Nsg Pharm Practice Test #1

Teaching the child to use a spacer is the best action for the nurse to take. Using a spacer can help improve the delivery of medication from the inhaler, especially for young children who may have difficulty coordinating their breathing and pressing the inhaler at the same time. A spacer also reduces the risk of side effects such as thrush or hoarseness, which can occur when the medication is directly inhaled. By teaching the child to use a spacer, the nurse is promoting effective and safe medication administration for the child's asthma control.

The correct answer is "Hold your breath for 10 seconds if you can after you inhale the medication." This instruction is important because it allows the medication to reach deep into the lungs and be absorbed effectively. Holding the breath for 10 seconds helps to ensure that the medication has enough time to be fully distributed in the airways before exhaling. This increases the effectiveness of the medication and improves its therapeutic effects.

Monitoring blood glucose levels every 4 hours when taking albuterol is the most important thing to teach the client with a history of diabetes and asthma. Albuterol is a medication used to treat asthma, but it can also increase blood glucose levels in individuals with diabetes. Regular monitoring of blood glucose levels helps to ensure that any changes can be detected and appropriate actions can be taken, such as adjusting diabetes medications or insulin doses. This is crucial in managing both conditions effectively and preventing complications.

The nurse's best action is to administer the albuterol inhaler first, wait five minutes, and then administer the ipratropium bromide inhaler. This is followed by administering the beclomethasone inhaler several minutes later. This sequence is appropriate because albuterol is a short-acting bronchodilator that provides immediate relief of bronchospasm. Ipratropium bromide is a long-acting bronchodilator that takes longer to take effect but provides sustained bronchodilation. Beclomethasone is a corticosteroid inhaler that reduces inflammation and should be administered last to prevent it from interfering with the bronchodilation effects of the other medications.

The client's comment suggests a lack of understanding about their medication regimen, indicating a knowledge deficit. This nursing diagnosis would involve assessing the client's knowledge and understanding of their medications, providing education and information to address any gaps in knowledge, and evaluating the client's ability to manage their medications safely and effectively.

The nurse's best response is "Its important not to take coffee or other caffeinated products with this medication as it may cause an increased HR as well as other problems." This response provides the patient with important information about the potential risks of combining coffee or other caffeinated products with the medication. It shows that the nurse is knowledgeable about the medication and is looking out for the patient's well-being.

To determine the amount of medication the client should receive, we need to convert their weight from pounds to kilograms. Since 1 kg is equal to 2.2 pounds, the client's weight in kilograms is 88 pounds divided by 2.2, which is approximately 40 kg. The dosage is 3 mg/kg, so we multiply 3 mg by 40 kg to get 120 mg. The medication is available in a 15 mg/mL elixir, so we divide 120 mg by 15 mg/mL to get 8 mL. Therefore, the client should receive 8 mL of the medication.

Bioavailability refers to the amount of medication in your blood that is available to produce an effect. It represents the fraction of the administered drug that reaches the systemic circulation and is able to exert its therapeutic effect. This can be influenced by factors such as the route of administration, drug formulation, and metabolism. Understanding bioavailability is crucial for determining the appropriate dosage of a medication and ensuring its effectiveness in producing the desired therapeutic outcome.

The correct order of the four sequential processes of the pharmacokinetic phase is absorption, distribution, metabolism, and excretion. Absorption refers to the movement of the drug from the site of administration into the bloodstream. Distribution involves the transport of the drug throughout the body to its target site. Metabolism, also known as biotransformation, is the process by which the drug is broken down and transformed into different substances. Excretion is the elimination of the drug and its metabolites from the body, usually through urine or feces.

Corticosteroids are known for their anti-inflammatory properties. When used in the treatment of acute respiratory disorders, they help to reduce inflammation in the airways, which can alleviate symptoms such as wheezing and shortness of breath. By decreasing inflammation, corticosteroids can also help to improve lung function and overall respiratory health.

The statement "I need to take the medicine as scheduled to reduce the possibility of damage to my body" best indicates that the client will adhere to the pharmacotherapy because it shows an understanding of the importance of taking the medication as prescribed to manage their diabetes and prevent potential complications. This statement demonstrates the client's commitment to following their treatment plan and taking responsibility for their health.

Albuterol is a rapidly acting bronchodilator and is the first-line medication to reverse airway narrowing in acute asthma attacks. The other medications work more slowly.

Hypoglycemia is the most common complication of insulin therapy. Insulin is a hormone that helps regulate blood sugar levels, and if too much insulin is administered or if the individual's diet or exercise routine changes, it can lead to low blood sugar levels. Hypoglycemia can cause symptoms such as dizziness, confusion, sweating, and in severe cases, loss of consciousness. It is important for individuals on insulin therapy to monitor their blood sugar levels regularly and adjust their insulin dosage accordingly to prevent hypoglycemia.

