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exam 1 Flashcards

1
Q

______-given orally to decontaminate the GI tract before surgical procedures

A

neomycin

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2
Q

most common Health care–associated infections

A

MRSA

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3
Q

The elderly patient will experience polypharmacy, but not much can be done about it.

1. True
2. False
A

false

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4
Q

When completing an admission assessment, the patient states that she is allergic to sulfa drugs. What will the nurse do next?

Mark the allergy on her medical record.

Place an “allergy” armband on the patient.

Ask the patient for more information about the allergic reaction she had.

Notify the physician about the patient’s allergy.

A

Ask the patient for more information about the allergic reaction she had.

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5
Q

. A patient with a new diagnosis of tuberculosis (TB) will be taking isoniazid (INH) as part of the anti-TB therapy. However, he is also known to be a slow acetylator. This means that:

  1. the dosage of INH may need to be lower to prevent INH accumulation.
  2. the dosage of INH may need to be higher due to the slow acetylation process.
  3. no adjustment of INH will be needed.
  4. he will need to take a combination of anti-TB drugs for successful therapy.
A
  1. the dosage of INH may need to be lower to prevent INH accumulation.
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6
Q

interactions for this Beta-Lactam antibiotic

Oral contraceptives, warfarin, NSAIDs, others

A

Penicillins

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7
Q

A patient has a prescription for a sulfa drug as treatment for a urinary tract infection. She is also taking an oral contraceptive, an oral sulfonylurea antidiabetic drug, and phenytoin for a history of seizures. Which drug may pose a potential serious interaction with the sulfa drug?’

The oral contraceptive
The oral antidiabetic drug
The phenytoin
All of these

A

All of these

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8
Q

—use of herbal products and other nontraditional remedies

A

Alternative medicine

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9
Q

margin of safety between toxic and effective dose (ratio)

The ratio between the toxic and therapeutic concentrations of a drug

A

Therapeutic index

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10
Q

Ongoing monitoring of plasma drug concentrations and dosage adjustment based on these values as well as other laboratory indicators such as kidney and liver function test results; it is often carried out by a pharmacist in collaboration with medical, nursing, and laboratory staff

A

Therapeutic drug monitoring

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11
Q

Adverse Effects

Increased liver enzymes

Use with caution in patients with renal and liver dysfunction

A

azoles

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12
Q

antibiotic that Adverse Effects

Strong affinity for calcium:
-Discoloration of permanent teeth and tooth enamel in fetuses and children, or nursing infants

-May retard fetal skeletal development if taken during pregnancy

Alteration in intestinal flora may result in:
-Superinfection,diarrhea,pseudomembranous colitis, Vaginal candidiasis, gastric upset, enterocolitis, maculopapular rash, other effects

A

Tetracyclines “cycline”

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13
Q

The study of how various drug forms influence the way in which the drug affects the body

A

Pharmaceutics

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14
Q

Most medications have been extensively studied in a variety of different populations and age groups.

1. True
2. False
A

false

The majority of drug studies have focused on people between the ages of 13 and 65

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15
Q

An 82-year-old woman is unable to take the influenza vaccine due to allergies, but she has been exposed to the virus through a family reunion. She does not yet have symptoms of the flu. Which option would be best for her?

She should receive the flu vaccine as soon as possible
.
She should receive zanamivir (Relenza) in the inhalation form
.
She should begin oral oseltamivir (Tamiflu) therapy when symptoms begin.

She should begin oral oseltamivir (Tamiflu) therapy as soon as possible.

A

She should begin oral oseltamivir (Tamiflu) therapy as soon as possible.

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16
Q

dosage is calculated for peds. by

A

weight in kg

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17
Q

______soluble- higher blood concentrations

A

Water

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18
Q

The transport of a drug by the bloodstream to its site of action

A

Distribution

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19
Q

Cephalosporins (cef, ceph) __________ generation

Good gram-positive and poor gram-negative coverage
Used for surgical prophylaxis

A

first

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20
Q

black box warning nephro & oto toxicity

gentamicin
neomycin
amikacin

A

aminoglycosides

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21
Q

Medications used to treat bacterial infections

A

Antibiotics

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22
Q

antibiotic where

Treatment of choice for MRSA (IV)

treatment for C. difficile and for staphylococcal enterocolitis (P.O)

A

Vancomycin (Vancocin)

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23
Q

Adverse Effects:

Pulmonary fibrosis and pneumonitis (bleomycin)

Heart failure—cardiomyopathy (daunorubicin)

A

Cytotoxic Antibiotics

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24
Q

Most drugs considered to be effectively removed after about ____ half-lives

A

5

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25
Q

A patient is prescribed ibuprofen 200 mg PO every 4 hours as needed for pain. The pharmacy sends up enteric-coated tablets, but the patient refuses the tablets, stating that she cannot swallow pills. What will the nurse do?

