Drug and Nursing Implications Answer

DRUGS AND NURSING IMPLICATIONS

Factors Affecting Drug Action

1. A – Taking food will decrease the rate of absorption. Furthermore, taking dairy products with an antibiotic such as tetracycline will cause calcium (Ca+) to bind to the drug and decrease absorption.
2. B- Toxic drug effects occur because there is less albumin or protein for the drug to bind to in the elderly.
3. B – The blood brain barrier is not fully developed in infants and CNS depressants can readily penetrate.

Drug Administration

1. 1.5 tablets. The formula to use is desired over have time quantity.
0.375 mg
----------- X 1 tablet = 1.5 tablets
0.25 mg

2. 2 capsules. First convert grams to mg.
1000 mg = 1 g
1000 mg X 0.1 g = 100 mg

Then use desired over have time quantity
200 mg
--------- X 1 capsule = 2 capsules
100 mg

3. 0.5 ml. The formula to use is desired over have time volume.
50,000 units
----------------- X 5 ml = 0.5 ml
500,000 units

4. 0.7 ml. First convert pounds to kg. 38.5 pounds divided by 2.2 pounds/kg = 17.5kg. Calculate total mg to be given.
0.4 mg
--------- X 17.5 kg = 7 mg
Kg
The uses desired over have time volume.
7 mg
--------- X 1 ml = 0.7 ml
10 mg

5. 0.7 ml. First convert pounds to kg. Divide 40 pounds by 2.2 pounds/kg for a weight of 18.18 kg. Multiply 5 mg/kg for a total daily dose of 91 mg. Calculate the dose using desired over have times volume.
91 mg
---------- X 1 ml = 0.7 ml
125 mg

6. 2 ml.
1,200,000 units
------------------- X 1 ml = 2 ml
600,000 units

7. 26 gtts/minute. Divide 2500 ml by 24 hours. Then divide the result by 60 minutes per hour and multiply by 15 gtts/ml.

8. 83 gtts/ minute.
2000 ml
---------------- X 60 = 83.3 ml
1440 minute

9. 0.25 ml. Desire is 25 mg. Available is 30 mg in 0.3 ml.
25 mg
-------- X 0.3 ml = 0.25 ml
30 mg

10. 0.7 ml. Desire is 50 mg. Available is 75 mg/ml.
50 mg
-------- X 1 ml = 0.66667 ml
75 m

11. C - Divide 500 cc by 20 cc to determine the number of hours of the infusion (25 hours). Next divide the 15,000 units into 25 hours to get units/hour (600 units of heparin/hour)

12. C
Total volume infused
---------------------------- X drop factor = gtts per minute
Time in minutes

50 cc 10 gtts
------------ X -------- = 16.6 = 17 gtts/minute
30 minute 1 cc

Local Anesthetics

1. A – Epinephrine prolongs anesthetic action. While shortening the onset of action and reducing blood flow to injection site.
2. C – Viscous lidocaine can interfere with swallowing reflex and clients should wait at least 60 minutes after use before eating.

Non Narcotic Analgesics and Antipyretics

1. A – Indomethacin may cause visual field changes or corneal cloudiness. Clients should have periodic ophthalmic examinations to monitor for visual change.
2. C – Acetaminophen (Tylenol) is as effective as aspirin in reducing fever. Both have similar antipyretic actions.
3. B – Due to aspirin’s antiplatelet effect, aspirin can be used to decrease TIA.
4. D – Ibuprofen (Motrin) is the drug of choice to treat primary dysmenorrheal.

Narcotic Analgesics

1. C – Narcotic drugs should be taken before pain becomes intense so the client can receive the fullest analgesic effects. By adhering to this, the client will have good pain control and will not be requesting additional doses.
2. B – Respiratory rate needs to be assessed before giving the client a narcotic as narcotics can have a life threatening.
3. C – An adverse effect of narcotic analgesic is hyperglycemia. The nurse would not expect to see hypoglycemia.


Narcotic Antagonists

1. C – Tremors are an adverse effect of naloxone hydrochloride (Narcan) and indicate an overdose of the drug.
2. A – If naloxone hydrochloride (Narcan) is given to a client who is addicted to narcotics, the client will experience withdrawal syndrome. Thus, narcotic addicts should use this drug cautiously.

Sedatives and Hypnotics

1. D – Adverse effects of pentobarbital sodium (Nembutal) do not include dry mouth and urinary retention. These effects are more typical on an anticholinergic drug.
2. B – Barbiturates are teratogenic and are contraindicated for pregnant women.

Anticonvulsants

1. C – Gingival hyperplasia is a common adverse effect of phenytoin (Dilantin) seen most often in children and adolescents.
2. D – Diazepam (Valium) is the drug of choice for status epilepticus.

Muscle Relaxants

1. B – Due to the depressant effects of baclofen (Lioresal), the client should not engage in any potentially dangerous activities until the client response to the drug is known.

Antipsychotic Agents

1. B – Handling the parenteral or liquid forms of chlorpromazine (Thorazine) may cause contact dermatitis.
2. A – Chlorpromazine (Thorazine) during initial use can cause orthostatic hypotension; ambulation should be supervised to prevent falls until tolerance develops.
3. C – Promethazine (Phenergan) is used as an antiemetic and rarely causes extrapyramidal symptoms.
4. A – Haloperidol (Haldol) is alsi used to treat Tourret’s syndrome and causes fewer sedative effects than other phenothiazine.
5. C – Clients need to maintain sodium intake (usually 6-10 g daily) to prevent lithium toxicity.
6. C – Imipramine (Tofranil) can cause drowsiness; the client should avoid driving or operating machinery
7. C – It takes several weeks (2-4 weeks) before clients may see improvement of depression.
8. A – Foods such as cheese that contain tyramine or tryptophan should be avoided while taking MAO inhibitors to prevent hypertensive crisis.
9. B – A skin rash resulting from use of fluoxetine (Prozac) indicates an allergic reaction and should be reported to the physician immediately.