The client is receiving heparin IV. Which lab tests should the nurse monitor closely?
Definition
aPTT
Term
The nurse is caring for a client receiving a thrombolytic drug. The nurse knows this drug may be prescribed for a variety of disorders. What disorders may the physician prescribe thrombolytics?
The nurse is preparing to administer alteplase recombinant (Activase) to a client diagnosed with an acute MI. The nurse knows this medication is given to:
Definition
dissolve pre-existing clots.
Term
How do angiotensin converting enzyme inhibitors such as fosinopril (Monopril) decrease blood pressure?
Definition
decreasing blood volume,
dilating arteries,
blocking the conversion of angiotensin I to angiotensin II
Term
When used to treat hypertension, what do diuretics such as hydrochlorothiazide (HydroDIURIL) do?
Definition
cause a reduction in blood volume
Term
The nurse is providing discharge teaching to a client going home on warfarin (Coumadin). What medications should the client avoid?
Definition
herbal supplements, OTC cough syrups,
vitamin K,
NSAIDs
Term
The nurse is admitting a client to the orthopedic unit following a total hip replacement. The physician has ordered enoxaparin (Lovenox) 30 mg SC every 12 hours. What is the highest priority nursing diagnosis with this drug?
Definition
risk for injury (bleeding)
Term
The client is being discharged on warfarin (Coumadin) 5 mg PO every day. What lab test should the client have checked regularly?
Definition
PT
Term
ACE inhibitors are useful for treating heart failure because they: ?
Definition
decrease cardiac preload
Term
Right-sided heart failure is associated with venous congestion that manifests as:
Definition
peripheral edema
Term
A client who has a history of angina and hypertension now complains of fatigue, shortness of breath, and cough. The nurse suspects that the client may be developing: ?
Definition
left-sided heart failure
Term
What drug is considered first-line treatment for heart failure?
Definition
ACE inhibitors like lisinopril (Prinivil)
Term
What drug has been shown to increase survival in clients with heart failure?
Definition
ACE inhibitors like lisinopril (Prinivil)
ACE inhibitors have been shown to increase survival in clients with heart failure and after acute myocardial infarction.
Term
The client has been started on propranolol (Inderal). The nurse expects what finding?
Definition
lowered heart rate
Term
When gathering information from a client regarding past health history, the nurse learns there is a long history of cardiac dysrhythmia, but the client states that he is not on any antidysrhythmics, and his condition has been stable. The nurse deduces that the client's condition is being controlled by:
Definition
an ICD
Implantable cardioverter defibrillators (ICDs) are placed in a client to restore normal rhythm by either pacing the heart or giving it an electrical shock when dysrhythmias occur. Use of an ICD is a nonpharmacological treatment for dysrhythmias and may be a choice to avoid the serious side effects caused by antidysrhythmic drugs.
Term
Clients taking digoxin (Lanoxin) will have plasma levels of what watched closely?
Definition
potassium
Hypokalemia increases the likelihood of digoxin toxicity; therefore plasma potassium levels are watched closely in clients taking this drug. Furthermore, changes in potassium levels (either increases or decreases) can promote dysrhythmias in clients with underlying cardiac disease.
Term
What drug would be a good choice for a client with both heart failure and angina?
Definition
isosorbide dinitrate (Isordil) is a nitrovasodilator that has a relatively selective action on veins. The peripheral venodilation it produces reduces cardiac preload, and thus is beneficial in clients with heart failure. Nitrovasodilators also dilate coronary arteries, thereby increasing coronary blood flow and improving angina symptoms.
Term
Clients taking what drug must be monitored closely for signs of toxicity because the therapeutic index is so narrow?
Definition
digoxin (Lanoxin)
Term
Is this statement true or false? "As long as I exercise, stress at my job will not bother me."
Definition
False
Term
Stable angina can be differentiated from unstable angina in that stable angina includes: ?
Definition
predictability of frequency and duration
Term
?
[image]
Definition
Vessels in your head are affected by the medication
Term
The client asks the nurse the reason for having NitroSL available when using a transdermal patch. What rationale would the nurse give?
Definition
Sublingual nitroglycerin is used for acute episodes in progress
Term
Antianginal drugs accomplish therapeutic effect by doing what?
The single most important action when a client is suspected of having a cerebral vascular accident is to:
Definition
initiate thrombolytic therapy
Term
When reviewing health history, the nurse knows a client of which ethnicity will demonstrate the highest incidence of angina pectoris?