Crush the tablets and mix them with applesauce or pudding.

Call the pharmacy and ask for the liquid form of the medication.

Call the pharmacy and ask for the IV form of the medication.

Encourage the patient to try to swallow the tablets

A

Call the pharmacy and ask for the liquid form of the medication.

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26
Q

Adverse Effects

Hair loss, nausea and vomiting, myelosuppression
Neurologic, cardiovascular, pulmonary, hepatobiliary, GI, genitourinary, dermatologic, ocular, otic, and metabolic toxicity

Tumor lysis syndrome

A

Antimetabolites

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27
Q

Assess baseline blood counts before administering ___________ drugs

A

antineoplastic

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28
Q

The study of what the drug does to the body

The study of the biochemical and physiologic interactions of drugs at their sites of activity. It examines the physicochemical properties of drugs and their pharmacologic interactions with body receptors.

A

Pharmacodynamics

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29
Q

A patient is diagnosed with onychomycosis. The nurse anticipates use of which medication for the treatment of this condition?

terbinafine (Lamisil)
voriconazole (Vfend)
fluconazole (Diflucan)
amphotericin B (Amphocin, Fungizone)

A

terbinafine (Lamisil)

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30
Q

During intravenous quinolone therapy in an 88-year-old patient, which potential problem is of most concern when assessing for adverse effects?

Hepatotoxicity
Rhabdomyolysis
Tendon rupture
Nephrotoxicity

A

Tendon rupture

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31
Q

_______soluble;- Higher concentration in fat, larger volume of distribution

A

fat-

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32
Q

this Beta-Lactam antibiotic has Adverse Effects

Serious: Allergic

Commons: Nausea, vomiting, diarrhea, abdominal pain

A

Penicillins

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33
Q

treatment of an infection before specific culture information has been reported or obtained

A

Empiric therapy

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34
Q

A nurse is administering gentamicin by IV infusion at 0900. The gentamicin will take 1 hr to infuse. When should the nurse plan for a peak serum level of gentamicin to be drawn?

A. 1000
B. 1030
C. 1100
D. 1130

A

B. 1030

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35
Q

Beta-Lactam antibiotic that

Reserved for complicated body cavity and connective tissue infections in acutely ill hospitalized patients

May cause drug-induced seizure activity

Used for treatment of bone, joint, skin, and soft-tissue infections; many other uses

Cilastatin inhibits an enzyme that breaks down imipenem

A

Carbapenems

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36
Q

treatment of serious systemic infections

Poor oral absorption; no PO forms (exception neomycin

Gentamicin
Amikacin

A

Aminoglycosides

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37
Q

determines the rate of drug dissolution (dissolving of solid dosage forms and their absorption from the GI tract).

A

Dosage form

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38
Q

Generally only inhibits the growth of microorganisms but does not necessarily kill them

Applied exclusively to living tissue

A

Antiseptics

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39
Q

to maintain health and wellness and “boost” one’s immune system

A

Proactive agents

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40
Q

The use of many different drugs concurrently in treating a patient, who often has several health problems.

A

Polypharmacy

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41
Q

antibiotic where

Primarily used for urinary tract infections (UTIs)

drug concentrates in the urine, use carefully if renal function is impaired

May cause fatal hepatotoxicity

A

nitrofurantoin (Macrodantin)

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42
Q

The study of what the body does to the drug

A

Pharmacokinetics

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43
Q

given as an oral lozenge or troche should be slowly and completely dissolved in the mouth (not chewed or swallowed whole)

suspension should be swished thoroughly in the mouth as long as possible before swallowing

A

Nystatin

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44
Q

major concern for thromycin

A

ototoxicity

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45
Q

Decrease in specific signs and symptoms of infection are noted (fever, elevated WBC, redness, inflammation, drainage, pain)

A

Therapeutic response

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46
Q

Pregnancy Safety Categorie where

Adverse effects reported in the animal fetus; information for humans is not available.

A

C

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47
Q

A laboratory measure of the lowest concentration of a drug needed to kill a certain standardized amount of bacteria

A

Minimum inhibitory concentration (MIC)

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48
Q

for treatment and cure of diseases

A

Therapeutic agents

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49
Q

The drug has a registered trademark; use of the name is restricted by the drug’s patent owner (usually the manufacturer)

A

Trade name (proprietary name)

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50
Q

A pregnant woman with liver disease is taking a pregnancy category B medication for her illness. Which statement is true in this situation?

  1. The mother’s liver disease will expose the fetus to less of the medication.
  2. The mother’s liver disease will expose the fetus to more of the medication.
  3. Because the medication is pregnancy category B, the medication is generally considered safe for the fetus.
  4. The liver of the fetus will protect the fetus from the effects of the medication.
A
  1. The mother’s liver disease will expose the fetus to more of the medication.

