Diuretics
What diuretic would be prescribed for a patient with low serum potassium?
Spironolactone (Aldactone)
Why is atropine typically given during surgery?
Answer: to reduce secretions
What drug class is often associated with causing rhabdomyolysis?
Answer: Statins
Rationale: Extensive and conclusive studies have been conducted indicating that the use of statins is a direct cause of rhabdomyolysis.
What parasympathetic neurotransmitter do cholinergic agonist drugs mimic?
Acetylcholine
Furosemide works on what part of the kidneys?
Loop of Henle
What drugs are typically used to treat overactive bladder? SATA
A. Vasopressin
B. Oxybutynin
C. Botox
D. Tolterodine
E. Atropine
Correct answer: B, C, D, E
Rationale: Oxybutynin, tolteradine, botox and atropine are commonly used in the treatment of overactive bladder. Vasopressin is an antidiuretic hormone and would have no effect on the muscle spasticity of the bladder.
A patient with AKI tests positive for MRSA. The nurse knows which class of antibiotics is contraindicated in patients with AKI?
Correct answer: Mycins
Rationale: Mycins are nephrotoxic and are typically not prescribed to patients who have AKI.
A patient is prescribed dicyclomine. The nurse would expect to administer this drug by which route? SATA
A. Oral
B. IVPB
C. IV
D. IM injection
E. Subcutaneous injection
Correct answer: A, D
Dicyclomine should only be administered orally and via IM injection.
Select all the medications below that are considered loop diuretics. (SATA)
A. Chlorothiazide
B. Bumetanide
C. Triamterene
D. Spironolactone
E. Furosemide
F. Torsemide
G. Hydrochlorothiazide
Correct answer: B, E, F
Rationale: Options A and G are thiazides. Options C and D are potassium sparing.
How can oxybutynin be administered? SATA
A. IV
B. Oral
C. Transdermal patch
D. Intramuscular injection
E. Subcutaneous injection
Correct answer: B, C
Rationale: Oxybutynin may only be administered via oral route or transdermal patch.
The nurse reviews a diabetic patient's medical chart prior to a CT scan with contrast. The nurse notices a drug that causes her to alert the surgical staff to increase fluids during the procedure to prevent AKI. What is the drug?
Metformin
Rationale: Diabetic patients using metformin are at increased risk for AKI when undergoing procedures using contrast dye. Increasing fluids aids in flushing the dye.
The nurse is preparing to administer a cholinergic drug. The nurse understands that the drug would be appropriate for which condition? SATA
A) Urinary retention
B) Overactive bladder
C) Myasthenia gravis
D) Parkinson's disease
E) Graves' disease
Correct answer: A, E
Rationale: Acetylcholinesterase makes the parasympathetic nervous system function differently by inactivating the neurotransmitter acetylcholine, thereby preventing the nerve synapse from continuing the nerve impulse.
What electrolyte imbalance would the nurse monitor for in the patient who is taking a loop diuretic? SATA
A. Hyperkalemia
B. Hypocalcemia
C. Hypernatremia
D. Hypokalemia
E. Hypomagnesemia
Correct answer: B, D, E
Rationale: Loop diuretics decrease potassium levels putting the patient at risk for hypokalemia, not hyperkalemia. Loop diuretics may cause hyponatremia, not hypernatremia.
Describe how atropine affects the bladder.
Blocks acetylcholine which triggers abnormal bladder contractions associated with overactive bladder.
A patient with a C. diff is due for their next scheduled dose of vancomycin. The nurse reviews the patient's most recent labs. Which labs alert the nurse to hold the scheduled dose and contact the healthcare provider?
A. BUN 58 mg/dL
B. WBC count 14,000 per microliter
C. creatinine 3 mg/dL
D. GFR 40 mL/min
E. Lactic acid 1.7 mmol/L
Correct answer: A, C, D
Rationale: The patient's BUN, creatinine, and GFR indicate renal impairment and the vancomycin should not be administered until the doctor has been consulted. The patient's WBC count is expected with an infection, and the lactic acid level is irrelevant.
A nurse would be alert for an increase in cholinergic effects if a client who is prescribed a cholinergic drug is also receiving which medication? Select all that apply.
A) Prednisone
B) Oxycodone
C) Diclofenac
D) Dexamethasone
E) Ibuprofen
Correct answer: A, D
Rationale: Cholinergic drugs administered concomitantly with corticosteroids, like prednisone and dexamethasone, can result in increased adverse effects of the cholinergic drug.
A pt receives furosemide intravenously at 0900. The nurse would expect to assess peak effects of the drug at what time?
Correct answer: 0930
Rationale: Furosemide typically peaks 30 minutes after intravenous administration.
What are signs and symptoms of oxybutynin toxicity? SATA
A. Hallucinations
B. Dilated pupils
C. Difficulty urinating
D. Restlessness
E. Hypertension
Correct answer: A, B, C, D
Rationale: All of these are signs and symptoms of oxybutynin toxicity, except for hypertension.
The nurse is managing care for a client with acute renal failure. What does the nurse recognize as the most important safety precaution with regard to medication administration?
Answer: Review the client's medication regimen to identify any nephrotoxic drugs.
Rationale: Persons in acute renal failure are at significantly increased risk of injury from nephrotoxic drugs.
The nurse is administering Bethanecol (urecholine) to a patient. The nurse knows that which interventions are normal with this medication? SATA
A. Give immediately after eating
B. Give 1 hour before, or 2 hours after a meal
C. Recording input and output is not a concern
D. Monitor liver enzymes
E. Assess for hypertension
Correct Answer: B, D
Rationale: Bethanecol should be given on an empty stomach. Fluid intake and output IS a concern, and you would assess for orthostatic hypotension, NOT hypertension. Bethanechol can be hepatotoxic and enzymes should be monitored.