ATI PHARMOCOLOGY DETAILED ANSWER KEY
TB-rifampin therapy - Answers :se: body secretions turning a red-orange color
digoxin. pt. is complaining of nausea & weakness - Answers :check vital signs FIRST
b/c digoxin tocixity
pt. difficulty to swallow for enteric-coated aspirin PO. ask if the med. can be curshed? -
Answers :"crushing the med might cause you to have a stomache or indigestion"
alendronate
Bone health
It can treat or prevent osteoporosis. It can also treat Paget's disease of the bone. -
Answers :must administer in the morning first on an empty stomach and wait at least 30
minutes before eating, drinking or taking other medication
bipolor is taking litium for a year. nurse need to assess before administration lithium -
Answers :thyroid hormone assess
b/c lithium may lead to thyroid dysfunction
thrombophlebitis - heparin by continuous IV infusion. - Answers :"heparin does not
dissolve clots. it STOPS new clots from forming"
teaching: asthma- cromolyn & albuterol, both by nebulizer - Answers :albuterol ------>
cromoly
ALBUTEROL: a short acting bronchodilator, should be used for the treatment of acute
bronchospasms
Cromolyn, a leukotriene modifier, is used for prophylaxis treatment of asthma, not acute
attacks.
calcium carbonate (over the counter) - Answers :drink a glass of water after taking the
medication
Rationale: Clients who take aluminum hydroxide, not calcium carbonate, antacids
should be advised
against excessive sodium intake in the diet
a client who has deep vein thrombosis and has been on heparin continuous infusion for
5
days. The provider prescribes warfarin PO without discontinuing the heparin. The client
asks the nurse why both
anticoagulants are necessary. - Answers :"Warfarin takes several days to work, so the
IV heparin will be used until the warfarin reaches a therapeutic
level."
Rationale: Heparin and warfarin are both anticoagulants that decrease the clotting
ability of the blood and
,help prevent thrombosis formation in the blood vessels. However, these medications
work in
different ways to achieve therapeutic coagulation and must be given together until
therapeutic
levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to
5 days.
When the client's PT and INR are within therapeutic range, the heparin can be
discontinued
asthma - inhaled beclomethasone - Answers :rinse the mouth after administration
C. Rinse the mouth after administration.
Rationale: Use of glucocorticoids by metered dose inhaler can allow a fungal
overgrowth in the mouth.
Rinsing the mouth after administration can lessen the likelihood of this complication
HTN-pt. asks if he can take propranolol - Answers :propranolol is contraindicated in pt
with asthma
Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma
because it can
cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents
smooth
muscle relaxatio
teaching: colchicine to tx gout - Answers :"Monitor for muscle pain."
Rationale: This medication can cause rhabdomyolysis. The client should monitor and
report muscle pain
teaching: CKD - epoetin alfa - Answers :increase dietary intake of IRON
Rationale: Epoetin alfa is a synthetic form of erythropoietin, a substance produced by
the kidneys that
stimulates the bone marrow to produce red blood cells. Increased iron is needed for the
production of hemoglobin and red blood cells by the bone marrow
cancer-morhine (PO) for pain. get increased the dose of morphine - Answers
:documentation: The client developed a tolerance to the medication.
Rationale: The nurse should document that the client has developed a tolerance to the
medication.
Morphine is a narcotic analgesic used for the treatment of severe pain. Tolerance is an
adverse effect of narcotic analgesics in which a larger dose is needed to produce the
same
response
assess IV vancomycin. nurse note: flushing of the neck and
tachycardia - Answers :intervention: Decrease the infusion rate on the IV.
, Rationale: This client is experiencing Red man syndrome, which includes a flushing of
the neck, face,
upper body, arms and back along with tachycardia, hypotension and urticaria. This can
lead to
an anaphylactic reaction if the IV infusion rate is not slowed down to run greater than 1
hour.
UTI-ciprofloxacin - Answers :"You should report any tendon discomfort you experience
while taking this medication."
Rationale: The nurse should instruct the client to report any tendon discomfort as well
as swelling or
inflammation of the tendons due to the risk of tendon rupture
cancer-ondansetron. tx) chemotherapy-induced nausea - Answers :adverse effect: A.
Headache
Rationale: Headache is a common adverse effect of ondansetron. Analgesic relief is
often required
cardiac dysrhythmia - verapamil by IV bolus - Answers :monitor: hyportension
rationale: Verapamil, a calcium channel blocker, can be used to control supraventricular
tachyarrhythmias. It also decreases blood pressure and acts as a coronary vasodilator
and
antianginal agent. A major adverse effect of verapamil is hypotension; therefore, blood
pressure and pulse must be monitored before and during parenteral administration
fungal infection - amphotericin B - Answers :assess: BUN 55 mg/dL
Rationale: This BUN level is above the expected reference range (10-20 mg/dL).
