ATI (chp 5)

Question 1

adverse effects on CNS

Answer 1

excitement or depression

If CNS stimulation is expected, clients may be at risk
for seizures, and precautions should be taken.

› If CNS depression is likely, advise clients not to
drive or participate in other activities that can
be dangerous.

Question 2

EPS

Answer 2

Extrapyramidal symptoms (EPS) (abnormal
body movements) may include involuntary
fine-motor tremors, rigidity, uncontrollable
restlessness, and acute dystonias (spastic
movements and/or muscle rigidity affecting the
head, neck, eyes, facial area, and limbs). These
may occur within a few hours or may take
months to develop.
-more common in mental health disorders that affect CNS

Question 3

Anticholinergic effects

Answer 3

result of muscarinic receptor blockade. Most
effects are seen in the eyes, smooth muscle,
exocrine glands, and the heart.

Question 4

NSAIDs

Answer 4

Nonsteroidal anti-inflammatory drugs
aspirin
ibuprofin
naproxen
-can cause GI upset

Question 5

Hematologic effects

Answer 5

Bone marrow depression/suppression is generally
associated with anticancer medications and
hemorrhagic disorders with anticoagulants and
thrombolytics. Educate clients taking anticoagulants
about bleeding (bruising, discolored urine/stool,
petechiae, bleeding gums).

Question 6

Nephrotoxicity

Answer 6

Nephrotoxicity may occur with a number of
medications, but it is primarily the result of
certain antimicrobial agents and NSAIDs.
Damage to the kidneys may interfere with
medication excretion, leading to medication
accumulation and adverse effects.

Question 7

Nursing intervention for nephrotoxicity

Answer 7

Aminoglycosides injure cells in the renal tubules of
the kidney. Monitor serum creatinine and BUN, as
well as peak and trough medication levels for clients
taking medication that is nephrotoxic.

Question 8

Drug that may be used to minimize liver damage when toxicity occurs

Answer 8

acetylcysteine

Question 9

diphenhydramine

Answer 9

used to treat allergic reactions

diphenhydramine

Question 10

How would you treat an Anaphylactic reaction?

Answer 10

Treat with epinephrine, bronchodilators, and

antihistamines

Question 11

Immunosuppression

Answer 11

decreased or absent immune response
example: glucocorticoids
-can mask the usual manifestations of
infection, such as fever

Question 12

Example of increased therapeutic effects using drug-drug interaction with albuterol (proventil) for asthma

Answer 12

albuterol (Proventil), a beta2
-adrenergic
agonist inhaler, 5 min prior to using triamcinolone acetonide (Azmacort), a
glucocorticoid inhaler, to increase the absorption of triamcinolone acetonide.

Question 13

How do diazepam and hydrocodone bitartrate interact together?

Answer 13

Adverse effect:
Diazepam (Valium) and hydrocodone bitartrate 5 mg/acetaminophen 500 mg
(Vicodin) both have CNS depressant effects. When these medications are used
together, clients have an increased risk for CNS depression.

Question 14

Ondansetron hydrochloride

Answer 14

Zofran - often given to decrease the side effects of primary drug. In this case, decrease nausea from chemotherapy

Question 15

If a medication can decrease the metabolism of a second medication then what is happening to the serum levels of the second medication

Answer 15

increase the serum level of the second medication, which can lead to toxicity

Question 16

Fluconazole

Answer 16

(Diflucan) inhibits hepatic medication-metabolizing enzymes

Question 17

OTC Antiacids

Answer 17

Antiacids relieve heartburn from stomach acid.

antacids can interfere with the absorption of ranitidine (Zantac) and other medications.

Question 18

Consuming foods with tyramine

Answer 18

otentially spoiled or pickled, aged, smoked, fermented, or marinated (some fish, poultry, and beef); most pork (except cured ham); chocolate; alcoholic beverages; and fermented foods, such as most cheeses (except ricotta, cottage, cream and Neufchâtel cheeses), sour cream, yogurt, shrimp paste, soy sauce, soybean condiments, teriyaki sauce, tempeh, miso soup, sauerkraut, kimchi, broad (fava) beans, green bean pods, Italian flat (Romano) beans, snow peas, edamame, avocados, bananas, pineapple, eggplants, figs, red plums, raspberries, peanuts, Brazil nuts, coconuts, processed meat, yeast, and an array of cacti.

Question 19

Consuming foods with tyramine while taking _______________ drugs can lead to hypertensive crisis (high BP w/ acute impairment of 1+ organ system)

Answer 19

monoamine oxidase inhibitors (MAOIs)

Question 20

Warfarin

Answer 20

(Coumadin)
anticoagulant (blood thinner). It reduces the formation of blood clots.

