Pharmacology Rationales
EPS dystonia treatment correct answers Rationale: The client is experiencing an
extrapyramidal side effect of risperidone in the form of a dystonic reaction. This is due to
dopamine depletion which is one of the physiologic actions of risperidone. This side
effect requires immediate management with the benztropine (Cogentin) medication
which diminishes excessive cholinergic effects created by the dopamine deficiency.
EPIDURAL PUMP PRIORITY correct answers --MONITOR VITAL SIGNS EVERY 15
MINUTES
--DO NOT ADMINISTER OTHER SEDATIVES
--BE SURE FEELING/FUNCTION HAS RETURNED TO LOWER EXTREMITIES
BEFORE RETURNING PATIENT TO THE FLOOR
--ALWAYS LABEL LINE OF TUBING.
Histamine 2 Receptor Antagonists Administration correct answers Histamine 2 receptor
antagonists should be administered with at least 8 ounces of water.
Donepezil (Aricept) effects correct answers Rationale: There is no known medication
that will cure Alzheimer's Disease. Donepezil (Aricept) can delay the symptoms for 6 to
12 months if prescribed in the early stages of the disease. The medication is prescribed
at the lowest dose and gradually increased.
Epinephrine Auto-Injector correct answers Rationale: The auto-injector epinephrine pen
should not be re-used. The nurse should correct this client's action.
Antibiotic effects correct answers Rationale: The lack of growth of an organism from a
specimen culture indicates that the antibiotic has been effective.
ADH desired outcome correct answers Rationale: DDAVP is an anti-diuretic hormone
that reduces nocturia when given at bedtime.
Miacalcin and rhinitis correct answers Rationale: Alternating the nostril in which the
medication is sprayed is recommended to reduce rhinitis, a common side effect of
calcitonin.
Anti-depressant side effects correct answers Rationale: Anticholinergic side effects
frequently occur with antidepressants and include dry mouth, blurred vision,
constipation, tachycardia, agitation, seizures, urinary retention, and delirium. It should
be noted that these common side effects often result in nonadherence to the drug
treatment regimen.
, Parkinson's Medications correct answers Rationale: The nurse should FIRST
determine if the client is receiving an anti-Parkinson's medication containing levodopa,
which has long-term adverse effects such as confusion, hallucinations, depression, and
dyskinesia.
Rifampin Hepatotoxic correct answers Rationale: Rifampin (Rifadin) can cause
hepatotoxic side effects, so yellow colored sclera or scleral icterus could indicate liver
damage.
Extravastion correct answers Rationale: If an infiltration has occurred, it is MOST
important to FIRST stop any further infusion of the vesicant solution from entering the
tissue.
ASA & Lab value correct answers Rationale: Because aspirin causes decreased
platelet aggregation, the client is at high risk for bleeding. A PTT of 60 secs/control of 30
indicates prolonged clotting time for which the nurse should take IMMEDIATE action,
including holding the prescribed dose of aspirin.
Peak & Trough results correct answers Rationale: Elevated peak and trough levels
indicate drug toxicity and potential risk for nephrotoxicity. The healthcare provider
should be notified immediately with the results.
Glaucoma miotic - Side effects correct answers Rationale: Miotics cause pupillary
constriction. This reduces the eye's ability to dilate at night, and reduces night vision.
Anti-hypertensives - Low K correct answers Rationale: A serum potassium level of 6.2
mEq/L (6.2mmol/L SI) is higher than normal. Hydrochlorothiazide is a potassium-
wasting diuretic and can safely be administered to this client.
Lantus & Novolog correct answers Rationale: Lantus does not have a peak (flat) and is
considered best for PM dosing (at bedtime) so that the client's blood glucose does not
drastically change during sleep. Novolog is a very rapid-acting insulin that should be
given with meals. To assess the client's need for additional insulin, the fingerstick
glucose should be checked no more than 15 to 30 minutes before the meal is served
and the Novolog sliding scale dose administered no more than 5 to 15 minutes before
eating.
Codeine - ambulate correct answers Rationale: An important nursing intervention
related to the administration of an opioid analgesic is to instruct the client to request
assistance with ambulation because the client is at an increase risk for falls due the
sedative effects of the medication.
Sucralfate (Carafate) correct answers Rationale: Sucralfate forms a viscous, sticky gel
that adheres to the ulcer crater, and it must be given on an empty stomach. It is usually
prescribed 4 times/day, 1 hour before meals, and at bedtime. Sucralfate does not cause
electrolyte imbalance.
