Who Am I
A patient with HF has less edema and fewer crackles after receiving a medication. Morning labs reveal a decreasing potassium level. Identify the medication.
What is furosemide
A patient receiving a loop diuretic develops an irregular cardiac rhythm. Which electrolyte result should the nurse investigate first?
Potassium
A patient receiving morphine becomes difficult to arouse with RR 8/min. Pain decreased from 9/10 to 2/10. Which finding determines the priority?
Respiratory depression
A patient taking prednisone says, “Once I feel better, I’ll stop taking it.” How should the nurse respond?
Further teaching is needed — prolonged corticosteroid therapy should not be stopped suddenly.
A patient taking lamotrigine reports dizziness and later develops a rash with blisters and mouth sores. Which finding represents the major adverse effect?
Stevens-Johnson syndrome.
A patient with Parkinson disease reports that tremors and rigidity become worse around mealtimes. The nurse discovers the patient recently increased large high-protein meals. Identify the medication whose effect may be reduced.
What is carbidopa-levodopa
A patient taking valsartan develops muscle weakness. Which two laboratory values deserve particular attention based on this medication?
Potassium and creatinine
An unconscious diabetic has severe hypoglycemia. No IV access is available. What medication should the nurse prepare?
Glucagon
A patient taking methylphenidate has experienced significant appetite suppression and weight loss. The parent asks whether the medication should be given before breakfast so it “starts working earlier.” What is the best administration plan?
Feed the child first, then administer methylphenidate.
Avoid giving it late in the day, and encourage high-calorie/high-protein foods when the medication effect is lowest.
A patient taking fluoxetine reports nausea and insomnia. Two days later, the patient develops agitation, fever, diaphoresis, diarrhea, tremor, and hyperreflexia. Which findings indicate the dangerous adverse effect?
Serotonin Syndrome.
A transplant recipient receiving an immunosuppressant develops hypertension, decreased urine output, hyperkalemia, and rising creatinine.
What is cyclosporine
A patient receiving epoetin alfa has little improvement in anemia despite therapy. Which additional value should the nurse consider along with Hgb/Hct?
Iron stores
During rituximab administration, the patient suddenly develops chills, dyspnea, flushing, and hypotension.
Stop the infusion and assess ABCs.
A patient is about to take alendronate first thing in the morning. What are 4 the administration requirements that reduce complications.
Take it on an empty stomach, use plain water, remain upright for at least 30 minutes, and avoid food or other medications immediately afterward.
A patient taking prednisone reports increased appetite, weight gain, and insomnia. What findings are these?
Expected/common side effects
A patient with increased ICP receives a medication that moves water from brain tissue into the circulation. Thirty minutes later, the nurse auscultates new crackles.
What is mannitol
The nurse evaluates a patient receiving IV unfractionated heparin. Which combination provides the most important picture of treatment safety?
aPTT/anti-Xa + platelets + Hgb/Hct + bleeding assessment.
Minutes into rituximab, a patient develops fever, chills, dyspnea, hypotension, and flushing. What is the immediate action?
Stop the infusion and assess ABCs
The nurse prepares a prefilled enoxaparin syringe for a patient requiring DVT prevention. Describe the correct site and administration technique.
Administer subcutaneously and do not massage the site.
During an IV vancomycin infusion, a patient suddenly develops intense flushing, itching, and redness of the face and neck. What complication should the nurse recognize.
Red Man Syndrome
A patient treated for a serious infection develops tinnitus, vertigo, and decreasing urine output. The medication inhibits bacterial protein synthesis.
What is gentamicin
A patient receiving methotrexate reports severe fatigue, mouth sores, fever, and bruising. Which laboratory assessment becomes especially important?
CBC — possible bone marrow suppression.
A patient receiving IV heparin suddenly develops a severe headache and decreased LOC without visible bleeding. What complication takes priority?
Monitor for suspected intracranial bleeding
A patient reports acute chest pain and has an order for nitroglycerin. Before administering the medication, the nurse discovers the patient recently used sildenafil. What action should the nurse take next?
Do not administer the nitroglycerin because combining it with sildenafil can cause severe hypotension.
A patient taking prazosin reports feeling dizzy when standing after receiving the first dose. What common medication effect explains this finding?
Orthostatic hypotension