Definition
black
Term
If the client is entering hypovolemic shock, the nurse understands that what becomes a priority?
Definition
maintenance of volume
Term
The earliest sign of shock that the nurse can assess might be: ?
Definition
restlessness Behavior changes are some of the earliest symptoms and may include restlessness, anxiety, confusion, depression, and lack of interest.
Term
The first step to treating shock is to provide: ?
Definition
basic life support
Term
Therapeutic lifestyle changes that can control high blood cholesterol levels include what percentage of total caloric intake as saturated fat?
Definition
7 percent
Term
The client has been diagnosed with hyperlipidemia and is being educated on types of food to include in his diet. The most appropriate nursing diagnosis for this client is:
Definition
deficient knowledge, related to need for altered lifestyle
Term
The client asks which components of the lipid profile should be low. The nurse's best response is that:
Definition
LDL should be low
Term
The client is going to be started on cholestyramine (Questran), 6 mg, three times daily. The nurse instructs the client to:
Definition
take with large amounts of fluid
Term
The anthrax vaccination has been licensed by the FDA for more than 30 years. The nurse knows that the Centers for Disease Control and Prevention recommends this vaccination for whom?
Definition
laboratory personnel,
those who deal with imported animal products, military personnel
Term
After assessing a client with allergic rhinitis, the most appropriate medication that the nurse will administer is:
Definition
diphenhydramine (Benadryl).
The primary use of diphenhydramine (Benadryl) is to treat symptoms of allergy and the common cold such as sneezing, runny nose, and tearing of the eyes. It reduces inflammation by blocking H1-receptors found within smooth muscle cells of the respiratory tract.
Term
The client asks the nurse how Lipitor will help lower cholesterol. The nurse responds, "Lipitor belongs to a class of drugs that:
Definition
interfere with how cholesterol is made."
Term
Lifestyle changes that can lower blood lipid levels include: ?
Definition
smoking cessation,
restriction of dietary saturated fat and cholesterol,
increased exercise
Term
True or False: A nurse is teaching her client cyclosporine therapy following a recent liver transplant would not need to use further teaching if the client made this statement.
"I can take this drug with any fluid as long as it is at the same time every day."
Definition
False
The primary adverse effect of cyclosporine occurs in the kidney, with up to 75 percent of clients experiencing reduction in urine flow.
Term
The client has an HDL cholesterol value of 38 mg/dl. The nurse interprets this value as:
Definition
low
Term
The nurse is admitting a client to the acute care floor with methicillin-resistant S.aureus. The nurse would expect the physician to order what medication for this client?
Definition
vancomycin
Vancomycin is the most effective drug for treating methicillin-resistant S.aureus.
Term
The nurse is providing discharge instructions to a client being discharged on ciprofloxacin (Cipro). What should be included in the teaching?
Definition
Do not take with antacids,
Do not take with mineral supplements,
You may have some dizziness.
Term
The nurse is admitting a client with a diagnosis of urinary tract infection. The physician has ordered an IV antibiotic. Before administering this medication, it is most important to obtain:
Definition
urine for culture and sensitivity
Term
The nurse is preparing discharge instructions for a client who will be taking penicillin G. The client tells the nurse she is also taking birth control pills. What is the nurse's best response?
Definition
"You will need to use another form of contraception while taking the antibiotic and for at least one month after you finish treatment."
Term
The nurse is admitting a client to the acute care floor. While obtaining the history, the client tells the nurse she is allergic to penicillin. What type of antibiotic medications, if ordered by the physician, would be safe for this client?
Definition
erythromycin
Term
The nurse is caring for a client who is being discharged with a prescription for a tetracycline. What type of statement, if made by the client, demonstrates an understanding of the discharge instructions?
Definition
"I will need to postpone my vacation at the beach until I finish this medication."
Clients should be advised to avoid direct exposure to sunlight because tetracyclines can cause photosensitivity during therapy.
Term
A client enters the emergency department with suspected exposure to anthrax. The physician confirms this suspicion and orders the client an antibiotic. What medication would the nurse expect the physician to order?
Definition
ciprofloxacin (Cipro)
The most widely used drug in the fluoroquinolones, ciprofloxacin (Cipro), is a drug of choice for exposure to anthrax.
Term
The nurse is preparing to administer the antifungal medication, nystatin, to an adult client. The nurse also has a PO medication to give this client. How should the nurse administer these medications?
Definition
Give the PO medication first.
The client should wait at least 10 minutes after antifungal treatment to put anything else in the mouth, so the PO medication should be given before the nystatin
Term
The nurse is admitting a client to the acute care unit with Trichomonas vaginalis. What is the drug of choice for this infection?
