Part 1.3: toxic effects of drugs

Question 1

bone marrow depression caused by drug effects on the rapidly multiplying cells of the bone marrow; lower-than-normal levels of blood components can be seen

Answer 1

blood dyscrasia

Question 2

skin reactions commonly seen as adverse effects of drugs; can range from simple rash to potentially fatal exfoliative dermatitis

Answer 2

dermatological reactions

Question 3

formation of antibodies to a drug or drug protein; causes an immune response when the person is next exposed to that drug

Answer 3

drug allergy

Question 4

excessive responsiveness to either the primary or the secondary effects of a drug; may be caused by a pathological condition or, in the absence of one, by a particular patient’s individual response

Answer 4

hypersensitivity

Question 5

overdose of a drug that causes damage to multiple body systems and has the potential for fatal reactions

Answer 5

poisoning

Question 6

inflammation of the mucous membranes related to drug effects; can lead to alterations in nutrition and dental problems

Answer 6

stomatitis

Question 7

infections caused by the destruction of normal flora bacteria by certain drugs, which allow other bacteria to grow out of control and cause infection; may occur during the course of antibiotic therapy

Answer 7

superinfections

Question 8

undesired effects that may be unpleasant or dangerous.

Answer 8

Adverse Effects

Question 9

why adverse effects occur

Answer 9

• the drug may have other effects on the body besides the therapeutic effect
• the patient may be sensitive to the drug
• the drug’s action on the body may cause other responses that are undesirable or unpleasant
• the pt may be taking too much or too little of the drug, leading to adverse effects

Question 10

What type of injury would present with symptoms including fever, malaise, nausea, vomiting, jaundice, change in colour of urine or stools, abdominal pain, elevated liver enzymes, alterations in bilirubin levels, and changes in clotting factors?

Answer 10

Liver injury

Question 11

what type of injury would present with symptoms including elevated blood nitrogen, elevated creatinine, decreased hematocrit, electrolyte imbalances, fatigue, malaise, edema, irritability, and skin rash?

Answer 11

Renal injury

Question 12

Type of altered metabolism that presents as:
fatigue, drowsiness, hunger, anxiety, headache, cold, clammy skin, shaking/tremulousness, increased heart rate, increased BP, numbness/tingling of the mouth, tongue and/or lips, confusion, rapid and shallow respirations. Severe: seizures and/or coma

Answer 12

hypoglycemia

Question 13

altered metabolism that presents as
polyuria (increased urination), polyphagia (increased hunger), polydipsia (increased thirst), deep respirations, restlessness, nausea, hot or flushed skin, fruity odor on breath

Answer 13

hyperglycemia

Question 14

electrolyte imbalance presenting as weakness, muscle cramps, numbness/tingling in extremities, nausea, vomitting, diarrhea, decreased bowel sounds, irregular pulse, weak pulse, orthostatic hypotension, disorientation?

Answer 14

hypokalemia (low potassium)
tx includes: replace serum potassium, cardiac monitoring, watch for falls due to disorientation.

Question 15

electrolyte imbalance presenting as weakness, muscle cramps, diarrhea, numbness and tingling, SLOW HR, LOW BP, decreased urine output, difficulty breathing

Answer 15

Hyperkalemia (high potassium)
tx includes: monitor cardiac irregularities, medication to decrease potassium, safety precautions for falls, severe cases may need dialysis.

Question 16

Normal lab values for potassium

Answer 16

3.5-5mEq/L

Question 17

An example of a drug allergy is

a.dry mouth occurring with use of an antihistamine.

b.increased urination occurring with use of a thiazide diuretic.

c.breathing difficulty after an injection of penicillin.

d.urinary retention associated with atropine use.

Question 18

A patient taking glyburide (an antidiabetic drug) has his morning dose and then does not have a chance to eat for several hours. An adverse effect that might be expected from this would be

a.a teratogenic effect.

b.a skin rash.

c.an anticholinergic effect.

d.hypoglycemia.

Question 19

A patient with a severe infection is given gentamicin, the only antibiotic shown to be effective in culture and sensitivity tests. A few hours after the drug is started intravenously, the patient becomes very restless and develops edema. Blood tests reveal abnormal electrolytes and elevated blood urea nitrogen. This reaction was most likely caused by

a.an anaphylactic reaction.

b.renal toxicity associated with gentamicin.

c.superinfection related to the antibiotic.

d.hypoglycemia.

Question 20

Patients receiving antineoplastic drugs that disrupt cell function often have adverse effects involving cells that turn over rapidly in the body. These cells include

a.ovarian cells.

b.liver cells.

c.cardiac cells.

d.bone marrow cells.

Question 21

A woman has had repeated bouts of bronchitis throughout the fall and has been taking antibiotics. She calls the clinic with complaints of vaginal pain and itching. When she is seen, it is discovered that she has developed a yeast infection. You understand that

a.her bronchitis has moved to the vaginal area.

b.she has developed a superinfection, because the antibiotics kill bacteria that normally provide protection.

c.she probably has developed a sexually transmitted disease related to her lifestyle.

d.she will need to take even more antibiotics to treat this new infection.

Question 22

Knowing that a patient is taking a loop diuretic and is at risk for developing hypokalemia, the nurse would assess the patient for

a.hypertension, headache, and cold and clammy skin.

b.decreased urinary output and yellowing of the sclera.

c.weak pulse, low blood pressure, and muscle cramping.

d.diarrhea and flatulence.