FREE Registered Nurse: Pharmacological & Parenteral Therapies Questions and Answers
Total parenteral nutrition (TPN) and lipids should be administered to a patient with an acute aggravation of inflammatory bowel disease. Which of these treatments should be given top priority while treating this patient?
Blood glucose levels need to be carefully managed since total parenteral nutrition (TPN) might lead to hyperglycemia. The TPN solution must be delivered through a central venous catheter due to its hypertonicity. TPN is an ideal medium for bacterial growth because of the high amounts of glucose and lipids. Therefore, if the TPN contains lipids, administration sets should be replaced every 24 hours.
A client intentionally overdosed on benzodiazepines, prompting the emergency department doctor to order flumazenil 200 mcg IV push STAT. Flumazenil is present as a 0.5 mg/5 mL solution in the stock vial. How many milliliters should the nurse prepare and give? Give a response with one decimal place.
The nurse will dispense 2.0 mL after drawing it up. To compute: 1. Convert 500 mcg from mg: 0.5 mg times 1000. 2. Acknowledged: 500 mcg in 5 mL. 3. 1 mL = 100 mcg. 4. 2 mL Equals 200 mcg. 5. You can also construct the following equation: (500 mcg x 200 mcg mL = 2.0 mL. A particular benzodiazepine antagonist called flumazenil is used to treat deliberate benzodiazepine overdoses and to undo the drowsiness and respiratory depression brought on by anesthesia.
A 3-year-old patient with acute otitis media is given the medication amoxicillin suspension 200 mg PO every 8 hours by the pediatrician. The youngster is 38 pounds (17.2 kg). For kids up to 40 kg, the suggested dose range is 20–40 mg/kg/day, divided into eight-hour intervals. What is the nurse's BEST course of action when following the 10 Rights of Medication Administration?
The dosage should be given by the nurse because it is within acceptable bounds. The youngster can safely take 115–230 mg of each drug, divided into dosages of 34–688 mg per day. The antibiotic of choice for treating acute otitis media in patients older than 2 years who are not penicillin allergic is amoxicillin (20-40/kg/day). At least one episode of acute otitis media will affect 80% of kids. Right patient, right medication, right dose, right route, right time, and right assessment are among the 10 Rights of Medication Administration that are relevant in this situation.
Which of the following is NOT required to be a part of the order when a practitioner prescribes an IV infusion drug to be titrated?
The Joint Commission lists the following as necessary components for drug titration orders: 3. the initial or commencing rate of infusion (dose/min); 1. the pharmaceutical name; 2. the mode of administration; The maximum rate (dosage) of infusion, the frequency for incremental doses (how frequently the dose (rate) can be increased or lowered), and the objective clinical endpoint or patient response are all factors to consider. The nurse adheres to the titration prescription and does not decide on her own how to administer the infusion.
For a patient with severe heartburn, the healthcare professional (HCP) recommends taking aluminum hydroxide suspension every two hours between meals and before bed. Which side effect should the nurse bring up when the patient returns for a follow-up appointment?
An antacid that immediately neutralizes stomach acid is aluminum hydroxide. It is used to alleviate stomach discomfort, acid reflux, and heartburn. In cases of specific kidney diseases, it can also lower phosphate levels. The greatest adverse effect is constipation, which can aggravate hemorrhoids or cause intestinal obstruction. Loss of appetite, urinary pain, sleepiness, and muscle weakness are some more side effects. The alternative methods have nothing to do with using aluminum hydroxide.
The lab and blood bank need a sample of the patient's blood before the patient can receive a transfusion of whole blood. What tests will be conducted?
To guarantee a match between the blood donor and the recipient, a blood type and crossmatch are required. Severe adverse outcomes and even death could occur as a result of an unsuitable match. Culture, sensitivity, difference, and CBC are not necessary. The proper test is a blood type and antibody screen, which will be carried out as part of the crossmatch; blood type and antigen screening is wrong.
Hepatitis is the patient's diagnosis upon admission to the medical facility. Which phase of pharmacokinetics is most affected by the patient's diagnosis when the healthcare professional is getting ready to administer intravenous medications?
Since the liver is the major site of drug metabolism, changes in liver function might impact how drugs are metabolized. Drug metabolism may become unpredictable due to liver illness, which can have negative effects. If the liver's capacity to make drugs water soluble is impaired, excretion may also be affected by liver function, albeit to a lesser extent.