Warfarin is used to prevent heart attacks, strokes

Pregnancy X category

Question 21

What vitamin should you avoid while taking warfarin?

Answer 21

Vitamin K to avoid blood clots

Question 22

Tetracycline

Answer 22

Tetracycline is an antibiotic used to treat bacterial infections such as urinary tract infections, chlamydia and acne

Question 23

What type of food should you avoid within 2 hours of taking tetracycline?

Answer 23

dairy products or chelating agents

Question 24

Grapefruit juice

Answer 24

inhibits medication metabolism in the small bowel, thus increasing the amount of medication available for absorption of certain oral medications.

Question 25

Precautions to avoid when giving Morphine (Duramorph)

Answer 25

depresses respiratory function, so it should be used with caution for
clients who have asthma or impaired respiratory function.

Question 26

Category A

Answer 26

There is no evidence of risk to fetus during pregnancy based on adequate and
well-controlled studies.

Question 27

Adverse effects have been demonstrated on animal and human fetuses based on
studies and data from investigational or marketing experience. The use of the medication is
contraindicated during pregnancy because the risks outweigh the potential benefits.

Answer 27

Category X

Question 28

Category D

Answer 28

Adverse effects have been demonstrated on human fetuses based on data from
investigational or marketing experience, but use of the medication during pregnancy may be warranted based on the potential benefits.

Question 29

Category B

Answer 29

There is no evidence of risk to animal fetuses based on studies, but there are no
adequate and well-controlled studies in pregnant women.

Question 30

Category C

Answer 30

Adverse effects have been demonstrated on animal fetuses. There are no adequate and
well-controlled studies in pregnant women, but use of the medication during pregnancy may be
warranted based on the potential benefits.

Question 31

Glucocorticoid (GC)

Answer 31

GCs are part of the feedback mechanism in the immune system that turns immune activity (inflammation) down. They are therefore used in medicine to treat diseases caused by an overactive immune system, such as allergies, asthma, autoimmune diseases, and sepsis.

Question 32

Prescribing glucocorticoid when there is a fungal infection is an example of _______

Answer 32

Contraindication

Question 33

Acetaminophen is contraindicated in people with ___________________

Answer 33

liver disorder

Question 34

Orthostatic hypotension is a common adverse effect in ______________ medication

Answer 34

antihypertensive medications

Question 35

orthostatic hypotension

Answer 35

postural hypotension — is a form of low blood pressure that happens when you stand up from sitting or lying down.

Question 36

extrapyramidal effects are ______ disorders

Answer 36

movement disorders – affect CNS

Question 37

Oxycodone and ibprufin

Answer 37

increase pain-relieving effects. Oxycodone is a narcotic analgesic, and ibuprofen is an NSAID. They work by
different mechanisms, but pain is better relieved when they are taken together

Question 38

naproxen

Answer 38

aleve

-Naproxen and other NSAIDs may cause renal insufficiency

Question 39

Antibiotic that can injure cells of the proximal renal tubules

Answer 39

getamicin

Question 40

BUN test

Answer 40

A common blood test, the blood urea nitrogen (BUN) test reveals important information about how well your kidneys and liver are working. A BUN test measures the amount of urea nitrogen that’s in your blood.

Here’s how your body typically forms and gets rid of urea nitrogen:

Your liver produces ammonia — which contains nitrogen — after it breaks down proteins used by your body’s cells.
The nitrogen combines with other elements, such as carbon, hydrogen and oxygen, to form urea, which is a chemical waste product.
The urea travels from your liver to your kidneys through your bloodstream.
Healthy kidneys filter urea and remove other waste products from your blood.
The filtered waste products leave your body through urine.

Question 41

Serum Creatinine Test

Answer 41

A creatinine test reveals important information about your kidneys.

Creatinine is a chemical waste product that’s produced by your muscle metabolism and to a smaller extent by eating meat. Healthy kidneys filter creatinine and other waste products from your blood. The filtered waste products leave your body in your urine.

If your kidneys aren’t functioning properly, an increased level of creatinine may accumulate in your blood.

Question 42

Specific gravity of urine

Answer 42

Urine SG can be used to assess the kidney’s ability to concentrate or dilute urine. However, because protein, glucose, and contrast dye have molecular masses that are relatively large compared to other major components of urine (eg, sodium, chloride, potassium), they disproportionately affect SG. In these cases, urine osmolality is a better measure of urine concentration.