Adverse Reactions
What adverse effects are a concern with aminoglycosides (amphotericin, gentamicin)?
otoxocity, nephrotoxicity, and hypersensitivity
How should the nurse monitor trough levels in a patient receiving vancomycin?
The trough is typically drawn prior to the administration of the dosed medication
A nurse is formulating a plan of care for a client receiving enteral feedings. The nurse identifies which nursing diagnosis as the highest priority for this client?
a) diarrhea
b) risk for aspiration
c) risk for deficient flid volume
d) imbalanced nutrition, less than body requirements
Answer:B
- Any condition in which gastrointestinal motility is slowed or esophageal reflux is possible places a client at risk for aspiration. Although options 1, 3, and 4 may be a concern, these are not the priority.
A head and neck physical examination is completed on a 50-year-old female patient. All physical findings are normal except for fine brittle hair. Based on the physical findings, which of the following laboratory tests would the nurse expect to be ordered?
A. Liver function test
B. Lead level
C. Thyroid-stimulating hormone test
D. Complete blood count
C
(Thyroid-stimulating hormone test)
Lorazepam, Clonazepam & Alprazalam
What are benzodiazepines?
You are the nurse with orders to admin antibiotics. During the administration of vancomycin (Vancocin) IV, you notice the client's neck and face becoming flushed. What action should the nurse take first?
Slow the rate of infusion
You are the nurse monitoring a patient's compliance with the diabetes mellitus treatment regimen. What value indicates compliance with the regimen?
HbA1C of 4%-6%. This is the best indicator of average blood glucose levels for the past 120 days.
The client has chronic atrial fibrillation. Which discharge teaching should the nurse
discuss first with the client?
1. Instruct the client to use a soft-bristle toothbrush.
2. Discuss the importance of getting a monthly partial thromboplastin time (PTT).
3. Teach the client about signs of pacemaker malfunction.
4. Explain to the client the procedure for synchronized cardioversion.
1. chronic A-fib treated with anticoagulant, places patient at risk for bleeding
PQRSTU is a mnemonic that helps the clinician to remember to address characteristics specific to:
A. severity of dementia.
B. substance use and abuse.
C. pain presentation.
D. the ability to perform activities of daily living (ADLs).
C
The eight critical characteristics of pain symptoms reported in the history are: P = provocative or palliative; Q = quality or quantity; R = region or radiation; S = severity scale; T = timing; and U = understand patient's perception.
Tests used to assess for dementia include the Mini-Mental State Examination, the Set Test, the Short Portable Mental Status Questionnaire, the Mini-Cog, and the Blessed Orientation-Memory-Concentration Test.
A functional assessment includes questions on substance use and abuse.
Functional assessment measures a person's self-care ability including the ability to perform ADLs.
dabigatran, rivaroxaban, & apixaban
What are DOACs?
Which of the following diabetes drugs acts by decreasing the amount of glucose produced by the liver?
a. Sulfonylureas
b. Meglitinides
c. Biguanides
d. Alpha-glucosidase inhibitors
c. Biguanides
Biguanides, such as metformin, lower blood glucose by reducing the amount of glucose produced by the liver.
Sulfonylureas and Meglitinides stimulate the beta cells of the pancreas to produce more insulin.
Alpha-glucosidase inhibitors block the breakdown of starches and some sugars, which helps to reduce blood glucose levels
A nurse caring for a patient who has diabetic ketoacidosis recognizes which of these characteristics in the patient? (Select all that apply.)
A) Occurs mainly in type 2 diabetes patients
B) Altered fat metabolism leading to ketones
C) Arterial blood pH of 7.35 to 7.45
D) Sudden onset, triggered by acute illness
E) Plasma osmolality of 300 to 320 milliosmoles/L
Answer: B, D, E
B) Altered fat metabolism leading to ketones
D) Sudden onset, triggered by acute illness
E) Plasma osmolality of 300 to 320 milliosmoles/L
The nurse instructs a patient about how insulin affects blood glucose. Arrange the events in sequence.
