Latest Pharmacology-Med Surg- UWORLD
Pharmacology/Med Surg- UWORLD
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1. Clients with nasal nonsteroidal anti-inflammatory drugs (NSAIDS), including aspirin. In addition,
polyps often NSAIDs can exacerbate asthma symptoms. Therefore, acetaminophen may be a
have sensitivity better choice for these clients
to
2. Beta blockers The selective beta blockers (eg, metoprolol, atenolol, bisoprolol) are generally
given for heart failure and hypertension control due to their beta1-blocking
effect. The nonselective beta blockers (eg, propranolol, nadolol), in addition,
have a beta2-blocking effect that results in bronchial smooth muscle constriction.
Therefore, nonselective beta blockers are generally contraindicated in clients with
asthma
3. Nursing inter- Assess client for gastrointestinal intolerance to feedings every 4 hours by moni-
ventions to re- toring gastric residual and assessing for abdominal distension, abdominal pain,
duce aspiration bowel movements, and flatus (Option 1)
risk for clients Assess feeding tube placement at regular intervals
receiving enteral Keep head of the bed at e 30 degrees, with 30-45 degrees being optimal to reduce
tube feedings in- gastroesophageal reflux and aspiration risk unless otherwise indicated (Option
clude: 3)
Keep endotracheal cuff inflated at appropriate pressure (about 25 cm H20) for
intubated clients, as low cuff pressure increases the risk for aspirating oropha-
ryngeal secretions and/or gastric contents (Option 4)
Suction any secretions that may have collected above the endotracheal tube
before deflating the cuff if deflation is necessary
Use caution when giving sedatives and frequently monitor for over-sedation,
which can slow gastric emptying and reduce gag reflex (Option 5)
Avoid bolus tube feedings for clients at high risk for aspiration
4. Lithium for bipo- Lithium is a mood stabilizer most often used to treat bipolar affective disorders. It
lar: has a narrow therapeutic index (0.6-1.2 mEq/L [0.6-1.2 mmol/L]). Risk factors for
lithium toxicity include dehydration, decreased renal function (in the elderly), diet
4/16/2026, 1:43:23 PM
, Latest Pharmacology-Med Surg- UWORLD
Pharmacology/Med Surg- UWORLD
Study online at https://quizlet.com/_3io1cx
low in sodium, and drug-drug interactions (eg, nonsteroidal anti-inflammatory
drugs [NSAIDS] and thiazide diuretics).
5. Lithium toxicity: Chronic toxicity can result in:
Neurologic manifestations - ataxia, confusion or agitation, and neuromuscular
excitability (tremor, myoclonic jerks)
Nephrogenic diabetes insipidus - polyuria and polydipsia (increased thirst) (Op-
tion 4)
Clients should be educated about monitoring for these symptoms and obtaining
serum lithium levels at regular intervals.
6. Small Bowel Fol- An SBFT examines the anatomy and function of the small intestine using x-ray
low Through- images taken in succession. Barium is ingested, and x-ray images are taken every
STUDY 15-60 minutes to visualize the barium as it passes through the small intestine.
Using this technique, decreased motility (eg, ileus), increased motility (eg, mal-
absorption syndromes), fistulas, or obstructions are identified.
Clients should be instructed as follows:
Fast 8 hours prior to the examination.
The test usually takes 60-120 minutes, but if obstruction or decreased motility is
present, it can take longer.
Drink plenty of fluids after the examination to facilitate barium removal. Chalky
stools may be present 24-72 hours after the examination. If brown stools do not
return after 72 hours or abdominal pain or fullness is present, contact the HCP.
