ATI PN Pharmacology Proctored Exam Review

ATI PN Pharmacology Proctored Exam Review Patient identifiers - -Medical record number -home telephone number What lab values should a nurse monitor for a patient with chronic renal failure? - ■ Urinalysis Hematuria, proteinuria, and alterations in specific gravity Serum creatinine - Gradual increase of 1 to 2 mg/dL per every 24 to 48 hr for acute renal failure (ARF) - Gradual increase over months to years for chronic renal failure (CRF) exceeding 4 mg/dL ■ Blood urea nitrogen (BUN) - 80 to 100 mg/dL within 1 week with ARF - Gradual increase with elevated serum creatinine over months to years for CRF - 180-200 mg/dL with (CRF) ■ Serum electrolytes - Decreased sodium (dilutional) and calcium, increased potassium, phosphorus, and magnesium ■ Complete blood count (CBC) - Decreased hemoglobin What food should you increase when taking Lasix? - -increased amounts of potassiumrich foods (e.g., bananas, prunes, raisins, and orange juice) Patient reports IV discomfort, what is your first action? - color and temperature Sumatriptan (treats migraine headaches) adverse effect - pain, tightness, pressure, or heaviness in the chest, throat, neck, and/or jaw slow or difficult speech Know about Transdermal patch - -• Apply at the same time once each day, preferably in the morning. Keep patch on for 12 to 14 hr each day. • Remove the patch at night to reduce the risk of developing tolerance to nitroglycerin. Be medication-free a minimum of 10 to 12 hr each day (usually at night). • Do not cut patches to ensure appropriate dosage. • Place the patch on a hairless area of skin (chest, back, or abdomen) and rotate sites ATI PN Pharmacology Proctored Exam Review to prevent skin irritation. • Wash skin with soap and water and dry thoroughly before applying new patch. RBC Blood transfusion - %20RN%208.0%20Chp% (prime with normal saline and infuse with sodium chloride). What to understand about Parkinson's Meds? - -they don't cure disease, they slow the process. NEUPOGEN (filgrastim)-what is the appropriate route of this med? - administered by subcutaneous injection or IV infusion Lisinopril therapeutic effect - blood pressure answer (e.g. 120/80) Medication for Schizophrenia - risperidone, Risperdal Macrodantin medication - used to treat or prevent certain urinary tract infections Haldol-inform if you are taking ____________ medication. - -benzodiazepine class of anti-anxiety drugs (all ending with "pam") and even, Xanax. Fosomax - same as-Alendronate is used for treating osteoporosis in men and postmenopausal women. Lipitor - -lowers cholesterol in blood, "statins". Reduce LDL and total cholesterol. Raise HDL. Garamycin- - Antibiotic that is toxic to the kidney, injected for radiology studies. Digoxin side effects - -Fatigue -Bradycardia -Anorexia -Nausea/Vomiting Singulair - used before exercise to prevent breathing problems during exercise (bronchospasm). What medication to administer with Tylenol overdose? - acetylcysteine (Mucomyst) must be given IV ATI PN Pharmacology Proctored Exam Review HPV vaccine - Human Papilloma Virus (HPV2, HPV4) - -Three doses should be given over a 6 month -interval for females at 11 to 12 years of age (minimum age is 9 years). -The second dose should be administered 2 months after the first dose, and the third dose should be administered 6 months after the first dose. -HPV4 may be given to males starting at age 9 years of age. Opioid toxicity-what to check first - oxygen saturation Valporic Acid lab - liver Lithium report immediately - slurred speech Prednisone report - sore throat Food to avoid when taking Lithium - -salty foods -alcoholic beverages Labs for patients taking hydrothiazide - Periodic determination of serum electrolytes to detect possible electrolyte imbalance should be done at appropriate intervals. 1) A nurse is caring for a client with hyperparathyroidism and notes that the client's serum calcium level is 13 mg/dL. Which medication should the nurse prepare to administer as prescribed to the client? 1. Calcium chloride 2. Calcium gluconate 3. Calcitonin (Miacalcin) 4. Large doses of vitamin D - 3. Calcitonin (Miacalcin) Rationale: The normal serum calcium level is 8.6 to 10.0 mg/dL. This client is experiencing hypercalcemia. Calcium gluconate and calcium chloride are medications used for the treatment of tetany, which occurs as a result of acute hypocalcemia. In hypercalcemia, large doses of vitamin D need to be avoided. Calcitonin, a thyroid hormone, decreases the plasma calcium level by inhibiting bone resorption and lowering the serum calcium concentration. 2.) Oral iron supplements are prescribed for a 6-year-old child with iron deficiency anemia. The nurse instructs the mother to administer the iron with which best food item? 1. Milk 2. Water 3. Apple juice 4. Orange juice - 4. Orange juice Rationale: ATI PN Pharmacology Proctored Exam Review Vitamin C increases the absorption of iron by the body. The mother should be instructed to administer the medication with a citrus fruit or a juice that is high in vitamin C. Milk may affect absorption of the iron. Water will not assist in absorption. Orange juice contains a greater amount of vitamin C than apple juice. 3.) Salicylic acid is prescribed for a client with a diagnosis of psoriasis. The nurse monitors the client, knowing that which of the following would indicate the presence of systemic toxicity from this medication? 1. Tinnitus 2. Diarrhea 3. Constipation 4. Decreased respirations - 1. Tinnitus Rationale: Salicylic acid is absorbed readily through the skin, and systemic toxicity (salicylism) can result. Symptoms include tinnitus, dizziness, hyperpnea, and psychological disturbances. Constipation and diarrhea are not associated with salicylism. 4.) The camp nurse asks the children preparing to swim in the lake if they have applied sunscreen. The nurse reminds the children that chemical sunscreens are most effective when applied: 1. Immediately before swimming 2. 15 minutes before exposure to the sun 3. Immediately before exposure to the sun 4. At least 30 minutes before exposure to the sun - 4. At least 30 minutes before exposure to the sun Rationale: Sunscreens are most effective when applied at least 30 minutes before exposure to the sun so that they can penetrate the skin. All sunscreens should be reapplied after swimming or sweating. 5.) Mafenide acetate (Sulfamylon) is prescribed for the client with a burn injury. When applying the medication, the client complains of local discomfort and burning. Which of the following is the most appropriate nursing action? 1. Notifying the registered nurs