RNyPharmacologyyVATIyRe-evaluationyAssessment
Theynurseyshouldyteachytheyclientytoydiscardyanyyregularyinsulinythatyappearsycloudy,yasyregularyinsulinyshouldyb
eyclear.yNPHyinsulinyhasyaycloudyyappearance.
TheynurseyshouldyteachytheyclientytoyinjectyairyintoytheyNPHyvialyfirst.yTheynurseyshouldyteachytheyclientytoydrawyu
pytheyregularyinsulinyintoytheysyringeyfirst.
Nystatinyoralysuspensionyshouldybeystoredyatyroomytemperature.yTheyactionyofynystatinyisylocal,yandyityisynotyabs
orbedythroughyintactyskinyorymucousymembranes.yThereyisynoyreasonytoytakeytheymedicationyonyanyemptyystom
a.yNystatinymustybeyswallowedytoymaximizeytheymedication'sylocalyeffectsyonytheymucosalyliningyofytheyupperyga
strointestinalytract.
Ferrousysulfateyprovidesytheyironyneededybyytheybodyytoyproduceyredybloodycells.yTakingyironysupplementsybetw
eenymealsyhelpsytoyincreaseytheybioavailabilityyofytheyiron.yTakingytheymedicationywithyfoodycanyreduceytheyGIys
ymptomsyassociatedywithyit.yHowever,ytakingytheymedicationybetweenymealsymaximizesyabsorption
Recliningyimmediatelyyafterytakingyferrousysulfateymayyleadytoyesophagealycorrosion.yClientsyshouldyremainyupri
ghtyfory15-30yminyfollowingyadministering.
Theynurseyshouldyexplainythatyfeverfewyinterferesywithyplateletyactionyandycanythereforeycauseybleeding.yItyisyuns
afeyforytheyclientytoytakeyduringypregnancy.
Sucralfateyforygastricyulcer:yTheynurseyshouldyadministerytheymedicationytoytheyclientyonyanyemptyystomachyfory
bestyabsorption.yTheynurseyshouldyinstructytheyclientytoyincreaseyfluidsywhileyonysucralfateytherapyytoydecreaseyth
eyriskyofyconstipationyrelatedytoytheymedication.yTheynurseyshouldyinstructytheyclientytoyavoidytakingyantacidsy30y
minybeforeyoryafterytheyadministrationyofysucralfate.
Packedyredybloodycellsyforyanemicypatient:yTheynurseyshouldycheckytheyclient'syvitalysignsyeveryy15yminyatytheys
tartyofytheytransfusion,ythenyeveryy1yhrytoymonitoryforyaytransfusionyreaction.y(answerysaidy“checkytheyclientsyvitals
yeveryyhour)y(Iychoseytoyinfuseyatyrateyofy200yml/
hr)yTheytransfusionyshouldyinfuseyiny2ytoy4yhrytoypreventyfluidyoverload.
Lactulose,yaydisaccharide,yisyaysugarythatyworksyasyanyosmoticydiuretic.yItypreventsyabsorptionyofyammoniayinyth
eycolon.yAccumulationyofyammoniayinytheybloodstream,ywhichyoccursyinypathologicyconditionsyofytheyliver,ysuchya
sycirrhosis,ymayyaffectytheycentralynervousysystem,ycausingyhepaticyencephalopathyyorycoma.
Theypillyisyenteric-
coatedytoypreventybreakdownyinytheystomachyandydecreaseytheypossibilityyofyGIydistress.yCrushingytheypillydestro
ysythatyprotection.yCrushingytheypillywillydestroyytheyentericycoating,yandytheyclientyshouldybeyadvisedyagainstythis,
ybutytheyentericycoatingydoesynotypreventytheyreleaseyofymedication.ySustainedyreleaseypreparationsydisburseythe
ymedicationyoverytime.
