Medication Safety & Nursing Priorities
What should the nurse include in documenation following a medication error?
Objective facts, client's response, notifications- no speculation or blame.
When teaching about sublingual nitroglycerin, what should the client do if chest pain persists after one tablet?
Call 911 and take up to two more tablets five minutes apart.
Which adverse effect of levodopa/carbidopa should clients be taught to expect?
Involuntary movements (dyskinesia) or dark-colored urine.
What finding indicates propylthiouracil (PTU) is effective?
Decreased heart rate, weight gain, and relief of hyperthyroid symptoms.
Which over-the-counter drug can interact dangerously with oxycodone?
Diphenhydramine (Benadryl) — increased sedation and respiratory depression.
What is the nurse's priority action for a client who develops a surgical infection?
Obtain blood/wound cultures before starting antibiotic therapy.
Which teaching should be reinforced about intranasal medication administration?
Blow nose before spraying and keep head upright.
Which lab finding or symptom should prompt stopping clozapine?
Low WBC count or signs of infection (fever, sore throat).
Which finding indicates methimazole therapy is working?
Reduced anxiety, heart rate, and heat intolerance.
Which over-the-counter product increases risk for CNS depression when taken with oxycodone?
Antihistamines and alcohol
What findings require follow up during medication therapy?
New confusion, rash, abnormal labs- anything suggesting allergic reaction or toxicity.
What should the nurse include in teaching about insulin administration?
Rotate injection sites within the same region to prevent lipodystrophy.
Which adverse effect requires prompt reporting with digoxin therapy?
Nausea, vomiting, or visual changes (yellow halos).
Which outcome indicates theophylline is effective?
Improved airflow and decreased wheezing (bronchodilation).
Which medications should be avoided in clients with sulfa allergy?
Sulfonamides such as trimethoprim-sulfamethoxazole (Bactrim).
What finding is a priority to report for a client recieving vancomyocin?
ototoxicity (hearing loss)
What should clients be reminded of when taking metoprolol?
Check pulse daily and report bradycardia or dizziness.
What is a common adverse effect of metformin that should improve with time?
Gastrointestinal upset (nausea, diarrhea).
Which finding indicates risperidone is having the desired therapeutic effect?
Decreased hallucinations, delusions, and agitation.
Which instruction should clients taking metformin follow before receiving IV contrast dye?
Hold metformin 24–48 hours before and after the procedure.
What finding is a priority to report for a client taking exenatide?
Severe abdominal pain (pancreatitis).
What teaching should be reinforced about lithium therapy?
Maintain consistent salt and fluid intake; monitor for toxicity (tremors, confusion, diarrhea).
Which adverse effect should be reported with amoxicillin?
Rash or difficulty breathing (allergic reaction).
Which lab value indicates long-term effectiveness of repaglinide?
Hemoglobin A1c within target range (<7%).
Clients with BPH or glaucoma are at risk from which drug class?
Anticholinergic medications
What is a nurse’s priority when identifying potential adverse effects due to multiple medications?
Assess for polypharmacy and drug interactions
Which finding indicates the client understands paliperidone palmitate injections?
“I’ll receive this injection every month to help control my schizophrenia symptoms.”
What serious adverse effect is associated with metformin?
Lactic acidosis
Which outcome indicates nitroglycerin therapy is effective?
Reduced frequency or intensity of angina attacks.
For a client taking warfarin, which OTC product(s) should be avoided?
NSAIDs
Ibuprofen, advil, motrin = risk of bleeding
Which supplement helps prevent peripheral neuropathy in clients taking isoniazid?
Vitamin B6 (pyrixidone)
What should clients do if they experience unexpected side effects from a medication?
Notify their provider before stopping the medication.
Which adverse effect is linked to digoxin toxicity?
Visual disturbances, bradycardia, or GI upset.
What is an expected side effect of sublingual nitroglycerin?
Headache and hypotension
A client taking lithium carbonate for bipolar disorder begins a new prescription for furosemide (Lasix) for hypertension. The nurse should recognize this combination places the client at risk for what complication?
lithium toxicity! Loop diuretics like furosemide cause sodium loss, which leads to increased lithium reabsorption and toxicity.
What type of insulin cannot be mixed with other insulins?
Insulin glargine (Lantus) cannot be mixed with any other insulin
Which instruction should be reinforced for metoprolol?
Monitor blood pressure and pulse; report bradycardia or dizziness.
Which sign indicates magnesium sulfate toxicity?
Absent deep tendon reflexes, respiratory depression, or low urine output.
What findings would indicate that furosemide (Lasix) was effective in a client with heart failure?
reduction in peripheral edema
lung sounds clear
diuresis
weight loss
A nurse is providing discharge teaching to a client prescribed linezolid for MRSA pneumonia. Which of the following dietary or medication interactions should the nurse warn about?
aged cheese/red wine. Linezolid has MAOI-like properties, so consuming tyramine-rich foods can cause hypertensive crisis.