Week 4: Chapter 6 and Chapter 30 Flashcards
A client is about to start taking aspirin (NSAID) [Salicylic acid] to prevent cardiovascular events. You should instruct the client to watch for and report which adverse drug reaction of aspirin:
Petechiae (purple - red spots)
What is the classification: Ibuprofen (propionic acid)
Nonsteroidal Anti-Inflammatory Drug (NSAID)
What is the classification: Naloxone
Opioid Antagonist (antagonist block the receptor site of a cell and prevent the actions of naturally occurring body substances and hormones)
What is the classification: Prednisone (corticosteroid)
Glucocorticoid
What is the classification: Morphine
Opioid
A client is about to start taking ORAL morphine (opioid) to treat acute pain from an injury. Which of the following instructions should you include when talking with the client about taking morphine?
Take with food
Rise slowly from sitting or reclining
Increase fiber and fluid intake
Do NOT take before driving
A provider prescribes prednisone (corticosteroid) for a client who has type 1 diabetes mellitus. Recognizing the risk for an adverse drug reaction to the prednisone, which of the following precautions should be the primary care take for this client?
Increase serum glucose monitoring
A client is about to start taking tramadol to treat moderate pain. Which of the following instructions should you include when talking with the client about taking this drug?
Allow 1 hour for it to take effect.
A client who is receiving chemotherapy takes allopurinol (Aloprim, Zyloprim) [Uric Acid Synthesis inhibitor] to the chemotherapy to reduce the risk for which condition?
Hyperuricemia
What is the therapeutic use: Morphine
Sedation
What is the therapeutic use: Acetaminophen
Fever reduction
What is the therapeutic use: Prednisone (corticosteroid)
Prevention of organ rejection
What is the therapeutic use: Butorphanol
Anesthesia adjunct
A client arrives to the emergency room immediately following an acetaminophen overdose. Which drug should you prepare to administer?
Acetylcysteine
Butorphanol is an unsafe analgesic choice for clients who:
Use a fentanyl patch for chronic pain
A clients is about to begin celecoxib (Celebrex - COX-2 inhibitor) therapy for osteoarthritis. You should instruct the client to watch and report which of the following possible indications of a serious reaction to this drug?
Black tarry stools
A patient who has been taking a systemic steroid [effects the whole body] for several months to treat rheumatoid arthritis runs out of the medication over the weekend and is unable to contact the prescriber. What symptom may indicate the severe adverse reaction of acute adrenal crisis in this patient?
Slow, irregular pulse
The nurse is caring for a patient having an inflammatory response. What health conditions can be caused by this type of response and may require anti-inflammatory drugs? (select all that apply)
Asthma
Heart disease
Rheumatoid arthritis
Transplant rejection
Which conditions or problems are side effects or adverse responses of systemic corticosteroid therapy? (select all that apply)
- Adrenal gland atrophy
- Acne
- Moon face
- Increased risk for infection
- Hypertension
The nurse is caring for a patient who is having an acute asthma attack. What anti-inflammatory drug should absolutely be avoided in patients with this condition?
Antihistamines (ex. Zyrtec, Benadryl, Allegra, Claratin)
The nurse is discharging a patient with a prescription for a corticosteroid. What information is important for the nurse to teach this patient? (select all that apply)
- Do not suddenly stop taking the medication.
- Avoid exposure to crowds.
- Wound healing may be delayed.
The nurse is giving a patient a systemic corticosteroid [effects the whole body]. What is a common side effect of these drugs?
Fat redistribution
The nurse is caring for a patient with an inflammation problem. The nurse knows that what type of inflammation may require antibiotics in addition to anti-inflammatory drugs?
Appendicitis
The nurse is caring for a patient who was taking an OTC COX-1 NSAID. The nurse tells the patient to avoid what medications when taking this OTC drug? (select all that apply)
Anticoagulants
Other NSAIDs
The nurse is discharging a patient with a prescription for an antihistamine. The nurse instructs the patient to call their prescriber immediately if which symptom occurs while taking this drug?
Eyebrow pain
The nurse is about to give a patient a leukotriene inhibitor. What must the nurse ensure first?
Liver function is normal.
The nurse is giving a corticosteroid to a patient in the morning. Why should these drugs be taken in the morning?
To mimic the action of the adrenal gland
The nurse is giving medication to a patient to treat pain and inflammation. What drug group is most often used for this problem?
Nonsteroidal anti-inflammatory drugs (NSAIDs)
A patient who is taking corticosteroids says to the nurse, “My face is getting rounder. Will this go away?” What is the nurse’s best response?
“This is a common side effect and will begin to go away when the therapy stops.”
The nurse is about to administer an NSAID to a patient. The nurse knows that what NSAIDs must be avoided in patients with sulfa allergies?
Celecoxib (Celebrex) [COX-2]
The nurse is giving a topical corticosteroid to an older adult. What consideration for this type of therapy is specific to older adults?
A lower strength should be used.
A patient taking 40 mg of prednisone (corticosteroid) daily for the past 3 months is experiencing the following signs and symptoms. Which ones are most likely related to the prednisone? (select all that apply)
- Excessive bruising
- Thinning scalp hair
- High blood pressure
Why are aspirin (NSAID) [Salicylic acid] and aspirin-containing drugs avoided for use with children?
Aspirin (NSAID) [Salicylic acid]is associated with the development of Reye’s syndrome
A child’s liver is too immature to metabolize aspirin (NSAID) [Salicylic acid]. Which anti-inflammatory drug class is similar to the natural cortisol your adrenal glands produce?
