia


-increase IV infusion rates

You are caring for a pt who is taking etanercept (Enbrel), a DMARD II that treats rheumatoid arthritis. You should monitor the pt for what indications of a serious adverse reaction to the drug?

Shortness of breath

You are caring for a pt who is taking raloxifene (Evista). What info should you include?

-Increase activity, such as walking


-use a contraceptive if there is any risk of pregnancy


-increase intake of calcium and vitamin D

You should tell a pt who is taking etanercept (Enbrel) for rheumatoid arthritis to report what?

skin rash

You are talking about self-administering methotrexate to a pt who has rheumatoid arthritis. You should tell the pt to...

drink 2 to 3 L of water per day to promote teh drug's excretion

You are caring for a pt who is beginning raloxifene (Evista) therapy to prevent osteoporosis. You should tell the pt to monitor for what as an indication of a serious adverse reaction to the drug?

calf pain