Impairment in maternal kidney or liver function may result in higher drug levels in the mother, which in turn may result in increased drug exposure to the fetus.

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51
Q

A period of continued bacterial suppression that occurs after brief exposure to certain antibiotic drug classes, especially aminoglycosides

continues to kill bacteria days after drug is given

A

Postantibiotic effect

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52
Q

Describes the drug’s chemical composition and molecular structure

A

Chemical name

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53
Q

A drug that binds to and stimulates the activity of one or more receptors in the body

A

Agonist

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54
Q

antibiotic that Nursing implications:

highly protein-bound: severe interactions with other protein-bound drugs

high incidence of GI upset, many drugs are taken after a meal or snack

A

Macrolides “thromycin”

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55
Q

Cephalosporins (cef, ceph) _________ generation

Most potent against gram-negative bacteria, Less active against gram-positive bacteria

A

third

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56
Q

Beta-Lactam antibiotic that Nursing implications:

Assess for penicillin allergy; may have cross allergy

Give orally administered forms with food to decrease GI upset, even though this will delay absorption

Some of these drugs may cause a disulfiram (Antabuse)-like reaction when taken with alcohol

A

Cephalosporins (cef, ceph)

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57
Q

Antibiotics that kill bacteria

A

Bactericidal antibiotics

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58
Q

Drug interactions in which the effect of a combination of two or more drugs with similar actions is greater than the sum of the individual effects of the same drugs given alone. For example, 1 + 1 is greater than 2

A

Synergistic effects

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59
Q

bind to calcium so have patient avoid dairy

A

cyclines

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60
Q

Adverse Effects

Nephrotoxicity
Extravasation causes tissue damage and necrosis
myelosuppression and alopecia

(phosphamide , platin)

A

Alkylating Drugs

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61
Q

The nurse identifies which of the following as the most significant neurotoxin of the cytotoxic drug class?

paclitaxel (Taxol)
docetaxel (Taxotere)
vincristine (Vincasar PFS)
etoposide (Toposar)

A

vincristine (Vincasar PFS)

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62
Q

Kills organisms

Used only on nonliving objects

A

Disinfectants

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63
Q

Antiemetics often work better if given__________minutes before chemotherapy is started

A

30 to 60

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64
Q

A drug that binds to and inhibits the activity of one or more receptors in the body

A

Antagonist

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65
Q

The clinical use of drugs to prevent and treat diseases

A

Pharmacotherapeutics

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66
Q

Antiretroviral Drug that

HIV treatment

Given to HIV-infected pregnant women and new born babies to prevent maternal transmission

Dose limited adverse effect: bone marrow suppression

A

zidovudine (Retrovir)

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67
Q

antibiotics with adverse effects

Increased risk of tendonitis and tendon rupture

Prolonged QT interval

A

Quinolones (Floxacin)

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68
Q

Lowest point in any fluctuating value over time; for example, the lowest white blood cell count measured after the count has been depressed by chemotherapy

10-28 days after first dose

A

Nadir

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69
Q

Mechanism of Action

Interference with cell wall synthesis
Bactericidal

A

Beta-Lactam Antibiotics

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70
Q

Bacteria that are resistant to one or more classes of antimicrobial drugs.

A

Multidrug-resistant organisms

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71
Q

Cephalosporins (cef, ceph) _________ generation

Broader spectrum of antibacterial activity than third generation, especially against gram-positive bacteria

A

fourth

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72
Q

Drugs used to treat cancer. Also called cancer drugs, anticancer drugs, cancer chemotherapy, and chemotherapy.

Narrow therapeutic index
Drug resistance
Combination of drugs
Harmful to all rapidly growing cells

A

Antineoplastic drugs

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73
Q

Inhibit fungal cell cytochrome P-450 enzymes, resulting in cell membrane leaking

Result: altered cellular metabolism and fungal cell death

A

Triazoles

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74
Q

antibiotic that Adverse Effects

GI effects, primarily with erythromycin

Nausea, vomiting, diarrhea, hepatotoxicity, flatulence, jaundice, anorexia

Azithromycin and clarithromycin: fewer GI adverse effects, longer duration of action, better efficacy, better tissue penetration

A

Macrolides “thromycin”

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75
Q

coadministration of two drugs that are metabolized by this system may result in competition for these enzymes, and thus higher levels of one of the drugs

A

Drug interaction

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76
Q
  • binds to protein, limited amount that can go to bloodstream,
A

Bound drug

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77
Q

Adverse Effects

  • Hemolytic and aplastic anemia
  • Photosensitivity
  • crystalluria
  • agranulocytosis
  • thrombocytopenia
  • exfoliative dermatitis
  • convulsions
  • peripheral neuritis
A

