Nurse administering unit packed red blood cells prbcs client
1. A nurse is caring for a client with many different medications who is newly prescribed acetazolamide. What medications can interact with acetazolamide?
Acetazolamide is a carbonic anhydrase inhibitor that is used to quickly lower IOP. It interacts with patients taking high-dose aspirin, quinidine, lithium, phenytoin and sodium bicarbonate.
4. A nurse is caring for a client with asthma who asks if Montelukast sodium can be taken for acute asthma symptoms. When should Montelukast sodium be taken?
Montelukast should be taken as a long term asthma management medication, once every night. For exercise-induced bronchospasm, they should take it 2 hours before exercise. This is not an asthma medication used for acute exacerbations.
7. A nurse is teaching a client who has a new prescription for alprazolam. What instructions should the nurse include?
Alprazolam is a benzodiazepine used to provide relief from anxiety in patients with GAD and panic disorder. This medication should be taken at the same time every day, if GI upset occurs then take with meals. Because sedation is a side effect, this medication should be taken at bedtime. Notify the provider if CNS depression, anterograde amnesia, toxicity, paradoxical response or withdrawal effects are seen.
A therapeutic serum level of digoxin is 0.5-0.8 ng/mL. Dosages should be based on serum levels and client response to medication. The nurse should monitor the patients potassium levels and ensure the patient is on a potassium sparing diuretic because hypokalemia increases risk for toxicity. The patients potassium levels should be between 3.5-5.0 mEq/L. Findings that indicate digoxin toxicity include fatigue, weakness, N/V/D, anorexia, dysrhythmias, visual changes such as diplopia and yellow-tinged vision. The nurse should hold this medication for a heart rate less than 60 beats per minute.
11. A nurse is providing instructions to a client who has a prescription for methotrexate. What should the nurse include in the client education?
13. A client has been prescribed oxybutynin for treatment of overactive bladder and has been experiencing anticholinergic side effects. List two (2) actions the client will take to prevent adverse effects of the medication therapy.
Oxybutynin is a muscarinic antagonist used to prevent contractions of the bladder and the urge to void. A side effect seen with this medication is anticholinergic effects including constipation, dry mouth, blurred vision, photophobia, dry eyes and tachycardia. To avoid these complications,
Other anticholinergic adverse effects include blurred vision, constipation and urinary retention.
16. A client with an upper respiratory infection is prescribed guaifenesin. Identify two (2) teaching points to discuss with the client prior to administering this medication. Guaifenesin is an expectorant used to increase cough production by increasing and thinning mucous secretions. The patient should increase fluids when taking guaifenesin to help liquify secretions. If GI upset occurs, the patient should take this medication with food. Report to the provider a cough lasting longer than one week.
