Antibiotics
One of your patients is allergic to penicillin. What other class of antibiotics should you use caution with for it has a potential for a cross allergy with penicillins?
A. Macrolides
B. Aminoglycocides
C. Flouroquinolones
D. Cephalosporins
D. Cephalosporins
Cephalosporins run the risk of causing an allergic reaction in those allergic to penicillins.
One of your patients has been on warfarin for a few weeks to prevent clots due to his a-fib. Which clotting times should be checked to see that the warfarin is at a therapeutic range?
PT and INR
a PT of 18-24 secs and an INR of 2-3 are considered therapeutic
Which vaccine is recommended for girls and women aged 9-26 and helps prevent diseases like cervical cancer?
HPV
Tdap
PCV13
MMR
1.
HPV infection is the number one cause of cervical cancer in young women and it is recommended that all girls and women aged 9-26 get vaccinated.
You just gave one of your patients epoetin alfa to treat her anemia caused by chronic kidney disease. What symptom of increasing BP should you monitor for?
Abdominal pain
Headaches
Pedal pulses of +2
Swelling of the hands and feet
2
Epoetin alfa can cause a dangerous rise in BP and headaches are a tell tale sign of high BP.
This the therapy of choice to treat HIV infection and the goal is to quickly reduce the viral load and keep it low for as long as possible.
HAART
Highly active antiretroviral therapy and this is done with a combination of antiretrovirals.
One of your patients is receiving gentamicin IV. What is a sign that they are having an adverse reaction to this medication?
A. Ankle pain
B. Edema and low urine output
C. Jaundice
D. Dizziness/lightheadedness
B.
Gentamicin is an aminoglycocide and is nephrotoxic. Kidney damage can present as low urinary output and generalized edema.
This medication is a non-NSAID antiplatelet medication that is used to prevent clots in conditions like afib.
clopidogrel
Things to consider during therapy are to monitor platelet counts, monitor for bleeding, and use caution in those on other anitplatelet/anticoagulant meds.
You just gave one of your patients their yearly flu shot. What type of immunity does this provide for them?
Active Natural
Passive Artificial
Passive Natural
Active Artificial
4
Active artificial immunity is the immunity that is gained through the production of antibodies by means of receiving a vaccine.
A nurse is assessing a patient who has chronic neutropenia and who has been receiving filgrastim. Which of the following actions should the nurse take to assess for an adverse effect of filgrastim?
A. Assess for bone pain.
B. Assess for right lower quadrant pain.
C. Auscultate for crackles in the bases of the lungs.
D. Auscultate the chest to listen for a heart murmur.
A
Bone pain is a dose-related adverse effect of filgrastim. It can be treated with acetaminophen and, if necessary, an opioid analgesic.
One of your patients is receiving ganciclovir to treat their CMV infection which is causing mono. What adverse effect should be monitored for?
A. Bruising/bleeding
B. Decreased urine output
C. Phlebitis/pain at injection site
D. Jaundice and RUQ pain
A. Bruising/bleeding
ganciclovir can cause bone marrow suppression and so cause low platelet counts, neutropenia, and anemia.
One of your patients is getting meropenem for a few weeks to help treat their bacterial pneumonia. What complaint by the patient should be assessed further as an adverse effect of this medication?
Feeling dizzy
Feeling drowsy
Diarrhea and abdominal pain
A headache
3.
Diarrhea and abdominal pain can be a sign of C. dif infection which is an opportunistic infection that can be caused by long-term, broad spectrum antibiotic use.
You have been giving one of your patients heparin for a few days to prevent DVTs while they recover from surgery. They start to develop hematuria and black, tarry stools. You suspect heparin toxicity. What should you give them as the antidote to heparin?
Protamine
If your patient starts to show signs of bleeding while on an anticoagulant like heparin or enoxaparin, protamine is the antidote to use.
This vaccine is recommended for adults to get a booster of every 10 years.
1. Influenza
2. Zoster
3. Tdap
4. MMR
3. Tdap
Tdap is recommended for adults to have every 10 years.