Sulfonamides

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78
Q

treat all forms of Mycobacterium

TB is most commonly characterized by granulomas in the lungs

A

Antitubercular drugs

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79
Q

Drug interactions in which the effect of a combination of two or more drugs with similar actions is equivalent to the sum of the individual effects of the same drugs given alone. For example, 1 + 1 = 2

A

Additive effects

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80
Q

routes of Absorption

A

Enteral (GI tract):

  • orally vs Sublingual and Buccal routes, G tube
  • first pass effect, variable absorption
Parenteral: 
-Intravenous (IV) 
Rapid onset; Avoid first pass effect
Nursing considerations: monitor drug, compatibilities, iv site
-Intramuscular (IM); subcutaneously 
Topical: 
Avoid first pass effect, except rectal administration 
Transdermal: 
deliver constant amount 
slower onset, prolong duration 
nursing consideration:
Topical 
Delivers meds directly to affected area, decease systemic absorption, 
Nursing consideration
Inhaled
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81
Q
  • extent of drug percentage that is left after it goes through liver (all P.O, NG,rectal)
A

First pass effect

82
Q

A patient tells the nurse that he wants to stop taking his antilipemic drugs and start taking garlic to lower his cholesterol. The nurse’s best reply would be:

“That decision is up to you.”

“You have every right to switch to herbal remedies.”

“You should not go against what the doctor has prescribed for you.”

“Let’s explore the evidence that supports the use of garlic to lower your cholesterol.”

A

“Let’s explore the evidence that supports the use of garlic to lower your cholesterol.”

83
Q

Four weeks after beginning antitubercular drug therapy on an outpatient basis, the patient reports that he still experiences night sweats, and his productive cough has not stopped. What is the main concern at this time?

  1. He is not taking his medication properly.
  2. More time is needed to see a therapeutic response.
  3. His infection may be resistant to the drug therapy ordered.
  4. He may have contracted a different strain of
    tuberculosis (TB).
A
  1. His infection may be resistant to the drug therapy ordered.
84
Q

Beta-Lactam antibiotic that

Structurally and pharmacologically related to penicillins
Bactericidal action
Broad spectrum
Have five generation

A

Cephalosporins (cef, ceph)

85
Q

The lowest concentration of drug reached in the body after it falls from its peak level, usually measured in a blood sample for therapeutic drug

A

Trough level

86
Q

4 Areas of rapid distribution:

A

heart, liver, kidneys, brain

87
Q

______ trimester fetus is at greatest risk for birth defects from drugs

A

First

88
Q

A patient with active HIV has been taking zidovudine (Retrovir). Which potential adverse effect may limit the length of time this medication can be taken?

Lactic acidosis
Bone marrow suppression
Hepatomegaly
Fatigue

A

Bone marrow suppression

89
Q

Therapy may last for up to 24 months

Take medications exactly as ordered, at the same time every day

A

treatment for TB

90
Q

The nurse is caring for a patient who received chemotherapy 24 hours ago. The patient’s white blood cell count is 4,400 mcL. Which symptom, if experienced by the patient, should the nurse report to the prescriber immediately?

Fatigue
Diarrhea
Fever
Nausea and vomiting

A

Fever

91
Q

Ideally, before beginning antibiotic therapy, the suspected areas of infection should be ______ to identify the causative organism and potential antibiotic susceptibilities

A

cultured

92
Q

A property of some antibiotics, especially aminoglycosides, whereby achieving high plasma drug concentrations, even if briefly, results in the most effective bacterial kill

once a day

A

Concentration-dependent killing

93
Q 
Natural products obtained from the plant
Vinca alkaloids (periwinkle)

Vincristine—IV only

Taxanes

paclitaxel (western yew tree: bark)

A

Mitotic Inhibitors

94
Q

With TB,

Perform__________ on the first Mycobacterium spp. that is isolated from a patient specimen

Begin a regimen with multiple _______ drugs (to reduce chances of development of resistance) Adjust drug regimen once the results of susceptibility testing are known

Monitor patient ________ closely during therapy

A

drug-susceptibility testing

antitubercular

compliance

95
Q

Name given by the United States Adopted Names Council

nonproprietary

A

Generic name (nonproprietary name)

96
Q

major concern for penecillin

A

allergy - monitor 30 mins after 1st dose

97
Q

—simultaneous use of both traditional and alternative medicine

A

Complementary medicine

98
Q

When working with a patient who is neutropenic, the nurse identifies which as the most effective measure to prevent the patient from developing an infection?