Definition
metronidazole (Flagyl)
Metronidazole is the drug of choice for both giardiasis and trichonomiasis due to Trichomonas vaginalis.
Term
The nurse is preparing to discharge a client who will be taking an antiretroviral agent. With what symptoms should the client discontinue the medication and inform the healthcare provider?
Definition
shortness of breath,
rash,
swelling of face,
wheezing
Term
A client is in chronic renal failure. The nurse understands that this client may require:
Definition
a significant dosage reduction in most medications.
Because the kidneys excrete most drugs, most medications will require a significant dosage reduction in patients with moderate to severe renal failure, which is classified as acute or chronic.
Term
The client is receiving cyanocobalamin (Cyanabin) every other week. Teaching includes:
Definition
treatment may be necessary throughout the lifespan
Term
A diuretic that is also used for treatment in certain types of glaucoma is:
Definition
mannitol (Osmitrol).
Osmotic diuretics have very specific applications. Mannitol is used to maintain urine flow in clients with acute renal failure or during prolonged surgery. It can also be used to lower intraocular pressure in certain types of glaucoma
Term
A client has been taking spironolactone (Aldactone) and continues to have peripheral edema. The nurse should ask the client if he is also taking:
Definition
aspirin
Aspirin and other salicylates may decrease the diuretic effect of spironolactone
A client who has been placed on spironolactone (Aldactone) should be closely monitored for hyperkalemia, especially if also on:
Definition
ACE inhibitor (Zestril)
Term
Thiazides may be preferred over loop diuretics because:
Definition
the frequency of adverse effects is much lower.
Term
Foods high in potassium include: ?
Definition
bananas, broccoli, dried fruits, peanut butter
Term
If Paget's disease is diagnosed late in the disease's progression, other disorders may also appear including:
Definition
arthritis, kidney stones, and heart disease.
Term
Assessment findings in a client with hypocalcemia include:
Definition
muscle twitching or tremor
Term
A client is receiving tizanidine ( Zanaflex) for treatment of muscle spasms. The nurse educates the client:
Definition
to exercise caution when operating machinery.
All centrally acting antispasmodics can cause sedation so caution should be exercised when driving or operating machinery
Term
A client is taking colchicine for gouty arthritis and Lasix for treatment of congestive heart failure. Teaching regarding drug interactions includes: ?
Definition
The client should call the physician if there is no improvement in gout symptoms.
Colchicine interacts with many drugs: loop diuretics may decrease colchicines effects
Term
A client with a spinal cord injury is left with spasticity and dystonia. The nurse understands the most effective treatment for this condition is:
Definition
physical therapy and medications
Term
A safe and inexpensive natural alternative to anti-inflammatory drugs for arthritis is:
Definition
glucosamine sulfate.
Term
Teaching for clients following sodium hyaluronate (Hyalgan) injections include:
Definition
avoid strenuous exercise for 48 hours after injection.
Term
True or False: Selective estrogen receptor modulators (SERMs) are contraindicated in patients with postmenopause.
Definition
False
Term
The nurse is educating the mother of an infant with dermatitis regarding long-term effects of the condition. A correct statement for the nurse to pass on to the mother is:
Definition
"Approximately 60 percent of infants with dermatitis have symptoms into adulthood."
Term
Which is a medication used to treat sickle cell anemia and also psoriatic symptoms?
Definition
Hydrea
Term
The most effective treatment for sunburn is:
Definition
prevention with use of sunscreens, sunglasses, and sufficient clothing
Term
A client with rosacea asks how to limit exacerbation of symptoms. The nurse recommends:
Definition
eliminating alcohol and spicy foods from the diet.
Term
A mother of a school-aged child asks the nurse why her child continues to have itching with no sign of mites. The nurse gives this response:
Definition
"Itching is common, even after the mites have been killed."
Term
Age-related changes in the skin include: ?
Definition
fragile epidermis,
loss of elasticity,
loss of hair follicles
Term
The client using amcinonide (Cyclocort ) should be instructed to:
Definition
apply the medication to affected areas.
Term
A client taking Tegretol for seizures has also been started on Accutane. The nurse recognizes that the client: ?
Definition
may have increased seizure activity.
Term
Periodic monitoring of what is indicated for the client taking tretinoin (Accutane)?
Definition
triglycerides.
Increased serum concentrations of triglycerids (by 50[image]70 percent) may occur in clients taking Accutane
