Miscellaneous
A patient has a medication order to give 1 ounce of a medication. The nurse documents that how many mL were given?
30 mL
The nurse is giving an initial dose of IV penicillin in the emergency room for a diagnosis of cellulitis. 10 minutes into the infusion, the patient complains of severe itching and the nurse notes periorbital and angioedema (edema and swelling of the lips). What is the nurse's priority action?
Stop the infusion immediately
Heparin 2000 units is ordered subcutaneously every 6 hours. Available is 5000 units per mL.
The nurse will administer how many mL's?
Answer:
0.4 ml
(always remember the leading zero!)
The nurse is reviewing the patient labs and history in preparation for the morning medication administration. The nurse notes the patient has been admitted with an acute kidney injury due to ongoing gastroenteritis and the BUN and Creatinine are elevated. Based on this information, the nurse is concerned about what pharmacologic process in this client?
Excretion of the medication
A nurse is preparing a health teaching plan for a patient who is taking raloxifene for prevention of post-menopausal osteoporosis. What are key points to include?
Encourage patient to perform weight bearing exercises like brisk walking/stair climbing daily (helps prevent blood clots and maintain bone mineral density)
Do not take estrogen replacement therapy during treatment
Ensure adequate amounts of calcium and vitamin D intake
Using the rounding rules:
The nurse calculates the dose of an ordered medication is 0.265. Following the rounding rules, the nurse will draw up _______ mL into a syringe?
0.27 mL
What is a characteristic of medication delivered by a transdermal medication patch?
It will deliver constant medication of over (longer acting this way)
An IV solution contains 30 mEq of potassium per liter. The patient is to receive 10mEq of potassium. The nurse will infuse ____ mL, so the patient gets the correct amount of potassium?
Answer=
333.333 ml
Using rounding rules 333.4 mL
The blood brain barrier in infants is less effective, which allows medications to enter the brain easier.
A nurse is caring for a patient on a medical surgical unit who has a new prescription for calcitonin-salmon. The nurse understands that this medication is appropriate for the patient who has _____________
Answer: Hypercalcemia due to hyperparathyroidism.
Remember the medication decreases serum calcium due to increasing calcium excretion
Signs of hypocalcemia include muscle spasms and tingling of the fingers and toes.
The nurse calculates the needed dose of a medication is 2.637
Using the rounding rules, the nurse will draw up ___mL into a syringe to give the patient?
2.6 mL
The nurse is administering medications on the medical surgical unit.
What are nursing actions related to the nursing process in the phase of: Assessment
Correct answers include:
Monitoring lab results
Checking if vital signs are in the appropriate range
Checking the allergy record
Ensuring the medication prescription has all the required elements.
Rocephin 800mg IM daily is ordered. What is available is a powder that when diluted equals 1 gram per 3.1 mL. The nurse will administer ____ mL?
Answer:
2.48 mL
Using rounding rules administer 2.5 mL
The nurse is caring for a client with a new prescription for methotrexate. Appropriate client instructions would include?
Answers include:
Drink 2 liters of water daily to ensure excretion of the drug (assisting the kidneys with excretion to avoid kidney damage)
Report any manifestations of infection (fatigue, chills, fever due to immunosuppression)
Report abnormal bleeding, bruising and petechiae
What is the definition of onset of action?
The amount of time it takes for the medication to demonstrate a therapeutic response
The nurse instructs the patient to take his medication with a full 8 ounces of water. How many mL of water will the nurse document was taken on the client's intake and output?
240 mL
The nurse is administering medications on the medical surgical unit.
What are nursing actions related to the nursing process in the phase of: Planning
Correct Answers include:
Avoiding distractions when planning and preparing medications
Goal setting with the patient
Verify high alert medications
Ampicillin 350mg is ordered every 12 hours. The nurse notes an oral suspension is available as 250 mg per teaspoon. The nurse will document that how many mL were given per dose?
What is 7 mL
A patient is being started on calcium citrate for osteoporosis. What are appropriate client instructions for the nurse to include in the plan of care?
Teach signs of hypercalcemia: constipation, nausea/vomiting, increased urine output and depression
Instruct to take calcium supplements 1-2 hours before or after taking calcium citrate
Instruct patients to report flank pain or blood in urine (risk is for kidney stones)
Take 1 hour after meals and at bedtime
What is the definition of peak action?
The time it takes for a medication to demonstrate its full therapeutic effect
A nurse is providing discharge instructions to a pediatric patient's mother. Amoxicillin 500mg orally every 8 hours is ordered. The medication is sent from the pharmacy and available in liquid as 250mg per ml. The nurse administers the first dose at 1600. What instructions (dose amount and next administration times) should the nurse give the patient's mother?
Give 2 mLs at 12 midnight and at 8am
The nurse is administering medications on the medical surgical unit.
What are nursing actions related to the nursing process in the phase of: Implementation
Correct answers include:
Only administer medications that you prepare
Explain the purpose of the medication
Delay administration if the client questions anything about the medication (recheck and review/verify to allay the clients' concerns
Rocephin 300mg IM is ordered every 6 hours. The nurse notes that what is available is 900mg per 6 mL. The nurse will administer _____ mL for one dose?
What is 2 mL
A patient who has osteoporosis has been prescribed alendronate. To prevent possible adverse effects the nurse provides what client instructions?
Take the medication with a full glass of water and sit/stand for 30 minutes to ensure it passes into the stomach and dissolves.
Give the medication 30 minutes before other medications, beverages or food.
What is meant by the therapeutic index?
It is the margin of safety. (Basically it compares the dose that has a therapeutic effect vs the dose that has toxic effects
What is the difference between a Category A drug in pregnancy and a Category X drug?
Category A is safe in pregnancy and Category X has demonstrated a relationship between fetus malformation and drug therapy
The nurse is administering medications on the medical surgical unit.
What are nursing actions related to the nursing process in the phase of: Evaluation
Correct answers include
Identify and document the clients response to the medications administered
Document any adverse effects
Ask the client to explain what the understand about the medication and how to take them (teach back)
A patient weighs 80 kg. A drug is ordered as a 5mg/kg for one dose. What is available is 250mg of the drug per ml
The nurse will give ____ml for one dose?
Answer
1.6 ml
The nurse is providing instructions to a client with a new prescription for etanercept. What are key items to include?
Answers include:
A tuberculosis test is done prior to starting the medication
Be current on vaccines/avoid life virus vaccines
Monitor the injection site for redness, pain or swelling
Report skin rashes immediately
Reports signs and manifestations of infection immediately
What is the difference between and agonist and an an antagonist?
Name an a frequently known example of an antagonist?
Agonists are medications that bind with a receptor that yields a greater than typical response
Antagonists are medications that bind with a receptor and block a response
Common example: Narcan (naloxone) is an antagonist to opioid medications