Administer prophylactic antibiotics
Stop administration of the chemotherapeutic drug
Perform hand hygiene
Vaccinate the patient to prevent bacterial infection

A

Perform hand hygiene

99
Q

A 58-year-old man is receiving vancomycin as part of the treatment for a severe bone infection. After the infusion, he begins to experience some itching and flushing of the neck, face, and upper body. He reports no chills or difficulty breathing. The nurse should suspect:

an allergic reaction has occurred.

an anaphylactic reaction is about to occur.

the medication will not be effective for the bone infection
.
the IV dose may have infused too quickly.

A

the IV dose may have infused too quickly.

100
Q

A measure of the extent of drug absorption for a given drug and route (from 0% to 100%)

A

Bioavailability

101
Q

Which cytotoxic antibiotic does the nurse identify as most likely to cause pulmonary fibrosis?’

plicamycin
mitoxantrone
mitomycin
bleomycin

A

bleomycin

102
Q

Fifteen minutes after an infusion of amphotericin B was started, the patient begins to complain of fever, chills, muscle pain, and nausea. His heart rate has increased slightly, but his blood pressure is down to 100/68. What is the nurse’s priority?

Notify the prescriber immediately.

Recognize an impending anaphylactic reaction and stop the infusion.

Assess for other symptoms of this expected infusion- related reaction.

Slow the infusion to reduce these adverse effects.

A

Assess for other symptoms of this expected infusion- related reaction.

103
Q

used to treat Many severe systemic fungal infections

A

Amphotericin B:

104
Q

: The time a drug concentration is sufficient to elicit a therapeutic response

A

Duration

105
Q

Beta-Lactam Antibiotics 4 groups

A

Penicillins
Cephalosporins
Carbapenems
Monobactams

106
Q

Antibiotics that do not actually kill bacteria but rather inhibit their growth

A

Bacteriostatic antibiotics

107
Q 
Which condition does the nurse anticipate when assessing a patient with tumor lysis syndrome?
Hyperuricemia
Hypophosphatemia
Hypokalemia
Hypercalcemia
A

Hyperuricemia

108
Q

The maximum concentration of a drug in the body after administration, usually measured in a blood sample for therapeutic drug monitoring.

A

Peak level

109
Q

Pregnancy Safety Categorie where

Possible fetal risk in humans has been reported; however, in selected cases consideration of the potential benefit versus risk may warrant use of these drugs in pregnant women.
A

D

110
Q

Adverse Effect:

Peripheral neuropathy—Pyridoxine

Hepatotoxicity

A

Isoniazid (INH)

111
Q

Drug interaction in which the bacterial killing effect of two antibiotics given together is greater than the sum of the individual effects of the same drugs given alone

A

Synergistic effect

112
Q

Pregnancy Safety Categorie where

Studies indicate no risk to the human fetus.

A

A

113
Q

A common genetic host factor in which the rate of metabolism of certain drugs is reduced.

A

Slow acetylation

114
Q

When handling and administering vesicant drugs the nurse will:

double-flush the patient’s bodily secretions in the commode.

use sterile towels to clean up after chemotherapy spills
.
mix chemotherapeutic drugs in the patient’s room
.
teach the patient how to administer parenteral chemotherapeutic drugs.

A

double-flush the patient’s bodily secretions in the commode.

115
Q

– does not dissolve until hits the small intestine (aspirin is a common one)

A

Enteric coated

116
Q

Pregnancy Safety Categorie where

Studies indicate no risk to the animal fetus; information for humans is not available.

A

B

117
Q

A mother calls the clinic to ask about giving acetaminophen to her infant. She says she has used the liquid form for her 5-year-old child, and she wants to know how much to give to her infant, who has a fever. The nurse should:

1. instruct the mother to give the infant the same dose as the child.
2. instruct the mother to give the infant half the dose that she would normally give the child.
3. assist the mother in calculating the dose for the infant.
4. consult with a physician before instructing the mother on giving the medication.
A

consult with a physician before instructing the mother on giving the medication.

The physician should be consulted before acetaminophen is used in children under the age of 2.

118
Q

The cellular processes involved in the drug and cell interaction

A

Drug actions

119
Q

physiologic reaction of the body to the drug

A

Drug effect:

120
Q

causes perm. discoloration of teeth

do not give to pregenant women or children under 8

A

cyclines

121
Q

indications for this Beta-Lactam antibiotic include

Prevention and treatment of infections caused by susceptible bacteria

Gram-positive bacteria, including Streptococcus spp., Enterococcus spp., Staphylococcus spp.