Lantus is the only option here that is a LONG-ACTING insulin which has NO peak and a 24 hour duration.

much of the drug is inactivated the first time it passes through the liver -- usually occurring before the drug distributes systemically.

Epinephrine (Adrenalin) is the best medication for an acute bronchospasm in a client with COPD. Epinephrine is a bronchodilator that works by relaxing the smooth muscles in the airways, allowing for easier breathing. It acts quickly and can provide immediate relief during an emergency situation. Zafirlukast (Accolate) is a leukotriene receptor antagonist used for long-term management of asthma, but it is not appropriate for acute bronchospasm. Dexamethasone (Decadron) is a corticosteroid used for reducing inflammation, but it is not the first-line treatment for acute bronchospasm. Oxitriphylline-theophyllinate (Choledyl) is a bronchodilator, but it is not commonly used in acute situations and has a slower onset of action compared to epinephrine.

A low therapeutic index means that there is a small difference between the therapeutic dose and the toxic dose of a drug. This implies that the drug has a narrow margin of safety, meaning that there is a higher risk of adverse effects or toxicity if the drug is not carefully monitored and administered. Therefore, the most important nursing implication of a drug with a low therapeutic index is to closely monitor the client for any signs of adverse effects and to ensure that the drug is administered at the correct dosage and frequency to prevent toxicity.

Discharge teaching for a client receiving a beta-agonist bronchodilator should emphasize reporting tachycardia as a side effect. Beta-agonist bronchodilators can stimulate the beta receptors in the heart, leading to an increased heart rate or tachycardia. This side effect should be reported promptly to the healthcare provider as it may indicate a need for a change in medication or dosage adjustment. Hypoglycemia, nonproductive cough, and sedation are not commonly associated with beta-agonist bronchodilators and would not be the priority side effect to report.

Flunisolide is a steroid. One of the big nursing considerations for any steroid is that steroids can cause for the occurence of oral fungus. It is important to have your pt rinse their mouth out after each use.

The correct answer indicates that the client understands that the anticholinergic inhaler, ipratropium bromide (Atrovent), is not meant to be used as a rescue inhaler for acute asthma attacks. This demonstrates that the client has grasped the teaching and is aware of the appropriate use of the medication.

Humalog is a rapid-acting insulin. It has an onset: 15 minutes and duration: 3 hours

Metformin (Glucophage) is held 48 hours prior to surgery (however a doctor's order is needed for this). Therefore, you should hold the dose and call the doctor for further orders.

After a nebulizer treatment with the beta agonist albuterol, it is expected for the patient to experience slight tremors of the hands and feel "shaky". This is a known adverse effect of albuterol, which is a bronchodilator medication commonly used to treat asthma and other respiratory conditions. The increase in heart rate from 88 BPM to 98 BPM is also a common response to albuterol, as it stimulates the beta receptors in the heart, leading to an increase in heart rate. Therefore, the patient's symptoms are consistent with the expected adverse effects of albuterol.

The client's statement, "I feel like I'm having an asthmatic attack," indicates that they are experiencing symptoms of an asthma attack. The nurse's best action would be to administer a beta2 adrenic agonist, as these medications are commonly used to relieve bronchospasm and improve breathing in individuals with asthma. This medication works by relaxing the smooth muscles in the airways, opening them up and allowing for easier breathing.

Insulin should be stored in the refrigerator to maintain its effectiveness. Freezing insulin can cause it to become denatured and lose its potency. Storing insulin in a dark, dry place is not recommended as it may expose it to extreme temperatures or humidity. Keeping insulin at room temperature for an extended period can also lead to degradation of the medication. Therefore, refrigerating the insulin is the correct way to store it and ensure its efficacy.

The correct answer is that the most important assessment is to evaluate for drug accumulation, because the excretion of drugs in children is slower. This means that medications may stay in a child's system for longer periods of time compared to adults. Therefore, it is crucial for the nurse to carefully monitor for any signs of drug accumulation, which can lead to potential toxicity or adverse effects. This knowledge helps the nurse make informed decisions about administering medications to children.

The given presentation of the diabetic patient suggests that they are experiencing hypoglycemia, which is a life-threatening condition. Administering 50% dextrose IV per protocol is the priority because it will rapidly increase the patient's blood glucose levels and help reverse the symptoms of hypoglycemia. Sending blood to the laboratory for analysis, administering oxygen, and administering insulin are important interventions, but they are not the priority in this situation.

Humulin R is a type of insulin that can be administered intravenously. Unlike NPH, Lantus, and Novolog, which are long-acting or rapid-acting insulins, Humulin R is a short-acting insulin that can be given intravenously for immediate effect. Intravenous administration allows for a quicker onset of action and is often used in emergency situations or in hospitals for better glycemic control.