Phenytoinyisyanyanticonvulsantyusedytoytreatyvariousytypesyofyseizures.yClientsyonyanticonvulsantymedicationsyco
mmonlyyrequireythemyforylifetimeyadministration,yandyphenytoinyshouldynotybeystoppedywithoutytheyadviceyofythey
client'syprovider.yTheyclientyunderstandsythatyphenytoinycausesyanyovergrowthyofytheygumsythatymakesydentalym
onitoringyimportant.
Thisystudyysourceywasydownloadedybyy100000829219024yfromyCourseHero.comyony05-10-
2022y11:53:50yGMTy-05:00
https://www.coursehero.com/file/36256769/pharm-re-evaluationdocx/
, Furosemideyisycorrect.yThisymedicationyisyusedytoyreduceyedemayandyhypertension,yandyanyadverseyeffectyisy
orthostaticyhypotension.
Telmisartanyisycorrect.yThisymedicationyisyusedytoycontrolyhypertension,yandyanyadverseyeffectyisyorthostaticyhy
potension.
Duloxetineyisycorrect.yThisymedicationyisyusedytoytreatydepressionyandyanxietyydisorder,yandyanyadverseyeffecty
isyorthostaticyhypotension.
Clopidogrelyisyincorrect.yThisymedicationyisyusedytoyreduceytheyriskyofyMIyandystrokeyandydoesynotycauseyortho
staticyhypotension.
Atorvastatinyisyincorrect.yThisymedicationyisyusedytoydecreaseycholesterolyandydoesynotycauseyorthostaticyhypo
tension.
Captopril:yneutropenia
Captopril,yanyACEyinhibitor,ycanycauseyhyperkalemiaydueytoypotassiumyretentionybyytheykidney.yTheyclientyshou
ldyavoidysaltysubstitutes,yasymostyofythemyareyhighyinypotassium.yTheyclientyshouldytakeycaptoprilyonyanyemptyys
tomach,y1yhrybeforeyory2yhryafteryaymeal,yinyorderytoynotyreduceytheymedication’syabsorption.
Theynurseyshouldyteachytheyclientythatyextendedyreleaseytabletsyshouldybeytakenywholeyandyshouldynotybeybroke
n,ycrushed,yorychewed.
Theyclientyshouldyavoidyactivitiesythatyrequireyalertness.yDiazepamyisyaybenzodiazepineythatycausesysedationya
ndydizziness.yTheyclientyshouldytakeythisymedicationyintermittentlyy(3yory4ynightsyperyweek)ytoypreventyphysicalyd
ependence.
Metabolicyalkalosisycanyoccuryinyclientsywhoyhaveyexcessiveyvomitingybecauseyofytheylossyofyhydrochloricyacid.
Hyperventilationycanycauseyrespiratoryyalkalosis.
Hypermetabolism,ysuchyasywithyfeveryoryexercise,ycanycauseymetabolicyacidosis.yRespirato
ryydepressionycanycauseyrespiratoryyacidosis.
Theyclientyshouldykeepytheyvialyinyuseyatyroomytemperatureytoyminimizeytissueyinjuryyandytoyreduceytheyriskyforylip
odystrophy.y(insulin)yTheyclientyshouldyinjectytheymedicationyintoysubcutaneousytissue.yTheyclientyshouldymixyco
mpatibleysolutions,ysuchyasyregularyinsulinyandyNPHyinsulin,ytoyreduceytheyneedyforyanyadditionalyinjectionyandyre
duceytheyriskyforylipodystrophy.
Adverseyeffectsyofynalbuphineyincludeyvisualydisturbancesysuchyasymiosis,yblurredyvision,yandydiplopia.yNalbuphi
neycanycauseyconstipation,ycramps,yandyabdominalypain,ybutyitydoesynotyhaveydiarrheayasyanyadverseyeffect.yNal
buphineyisyunlikelyytoycauseyjointypain;yhowever,yitycanycauseyheadacheyandyabdominalycramps.