A

Penicillins

122
Q

this Beta-Lactam antibiotic has Nursing implications:

Take oral doses with water (not juices) as acidic fluids may nullify drug’s antibacterial action

Monitor patients taking penicillin for an allergic reaction for at least 30 minutes after administration

A

Penicillins

123
Q

The 3 most common adverse effects of antibiotics are ________________________________

A

nausea, vomiting, and diarrhea

124
Q

Active in all phases of the cell cycle, blockade of DNA

Natural substances produced by the mold Streptomyces

A

Cytotoxic Antibiotics

125
Q

type of antibiotic where Indications

Both gram-positive and gram-negative bacteria

Treatment of
UTI
Pneumocystis jirovecii pneumonia (PJP)

Upper respiratory tract infections

Staphylococcus infections due to the high rate of community-acquired MRSA infections

A

Sulfonamides (Sulf)

126
Q

Metabolized in the liver through acetylation—watch for “slow acetylators”

Used alone or in combination with other drugs

Contraindicated with liver disease

Used for the prophylaxis and treatment of TB

A

Isoniazid (INH)

127
Q

A general term for drugs that destroy viruses, either directly or indirectly by suppressing their replication

caused by viruses other than HIV

Influenza viruses
HSV, VZV
CMV
Hepatitis A, B, C (HAV, HBV, HCV)

A

Antiviral drugs

128
Q

Cephalosporins (cef, ceph) ___________ generation

Good gram-positive coverage, better gram-negative coverage than first generation

Use prophylactically

A

second

129
Q

nursing implications:

Monitor vital signs of patients receiving IV infusions every 15 to 30 minutes

During IV infusions, monitor I&O to identify adverse effects

Use IV infusion pumps and the most distal veins possible

A

Antifungal Drugs

130
Q

antibiotic with

Used for chronic bone infections, GU infections, etc,

FDA black box warning: C diff associated diarrhea

A

clindamycin (Cleocin)

131
Q

The desired or intended effect of a particular medication

A

Therapeutic effect

132
Q

Contracted in a hospital or institutional setting

Were not present or incubating in the patient on admission to the facility

A

Health care–associated infections

133
Q

Signs and symptoms of infection do not improve

sometimes wrong antibiotic, drug resistance

A

Subtherapeutic response

134
Q

A significant side effect of _________ is a red-orange discoloration of urine, saliva, tears, and sweat.

A

rifampin

135
Q

Factors that ________ metabolism

Fast acetylator, Barbiturate therapy, Rifampin therapy, Phenytoin therapy

A

increase

136
Q

3 Areas of slow distribution:

A

muscle, skin, fat

137
Q

A pregnant woman has been diagnosed with cancer and is meeting with her oncologist to plan treatment. Which statement about chemotherapy and pregnancy is true?

She will have to wait until the baby is born before starting chemotherapy.

The greatest risk of fetal harm from chemotherapy is during the third trimester.

Chemotherapy treatment during the second or third trimester poses less risk to the fetus.

Chemotherapy is unsafe during pregnancy, but radiation therapy is safe in low doses.

A

Chemotherapy treatment during the second or third trimester poses less risk to the fetus.

138
Q

antibiotic that: nursing implications:

Avoid milk products

Take all medications with 6 to 8 ounces of fluid,

photosensitivity, avoid sunlight and tanning beds

A

Tetracyclines “cycline”

139
Q

antibiotic where

Used for anaerobic organisms, protozoal infections, etc

Contraindications: alcohol use w/in 3 days, pregnancy 1st trimester

Avoid alcohol 24 hours before first dose and 36 hours after last dose

A

metronidazole (Flagyl)

140
Q

– percentage of drug absorbed into bloodsteam

A

Bioavailability

141
Q

A patient is complaining of severe pain and has orders for morphine sulfate. The nurse knows that the route that would give the slowest pain relief would be which route?

IV
IM
Subcut
PO

A

PO

142
Q

Movement of a drug from its site of administration into the bloodstream for distribution to the tissues

A

Absorption

143
Q

Alter the chemical structure of the cells’ DNA

A

Alkylating Drugs

144
Q

Monitor for expected effects of bone marrow suppression

Expect nausea, vomiting, diarrhea, stomatitis

Hydration–nephrotoxicity

Report ringing/roaring in the ears—possible ototoxicity

Report tingling, numbness, or pain in extremities— peripheral neuropathies may occur

A

Alkylating drugs

145
Q

Adverse effects:

Extravasation

Hair loss, nausea and vomiting, myelosuppression

Convulsions

A

Mitotic Inhibitors

146
Q

The time it takes for a drug to reach its maximum therapeutic response

A

Peak:

147
Q

in pediatrics ________&_________ are immature, impairing drug metabolism and excretion

A

Liver and kidneys

148
Q

A patient is taking nystatin (Mycostatin) in an oral troche form for oral candidiasis. Which instruction is correct?

Allow the troche to dissolve slowly in the mouth.

Swish the medication in the mouth and then swallow it.

Chew the troche thoroughly to activate the medication.