50% protein binding indicates that a medication is
The quantity of the drug that is free to function as predicted is equal to the percentage of the drug that is NOT protein bound. Because it is protein-bound, 50% of the medication in this instance is ineffective. Drug excretion, dietary protein intake, or protein oxidation are unrelated to protein binding.
Holding a sterile gauze pad over the injection site while removing the needle serves to
The discomfort of the pulling sensation is lessened by pressing the gauze pad firmly against the skin while the needle is removed. Once all of the medication has been injected, carefully and steadily remove the needle. Keep the needle's insertion angle in mind when you remove it.
A patient is admitted to the medical unit for alcohol withdrawal and detoxification who has a history of serious alcohol misuse. The individual acknowledges consuming alcohol two hours prior to admission. Which drug from the list below will the healthcare professional (HCP) recommend for this patient?
For a severe alcohol withdrawal that is predicted, a hospital offers the safest environment. Thiamine 100 mg should be administered to every client as soon as feasible and then every day throughout the withdrawal phase. Prescriptions for benzodiazepines (such diazepam, alprazolam, chlordiazepoxide, or lorazepam) are given to treat potential seizures as well as lessen agitation and anxiety. An opioid overdose can be reversed with the help of naloxone hydrochloride. By causing a severe sensitivity to alcohol use, disulfiram is used to support the treatment of alcohol abuse. Anti-psychotic medication haloperidol is administered for schizophrenia and other psychoses.
A patient complains of having watery diarrhea for the last three days when they arrive at the emergency room. Blood pressure readings of 100/60, a pulse of 98, and dry mucous membranes are other assessment findings. Which of the following fluids would the healthcare provider expect to provide intravenous treatment with?
The intravascular compartment is expanded to treat hypovolemia. The intravascular compartment will grow with an isotonic IV solution unaffected by the cells and tissues of other fluid compartments. Colloid and hypertonic solutions would draw fluid away from other fluid compartments and into the intravascular area.
The doctor prescribes Zofran 8 mg PO once daily. A 100 mL bottle with the label "4 mg/tsp" is sent by the pharmacy. How many milliliters should each dose contain?
5 mL and 4 milligrams make up 1 tsp. In order to get the prescribed dose of 8 mg, multiply 4 mg by 2. To administer 8 mg of Zofran, you will need 10 mL (2 tsp).
To treat primary hypertension, a patient is given a prescription for a calcium channel blocker. Which of these foods will the healthcare professional advise the patient to avoid while explaining the medication?
Furanocoumarins, which are found in grapefruit and its juice, prevent the cytochrome P450 enzyme CYP3A4 from functioning. Numerous medications, including calcium channel blockers, are processed by CYP3A4. Blood medication levels may rise and become poisonous. When grapefruit or grapefruit juice is ingested, the levels of calcium channel blockers rise, potentially leading to hypotension. Other medications, such as certain antibiotics, several cancer medications, and statins (atorvastatin, lovastatin, simvastatin), can also be affected by grapefruit.
The healthcare professional gives NPH insulin to a diabetic patient at 6:00 a.m. How soon might the patient exhibit hypoglycemic symptoms?
Intermediate-acting NPH insulin is often used once or twice daily. The greatest action of NPH insulin happens four to twelve hours after treatment, thus the nurse should start watching for hypoglycemic symptoms at ten o'clock in the morning. Blood sugar levels below 70 mg/dl are considered to be hypoglycemic. Shaking, lightheadedness, anxiousness, bewilderment, perspiration, chills, and clammy skin are symptoms. The patient's pulse could quicken. The patient can express complaints of headaches, impaired vision, weariness, hunger, or nausea.
The medical professional is ready to provide a corticosteroid to a patient who has been diagnosed with asthma. What justification exists for giving this medication to this patient?
The way that corticosteroids and other anti-inflammatory medications operate to treat asthma is by lessening swelling, mucus production, and airway irritation. The outcome is that the airways are less irritated and more resistant to responding to asthma triggers. The most effective treatment for asthma is inhaled corticosteroids.
The nurse checks with the patient to see if there are any drug sensitivities before giving penicillin intramuscularly to a patient with "NKDA" on his medical record. The customer replies, "I'm not certain. One time, when I was ill and received a shot, I might have developed a rash." Which course of action is best for the nurse?
While holding the penicillin, the nurse should get in touch with the person who placed the drug request. The client is at risk for an anaphylactic reaction, which normally happens within an hour of administration, even if they have previously experienced a minor reaction. Rash, hives, itching, and swelling of the face, lips, and tongue are typical penicillin side effects.