Nalbuphineyisyunlikelyytoycauseyoliguria;yhowever,yitycanycauseyurinaryyurgency.
Lithiumyisyaysalt.yIfysodiumylevelyfalls,ytheyclientywillyretainylithiumyandyhaveyanyincreasedyriskyforylithiumytoxicity.
Theynurseyshouldyfirstyassessytheyclient’syairwayyandyoxygenysaturationytoydetermineytheyneedyforyrespiratoryys
upport.yIntubationyorytracheotomyyisyconsideredyifyadequateyoxygenationyisynotymaintained.yTheysecondystepyth
eynurseyshouldytakeyisytoycallytheyrapidyresponseyteamytoyprovideyemergencyytreatmentyinycaseyofycardiacyoryres
piratoryyarrest.yNext,ytheynurseyshouldyapplyyhigh-
flowyoxygenytoyincreaseyoxygenationyandythenyinitiateyanyIVysite,yifyoneyisynotypresent,yandyadministeryisotonicyI
VyfluidsytoypreventyhypotensionyandyprovideyaccessyforyIVymedications.yTheynurseyshouldythenyadministeryIVyep
inephrineytoyconstrictybloodyvessels,ydilateybronchioles,yandyincreaseycardiacyfunction.yAndyfinally,ytheynurseysh
ouldyadministeryIVyantihistaminesyandycorticosteroidsytoyblockytheyeffectsyofyhistamineyandydecreaseyedema.
Furosemideyisyayloopydiureticythatypromotesytheyexcretionyofypotassium.yTheynurseyshouldymonitorytheyclient'sypo
tassiumylevelytoywatchyforyhypokalemia.
Grapefruitsyandygrapefruityjuiceycanyreduceymetabolismyofyatorvastatin,ywhichyincreasesytheyriskyforytoxicity.
Thisystudyysourceywasydownloadedybyy100000829219024yfromyCourseHero.comyony05-10-
2022y11:53:50yGMTy-05:00
https://www.coursehero.com/file/36256769/pharm-re-evaluationdocx/
Theynurseyshouldyteachytheyclientytoydiscardyanyyregularyinsulinythatyappearsycloudy,yasyregularyinsulinyshouldyb
eyclear.yNPHyinsulinyhasyaycloudyyappearance.
TheynurseyshouldyteachytheyclientytoyinjectyairyintoytheyNPHyvialyfirst.yTheynurseyshouldyteachytheyclientytoydrawyu
pytheyregularyinsulinyintoytheysyringeyfirst.
Nystatinyoralysuspensionyshouldybeystoredyatyroomytemperature.yTheyactionyofynystatinyisylocal,yandyityisynotyabs
orbedythroughyintactyskinyorymucousymembranes.yThereyisynoyreasonytoytakeytheymedicationyonyanyemptyystom
a.yNystatinymustybeyswallowedytoymaximizeytheymedication'sylocalyeffectsyonytheymucosalyliningyofytheyupperyga
strointestinalytract.
Ferrousysulfateyprovidesytheyironyneededybyytheybodyytoyproduceyredybloodycells.yTakingyironysupplementsybetw
eenymealsyhelpsytoyincreaseytheybioavailabilityyofytheyiron.yTakingytheymedicationywithyfoodycanyreduceytheyGIys
ymptomsyassociatedywithyit.yHowever,ytakingytheymedicationybetweenymealsymaximizesyabsorption
Recliningyimmediatelyyafterytakingyferrousysulfateymayyleadytoyesophagealycorrosion.yClientsyshouldyremainyupri
ghtyfory15-30yminyfollowingyadministering.
Theynurseyshouldyexplainythatyfeverfewyinterferesywithyplateletyactionyandycanythereforeycauseybleeding.yItyisyuns
afeyforytheyclientytoytakeyduringypregnancy.