Swallow the troche whole without chewing.

A

Allow the troche to dissolve slowly in the mouth.

149
Q

Factors that _________ metabolism

Cardiovascular dysfunction, renal insufficiency, starvation, obstructive jaundice, slow acetylator, ketoconazole therapy

A

decrease

150
Q

____ trimester fetus is more likely to have side effects from drugs

A

Last

151
Q

A specific term for antiviral drugs that work against retroviruses such as HIV

Used to treat infections caused by HIV, the virus that causes AIDS

A

Antiretroviral drugs

152
Q

antibiotic that

Bacteriostatic

Bind (chelate) to Ca+++ and Mg++ and Al+++ ions to form insoluble complexes

Dairy products, antacids, and iron salts reduce oral absorption

Should not be used in children under age 8 or in pregnant/lactating women because tooth discoloration will occur if the drug binds to the calcium in the teeth

A

Tetracyclines “cycline”

153
Q

Before any antibiotics monitor what 7 things

A 
Allergies 
Kidney and liver function 
Labs- cbc- wbc- bmp
Culture & sensitivity 
Contraindications 
Drug interactions 
Signs and symptoms of super infection
154
Q

treatment with antibiotics to prevent an infection, as in intraabdominal surgery or after trauma

A

Prophylactic therapy:

155
Q

Adverse Effects:

Cardiac dysrhythmias
Neurotoxicity
Renal toxicity,
Pulmonary infiltrates

A

Amphotericin B:

156
Q

what is the major concern for beta lactams

A

pcn cross sensitivity

157
Q

A property of most antibiotic classes whereby prolonged high plasma drug concentrations are required for effective bacterial kill

penicillin, beta lactams

give multiple times a day

A

Time-dependent killing

158
Q

Pregnancy Safety Categorie where

Fetal abnormalities have been reported, and positive evidence of fetal risk in humans is available from animal and/or human studies. These drugs are not to be used in pregnant women.

A

X

159
Q

antibiotic where

Toxic level: >20 mcg/ml (Trough) right b4 3rd dose

Red man syndrome may occur (rapid infusion)

Should be infused over 60 minutes

Serious: Rapid infusions may cause hypotension

May cause ototoxicity and nephrotoxicity

A

Vancomycin (Vancocin)

160
Q

Contraindications:
Liver failure
Renal failure
Drug allergy

A

Antifungal Drugs

161
Q

The time it takes for one half of the original amount of a drug to be removed from the body

A measure of the rate at which a drug is removed from the body

A

Half-life

162
Q

major concerns:

crystaluria
photosensitivity
decreased kidney function

A

sulfonamides

163
Q

Used to suppress replication of HSV-1, HSV-2, VZV

Drug of choice for treatment of initial and recurrent episodes of these infections

Oral, topical, parenteral forms

A

acyclovir (Zovirax)

164
Q

The leakage of any intravenously or intraarterially administered medication into the tissue space surrounding the vein or artery; can cause serious tissue injury

A

Extravasation

165
Q

antibiotics where adverse effect

Nephrotoxicity and Ototoxicity (auditory impairment and vestibular impairment [eighth cranial nerve])

Others: Headache, paresthesia, fever,superinfections, vertigo, skin rash,dizziness

A

Aminoglycosides

166
Q

Beta-Lactam antibiotic that Adverse Effects

Similar to penicillins

Mild diarrhea, abdominal cramps, rash, pruritus, redness, edema

Potential cross-sensitivity with penicillins

A

Cephalosporins (cef, ceph)

167
Q

anything with ase means

A

enzyme

168
Q

Occur when antibiotics reduce or completely eliminated the normal bacterial flora

Pseudomembranous colitis—Antibiotic associated infection

A

Superinfection

169
Q

The biochemical alteration of a drug into an inactive metabolite, a more soluble compound, a more potent active metabolite, or a less active metabolite

A

Metabolism/Biotransformation

170
Q

patient who is receiving high-dose chemotherapy with methotrexate is also receiving leucovorin. The purpose of the leucovorin is to:

produce an additive effect with the methotrexate by increasing its potency against the cancer cells.

reduce the incidence of cardiomyopathy caused by the methotrexate.

add its antiinflammatory effects to the treatment regimen.

reduce the bone marrow suppression caused by the methotrexate.

A

reduce the bone marrow suppression caused by the methotrexate.