Corticosteroids
Which NSAID (COX-1 or COX-2) is less likely to affect platelets and blood clotting?
meloxicam (Mobic)
Which drug is an H1 histamine blocker?
cetiriznie (Zyrtec)
Which side effects are commonly associated with most antihistamines? (select all that apply)
- Dry mouth
- Drowsiness
- Hypertension
- Urinary Retention
What is the most common side effect of any leukotriene inhibitor?
Headache
How are most disease modifying antirheumatic drugs administered?
Subcutaneous injection
The patient who is taking an oral corticosteroid for the past month to treat a breathing problem has been tapered down and off the drug. One week later, she has all of the following changes. Which one do you report to the prescriber immediately?
Serum potassium level of 6.2 mEq/L
The patient who had a total knee replacement is discharged home and prescribed to take 400 mg of celecoxib (Celebrex) orally daily for the next 10 days. Which precaution is most important to teach this patient?
Do NOT increase the dose or frequency of this drug
Why is indomethacin (Indocin) NEVER prescribed for women late pregnancy?
The drug can cause early closure of a fetal blood vessel
Which question is most important to ask a patient before giving the first dose of an NSAID?
Have you ever had an allergic reaction to aspirin?
The patient prescribed fexofenadine (Allegra) for a nasal allergy reports that his mouth is dry and sticky. What is your best response or action?
Suggest that the patient increase his water intake
For which patient should the antihistamine diphenhydramine (Benadryl) be avoided?
65- y/o man who has an enlarged prostate
A man taking zileuton (Zyflo) [Leukotriene] for the past 6 month for seasonal allergies has all the following side effects. Which one indicates a possible severe health problem related to the use of this drug?
Cola-colored urine
When drawing up a dose of etanercept (Enbrel) [DMARD], you notice a few particles floating in the clear and colorless drug. What should you do?
Draw up and administer the drug as prescribed
Which drugs belong to the bisphosphonate ( alendronate{fosamax}, ibandronate {Boniva}) {treats osteoporosis} {treats osteoporosis} class?
- alendronate (Fosamax)
- ibandronate (Boniva)
- risedronate (Actonel)
- zoledronic (Reclast)
Which class of drugs to treat osteoporosis is most likely to cause a severe allergic or hypersensitivity reaction?
monoclonal antibodies {treats osteoporosis}
Why is activated vitamin D often prescribed to be taken with calcium supplements for management of osteoporosis?
Intestinal absorption of dietary calcium requires the presence of activated vitamin D
Which class of drugs is most effective at reducing episodes of gouty arthritis?
Uric acid synthesis inhibitors
For which condition or health problem is a contraindication for the use of rasburicase (Elitek)?
G6PD deficiency
For which patient is methocarboamol (Robaxin) contraindicated?
75 y/o man who had cataract surgery 1 week ago
A woman taking a bisphosphonate ( alendronate{fosamax}, ibandronate {Boniva}) {treats osteoporosis} sees all of these medical professionals annually. Which professional is it most important that she report her use of bisphosphonates?
Dentist
Which activity should you tell a patient presribed to take raloxifene (Evista) to avoid?
Smoking cigarettes
Which drug class reduced skeletal muscle spasms by changing the influence of serotonin in the spinal cord?
Cyclobenzaprine’s ( Felxeril, Amrix) [skeletal muscle relaxant]
What are the most common adverse effects of the carbamates?
Slow and irregular pulse
Which instruction is most important to teach a patient prescribed to take alendronate (Fosamax), 10 mg daily?
Remain in the upright position for at least 30 min. after taking the drug.
What is the main reason drugs for osteoporosis are prescribed only for adults?
Osteoporosis seldom occurs in people less than 40 y/o
The nurse is giving a muscle relaxant to a patient. What class of skeletal muscle relaxant drug is similar in structure to tricyclic antidepressants?
Cyclobenzaprines ( Felxeril, Amrix) [skeletal muscle relaxant]
The nurse is giving a bisphosphonate ( alendronate{fosamax}, ibandronate {Boniva}) calcium drug to a patient. What is the action of this drug?
Prevents bones from losing calcium
The nurse is giving a patient an osteoporosis drug. What drug is prescribed to treat severe osteoporosis in patients for whom other treatments have not been effective?
Osteoclast monoclonal antibodies
The nurse is explaining the risk factors to a patient with severe osteoporosis. Besides skeletal system problems (including risk of falls and fractures), in what body system can other problems occur?
Respiratory
The nurse is explaining to a patient with joint problems how muscles and bones work. What statement about muscles, bones, and joints is correct?
Muscles move bones around joints by pulling the bones.
The nurse is preparing to administer denosumab (Prolia) 60 mg subcutaneously (sc) to a patient. What is the most important intervention the nurse should take with the administration of this injection?
Assess for any allergic reaction during and after the injection.
The nurse is administering a drug to a patient with arthritis. What are the specific classes of drugs used to manage arthritis? (select all that apply)
- Pain control
- Hyperuricemia
- Anti-inflammatory drugs
The nurse is administering a uric acid synthesis inhibitor to a patient. What is the action of this class of drug?
Reduces an enzyme needed to convert purines into uric acid.
The nurse is admitting a patient with a diagnosis of arthritis. What different types of arthritis are there? (select all that apply)
- Osteoarthritis
- Gouty arthritis
- Psoriatic arthritis
- Rheumatoid arthritis
The nurse is discharging a patient who has a prescription for allopurinol (Aloprim, Zyloprim) [Uric Acid Synthesis inhibitor]. What teaching point is most important for the nurse to provide the patient?
Take it after a full meal.
The nurse is caring for a patient with osteoporosis. The nurse knows that the process of old bone cell removal (osteoclastic activity) also causes bones to lose minerals. What mineral is especially lost during this process?
Calcium