Med Cards for Exam 3

Question 1

acetaminophen: complications

Answer 1

Liver damage (overdose)
* Hypertension (with daily use, particularly women)

Question 1

acetaminophen: therapeutic use

Answer 1

Analgesia for mild to moderate pain
* Fever reduction

Question 2

acetaminophen: interventions

Answer 2

Monitor for early symptoms of overdose/poisoning (abdominal discomfort, nausea, vomiting, sweating, diarrhea); liver damage results in 48 to 72 hr following
overdose.

Prepare to administer acetylcysteine (Mucomyst, Acetadote) orally or IV to counteract overdose and reduce liver injury.

Monitor blood pressure

Question 3

acetaminophen: admin

Answer 3

Administer orally or rectally.

Caution clients that the drug is available in many combination products as well as
many formulations; clients must read labels carefully to avoid overdose.

Do not administer more than 4 g/day (adults).

Infants and children should be given the manufacturer’s recommended dose
based on their age.

Question 4

acetaminophen: client instructions

Answer 4

Do not exceed 4 g/day (adults).

Report any abdominal discomfort, nausea, vomiting, sweating, or diarrhea immediately.

Have blood pressure checked regularly.

Question 5

acetaminophen: contraindictions

Answer 5

Alcohol use disorder

Question 6

acetaminophen: precautions

Answer 6

Anemia

Immunosuppression

Hepatic or kidney disease

Question 7

acetaminophen: interactions

Answer 7

Alcohol increases the risk of liver injury (with high doses of acetaminophen).

Warfarin (Coumadin) increases the risk of bleeding.

Cholestyramine (Questran) reduces absorption.

Question 8

ibuprofen: therapeutic use

Answer 8

Inflammation suppression

Analgesia for mild to moderate pain

Fever reduction

Dysmenorrhea

Inhibition of platelet aggregation (aspirin)

Question 9

ibuprofen: complications

Answer 9

Gastric upset, heartburn, nausea, gastric ulceration

Bleeding (less with non-aspirin NSAIDs)

Kidney dysfunction

Salicylism (aspirin)

Reye’s syndrome (aspirin)

Thromboembolic events (non-aspirin NSAIDs)

Question 10

ibuprofen: interventions

Answer 10

Monitor for signs of gastrointestinal bleeding (black or dark-colored stools, abdominal pain, nausea, hematemesis).
* Test for and treat Helicobacter pylori infection prior to long-term therapy.
* For clients at high risk for gastric bleeding, recommend a proton pump inhibitor.
* Monitor for signs of bleeding (easy bruising, petechiae, excessive bleeding from
minor injuries).
* Monitor intake and output; watch for low urine output and fluid retention.
* Monitor for rapid rises in BUN and creatinine.
* Monitor for tinnitus, diaphoresis, headache, dizziness, and respiratory alkalosis.
Stop aspirin therapy for clients reporting these symptoms.
* Recommend acetaminophen (Tylenol) and not aspirin or NSAIDs for children and
adolescents under age 18 who have viral infections, particularly chickenpox and
influenza.
* Recommend non-aspirin NSAIDs for short periods and in low doses only.
* Recommend low-dose aspirin to prevent these events if prescribed by provider.
* Monitor for signs of myocardial infarction and cerebrovascular accident.

Question 11

ibuprofen: admin

Answer 11

Make sure clients swallow enteric-coated or sustained-release forms whole and
do not crush or chew them.
* Discontinue 1 week before scheduled surgery.
* Monitor for initial and continued therapeutic effects.

Question 12

omeprazole: therapeutic use

Answer 12

• Gastric and duodenal ulcers
• Prolonged dyspepsia
• Gastrointestinal reflux disease (GERD)
• Erosive esophagitis
• Hypersecretory disorders such as Zollinger-Ellison syndrome, systemic
  mastocytosis

it is a PPI

Question 13

omeprazole: complications

Answer 13

Bone loss (long-term use)
* Headache, abdominal pain, nausea, vomiting, and diarrhea
* Hypomagnesemia

Question 14

omeprazole: interventions

Answer 14

Limit drug therapy to the lowest dose and shortest duration possible.
* For longer-term therapy, monitor for bone loss via bone density
scanning at recommended intervals.
* Monitor for severe vomiting or diarrhea.
* Monitor magnesium levels

Question 15

omeprazole: admin

Answer 15

Administer orally once daily before the first meal of the day.
* Make sure clients do not crush, chew, or break delayed-release
capsules of omeprazole.

Question 16

omeprazole: client education

Answer 16

Perform weight-bearing exercise daily.
* Consume adequate calcium and vitamin D.
* Report vomiting or diarrhea.
* Drink plenty of clear fluids.
* Take magnesium supplements as needed.

Question 17

omeprazole: contraindictions

Answer 17

Hypersensitivity to the drug
* Concurrent use of rilpirivine

Question 18

omeprazole: precautions

Answer 18

Liver dysfunction
* Pregnancy and lactation

Question 19

omeprazole: interactions

Answer 19

Absorption of atazanavir (Reyataz), ketoconazole (Nizoral), and
itraconazole decreases.
* Food can reduce absorption.
* Levels of warfarin (Coumadin), phenytoin (Dilantin), and diazepam
(Valium) increase.
* St. John’s wort decrease drug levels.