7. Side effects of tri-
cyclic antidepres-
sants
4/16/2026, 1:43:23 PM
, Latest Pharmacology-Med Surg- UWORLD
Pharmacology/Med Surg- UWORLD
Study online at https://quizlet.com/_3io1cx
8. Phenytoin Phenytoin (Dilantin), an anticonvulsant drug, is used to treat generalized ton-
ic-clonic seizures. The therapeutic serum phenytoin reference range is 10-20
mcg/mL. In the presence of an elevated reference range (32 mcg/mL), if no
seizure activity is observed, the nurse would anticipate the HCP to prescribe a
decreased daily dose. The nurse will continue to monitor for signs of toxicity (eg,
ataxia, nystagmus, slurred speech, decreased mentation).
The nurse should discuss the need to perform good oral hygiene with a soft-bris-
tle toothbrush and to visit the dentist regularly as phenytoin can cause gingival
hyperplasia (overgrowth of the gum tissues or reddened gums that bleed easily),
especially in high doses. Folic acid supplementation can also reduce this side
effect.
The other major side effects of phenytoin use are an increase in body hair, rash,
folic acid depletion, and decreased bone density (osteoporosis).
9. When to return Before a blood transfusion, the nurse should verify the client's identity, crossmatch
blood to blood the client's determined ABO blood-type and Rhesus (Rh) factor with the unit's
bank blood group label, and verify the unit donor number and expiration date against
the blood bank receipt. The nurse should also inspect the blood product for any
signs of blood product contamination. Blood products are a protein- and sug-
ar-rich medium for bacterial growth. Indications of contaminated blood include:
Green, black, white, or dusky discoloration
Accumulations of air
Evidence of clotting or presence of inclusions
Malodor
Units exhibiting any of these signs should be returned to the blood bank
10. Serotonin syn- Serotonin syndrome, a potentially life-threatening condition, develops when
drome drugs affecting the body's serotonin levels are administered simultaneously or in
overdose. Drugs, which may trigger this reaction, include selective serotonin re-
uptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), dextromethor-
4/16/2026, 1:43:23 PM
, Latest Pharmacology-Med Surg- UWORLD
Pharmacology/Med Surg- UWORLD
Study online at https://quizlet.com/_3io1cx
phan, ondansetron, St. John's wort, and tramadol.
The diagnosis is primarily clinical and based on medication history and clinical
findings.
Symptoms may include mental status changes (eg, anxiety, agitation, disorienta-
tion), autonomic dysregulation (eg, hyperthermia, diaphoresis, tachycardia/hy-
pertension), and neuromuscular hyperactivity (eg, tremor, muscle rigidity, clonus,
hyperreflexia).
11. Codeine and Codeine is a narcotic analgesic used for acute pain or as a cough suppressant.
COPD Depressing the cough reflex can cause an accumulation of secretions in the
presence of chronic obstructive pulmonary disease (COPD), leading to respiratory
difficulty. In general, sedatives (eg, narcotics, benzodiazepines) can also depress
the respiratory center and effort; therefore, they should not be given to clients
with respiratory diseases (eg, asthma, COPD).
12. Enoxaparin w/ The Joint Commission Surgical Improvement Project CORE measure set has shown
H&H that preventives (eg, heparin, enoxaparin, aspirin) in select surgical procedures,
given 24 hours before and after surgery, reduce the risk of venous throm-
boembolism. However, the estimated blood loss in a client with a fracture can
be significant depending on the site (eg, 250-1200 mL). Although this client's
admission hematocrit (36% [0.36]) and hemoglobin (12 g/dL [120 g/L]) are
only slightly low for an adult male (normal: 39%-50% [0.39-0.50], 13.2-17.3 g/dL
[132-173 g/L]), the blood loss may not yet be evident. Therefore, the nurse would
validate the prescription for enoxaparin (Lovenox) with the health care provider
before administration.
