NURS 317 Unit 7 Pharm Chapter 12 Flashcards
Based on the client’s history, the nurse suspects a client with Plasmodium falciparum malaria will have difficulty complying with pharmacotherapy if he or she has to take several different pills per day. What approach has the best potential to improve compliance?
A) Prophylactic therapy
B) Outpatient treatment
C) PRN (as-needed) dosing
D) Combination therapy
D) Combination therapy
Rationale:Combination therapy can be helpful in improving compliance because there are fewer pills to take and the medications are taken less frequently. Prophylactic therapy would not be helpful because prophylactic doses tend to be smaller and would not treat an existing condition. Outpatient treatment is likely, but this setting does not enhance compliance in most cases. Dosing must be regularly scheduled in order to be effective.
A nurse is reviewing the health record of a client for whom antimalarial therapy is being proposed. The nurse should identify what aspect of the client’s history as contraindicating the use of antimalarials?
A) Type 2 diabetes
B) Alcoholic liver disease
C) Atherosclerosis
D) Sensorineural hearing loss
B) Alcoholic liver disease
Rationale:A history of liver disease is a contraindication because of the parasitic invasion of the liver causing damage and the metabolism of the drug, which could further contribute to hepatotoxicity. Diabetes, hearing loss, and atherosclerosis do not contraindicate the safe and effective use of antimalarials.
The organism that causes amebiasis exists in five stages.
A) FALSE
B) TRUE
A) FALSE
Rationale:The organism that causes amebiasis exists in two stages: a cystic dormant stage and a trophozoite stage.
Crowded unsanitary conditions help contribute to protozoal infections.
A) FALSE
B) TRUE
B) TRUE
Rationale:Unsanitary conditions contribute to protozoal infections, especially giardiasis and amebiasis.
A client has been diagnosed with malaria and will begin treatment promptly. How can the nurse best attack the Plasmodium protozoa at the different stages of its life cycle?
A) Supplement chloroquine with antifungal medications as prescribed.
B) Administer combination therapy as prescribed.
C) Administer larger doses in the morning and smaller ones in the evening, as prescribed.
D) Vary administration times throughout the course of treatment.
B) Administer combination therapy as prescribed.
Rationale:Antimalarial drugs are usually given in combination form to attack the Plasmodium at various stages of its life cycle. Using this approach, it is possible to prevent the acute malarial reaction in individuals who have been infected by the parasite. Antifungal have not therapeutic effect. Varying the time and dosage does not vary the effect on the protozoa’s life cycle
A male who has trichomoniasis typically has signs and symptoms of it when transmitting it.
A) TRUE
B) FALSE
B) FALSE
Rationale:A male with trichomoniasis typically has no signs or symptoms. Women will present with reddened, inflamed vaginal mucosa, itching, burning, and a yellowish-green discharge.
A client is receiving drug therapy for treatment of giardiasis. The nurse asks which assessment question to incorporate knowledge of transmission into patient teaching?
A) “Have you recently begun any new sexual relationships?”
B) “Have you drunk any water that might have been contaminated?”
C) “Has anyone else in your family been sick lately?”
D) “Have you been exposed to large number of mosquitoes lately?”
B) “Have you drunk any water that might have been contaminated?”
Rationale:Giardiasis is transmitted by the ingestion of contaminated water or food. Trichomoniasis typically is transmitted by sexual intercourse with persons who have no signs and symptoms of the infection. Malaria is transmitted by a mosquito bite. Family history of illness is relevant, but the main variable is intake of contaminated water.
The nurse is caring for a client taking antimalarials for prophylaxis while serving in the Peace Corps in Africa. The client has taken the medication for 2 months and is continuing to lose significant weight due to the GI effects of the drug. What recommendations should the nurse make to reduce GI adverse effects and promote healthy nutrition for this client? Select all that apply.
A) Lie down immediately after eating.
B) Eat 5 to 6 small meals a day.
C) Take the drug immediately after meals.
D) Sit upright for 60 to 90 minutes after taking the drug.
E) Add extra fat to diet for calories.
B) Eat 5 to 6 small meals a day.
C) Take the drug immediately after meals.
Rationale:The client should be taught to take the drug with food and eat five or six small meals a day instead of three large meals to avoid overdistention of the stomach. Sitting upright may be beneficial, but doing so for 60 to 90 minutes is impractical and unnecessary. Lying down after eating would increase risk of gastroesophageal reflux and would not reduce GI adverse effects. Fatty foods tend to increase risk of nausea, so this would not be appropriate for the client.
A 9-year-old child developed amebiasis after a camping trip. The child weighs 66 lbs and has been prescribed metronidazole 40 mg/kg/day PO in three divided doses. How many milligrams of metronidazole should the nurse administer for the child’s first dose?
___________ mg
400mg
Rationale:The child’s weight in kilograms must be determined first: 66 lbs/2.2 = 30 kg. The child has been ordered 40 mg/kg, and 40 mg × 30 kg = 1,200 mg. This is the daily dose, so dividing by 3 yields each individual dose: 400 mg.
