ATI Proctor RN Pharmacology

1. Legal Responsibilities: Responding to a client who refuses to receive a vaccine a. Clients have the right to refuse treatment, including the right to leave a health care facility without a discharge prescription from the provider. b. If the client refuses a treatment or procedure, the nurses and the providers discuss the risk involved with refusing the treatment or procedure. c. The nurse asks the client to sign an "Against Medical Advice" form and documents the incident. 2. Fluid Imbalances: Identifying manifestations of fluid volume deficit a. Vital signs: Hypothermia (hypovolemia) or hyperthermia (dehydration), tachycardia, thread pulse, hypotension, hypotension, tachypnea, hypoxia b. Neuro-musculoskeletal: Dizziness, confusion, weakness, fatigue; seizures c. GI: Thirst, dry mucous membranes, dry furrowed tongue, nausea, vomiting d. Renal: Oliguria e. Other findings: Diminished capillary refill, cool clammy skin, diaphoresis, sunken eyeballs, flattened neck veins, absence of tears, decreased skin turgor. 3. Antibiotics Affecting protein synthesis: Planning care for a client prescribed erythromycin lactobionate a. Administer erythromycin lactobionate with meal b. Monitor for and report adverse GI effects c. Monitor liver function test d. Can not use with drugs: verapamil and diltiazem, HIV protease inhibitors, antifungal medications and nefazodone -- can cause toxicity.