13. Medications Cefazolin (Ancef), a bone-penetrating cephalosporin antibiotic that is active
commonly against skin flora (Staphylococcus aureus); it is given prophylactically before and
prescribed for a after surgery to prevent infection (Option 1)
client with an
Cyclobenzaprine (Flexeril), a central and peripheral muscle relaxant given to
4/16/2026, 1:43:23 PM
Pharmacology/Med Surg- UWORLD
Study online at https://quizlet.com/_3io1cx
1. Clients with nasal nonsteroidal anti-inflammatory drugs (NSAIDS), including aspirin. In addition,
polyps often NSAIDs can exacerbate asthma symptoms. Therefore, acetaminophen may be a
have sensitivity better choice for these clients
to
2. Beta blockers The selective beta blockers (eg, metoprolol, atenolol, bisoprolol) are generally
given for heart failure and hypertension control due to their beta1-blocking
effect. The nonselective beta blockers (eg, propranolol, nadolol), in addition,
have a beta2-blocking effect that results in bronchial smooth muscle constriction.
Therefore, nonselective beta blockers are generally contraindicated in clients with
asthma
3. Nursing inter- Assess client for gastrointestinal intolerance to feedings every 4 hours by moni-
ventions to re- toring gastric residual and assessing for abdominal distension, abdominal pain,
duce aspiration bowel movements, and flatus (Option 1)
risk for clients Assess feeding tube placement at regular intervals
receiving enteral Keep head of the bed at e 30 degrees, with 30-45 degrees being optimal to reduce
tube feedings in- gastroesophageal reflux and aspiration risk unless otherwise indicated (Option
clude: 3)
Keep endotracheal cuff inflated at appropriate pressure (about 25 cm H20) for
intubated clients, as low cuff pressure increases the risk for aspirating oropha-
ryngeal secretions and/or gastric contents (Option 4)
Suction any secretions that may have collected above the endotracheal tube
before deflating the cuff if deflation is necessary
Use caution when giving sedatives and frequently monitor for over-sedation,
which can slow gastric emptying and reduce gag reflex (Option 5)
Avoid bolus tube feedings for clients at high risk for aspiration
4. Lithium for bipo- Lithium is a mood stabilizer most often used to treat bipolar affective disorders. It
lar: has a narrow therapeutic index (0.6-1.2 mEq/L [0.6-1.2 mmol/L]). Risk factors for
lithium toxicity include dehydration, decreased renal function (in the elderly), diet
4/16/2026, 1:43:23 PM
, Latest Pharmacology-Med Surg- UWORLD
Pharmacology/Med Surg- UWORLD
Study online at https://quizlet.com/_3io1cx
low in sodium, and drug-drug interactions (eg, nonsteroidal anti-inflammatory
drugs [NSAIDS] and thiazide diuretics).
5. Lithium toxicity: Chronic toxicity can result in:
Neurologic manifestations - ataxia, confusion or agitation, and neuromuscular
excitability (tremor, myoclonic jerks)
Nephrogenic diabetes insipidus - polyuria and polydipsia (increased thirst) (Op-
tion 4)
Clients should be educated about monitoring for these symptoms and obtaining
serum lithium levels at regular intervals.
6. Small Bowel Fol- An SBFT examines the anatomy and function of the small intestine using x-ray
low Through- images taken in succession. Barium is ingested, and x-ray images are taken every
STUDY 15-60 minutes to visualize the barium as it passes through the small intestine.
Using this technique, decreased motility (eg, ileus), increased motility (eg, mal-
absorption syndromes), fistulas, or obstructions are identified.
Clients should be instructed as follows:
Fast 8 hours prior to the examination.
The test usually takes 60-120 minutes, but if obstruction or decreased motility is
present, it can take longer.
Drink plenty of fluids after the examination to facilitate barium removal. Chalky
stools may be present 24-72 hours after the examination. If brown stools do not
return after 72 hours or abdominal pain or fullness is present, contact the HCP.
7. Side effects of tri-
cyclic antidepres-
sants
4/16/2026, 1:43:23 PM
, Latest Pharmacology-Med Surg- UWORLD
Pharmacology/Med Surg- UWORLD
Study online at https://quizlet.com/_3io1cx
8. Phenytoin Phenytoin (Dilantin), an anticonvulsant drug, is used to treat generalized ton-
ic-clonic seizures. The therapeutic serum phenytoin reference range is 10-20
mcg/mL. In the presence of an elevated reference range (32 mcg/mL), if no
seizure activity is observed, the nurse would anticipate the HCP to prescribe a
decreased daily dose. The nurse will continue to monitor for signs of toxicity (eg,
ataxia, nystagmus, slurred speech, decreased mentation).
