Week 7
The nurse knows that clavulanic acid is combined with certain penicillins to?
A. Increase activity against penicillinase producing bacteria
B. Increase activity against beta-lactamase producing bacteria
C. Increase stability in stomach acid
D. Increase duration of action of the antibiotic
B. Increase their activity against beta-lactamase producing bacteria
Aminoglycosides are ________ (causing damage to kidneys) and _______ (causing damage to inner ear).
Aminoglycosides are nephrotoxic (causing damage to kidneys) and ototoxic (causing damage to inner ear).
Which statement about St. John’s wort does the nurse identify as true?
Answer: D
Rationale: Combining St. John’s wort with certain drugs can intensify serotonergic transmission to a degree sufficient to cause potentially fatal serotonin syndrome. Although St. John’s wort can enhance serotonergic transmission by itself, its effect is relatively weak; when used alone, the herb poses little risk. However, if St. John’s wort is combined with other serotonin-enhancing agents, the risk is greatly increased; therefore, St. John’s wort should not be combined with such drugs. Also, because St. John’s wort has a variety of known adverse interactions and is likely to have more that are as yet unknown, caution is clearly advised. St. John’s wort is not recommended for treating depression in patients taking other medications. St. John’s wort greatly reduces levels of digoxin, a drug for heart failure. For patients with mild to moderate major depression, St. John’s wort appears superior to placebo and equal to tricyclic antidepressants. For patients with severe depression, there is no convincing proof of efficacy.
What does SBAR stand for?
Situation
Background
Assessment
Recommendation
Skeletal muscle relaxants can be helpful reducing pain from muscle spasm. These medications work in the CNS by slowing muscle nerve transmission leading to reduced muscle spasm. There are two commonly used medications: ___________ and ____________
There are two commonly used medications: methocarbamol and cyclobenzaprine.
The nurse knows that IV infusions of vancomycin should be given slowly to avoid the development of what syndrome?
Red Man Syndrome
•Give IV infusions slowly, over at least 60 minutes or longer
•Rapid infusion can cause flushing, rash, pruritus, urticaria, tachycardia, and hypotension (“Red Man” syndrome). Slow infusion reduces this risk.
The practical nurse is describing to the student nurse how sulfonamides work. The patient has been prescribed suflamethoxazole and trimethoprim. What is the MOA of the sulfonamides?
These medications are called bacterial metabolism inhibitors. These medications are bacteriostatic and prevent bacteria from making a final form of folic acid required for bacterial growth and function.
The most commonly prescribed sulfonamide is a combination of the sulfonamide, sulfamethoxazole and trimethoprim.
A postoperative patient who received an intravenous infusion of morphine has a respiratory rate of 8 breaths per minute and is lethargic. Which as-needed medication should the nurse administer to the patient?
A.Methadone [Dolophine]
B.Nalbuphine [Nubain]
C.Tramadol [Ultram]
D.Naloxone [Narcan]
•Answer: D
•Rationale: After surgery, naloxone may be used to reverse the excessive respiratory and central nervous system depression that can be caused by opioids.
What would be included in the B of SBAR?
What are the fat-soluble vitamins?
DEAK
The nurse is providing education to a new nurse about tetracycline. Which statement made by the new nurse would indicate for the need for additional teaching?
A. I should tell my patients to take this medication with milk to prevent nausea and vomiting.
B. This medication can stain developing teeth
C. There is a contraindication for use with pregnant women and children younger than 8 years of age
D. Diarrhea may indicate a potentially life-threatening suprainfection of the bowel
A. Tetracycline should not be taken with calcium as it can impair absorption
A fungal infection, or _________, can be found on any body part, for example, nails, feet, and perineum. People at greatest risk for fungal infection are those with immune system compromise: people with cancer on chemotherapy, people with HIV, transplant patients on anti-rejection medications, and people who have diabetes.
A fungal infection, or mycosis, can be found on any body part, for example, nails, feet, and perineum. People at greatest risk for fungal infection are those with immune system compromise: people with cancer on chemotherapy, people with HIV, transplant patients on anti-rejection medications, and people who have diabetes.
Also called narcotics, opioids are derived naturally from the opium poppy or synthesized as a chemical similar. By blocking the pain receptor _____, opioids alter the perception of pain and can also inhibit respiratory drive. These medications have a high addiction potential and must be regulated carefully.
Mu receptor
The practical nurse is about to reinforce education to a patient and learns that they speak a different language than the nurse. How should the LPN make sure the education can be delivered?
What is the difference between tolerance and addiction?
Over time, the body metabolizes opioids at an increasing rate resulting in a fixed dose being less effective as it initially was at relieving pain. This is called tolerance.
If a person has been taking opioids for a long period of time, with increasing doses to effectively treat pain, the doses should be gradually tapered down over time. If this is done too rapidly, the patient may experience symptoms of withdrawal, nausea, and anxiety.
If an individual develops a psychological dependence for opioids, this is addiction and requires expert substance abuse intervention, strategies and programs.
Which statement about allergic reactions to penicillin does the nurse identify as true?
A.Anaphylactic reactions occur more frequently with penicillins than with any other drug.
B.Allergy to penicillin always increases over time.
C.Benadryl is the drug of choice for anaphylaxis due to penicillin allergy.
D.Patients allergic to penicillin are also allergic to vancomycin.
Answer: A
Rationale: Anaphylactic reactions occur more frequently with penicillins than with any other drug. Allergy to penicillin can decrease over time. Epinephrine is the drug of choice for anaphylaxis. Vancomycin, erythromycin, and clindamycin are effective and safe alternatives for patients with penicillin allergy.
Herpes simplex virus type 1 (HSV-1) causes “cold sores” on the _____ and ______ and can be very painful. Herpes simplex virus type 2 (HSV-2) causes _____ herpes and lesions.
Herpes simplex virus type 1 (HSV-1) causes “cold sores” on the lips and mouth and can be very painful. Herpes simplex virus type 2 (HSV-2) causes genital herpes and lesions.
The nurse knows that ibuprofen is generally a well tolerated medication and the incidences of adverse effects are low in most patients. Compared to aspirin, the nurse knows that ibuprofen increases a patients risk of ___ and ____ and thus should be used in the lowest effective dosage for the shortest possible time.
·although they can suppress platelet aggregation, these drugs are not used to prevent MI and stroke.
·These drugs actually increase the risk of MI and stroke and thus should be used in the lowest effective dosage for the shortest possible time.
What is one method that can be used to complete dosage calculation?
Dimensional Analysis Method
Category - Nociceptive
Category - Nociceptive
A patient is started on an antibiotic at the clinical and asks the practical nurse about her birth control. What does the practical nurse tell the patient?
It would be a good idea to use another type of contraception well taking the antibiotic, such as a barrier method (condoms, etc)
Neuraminidase inhibitors (oseltamivir and zanamivir) are highly active against all current strains of influenza A and B. The practical nurse knows that these medications must be administered within how many hours of the onset of symptoms?
48 hours
A patient who is in the early stages of Wernicke-Korsakoff syndrome has been admitted to the healthcare facility.The practical nurse knows that this is caused by a deficiency of what vitamin?
Wernicke-Korsakoff syndrome is a serious disorder of the central nervous system, caused by thiamin deficiency, that has neurologic and psychologic manifestations.
54.5 lbs
What are examples of synthetic opioids?
The synthetic opioids based on the chemical structure of morphine are hydrocodone, hydromorphone, fentanyl, and oxycodone.