New pharm material
Why should a nurse conduct a bilateral lower extremity (BLE) assessment on a patient taking hydrocortisone?
SE: Thromboembolism
This bacterial infection involves the dermis and subcutaneous tissue, often begins after a break in the skin, and presents as an expanding, tender, red plaque with warmth, fever, and edema, and can progress to sepsis if untreated.
Cellulitis
What is the peak time for lispro (Humalog)?
0.5-1.5
A trauma patient with a suspected spinal cord injury has BP 78/40 and HR 52. Their skin is warm and dry, and there is no obvious external bleeding. You suspect shock.
This specific vital sign pattern is what helps you distinguish this type of shock
Hypotension and Tachycardia
A patient experiencing an acute gout attack would be prescribed which medication?
colchicine (Colcrys) is used in acute gout attacks. Expect 24-48 hours before symptom relief
Your patient reports black tarry stools while taking ferrous sulfate (Feosol). Should you report this to the provider immediately?
No. Black tarry stools are an expected side effect while taking iron supplements
This painful condition occurs when functional endometrial tissue implants outside the uterus, causing pelvic pain, dyspareunia, back pain, and potential infertility due to adhesions.
Endometriosis
Do the selective beta blockers (metoprolol, atenolol, and esmolol) directly lower the heart rate?
Yes!
A patient has chest pain that started with exertion and now continues at rest. Their first troponin is normal, and the ECG shows no ST elevation. Based on these symptoms, what is this patient most likely experiencing?
Unstable angina
A patient has a wound on his leg that is red, swollen, hot to the touch, with purulent drainage. His WBC count is high. Do you suspect inflammation or infection?
Infection. All signs of inflammation PLUS: fever, elevated WBC, purulent drainage, malaise
Which life-threatening side effect is associated with ondansetron (Zofran)?
Serotonin syndrome
A patient with BPH says it takes him forever to start peeing and the stream is weak. What simple explanation explains why the urine can’t come out normally?
The enlarged prostate is pressing on the urethra so urine can’t flow freely
A nurse knows to conduct an MSK assessment in a patient taking ciprofloxacin (Cipro) because of what SE?
Cartilage toxicity (Achilles tendon)
ABG results show: pH 7.30, PaCO₂ 50, HCO₃⁻ 28. The patient has a history of COPD and is drowsy. Using ROME, how would you accurately interpret this ABG and explain why?
Respiratory Acidosis (d/t low pH and high CO2)
Which insulin would you expect to be ordered with epinephrine (Adrenalin)?
Regular IV (POC blood glucose checked q 30 mins)
A pregnant person receives IV oxytocin (Pitocin) before giving birth. What is the goal of this medication?
Increase the intensity and frequency of contractions to promote induction of labor
A patient can see things out of the sides of their vision but can’t make out details right in front of them, like faces or reading. What part of the eye that gives us sharp, central vision is not working properly?
The macula is being damaged (as in macular degeneration)
The nursing implications for a patient receiving IV heparin include?
PTT or anti-Xa
A patient with low blood pressure and weak pulses has cool, pale extremities. Thirty minutes later, their urine output drops and their mental status becomes confused.
Based on perfusion concepts, explain what this change from early to later symptoms indicates.
Poor tissue perfusion (cool, pale skin) is now progressing to organ perfusion problems, leading to organ failure — especially kidney failure (low urine output) and decreased brain perfusion (confusion)
When should a patient taking doxazosin (Cardura) for BPH be assessed for orthostatic hypotension?
At the first dose and dose increases
What are the side effects of epinephrine (Adrenalin)?
Hypertension, tachycardia, hyperglycemia
A patient with low red blood cells gets out of breath just walking across the room. Why would having fewer RBCs make breathing feel harder?
Because there’s less oxygen being carried in the blood, so the body has to work harder to get enough
A patient tells the nurse she will use her salmeterol (Serevent Diskus) next time she is having an acute asthma attack. How should the nurse respond?
Salmeterol will NOT abort an acute attack, it is for maintenance only. Advise her to use a rescue inhaler instead.
A patient in anaphylaxis develops sudden hypotension, wheezing, and widespread hives within minutes of receiving an antibiotic. Using the pathogenesis of anaphylaxis, explain what internal process causes all of these symptoms to appear so quickly.
Massive histamine release from mast cell degranulation, causing vasodilation (low BP), increased capillary leak (hives), and bronchoconstriction (wheezing)
A patient in the ER presents with Kussmaul respirations and fruity breath odor. What does the nurse immediately suspect?
Diabetic ketoacidosis (DKA)