2020/2021 EXAM REVIEW

What class of medication is amitriptyline and why is this medication used as an adjuvant medication for pain? • Therapeutic class: Antidepressant • Pharmacological class: Tricyclic Antidepressant (TCA) • Used as an adjuvant med for pain because it treats chronic pain syndromes, such as neuropathic pain, by potentiating both serotonin and norepinephrine in the CNS. A nurse is caring for a client prescribed the inhaled glucocorticoid beclomethasone (QVAR) for the treatment of asthma. What is a potential adverse effect of this medication and what are two (2) teaching points to discuss to address these adverse effects? • (Class: Glucocorticoids) • Adverse effects include difficulty speaking hoarseness, and candidiasis • Teaching points: o Rinse mouth/gargle with water/salt waster after use to prevent candidiasis o Notify provider if redness, sores, or white patches appear in mucous membrane A nurse is preparing to administer gentamicin to a client. What are three (3) contraindications/precautions for this medication? • (Class: Aminoglycosides Antibiotics) • Contraindicated who have a hypersensitivity to gentamicin or other aminoglycosides antibiotics • Use cautiously when patient has o Kidney impairment o Pre-existing hearing loss o Myasthenia gravis A nurse is administering vancomycin to a client who develops infusion reaction (red man syndrome). What action by the nurse could have prevented this reaction? • (Class: Antibiotics) • Prevention of red man syndrome (i.e. SxS: rash, flushing, tachycardia, hypotension) is to administer vancomycin slowly over 60 min • Also monitor for peak & trough levels A client has been prescribed niacin. What is this medication used for and what are three (3) adverse effects of this medication? • (Class: Lipid Lowering Agent) • Therapeutic use: o Decrease LDL cholesterol & triglyceride levels o Also used an adjuvant in certain hyperlipidemias • Adverse effects include o GI distress o Facial flushing (Feeling of warmth, tingling of hands & feet), Hyperglycemia o Hepatotoxicity o Hyperuricemia A client has been prescribed intranasal calcitonin (Miacalcin) for the treatment of osteoporosis. What client education should be provided by the nurse to prevent nasal dryness and irritation? • (Class: Hypocalcemic Hormone)-CALCITONIN SALMON-Manmade hormone that occurs naturally in the thyroid gland used to treat Paget’s disease of the bone ,postmenopausal osteoporosis an hypercalcemia • Prevention of nasal dryness & irritation includes: o Alternate nostrils daily o Inspect nasal mucosa periodically for ulcerations o Use the medication at the lowest effective dosage for the shortest duration possible. A client has been prescribed leuprolide (Lupron) for the treatment of prostate cancer. What are three (3) potential adverse effects of leuprolide and nursing interventions/client education related to these effects? • (Class: Antineoplastic)-works by lowering the amount of testosterone in the body. This helps slow growth of cancer cells. • Adverse effects o Hot flashes o Depression o fatigue o Decreased bone density o Arrhythmias & Pulmonary edema o LONG TERM EFFECTS;Bone density loss,memory loss,joint pain,weight gain,acne and headache. • Nursing interventions related to adverse effects o Advise patient may cause hot flashes o Advise patient to increase intake of calcium & vitamin D. Also advise to increase bone mass with weight-bearing exercises o Notify provider & seek immediate emergency services if shortness of breath occurs A client with diabetes mellitus whose blood glucose levels are well controlled with current oral therapy asks the nurse when he may require insulin. What information should the nurse provide? • Advise patient there is no need for patient to require insulin at this time • Educate patient to take oral therapy at appropriate time, follow appropriate dietary guidelines, and maintain log of glucose levels & patterns that affect glucose levels A client receiving methyldopa (Aldomet) for blood pressure control. List three (3) adverse effects of this medication. • (Classification: Centrally Acting Alpha2 Agonist) • Adverse effects o Drowsiness/sedation ...............................................................................CONTINUED