The nurse should discuss the need to perform good oral hygiene with a soft-bris-
tle toothbrush and to visit the dentist regularly as phenytoin can cause gingival
hyperplasia (overgrowth of the gum tissues or reddened gums that bleed easily),
especially in high doses. Folic acid supplementation can also reduce this side
effect.
The other major side effects of phenytoin use are an increase in body hair, rash,
folic acid depletion, and decreased bone density (osteoporosis).
9. When to return Before a blood transfusion, the nurse should verify the client's identity, crossmatch
blood to blood the client's determined ABO blood-type and Rhesus (Rh) factor with the unit's
bank blood group label, and verify the unit donor number and expiration date against
the blood bank receipt. The nurse should also inspect the blood product for any
signs of blood product contamination. Blood products are a protein- and sug-
ar-rich medium for bacterial growth. Indications of contaminated blood include:
Green, black, white, or dusky discoloration
Accumulations of air
Evidence of clotting or presence of inclusions
Malodor
Units exhibiting any of these signs should be returned to the blood bank
10. Serotonin syn- Serotonin syndrome, a potentially life-threatening condition, develops when
drome drugs affecting the body's serotonin levels are administered simultaneously or in
overdose. Drugs, which may trigger this reaction, include selective serotonin re-
uptake inhibitors (SSRIs), monoamine oxidase inhibitors (MAOIs), dextromethor-
4/16/2026, 1:43:23 PM
, Latest Pharmacology-Med Surg- UWORLD
Pharmacology/Med Surg- UWORLD
Study online at https://quizlet.com/_3io1cx
phan, ondansetron, St. John's wort, and tramadol.
The diagnosis is primarily clinical and based on medication history and clinical
findings.
Symptoms may include mental status changes (eg, anxiety, agitation, disorienta-
tion), autonomic dysregulation (eg, hyperthermia, diaphoresis, tachycardia/hy-
pertension), and neuromuscular hyperactivity (eg, tremor, muscle rigidity, clonus,
hyperreflexia).
11. Codeine and Codeine is a narcotic analgesic used for acute pain or as a cough suppressant.
COPD Depressing the cough reflex can cause an accumulation of secretions in the
presence of chronic obstructive pulmonary disease (COPD), leading to respiratory
difficulty. In general, sedatives (eg, narcotics, benzodiazepines) can also depress
the respiratory center and effort; therefore, they should not be given to clients
with respiratory diseases (eg, asthma, COPD).
12. Enoxaparin w/ The Joint Commission Surgical Improvement Project CORE measure set has shown
H&H that preventives (eg, heparin, enoxaparin, aspirin) in select surgical procedures,
given 24 hours before and after surgery, reduce the risk of venous throm-
boembolism. However, the estimated blood loss in a client with a fracture can
be significant depending on the site (eg, 250-1200 mL). Although this client's
admission hematocrit (36% [0.36]) and hemoglobin (12 g/dL [120 g/L]) are
only slightly low for an adult male (normal: 39%-50% [0.39-0.50], 13.2-17.3 g/dL
[132-173 g/L]), the blood loss may not yet be evident. Therefore, the nurse would
validate the prescription for enoxaparin (Lovenox) with the health care provider
before administration.
13. Medications Cefazolin (Ancef), a bone-penetrating cephalosporin antibiotic that is active
commonly against skin flora (Staphylococcus aureus); it is given prophylactically before and
prescribed for a after surgery to prevent infection (Option 1)
client with an
Cyclobenzaprine (Flexeril), a central and peripheral muscle relaxant given to
4/16/2026, 1:43:23 PM