Sucralfateyforygastricyulcer:yTheynurseyshouldyadministerytheymedicationytoytheyclientyonyanyemptyystomachyfory
bestyabsorption.yTheynurseyshouldyinstructytheyclientytoyincreaseyfluidsywhileyonysucralfateytherapyytoydecreaseyth
eyriskyofyconstipationyrelatedytoytheymedication.yTheynurseyshouldyinstructytheyclientytoyavoidytakingyantacidsy30y
minybeforeyoryafterytheyadministrationyofysucralfate.
Packedyredybloodycellsyforyanemicypatient:yTheynurseyshouldycheckytheyclient'syvitalysignsyeveryy15yminyatytheys
tartyofytheytransfusion,ythenyeveryy1yhrytoymonitoryforyaytransfusionyreaction.y(answerysaidy“checkytheyclientsyvitals
yeveryyhour)y(Iychoseytoyinfuseyatyrateyofy200yml/
hr)yTheytransfusionyshouldyinfuseyiny2ytoy4yhrytoypreventyfluidyoverload.
Lactulose,yaydisaccharide,yisyaysugarythatyworksyasyanyosmoticydiuretic.yItypreventsyabsorptionyofyammoniayinyth
eycolon.yAccumulationyofyammoniayinytheybloodstream,ywhichyoccursyinypathologicyconditionsyofytheyliver,ysuchya
sycirrhosis,ymayyaffectytheycentralynervousysystem,ycausingyhepaticyencephalopathyyorycoma.
Theypillyisyenteric-
coatedytoypreventybreakdownyinytheystomachyandydecreaseytheypossibilityyofyGIydistress.yCrushingytheypillydestro
ysythatyprotection.yCrushingytheypillywillydestroyytheyentericycoating,yandytheyclientyshouldybeyadvisedyagainstythis,
ybutytheyentericycoatingydoesynotypreventytheyreleaseyofymedication.ySustainedyreleaseypreparationsydisburseythe
ymedicationyoverytime.
Phenytoinyisyanyanticonvulsantyusedytoytreatyvariousytypesyofyseizures.yClientsyonyanticonvulsantymedicationsyco
mmonlyyrequireythemyforylifetimeyadministration,yandyphenytoinyshouldynotybeystoppedywithoutytheyadviceyofythey
client'syprovider.yTheyclientyunderstandsythatyphenytoinycausesyanyovergrowthyofytheygumsythatymakesydentalym
onitoringyimportant.
Thisystudyysourceywasydownloadedybyy100000829219024yfromyCourseHero.comyony05-10-
2022y11:53:50yGMTy-05:00
https://www.coursehero.com/file/36256769/pharm-re-evaluationdocx/
, Furosemideyisycorrect.yThisymedicationyisyusedytoyreduceyedemayandyhypertension,yandyanyadverseyeffectyisy
orthostaticyhypotension.
Telmisartanyisycorrect.yThisymedicationyisyusedytoycontrolyhypertension,yandyanyadverseyeffectyisyorthostaticyhy
potension.
Duloxetineyisycorrect.yThisymedicationyisyusedytoytreatydepressionyandyanxietyydisorder,yandyanyadverseyeffecty
isyorthostaticyhypotension.
Clopidogrelyisyincorrect.yThisymedicationyisyusedytoyreduceytheyriskyofyMIyandystrokeyandydoesynotycauseyortho
staticyhypotension.
Atorvastatinyisyincorrect.yThisymedicationyisyusedytoydecreaseycholesterolyandydoesynotycauseyorthostaticyhypo
tension.
Captopril:yneutropenia
Captopril,yanyACEyinhibitor,ycanycauseyhyperkalemiaydueytoypotassiumyretentionybyytheykidney.yTheyclientyshou
ldyavoidysaltysubstitutes,yasymostyofythemyareyhighyinypotassium.yTheyclientyshouldytakeycaptoprilyonyanyemptyys
tomach,y1yhrybeforeyory2yhryafteryaymeal,yinyorderytoynotyreduceytheymedication’syabsorption.