Amphotericin B is
nephrotoxic and is contraindicated if BUN is > 40mg/dL. The nurse should report this
laboratory
value to the provider before initiating the medication
teaching: renal failure - elevated phosphorous level
px) aluminum hydroxide 300 mg PO - Answers :AE: constipation
Rationale: Constipation is a common side effect of aluminum-based antacids. The nurse
should instruct
the client to increase fiber intake and that stool softeners or laxatives may be needed.
assess: pt. with levothyroxine - Answers :s/s overdose
Insomnia
Rationale: Levothyroxine overdose will result in manifestations of hyperthyroidism,
which include
insomnia, tachycardia, and hyperthermia
asthma with prednisone and discountiune - Answers :reduce dose gradually b/c
Adrenocortical insufficiency
TB-rifampin therapy - Answers :se: body secretions turning a red-orange color
digoxin. pt. is complaining of nausea & weakness - Answers :check vital signs FIRST
b/c digoxin tocixity
pt. difficulty to swallow for enteric-coated aspirin PO. ask if the med. can be curshed? -
Answers :"crushing the med might cause you to have a stomache or indigestion"
alendronate
Bone health
It can treat or prevent osteoporosis. It can also treat Paget's disease of the bone. -
Answers :must administer in the morning first on an empty stomach and wait at least 30
minutes before eating, drinking or taking other medication
bipolor is taking litium for a year. nurse need to assess before administration lithium -
Answers :thyroid hormone assess
b/c lithium may lead to thyroid dysfunction
thrombophlebitis - heparin by continuous IV infusion. - Answers :"heparin does not
dissolve clots. it STOPS new clots from forming"
teaching: asthma- cromolyn & albuterol, both by nebulizer - Answers :albuterol ------>
cromoly
ALBUTEROL: a short acting bronchodilator, should be used for the treatment of acute
bronchospasms
Cromolyn, a leukotriene modifier, is used for prophylaxis treatment of asthma, not acute
attacks.
calcium carbonate (over the counter) - Answers :drink a glass of water after taking the
medication
Rationale: Clients who take aluminum hydroxide, not calcium carbonate, antacids
should be advised
against excessive sodium intake in the diet
a client who has deep vein thrombosis and has been on heparin continuous infusion for
5
days. The provider prescribes warfarin PO without discontinuing the heparin. The client
asks the nurse why both
anticoagulants are necessary. - Answers :"Warfarin takes several days to work, so the
IV heparin will be used until the warfarin reaches a therapeutic
level."
Rationale: Heparin and warfarin are both anticoagulants that decrease the clotting
ability of the blood and
,help prevent thrombosis formation in the blood vessels. However, these medications
work in
different ways to achieve therapeutic coagulation and must be given together until
therapeutic
levels of anticoagulation can be achieved by warfarin alone, which is usually within 1 to
5 days.
When the client's PT and INR are within therapeutic range, the heparin can be
discontinued
asthma - inhaled beclomethasone - Answers :rinse the mouth after administration
C. Rinse the mouth after administration.
Rationale: Use of glucocorticoids by metered dose inhaler can allow a fungal
overgrowth in the mouth.
Rinsing the mouth after administration can lessen the likelihood of this complication
HTN-pt. asks if he can take propranolol - Answers :propranolol is contraindicated in pt
with asthma
Rationale: Propranolol, a beta-blocker, is contraindicated in clients who have asthma
because it can
cause bronchospasms. Propranolol blocks the sympathetic stimulation, which prevents
smooth
muscle relaxatio
teaching: colchicine to tx gout - Answers :"Monitor for muscle pain."
Rationale: This medication can cause rhabdomyolysis. The client should monitor and
report muscle pain
teaching: CKD - epoetin alfa - Answers :increase dietary intake of IRON
Rationale: Epoetin alfa is a synthetic form of erythropoietin, a substance produced by
the kidneys that
stimulates the bone marrow to produce red blood cells. Increased iron is needed for the
production of hemoglobin and red blood cells by the bone marrow
cancer-morhine (PO) for pain. get increased the dose of morphine - Answers
:documentation: The client developed a tolerance to the medication.
Rationale: The nurse should document that the client has developed a tolerance to the
medication.
Morphine is a narcotic analgesic used for the treatment of severe pain. Tolerance is an
adverse effect of narcotic analgesics in which a larger dose is needed to produce the
same
response
assess IV vancomycin. nurse note: flushing of the neck and
tachycardia - Answers :intervention: Decrease the infusion rate on the IV.
, Rationale: This client is experiencing Red man syndrome, which includes a flushing of
the neck, face,
upper body, arms and back along with tachycardia, hypotension and urticaria. This can
lead to
an anaphylactic reaction if the IV infusion rate is not slowed down to run greater than 1
hour.
UTI-ciprofloxacin - Answers :"You should report any tendon discomfort you experience
while taking this medication."
Rationale: The nurse should instruct the client to report any tendon discomfort as well
as swelling or
inflammation of the tendons due to the risk of tendon rupture
cancer-ondansetron. tx) chemotherapy-induced nausea - Answers :adverse effect: A.
Headache
Rationale: Headache is a common adverse effect of ondansetron. Analgesic relief is
often required
cardiac dysrhythmia - verapamil by IV bolus - Answers :monitor: hyportension
rationale: Verapamil, a calcium channel blocker, can be used to control supraventricular
tachyarrhythmias. It also decreases blood pressure and acts as a coronary vasodilator
and
antianginal agent. A major adverse effect of verapamil is hypotension; therefore, blood
pressure and pulse must be monitored before and during parenteral administration
fungal infection - amphotericin B - Answers :assess: BUN 55 mg/dL
Rationale: This BUN level is above the expected reference range (10-20 mg/dL).
Amphotericin B is
nephrotoxic and is contraindicated if BUN is > 40mg/dL. The nurse should report this
laboratory
value to the provider before initiating the medication
teaching: renal failure - elevated phosphorous level
px) aluminum hydroxide 300 mg PO - Answers :AE: constipation
Rationale: Constipation is a common side effect of aluminum-based antacids. The nurse
should instruct
the client to increase fiber intake and that stool softeners or laxatives may be needed.
assess: pt. with levothyroxine - Answers :s/s overdose
Insomnia
Rationale: Levothyroxine overdose will result in manifestations of hyperthyroidism,
which include
insomnia, tachycardia, and hyperthermia
asthma with prednisone and discountiune - Answers :reduce dose gradually b/c
Adrenocortical insufficiency