171
Q

It is ESSENTIAL to obtain _______ from appropriate sites BEFORE beginning antibiotic therapy

A

cultures

172
Q

treatment of systemic infection

synergistic effect with pcn

A

aminoglycosides

173
Q

Inhibit viral replication

adverse effects:
-Healthy cells are often killed also, resulting in serious toxicities

A

Antiviral Drugs

174
Q

application of hot or cold packs and/or sterile occlusive dressings, and elevation and rest of the affected limb

leave the intravenous catheter in place

aspirate any residual drug and/or blood from the catheter

these are all steps in case _____ occurs

A

Extravasation

175
Q

The elimination of drugs from the body
Kidneys (main organ)
Others: liver, bowel

A

Excretion

176
Q

antibiotic that has Indications of

Strep infections

Mild to moderate URI and LRI (respiratory infection)

Clarithromycin combination with omeprazole: active ulcer disease associated with Helicobacter pylori infection

Syphilis and Lyme disease, Gonorrhea, Chlamydia, Mycoplasma

A

Macrolides “thromycin”

177
Q

avoid alcohol

c.diff / collitis - black box warning

A

flagyl

178
Q

for long-term prevention of disease

A

Prophylactic agents

179
Q

The nurse is giving a medication that has a high first-pass effect. The health care provider has changed the route from IV to PO. The nurse expects the oral dose to be

higher because of the first-pass effect.
lower because of the first-pass effect.
the same as the IV dose.
unchanged.

A

higher because of the first-pass effect.

180
Q

An infection that is acquired by a person who has not been hospitalized or had a medical procedure (such as dialysis, surgery, catheterization) within the past year

A

Community-associated infections

181
Q

is the metabolism of a drug before it becomes systemically available, and it reduces the bioavailability of the drug.

A

: The first-pass effect

182
Q

highly protein bound antibiotic

A

thromycin

183
Q

antibiotic with Indications

Pseudomonas
Complicated urinary tract
respiratory
bone and joint
GI
skin
sexually transmitted infections)
A

Quinolones (Floxacin)

184
Q

type of antibiotic where

combined with trimethoprim (Bactrim, Septra)

Bacteriostatic action

Take with 2000 to 3000 mL of fluid/24 hr

Assess RBCs prior to beginning therapy

Take oral doses with food

A

Sulfonamides

185
Q

Folate (folic acid) antagonists:

A

Antimetabolites

186
Q

main organ or metabolism

A

liver

187
Q

Drugs are organized into pharmacologic classes

7 Types of Therapies

A
  • Acute therapy
  • Maintenance therapy
  • Supplemental/replacement therapy
  • Palliative therapy
  • Supportive therapy
  • Prophylactic therapy
  • Empiric therapy
188
Q

Block activity of the enzyme reverse transcriptase, preventing production of new viral DNA

A

Reverse transcriptase

189
Q

Factors that are unique to a particular patient that affect the patient’s susceptibility to infection and response to various antibiotic drugs. Examples include a low neutrophil count or a lack of immunoglobulins in the blood that carry antibodies.

A

Host factors

190
Q

May postpone effective treatment of more chronic disease states

May delay treatment of serious and/or life-threatening disorders

May relieve symptoms of a disorder but not the cause

A

over the counter drugs

191
Q

Substances that can interfere with normal prenatal development and cause one or more developmental abnormalities in the fetus.

A

Teratogens

192
Q

A 56-year-old man is taking over-the-counter antacids for relief of indigestion. He tells the nurse that he consumes at least one bottle a week and has done so for over a month because “it works for me.” The nurse’s main concern is that

this self-treatment is expensive.

this self-treatment may be delaying treatment of a more serious problem.

this self-treatment may be the best treatment of his indigestion.

the long-term use of antacids may make the indigestion worse.

A

this self-treatment may be delaying treatment of a more serious problem.

193
Q

antibiotic therapy tailored to treat organism identified with cultures

A

Definitive therapy:

194
Q

antibiotic that

Prevent protein synthesis within bacterial cells
Considered bacteriostatic, in high enough

concentrations, may also be bactericidal

A

Macrolides “thromycin”

195
Q

Active against influenza types A and B

Treatment should begin within 2 days of influenza symptom onset

A

oseltamivir (Tamiflu) and zanamivir (Relenza)

196
Q

: The time it takes for the drug to elicit a therapeutic response

A

Onset

197
Q

Medications combined with certain penicillin drugs to block the effect of beta-lactamase enzymes

A

Beta-lactamase inhibitors

198
Q

A patient is receiving amphotericin B lipid complex. The nurse knows that an advantage of the lipid formulations of this drug is that they

have a lower cost.
can be administered quickly.
take longer to be absorbed.
cause fewer adverse effects.

A

cause fewer adverse effects.

199
Q

Bone marrow suppression (BMS)

Bone marrow depression (BMD)

A

Myelosuppression

200
Q

Used to treat infection with cytomegalovirus (CMV) & CMV retinitis

Oral, parenteral forms

Ophthalmic form surgically implanted (Vitrasert)

watch out for Bone marrow toxicity

A

ganciclovir (Cytovene)

pharm (5 decks)

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