Who Am I?
I decrease platelet aggregation and may be used in ACS or for prevention of certain MIs and strokes. My usefulness becomes dangerous when the patient develops active GI bleeding.
Aspirin
A patient being treated for Graves disease calls the clinic reporting a fever and sore throat. The patient wants to take the next dose and “see if it passes.” What should happen instead?
Hold/stop and report the symptoms because agranulocytosis is a concern.
A patient taking memantine develops dizziness and constipation but has no acute deterioration. Are these expected effects or evidence that the medication has cured the dementia?
Expected/common side effects. Memantine does not cure dementia
A patient taking thyroid replacement develops palpitations, weight loss, heat intolerance, and insomnia. Which laboratory studies help determine whether replacement is excessive?
TSH and T4; HR is also monitored
A patient taking carbidopa-levodopa says, “I’m going to start eating huge high-protein meals because I need more energy.” What should the nurse teach?
Large high-protein meals may decrease the medication's effect. Also change positions slowly because the medication can cause orthostatic hypotension.
I regulate glutamate activity rather than increasing acetylcholine. I may help function in moderate-to-severe Alzheimer disease, but I do not cure it.
Memantine
A patient reports acute angina and requests nitroglycerin. During assessment, the nurse discovers the patient recently used sildenafil. What is the nurse priority?
Do not administer the nitroglycerin because the combination can cause Orthostatic hypotension.
A patient is prescribed prednisone for long-term inflammatory control. Name two common side effects.
Increased appetite, weight gain, mood changes, insomnia, fluid retention.
A patient receiving treatment for HF has less edema and fewer crackles but suddenly develops palpitations. Which electrolyte result becomes especially important?
Potassium
A patient on amoxicllin says, “My fever is gone, so I'll save the remaining pills for the next time I'm sick.” What teaching is required?
Finish the entire prescribed course even when feeling better.
I don't directly replace RBCs. Instead, I stimulate the bone marrow to make them. My effectiveness depends partly on whether the patient has adequate iron.
Epoetin alfa
A patient's severe pain improves from 9/10 to 2/10. The patient is now difficult to arouse, RR is 8/min, and oxygenation is falling after taking Morphine. What is the nurse priority?
Naloxone - Respiratory depression — airway/breathing first; naloxone is the antidote
A nurse begins IV vancomycin for a patient with a serious infection. After starting the infusion, what problems are you watching for?
Infusion reaction: flushing, itching, face/neck redness, and sometimes hypotension
Which value must be monitored to evaluate the safety of Insulin Glargine especially when the patient becomes shaky or symptomatic?
Blood Glucose - Assess for hypoglycemia
A patient newly prescribed albuterol asks, “Why do I need this medication if I already have other medications for my breathing?” What should the nurse teach?
Albuterol is a rescue medication used for quick relief when the airways tighten. It relaxes the airway muscles, helping open the airways so the patient can breathe more easily during bronchospasm.
I suppress T-cell activity after organ transplantation. My therapeutic purpose is completely different from an aminoglycoside, yet both medications can make a rising creatinine especially concerning.
Cyclosporine.
A patient receiving methylprednisolone for a COPD exacerbation develops black, tarry stool. What should the nurse recognize as the priority concern?
Possible GI bleeding
A patient taking baclofen reports drowsiness, dizziness, and weakness. What can the nurse expect from these findings.
Normal. Drowsiness/weakness are side effects
A patient receiving an antiemetic already has a prolonged QT interval. Which two electrolytes should the nurse pay particular attention to when evaluating dysrhythmia risk?
Potassium and magnesium. Low K + prolonged QT + ondansetron with dysrhythmia risk.
A patient newly prescribed alendronate asks how to take the medication at home. What are the most important administration instructions the nurse should teach?
Take in the morning on an empty stomach with plain water, remain upright for at least 30 minutes, and do not eat or take other medications right away. Report chest pain, heartburn, or difficulty swallowing.
I am an ARB prescribed for hypertension or heart failure. A nurse caring for a patient taking me must connect worsening renal function and an elevated potassium level to my major risks.
Valsartan.
A patient receiving mannitol for increased ICP develops new crackles and shortness of breath. What is the nurse's priority action?
Stop and evaluate the patient for pulmonary edema.
A patient taking lamotrigine develops a new rash followed by blisters, mouth sores, and skin peeling. What adverse effect should the nurse suspect?
Stevens-Johnson syndrome.
A patient with CKD has received epoetin alfa for several weeks, but the anemia is not improving as expected. Which three laboratory areas/measurements should the nurse connect with this medication?
Hemoglobin, hematocrit, and iron stores. The patient needs adequate iron for epoetin alfa to work. BP is also monitored for safety
A patient newly prescribed fluoxetine asks when they should expect improvement and whether they can also take St. John's wort. What should the nurse teach?
Fluoxetine may take 2 weeks to have its full effect. Do not stop it suddenly, and avoid St. John's wort and MAOIs because of the risk for serotonin-related complications