A nurse is caring for a patient who is receiving daily doses of oprelvekin. Which of the following laboratory values should the nurse monitor to determine effectiveness of this medication?
A. Hemoglobin and hematocrit
B. Absolute neutrophil count
C. Platelet count
D. Total white blood cell count
C. Platelet count
Oprelvekin stimulates platelet production in those with thrombocytopenia.
Why is it important to educate patients taking anti-HIV medications to take them at the same time every day and not to miss doses?
Missing doses can cause the virus to become resistant to further treatment and so it is important to stress not missing doses.
A nurse is preparing to administer cefotaxime IV to a patient who has a severe infection and has been receiving cefotaxime for the past week. Which of the following findings indicates a potentially serious adverse reaction to this medication that the nurse should report to the provider?
A. Diaphoresis
B. Epistaxis
C. Diarrhea
D. Alopecia
C.
Diarrhea is an adverse effect of cefotaxime and other cephalosporins that requires reporting to the provider. Severe diarrhea might indicate that the client has developed antibiotic-associated pseudomembranous colitis, which could be life-threatening.
This medication is a thrombolytic used to dissolve clots in people having MIs, strokes, and PEs.
Alteplase
Things to watch out for are massive bleeding, avoid uneeded needle sticks, those who are or are suspected of bleeding can't get this, and those who have had recent surgery can get this either.
These vaccines are live vaccines and should be avoided being given to those who are immunocompromised/immunosuppressed. (Select all)
MMR
Tdap
Varicella
Influenza (IM form)
PCV13
1, 3
The live (but weakened) vaccines consist of MMR, Varicella, influenza (nasal), and Zoster
A nurse is monitoring a patient who is receiving epoetin alfa for adverse effects. The nurse should identify which of the following findings as an adverse effect of this medication? (Select all that apply)
A. Leukocytosis
B. Hypertension
C. Edema
D. Blurred vision
E. Headache
B and E
Headache and increased BP are two of the most prevalent side effects of epoetin alfa.
Your're about to give one of your patients IV acyclovir to treat a herpes infection. What should you do when administering it? (Select all)
A. Administer over 1 hr
B. Monitor for hearing loss
C. Tell your patient to practice good dental hygiene
D. Monitor for rash and/or itchiness
E. Monitor liver labs
A, C, D
Acyclovir is renal toxic and can also cause gingival hyperplasia. This is why it is administered over at least 1 hour and good dental hygiene is recommended. Allergic reactions can happen with any medication so monitor for signs of that as well (itching, swelling, rash)
You have a patient with a UTI and they are receiving ciprofloxacin to treat it. What's one sign of an adverse reaction you should be monitoring for?
A. Headache
B. Pain/tenderness near their ankle
C. Parasthesia
D. Ataxia
B.
Cipro has the adverse effect of potentially causing Achilles tendon rupture and so it should be monitored for.
This medication is a strictly clotting factor Xa inhibitor and it is given orally.
Rivaroxaban
Aka xarelto, this can also cause serious bleeding and liver damage so monitor for signs of bleeding and liver injury (RUQ pain, N/V, jaundice)
This type of immunity is gained when someone receives antibodies in the form of immune globulins. It is temporary and is usually given to people traveling to foreign countries.
Passive artificial immunity
This drug is given to stimulate WBC production (all types), usually in those who have had a bone marrow transplant or are receiving treatment for diseases like leukemia.
Filgrastim
Oprelvekin
Sargramostim
Tetracycline
3.
Sargramostim acts on hematopoietic cells to stimulate proliferation & differentiation particularly into neutrophils, monocytes/macrophages & myeloid-derived dendritic cells.
A nurse is caring for a patient who is taking ritonavir, a protease inhibitor, to treat HIV infection. The nurse should monitor for which of the following adverse effects of this medication?
A. Increased TSH level
B. Decreased ALT level
C. Hypoglycemia
D. Hyperlipidemia
D
Increased cholesterol and triglyceride amounts is an adverse effect of protease inhibitors.