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Pharmacology → PRIORITY ONE
• A nurse is caring for a client who is taking phenytoin. For
which of the following adverse effects should the nurse
monitorand report to the provider?
a. Cognitive impairment
b. Tachycardia +.
c. Elevated blood pressure
d. Tinnitus
Rationale:
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phenytoin (Dilantin, Phenytek) : Classification: antiarrhythmics,
anticonvulsants. Pharmacologic: Hydantoins. Pregnancy category:
D. Indications: treatment/prevention of tonic-clonic (grand mal)
seizures and complex partial seizures via enhancing inhibitory effects
of GABAand decreases neuron firing. Also used as an
antiarrhythmic, particularly for ventricular arrhythmias associated
with digoxin toxicity& prolonged QT interval. Adverse effects: CNS
effects (nystagmus, sedation, ataxia, double vision, cognitive
impairment) notify providersif these occur, Gingival hyperplasia
(softening and overgrowth of gumtissue, tenderness, and bleeding
gums; maintain good oral hygiene), Skin rash (stop med if this
occurs), Cardiovascular effects (dysrhythmias, hypotension),
Endocrine and other effects (coarsening of focal features, hirsutism,
and interference with vitamin D metabolism), and Interfering with
vitamin K-dependent clotting factorscausing bleeding in newborns.
• . A nurse is assessing a client who is receiving via continuous
IV infusion for labor augmentation. The nurse notes six
contractions ina 10-minute period with a nonreassuring FHR.
Which of the following actions should the nurse take first?
a. Administer Terbutaline 0.25 mg subcutaneously
b. Discontinue the oxytocin IV infusion
c. Turn the client on the left side
d. Apply oxygen at 10 L / min via face mask
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Rationale:Pharmacology 7.0 Chapter 32 page 253:
Oxytocin (Pitocin): hormone, oxytocics, pregnancy category X.
Uterine stimulants increase the strength, frequency, and length of
uterine contractions. (contractions lasting longer than 60 secs, and
occurring more frequently than every 2 to 3 min, stop the infusion,
andnotify the provider.
Practice question from RN Pharmacology Practice Questions A:
the priority question is for the nurse to place the client in lateral
position.
. A nurse is administering Lactated Ringer solution at 100ml/hr.
Thedrop factor of the manual IV tubing is 15 gtt/ml. The nurse
shouldset the manual IV infusion to deliver how many drops per
minute?Round the answer to the nearest whole number? mL/
min x drop factor (gtt/min)
1 hr. = 60 min
100 mL/60 min x 15 gtt/mL = 25 gtt/min
• . A client who has active tuberculosis and is taking rifampin
reports that this urine and sweat have developed a red orange
tinge. Whichof the following actions should the nurse take?
page 376
Adverse effects: Hepatotoxic sxs (jaundice,
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anorexia, fatigue, nausea vomiting, Metabolizes,
warfarin, HIV
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