Pharmacology Exit HESI.

Nurse should observe most closely for drug toxicity when a client receives med that has what characteristic Narrow therapeutic index The nurse should observe most closely for drug toxicity when a client receives a medi ...

Nurse should observe most closely for drug toxicity when a client receives med that has what characteristic Narrow therapeutic index The nurse should observe most closely for drug toxicity when a client receives a medication that has which characteristic? • Low bioavailability • Rapid onset of action • Short half life • Narrow therapeutic index. • Rationale: A drug with a narrow therapeutic index has a high risk for toxicity because there is a narrow range between the therapeutic dose and the toxic dose. Nurse is conducting DC teaching about anti-anxiety drug diazepam (valium) Evaluate the ingredients of all over-the-counter drugs for alcohol content Nursing instruction most important for patient on Zyloprim Increase fluid intake Client getting Tofranil (Imipramine) Give medication at night Magnesium antidote Calcium gluconate Patient with hyperthyroidism taking inderal (propanalol) Decreases pulse rate A client with hyperthyroidism is receiving propranolol (Inderal). Which finding indicates that the medication is having the desired effect? • Decrease in serum T4 levels • Increase in blood pressure • Decrease in pulse rate • Goiter no longer palpable Medication dosing-heparin 25000 units at 7ml/hr doctor changed rate to 900 units what is the Mls/hr Med was ordered 100mg in 4 divided doses in 24 hours available in 25mg, how many will you give every 6 hours 1 Patient on benzos Answer is not narcan - A client experiencing withdrawal from the benzodiazepines alprazolam (Xanax) is demonstrating severe agitation and tremors. What is the best initial nursing action? • Administer naloxone (Narcan) per PNR protocol • Initiate seizure precautions • Obtain a serum drug screen • Instruct the family about withdrawal symptoms. • Rationale: Withdrawal of CNS depressants, such as Xanax, results in rebound over-excitation of the CNS. Since the client exhibiting tremors, the nurse should anticipate seizure activity and protect the client. Patient Dx with bipolar-how to know if meds are effective Family states patient is doing better with manic phases - A client with bipolar disorder began taking valproic acid (Depakote) 250 mg PO three times daily two months ago. Which finding provides the best indication that the medication regimen is effective? •The family reports a great reduction in client’s maniac behavior Patient on Heparin going for surgery in a.m.,-priority Assess patient for bleeds Best time to give patient Abx (I think) Time was like 1000, 1400, 1200, and 0400…best to give around the clock Medication calculation-patient weighs equal to 16kg-order for Tamiflu 45mg BID Must round up-answer is 3.8ml Peptic ulcer med-what action Histamine 2 agonist Patient on folliculitis medication-what to teach Drink with full glass of water Vasopressin Vasoconstrictor Know why Digoxin and Lasix are used together - Someone's on digoxin and Lasix how do you know the meds are working; is it because potassium is at 4, magnesium or something else Tamoxifen Citrate use and therapeutic outcome - Breast cancer Fosomax for osteoarthritis patient teaching 1. A female client receives a prescription for alendronate sodium (Fosamax) to treat her newly diagnose osteoporosis. W /hat instruction should the nurse include in the client’s teaching plan? • Take on an empty stomach with a full glass of water Rifampin for TB Rusty-orange/red colored urine and body fluids Pyridium for bladder infection Orange/red/pink urine Stay in bed for 3 hours post first Ace Inhibitor dose Avoid grapefruit juice with CCB Lipitor (statins) in PM only-no grapefruit juice Trough draw - A peak and trough level must be drawn for a client receiving antibiotic therapy. What is the optimum time for the nurse to obtain the trough level? A) Sixty minutes after the antibiotic dose is administered. B) Immediately before the next antibiotic dose is given. C) When the next blood glucose level is to be checked. D) Thirty minutes before the next antibiotic dose is given. - Trough levels are drawn when the blood level is at its lowest, which is typically just before the next dose is given (B). (A, C, and D) do not describe the optimum time for obtaining a trough level of an antibiotic. Peak draw 30-60 minutes after administration Potassium sparing diuretic need to watch for hyperkalemia Aldactone (spirinolactone) Using bronchodilators before steroids for asthma teaching Exhale completely, inhale deeply, hold breath for 10 seconds Insulin can be kept at room temp 28 days Drawing insulin Clear (regular) first then cloudy (NPH) Know the insulins and their peak/onset (there are several Qs about this in different formats) Rapid-Lispro (Humalog) and Aspart (Novolog) Onset: 5-15 minutes Peak: . 5-1.5 hours Short acting- regular (humulin) Onset: 30-60 minutes Peak: 2-3 hours (IV ok) Intermediate acting- NPH Onset: 1-2 hours Peak 6-12 hours Long acting- Glargine (lantus) Onset: 1.1 hour Peak: 14-20 hours (DO NOT MIX) Chlamidia Tetracycline Trichomoniasis Flagyl Candidiasis Nystatin Herpes Simplex 2 Acyclovir Parkinson’s disease Levodopa/Carbidopa Phenobarbitol Seizures Preparing to administer a drug to a pt with an infection The drug will destroy the microorganism RN is teaching a pt about a new drug… what’s most important to teach the pt to improve the intensity of the response to the drug Take the prescribed dose A nurse is giving morphine 2 mg IV to a pt after surgery and she has followed the “six rights of administration”… Know the possible reactions to morphine RN doesn’t understand why a pt is to receive a prescribed med Verity the reason with the prescribing healthcare provider for use Administration of schedule IV drug, the RN understands The drug has acceptable medical application with low potential for abuse - A nurse is administering a drug that is categorized as Schedule IV. The nurse understands that this means the drug: A. Has acceptable medical applications with low potential for abuse B. Is a controlled sub with no accepted medical use C. Is dangerous to admin to pregnant or breast-feeding pts D. Has the potential for serious and life-threatening adverse effects Where would a RN direct a pt to obtain more info about prescribed medications A pharmacist RN is prepared to administer Epinephrine to pt that has a severe allergic reaction IV – no first pass effect Digoxin has 36-48 hr half life – because of the length of half life, the RN expects to be dosing this medication Once a day Pt is prescribed Cimetidine (histamine 2 antagonist) to treat gastric ulcer Inhibit the action of histamine at receptor sites and block gastric acid secretion - When teaching a patient who has a gastric ulcer about cimetidine (a histamine H2 antagonist) therapy, the nurse should include which information about antagonists A. An antagonist causes a chemical reaction in the stomach B. An antagonist activates receptors in the stomach lining C. An antagonist prevents receptor activation in the stomach D. An antagonist improves receptor sensitivity in the stomach