RN Pharmacology VATI Re-evaluation Assessment

RN Pharmacology VATI Re-evaluation Assessment The nurse should teach the client to discard any regular insulin that appears cloudy, as regular insulin should be clear. NPH insulin has a cloudy appearance. The nurse should teach the client to inject air into the NPH vial first. The nurse should teach the client to draw up the regular insulin into the syringe first. Nystatin oral suspension should be stored at room temperature. The action of nystatin is local, and it is not absorbed through intact skin or mucous membranes. There is no reason to take the medication on an empty stoma. Nystatin must be swallowed to maximize the medication's local effects on the mucosal lining of the upper gastrointestinal tract. Ferrous sulfate provides the iron needed by the body to produce red blood cells. Taking iron supplements between meals helps to increase the bioavailability of the iron. Taking the medication with food can reduce the GI symptoms associated with it. However, taking the medication between meals maximizes absorption Reclining immediately after taking ferrous sulfate may lead to esophageal corrosion. Clients should remain upright for 15-30 min following administering. The nurse should explain that feverfew interferes with platelet action and can therefore cause bleeding. It is unsafe for the client to take during pregnancy. Sucralfate for gastric ulcer: The nurse should administer the medication to the client on an empty stomach for best absorption. The nurse should instruct the client to increase fluids while on sucralfate therapy to decrease the risk of constipation related to the medication. The nurse should instruct the client to avoid taking antacids 30 min before or after the administration of sucralfate. Packed red blood cells for anemic patient: The nurse should check the client's vital signs every 15 min at the start of the transfusion, then every 1 hr to monitor for a transfusion reaction. (answer said “check the clients vitals every hour) (I chose to infuse at rate of 200 ml/hr) The transfusion should infuse in 2 to 4 hr to prevent fluid overload. Lactulose, a disaccharide, is a sugar that works as an osmotic diuretic. It prevents absorption of ammonia in the colon. Accumulation of ammonia in the bloodstream, which occurs in pathologic conditions of the liver, such as cirrhosis, may affect the central nervous system, causing hepatic encephalopathy or coma. The pill is enteric-coated to prevent breakdown in the stomach and decrease the possibility of GI distress. Crushing the pill destroys that protection. Crushing the pill will destroy the enteric coating, and the client should be advised against this, but the enteric coating does not prevent the release of medication. Sustained release preparations disburse the medication over time. Phenytoin is an anticonvulsant used to treat various types of seizures. Clients on anticonvulsant medications commonly require them for lifetime administration, and phenytoin should not be stopped without the advice of the client's provider. The client understands that phenytoin causes an overgrowth of the gums that makes dental monitoring important. Furosemide is correct. This medication is used to reduce edema and hypertension, and an adverse effect is orthostatic hypotension. Telmisartan is correct. This medication is used to control hypertension, and an adverse effect is orthostatic hypotension. Duloxetine is correct. This medication is used to treat depression and anxiety disorder, and an adverse effect is orthostatic hypotension. Clopidogrel is incorrect. This medication is used to reduce the risk of MI and stroke and does not cause orthostatic hypotension. Atorvastatin is incorrect. This medication is used to decrease cholesterol and does not cause orthostatic hypotension. Captopril: neutropenia Captopril, an ACE inhibitor, can cause hyperkalemia due to potassium retention by the kidney. The client should avoid salt substitutes, as most of them are high in potassium. The client should take captopril on an empty stomach, 1 hr before or 2 hr after a meal, in order to not reduce the medication’s absorption. The nurse should teach the client that extended release tablets should be taken whole and should not be broken, crushed, or chewed. The client should avoid activities that require alertness. Diazepam is a benzodiazepine that causes sedation and dizziness. The client should take this medication intermittently (3 or 4 nights per week) to prevent physical dependence.