Study Guide Test 2-DONE

Question 1

1. Vancomycin manifestations

Answer 1

Nephrotoxicity (damage to the kidneys) and ototoxicity (damage to the organs of hearing) , phlebitis at injection site

Question 2

2. Cross sensitivity w/Penicillins?

Answer 2

Cephalosporins (“CEPH/CEF” or “cillins)

Question 3

3.Steps to instill ear drops

Answer 3

Client lays on untreated side
Ear canal should be straightened.
Drop solution into the ear canal.
Dont touch dropper to eye or ear.
Apply some pressure on the tragus while instilling ear drops

Question 4

4. Nursing considerations w.cephalosporin & client w/renal impairment

Answer 4

Cephalosporins should be used cautiously in clients with renal disease seizures may occur.
*can cause c diff
• Monitor I&O and kidney function
• Give a lower dosage of most cephalosporins to prevent accumulation to toxic levels.

Question 5

5. Do you teach to administer cephalosporins w/or without food? What would change this recommendation? (Slide 29 pp. Week 4)

Answer 5

Without food 1hr before or 2 hours after meal,unless the patient has gastrointestinal issues or upset

Question 6

6. List disulfuram-like reactions when taking cephalosporin & alchol (slide 18 pp wk 4)

Answer 6

Flushing, throbbing, respiratory problems, vomiting, sweating, chest pain, hypotension, dysrhythmias and unconsciousness

Question 7

7. Client education when taking PCNs (penicilliins)

Answer 7

• complete full course therapy, do not stop taking drug even if the symptoms have diappeared.
• Take the drug at the same time of day(important to keep adequate amount of drug in the body throughout 24hrs)
• Take oral PCNS on empty stomach 1-2hr before or after meals except for penicillin v & amoxicillin
• use additional contraceptive for oral PCNS

Question 8

8.Adverse effects with tretacycline

Answer 8

• Stomatitis
• photosensitivity
• sore throat
• skin rashes
• yellow/brown tooth discoloration
• diarrhea
• yeast infection(vagina,bowels,mouth)

Question 9

9.What is Stevens-Johnson syndrome? What are nursing interventions for it?

Answer 9

Rare serious disorder of the skin. lesions appear as red wheal or blisters, often starting on the face,mouth,neck,lips, extremeties. It is a reaction to a medication, mainly associated with vancomycin.

Immiadetaly stop medication that caused reaction and notify RN.

Question 10

10. Manifestations of superinfections when on antibiotics

Answer 10

• abdominal pain
• diarrhea
• dark urine
• fever
• jaundice
• nausea

Question 11

11.Client teaching about sulfasalazine

Answer 11

• take at prescribed intervals,do not omit dose
• complete course of treatment
• Avoid exposure to sunlight or ultraviolet lights.
• Avoid tasks that require mental alertness(may cause dizziness)
• urine may be orange yellow. contacts can turn a yellow tint as well.

Question 12

12.Nursing considerations w/client taking atorvastatin (ATI CH.21)

Answer 12

• st Johns wort(treatment for depression) can decrease effectiveness
• dosage of atorvastatin should be reduced for clients who have severe kidney impairment
• grapefruit juice should not be taken
• best if given in the evening
• may cause hyperglycemia

Question 13

13.Manifestations when taking atorvastatin that should be reported (ATI CH. 21)

Answer 13

• memory & cognitive impairment
• anorexia,jaundice
• hyperglycemia
• leg pain, muscle aches or cramping (indication of rhabdomyolysis)

Question 14

14. What time should simvastatin be administered?

Answer 14

In the evening or bedtime

Question 15

15. Client education for simvastatin

Answer 15

• Medication should be used inconjunction w/diet restrictions
• inform PCP of all medications,vitamins,herbal supps being taken
• notify PCP if any vomiting,nausea, jaundice occur (indications of liver dyfunction)
• Report muscle aches, pain & tenderness
• wear sunscreen or cover up
• use effective contraceptive, notify pcp if pregnancy is suspected
• emphasize importance of follow up exams, likeliver & kidney function tests

Question 16

16. Client education for colestipol granules(cholesterol

Answer 16

• mix dose liquid to avoid irritation of esophagus
• Increase intake of fiber and oral fluids if not restricted.
• Any medications that interact w/drug should be taken 1hr before or 4hr after colestipol.

Question 17

17.Expected manifestation of tamoxifen

Answer 17

Hot flashes, constipation, deep vein thrombosis, Pulmonary embolism, endomitrial cancer, heavy vaginal bleeding

Question 18

18. Manifestation of thrombocytopenia

Answer 18

easy bruising and unusual bleeding after moderate to slight trauma to the skin or mucous membranes(bleeding gums)

Question 19

19. What should be monitored on a client taking cisplatin?

Answer 19

The I&O of patient, blood pressure, skin turgor

Question 20

20. Common adverse reaction to antineoplastic drugs that affect self esteem

Answer 20

hair loss

Question 21

CESPHALOSPORINS

Answer 21

Can cause C diff but not treat it.
Sign of C diff is bloody diarrhea
*cross sensitivity with penicillins
**definitely avoid alcohol**
*avoid drinking for 3 days after completing course of therapy when taking (cephalosporins)

Question 22

What lab do should be evaluated for nephrotoxity?

Answer 22

Bun & creatine

Over 1.3 = bad kidney

Question 23

What do you avoid for all antibiotics?

Answer 23

alcohol

Question 24

ANTINEOPLASTICS

Answer 24

• lowering red blood cells
• lowering white blood cells
• lowering platelets (thrombocytopenia)
• Cause immunosuppression- no fresh flowers, no fresh fruit,avoid large crowds
• use soft toothbrush to prevent bleeding

Question 25

nursing considerations for statin meds

Answer 25

• increased myopathy(muscle weakness) risk for older adult clients, clients who are frail, have small body frame or have hypothyroidism.
• no grapefruit juice
• dosages should be lower for clients w/severe kidney impairment
• take in evening or bedtime
• cause photosensitivity