Nokea
A nurse is preparing to administer antiviral therapy. The nurse integrates knowledge of this therapy, administering the drugs cautiously to clients with which of the following? Select all that apply.
- A. Hepatic impairment
- B. Renal impairment
- C. Diabetes
- D. Low blood cell count
- E. Hypertension
Correct Answer: B,D
Rationale: Antivirals should be used cautiously in clients with renal impairment, low blood cell counts, history of epilepsy (rimantadine), and history of respiratory disease (zanamivir).
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A nurse is reviewing information about cidofovir in preparation for administration. The nurse understands that which of the following are true? Select all that apply.
- A. It should not be given to clients who have renal impairment.
- B. The drug should not be given to clients receiving aminoglycosides.
- C. Cidofovir is used in the treatment of cytomegalovirus retinitis.
- D. It is administered by placing one drop in both eyes twice daily.
- E. The drug should not be given with HMG-CoA reductase inhibitors.
Correct Answer: A,B,C
Rationale: Cidofovir should not be given to clients who have renal impairment or who are receiving other nephrotoxic drugs, such as aminoglycosides. The drug is used to treat cytomegalovirus retinitis and is administered IV.
When teaching a client about antiviral therapy, the nurse would include information about the possibility of which adverse reactions? Select all that apply.
- A. Rash
- B. Sedation
- C. Chills
- D. Diarrhea
- E. Headache
Correct Answer: A,D,E
Rationale: Adverse reactions associated with antiviral drugs include nausea, vomiting, diarrhea, headache, rash, fever, and insomnia.
A nursing instructor is describing the different categories of antiretroviral agents used in treatment for HIV infection. The instructor determines that the teaching was successful when the students identify which category as affecting an enzyme so that new viral particles cannot mature?
- A. Protease inhibitors
- B. Reverse transcriptase inhibitors
- C. Nonnucleoside reverse transcriptase inhibitors
- D. Integrase inhibitors
- E. Entry inhibitors
Correct Answer: A
Rationale: Protease inhibitors block the protease enzyme so the new viral particles cannot mature. Reverse transcriptase inhibitors block the reverse transcriptase enzyme so the HIV material cannot change into DNA in the new cell, preventing new HIV copies from being created. Nonnucleoside reverse transcriptase inhibitors latch on to the reverse transcriptase molecule to block the ability to make viral DNA. Integrase inhibitors prevent enzymes from inserting HIV genetic material into the cell's DNA. Entry inhibitors block HIV from entering the cell.
A patient is being discharged from a health care facility but is required to continue antiviral therapy at home. Which of the following points should the nurse include in the teaching plan to educate the patient?
- A. A slight elevation in temperature is normal and needn't be reported.
- B. Double the dosage of the drug if you miss a dose.
- C. Stop taking the drug as soon as the symptoms of the infection disappear.
- D. Make sure to notify your primary health care provider if you develop any adverse reactions.
- E. Take the drug with food to reduce stomach upset
Correct Answer: D
Rationale: The nurse should instruct the patient to report adverse reactions to the primary health care provider. The nurse should also tell the patient to report any increase in temperature, even if it is a slight increase. If the patient misses a dose, the next dose should be taken as soon as remembered, but it should not be doubled. The nurse should also instruct the patient to take the drug exactly as directed for the full course of therapy, even if the symptoms of the infection disappear. Taking the drug with food is not a general requirement for all antivirals but may apply to specific drugs.
A patient with skin lesions due to a viral infection has been prescribed a topical antiviral agent. When teaching the patient about this therapy, which of the following would the nurse emphasize?
- A. The drug will not prevent the spread of the disease to others.
- B. Topical drugs should be applied using the hand, not a finger cot or gloves.
- C. All lesions should be left open and not covered in any way.
- D. Sexual contact when lesions are present is permissible if barrier methods are used.
- E. Apply the drug twice daily for best results
Correct Answer: A
Rationale: The nurse should inform the patient that application of the drug does not prevent the spread of the disease to others. Topical drugs should be applied with a finger cot or gloves but not with bare hands. The nurse should instruct the patient to cover all lesions and not leave them open. The nurse should also stress the importance of avoiding sexual contact when lesions are present irrespective of contraceptive measures. The frequency of application depends on the specific drug prescribed.