Theynurseyshouldyteachytheyclientythatyextendedyreleaseytabletsyshouldybeytakenywholeyandyshouldynotybeybroke
n,ycrushed,yorychewed.
Theyclientyshouldyavoidyactivitiesythatyrequireyalertness.yDiazepamyisyaybenzodiazepineythatycausesysedationya
ndydizziness.yTheyclientyshouldytakeythisymedicationyintermittentlyy(3yory4ynightsyperyweek)ytoypreventyphysicalyd
ependence.
Metabolicyalkalosisycanyoccuryinyclientsywhoyhaveyexcessiveyvomitingybecauseyofytheylossyofyhydrochloricyacid.
Hyperventilationycanycauseyrespiratoryyalkalosis.
Hypermetabolism,ysuchyasywithyfeveryoryexercise,ycanycauseymetabolicyacidosis.yRespirato
ryydepressionycanycauseyrespiratoryyacidosis.
Theyclientyshouldykeepytheyvialyinyuseyatyroomytemperatureytoyminimizeytissueyinjuryyandytoyreduceytheyriskyforylip
odystrophy.y(insulin)yTheyclientyshouldyinjectytheymedicationyintoysubcutaneousytissue.yTheyclientyshouldymixyco
mpatibleysolutions,ysuchyasyregularyinsulinyandyNPHyinsulin,ytoyreduceytheyneedyforyanyadditionalyinjectionyandyre
duceytheyriskyforylipodystrophy.
Adverseyeffectsyofynalbuphineyincludeyvisualydisturbancesysuchyasymiosis,yblurredyvision,yandydiplopia.yNalbuphi
neycanycauseyconstipation,ycramps,yandyabdominalypain,ybutyitydoesynotyhaveydiarrheayasyanyadverseyeffect.yNal
buphineyisyunlikelyytoycauseyjointypain;yhowever,yitycanycauseyheadacheyandyabdominalycramps.
Nalbuphineyisyunlikelyytoycauseyoliguria;yhowever,yitycanycauseyurinaryyurgency.
Lithiumyisyaysalt.yIfysodiumylevelyfalls,ytheyclientywillyretainylithiumyandyhaveyanyincreasedyriskyforylithiumytoxicity.
Theynurseyshouldyfirstyassessytheyclient’syairwayyandyoxygenysaturationytoydetermineytheyneedyforyrespiratoryys
upport.yIntubationyorytracheotomyyisyconsideredyifyadequateyoxygenationyisynotymaintained.yTheysecondystepyth
eynurseyshouldytakeyisytoycallytheyrapidyresponseyteamytoyprovideyemergencyytreatmentyinycaseyofycardiacyoryres
piratoryyarrest.yNext,ytheynurseyshouldyapplyyhigh-
flowyoxygenytoyincreaseyoxygenationyandythenyinitiateyanyIVysite,yifyoneyisynotypresent,yandyadministeryisotonicyI
VyfluidsytoypreventyhypotensionyandyprovideyaccessyforyIVymedications.yTheynurseyshouldythenyadministeryIVyep
inephrineytoyconstrictybloodyvessels,ydilateybronchioles,yandyincreaseycardiacyfunction.yAndyfinally,ytheynurseysh
ouldyadministeryIVyantihistaminesyandycorticosteroidsytoyblockytheyeffectsyofyhistamineyandydecreaseyedema.
Furosemideyisyayloopydiureticythatypromotesytheyexcretionyofypotassium.yTheynurseyshouldymonitorytheyclient'sypo
tassiumylevelytoywatchyforyhypokalemia.
Grapefruitsyandygrapefruityjuiceycanyreduceymetabolismyofyatorvastatin,ywhichyincreasesytheyriskyforytoxicity.
Thisystudyysourceywasydownloadedybyy100000829219024yfromyCourseHero.comyony05-10-
2022y11:53:50yGMTy-05:00
https://www.coursehero.com/file/36256769/pharm-re-evaluationdocx/