To avoid magnesium toxicity it is important to make sure the patient is urinating efficiently. Magnesium sulfate can cause respiratory depression and hypotension. https://www.nrsng.com/magnesium-sulfate-mgso4-nursing-pharmacology-considerations/

extended release is common, but not over a days to weeks time frame.

Long-acting 2-agonists should be used only in patients who also are using an inhaled corticosteroid for long-term control. Salmeterol should not be used as the first-line therapy for long-term control. Using a bronchodilator before exercise is appropriate. The other information given by the patient requires further assessment by the nurse, but is not unusual for a patient with asthma.

Implication is the key word.

2.2 lbs per 1000ml or 1kg per 1000 ml

Pharmacokinetics refers to the study of how the body processes and affects a drug. It involves understanding how a drug is absorbed, distributed, metabolized, and eliminated by the body. This includes factors such as drug absorption rates, distribution throughout different tissues, metabolism by enzymes, and excretion through various routes. By studying pharmacokinetics, healthcare professionals can determine the optimal dosing regimen for a drug, predict drug interactions, and assess the overall effectiveness and safety of a medication.

As individuals age, there are several physiological changes that occur in the body, including changes in the gastrointestinal system. One of these changes is an increase in the pH of gastric secretions, which refers to the acidity level of the stomach. This increase in pH can affect the absorption of oral medications in older adults. When the pH of gastric secretions is higher, it can alter the solubility and breakdown of medications, leading to slower absorption. Therefore, the nurse knows that the 88-year-old client's slower absorption of oral medications is primarily due to the increased pH of gastric secretions.

Exposure to digestive enzymes, gastric acid instability, and the first pass effect can all reduce drug bioavailability. Digestive enzymes can break down the drug before it is absorbed into the bloodstream. Gastric acid instability can affect the drug's stability and make it less available for absorption. The first pass effect refers to the metabolism of the drug in the liver before it reaches systemic circulation, which can also decrease its bioavailability.

Glucagon injection is the correct answer because it is an effective treatment for hypoglycemia in comatose patients. Glucagon stimulates the liver to release stored glucose into the bloodstream, raising blood sugar levels. It can be administered either subcutaneously or intramuscularly. Providing glucose solution through IV infusion may also be effective, but it is not the immediate management option for a comatose patient. Having the patient drink orange juice may not be feasible or effective in this situation.

Factors such as dietary considerations, smoking, age, and genetic factors can potentially influence the intrinsic drug clearance. Dietary considerations can affect the metabolism and absorption of drugs, while smoking can alter the activity of drug-metabolizing enzymes. Age-related changes in liver and kidney function can impact drug clearance, and genetic factors can lead to variations in drug-metabolizing enzymes and transporters. These factors can individually or collectively modify the intrinsic drug clearance, ultimately affecting the pharmacokinetics and efficacy of drugs.

The volume of distribution is a pharmacokinetic parameter that describes the extent of drug distribution in the body. It is influenced by various factors. The patient's gender can affect the volume of distribution due to differences in body composition and hormonal levels. The patient's age can also impact the volume of distribution as it may affect factors such as body composition and organ function. The patient's disease state can alter the volume of distribution by affecting factors such as protein binding and tissue perfusion. Additionally, the patient's body composition, including factors such as muscle mass and fat content, can influence the volume of distribution.

Insulin-induced hypoglycemia can cause a variety of effects on the body. Tachycardia refers to an increased heart rate, which can occur as a result of low blood sugar levels. Palpitations are sensations of a racing or irregular heartbeat, which can also be caused by hypoglycemia. Diaphoresis refers to excessive sweating, which is another common symptom of low blood sugar. Nausea can occur as a result of the body's response to hypoglycemia. However, polyuria (excessive urination) and headaches are not typically associated with insulin-induced hypoglycemia.

The recommended child's drug dosage for naloxone is 0.01 mg/kg. Since the child's weight is 20 kg, the total dosage required would be 0.01 mg/kg x 20 kg = 0.2 mg.

The naloxone solution is available in a concentration of 400 mcg/mL. To calculate the volume needed, we can use the formula:

Volume (mL) = Total dosage (mg) / Concentration (mg/mL)

Substituting the values, we get:

Volume (mL) = 0.2 mg / 400 mcg/mL = 0.2 mg / 0.4 mg/mL = 0.5 mL

Therefore, the nurse should administer 0.5 mL of naloxone to the child.

In the assessment phase of the nursing process, nursing responsibilities include identifying side effects of drugs that are nonspecific and checking peak and trough levels of drugs. This is important to ensure the safety and effectiveness of the medication regimen for the client. By identifying side effects, the nurse can monitor and manage any adverse reactions that may occur. Checking peak and trough levels helps to determine the appropriate dosage and timing of medication administration. Both of these responsibilities contribute to the overall assessment of the client's response to the drug therapy.