1. Beta cells are stimulated to release insulin.
2. Glucose enters the bloodstream.
3. Glycogen is converted to glucose by alpha cells (glycogenesis).
4. Glycogen is stored in the liver.
5. Insulin transports glucose to muscle cells.
Answer: 2,1,5,4,3
2. Glucose enters the bloodstream.
1. Beta cells are stimulated to release insulin.
5. Insulin transports glucose to muscle cells.
4. Glycogen is stored in the liver.
3. Glycogen is converted to glucose by alpha cells (glycogenesis).
You are assessing a 20-year-old male suspected of overdosing. He is staring off into space, writhing and babbling. When you start an IV, he cries out incomprehensibly but does not pull away. What is his Glasgow Coma score
What is 9?
Part 1: Hydrochlorothiazide, Spironolactone & Lasix
Part 2: What makes them different?
Part 1: Diuretics
Part 2:
Hydrocholorthizide: Thiazide Diuretics
Spironolactone: Potassium Sparing Diuretic
Lasix Potassium Wasting Diuretics
the nurse is preparing to administer the first dose of enalapril (Vasotec). identify the potential adverse effects of this medication (select all)
1.reflex hypertension
2.hyperkalemia
3..persistent cough
4.angiodema
5.Hypotension
-hyperkalemia
-persistent cough
-angiodema
-Hypotension
A nurse is caring for a client with a history of rheumatoid arthritis who is receiving methotrexate (Rheumatrex). What should be included in client education?
The CBC will be monitored.
After receiving change-of-shift report on the following four patients, which patient should the nurse see first?
a. A 60-year-old patient with right-sided weakness who has an infusion of tPA prescribed
b. A 50-year-old patient who has atrial fibrillation and a new order for warfarin (Coumadin)
c. A 40-year-old patient who experienced a transient ischemic attack yesterday who has a dose of aspirin due
d. A 30-year-old patient with a subarachnoid hemorrhage 2 days ago who has nimodipine (Nimotop) scheduled
A. tPA needs to be infused within the first few hours after stroke symptoms start in order to be effective in minimizing brain injury. The other medications should also be given as quickly as possible, but timing of the medications is not as critical.
The purpose of the scale is to help health professionals, especially nurses, assess a patient's risk of developing a pressure ulcer.
What is the Braden Scale?
Erythromycin, Azithromycin, Clarithromycin
Macrolides
a client has stated clopidogrel after experiencing a transient ischemic attack (TIA). whats the desired therapeutic effect of this drug
1.anti inflammatory and antipyretic effects
2.to reduce the risk of a stroke from a blood clot
3.analgesic as well as clot-dissolving effects
4.to stop clots from becoming emboli
to reduce the risk of a stroke from a blood clot
the nurse reviews lab studies of a client receiving digoxin (Lanoxin). Which intervention by the nurse is required if the results include which of the following lab values
1.serum digoxin 1.2
2.serum potassium level of 3
3.hemoglobin of 14.4
4.serum sodium level of 140
serum potassium level of 3
A client is scheduled for an arteriogram using a radiopaque dye. The nurse assesses which most critical item before the procedure?
a) vital signs
b) intake and output
c) height and weight
d) allergy to iodine or shellfish
Answer: D
- Allergy to iodine or seafood is associated with allergy to the radiopaque dye that is used for medical imaging examinations. Informed consent is necessary, because an arteriogram requires the injection of a radiopaque dye into the blood vessel. Although options A, B, and C are components of the preprocedure assessment, the risks of allergic reaction and possible anaphylaxis are the most critical.
When caring for a patient who is receiving epidural morphine, which information obtained by the nurse indicates that the patient may be experiencing a side effect of the medication?
a.
The patient complains of a "pounding" headache.
b.
The patient becomes restless and agitated.
c.
The patient has not voided for over 10 hours.
d.
The patient has cramping abdominal pain.
The patient has not voided for over 10 hours
Part 1: Lovenox, Heparin and Coumadin
Part 2: Discern which have prophylactic indications versus treatment only
Part 1: Anticoagulants
Part 2: Lovenox and Heparin have Prophylactic and Treatment doses while Coumadin is not used prophylactically