EPS dystonia treatment correct answers Rationale: The client is experiencing an
extrapyramidal side effect of risperidone in the form of a dystonic reaction. This is due to
dopamine depletion which is one of the physiologic actions of risperidone. This side
effect requires immediate management with the benztropine (Cogentin) medication
which diminishes excessive cholinergic effects created by the dopamine deficiency.
EPIDURAL PUMP PRIORITY correct answers --MONITOR VITAL SIGNS EVERY 15
MINUTES
--DO NOT ADMINISTER OTHER SEDATIVES
--BE SURE FEELING/FUNCTION HAS RETURNED TO LOWER EXTREMITIES
BEFORE RETURNING PATIENT TO THE FLOOR
--ALWAYS LABEL LINE OF TUBING.
Histamine 2 Receptor Antagonists Administration correct answers Histamine 2 receptor
antagonists should be administered with at least 8 ounces of water.
Donepezil (Aricept) effects correct answers Rationale: There is no known medication
that will cure Alzheimer's Disease. Donepezil (Aricept) can delay the symptoms for 6 to
12 months if prescribed in the early stages of the disease. The medication is prescribed
at the lowest dose and gradually increased.
Epinephrine Auto-Injector correct answers Rationale: The auto-injector epinephrine pen
should not be re-used. The nurse should correct this client's action.
Antibiotic effects correct answers Rationale: The lack of growth of an organism from a
specimen culture indicates that the antibiotic has been effective.
ADH desired outcome correct answers Rationale: DDAVP is an anti-diuretic hormone
that reduces nocturia when given at bedtime.
Miacalcin and rhinitis correct answers Rationale: Alternating the nostril in which the
medication is sprayed is recommended to reduce rhinitis, a common side effect of
calcitonin.
Anti-depressant side effects correct answers Rationale: Anticholinergic side effects
frequently occur with antidepressants and include dry mouth, blurred vision,
constipation, tachycardia, agitation, seizures, urinary retention, and delirium. It should
be noted that these common side effects often result in nonadherence to the drug
treatment regimen.
, Parkinson's Medications correct answers Rationale: The nurse should FIRST
determine if the client is receiving an anti-Parkinson's medication containing levodopa,
which has long-term adverse effects such as confusion, hallucinations, depression, and
dyskinesia.
Rifampin Hepatotoxic correct answers Rationale: Rifampin (Rifadin) can cause
hepatotoxic side effects, so yellow colored sclera or scleral icterus could indicate liver
damage.
Extravastion correct answers Rationale: If an infiltration has occurred, it is MOST
important to FIRST stop any further infusion of the vesicant solution from entering the
tissue.
ASA & Lab value correct answers Rationale: Because aspirin causes decreased
platelet aggregation, the client is at high risk for bleeding. A PTT of 60 secs/control of 30
indicates prolonged clotting time for which the nurse should take IMMEDIATE action,
including holding the prescribed dose of aspirin.
Peak & Trough results correct answers Rationale: Elevated peak and trough levels
indicate drug toxicity and potential risk for nephrotoxicity. The healthcare provider
should be notified immediately with the results.
Glaucoma miotic - Side effects correct answers Rationale: Miotics cause pupillary
constriction. This reduces the eye's ability to dilate at night, and reduces night vision.
Anti-hypertensives - Low K correct answers Rationale: A serum potassium level of 6.2
mEq/L (6.2mmol/L SI) is higher than normal. Hydrochlorothiazide is a potassium-
wasting diuretic and can safely be administered to this client.
Lantus & Novolog correct answers Rationale: Lantus does not have a peak (flat) and is
considered best for PM dosing (at bedtime) so that the client's blood glucose does not
drastically change during sleep. Novolog is a very rapid-acting insulin that should be
given with meals. To assess the client's need for additional insulin, the fingerstick
glucose should be checked no more than 15 to 30 minutes before the meal is served
and the Novolog sliding scale dose administered no more than 5 to 15 minutes before
eating.
Codeine - ambulate correct answers Rationale: An important nursing intervention
related to the administration of an opioid analgesic is to instruct the client to request
assistance with ambulation because the client is at an increase risk for falls due the
sedative effects of the medication.
Sucralfate (Carafate) correct answers Rationale: Sucralfate forms a viscous, sticky gel
that adheres to the ulcer crater, and it must be given on an empty stomach. It is usually
prescribed 4 times/day, 1 hour before meals, and at bedtime. Sucralfate does not cause
electrolyte imbalance.
