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A nurse is preparing to administer ribavirin via inhalation to a client. Which of the following would the nurse need to keep in mind? Select all that apply.
- A. Administration is via a nebulizer.
- B. Solution should be discarded and replaced every 24 hours.
- C. Respiratory status can be worsened by the drug.
- D. Extrapyramidal effects can occur upon administration of the drug.
- E. Women of childbearing age should not inhale the drug.
Correct Answer: B,C,E
Rationale: Ribavirin is administered by inhalation using a small-particle aerosol generator. The solution should be discarded and replaced every 24 hours. This drug can worsen respiratory status, this drug is pregnancy category \mathrm{X}, and women of childbearing age should take care not to inhale the drug.
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The nurse is reviewing the medical record of a client who is to receive ritonavir. Which medication if found in the medication history would lead the nurse to contact the primary health care provider because the prescribed drug would be contraindicated? Select all that apply.
- A. Triazolam (Halcion)
- B. Bupropion (Wellbutrin)
- C. Zolpidem (Ambien)
- D. Lisinopril (Prinivil)
- E. Procainamide (Procanbid)
Correct Answer: B,C,E
Rationale: Ritonavir (Norvir) is contraindicated if the client is taking bupropion (Wellbutrin), zolpidem (Ambien), or an antiarrhythmic drug.
A client diagnosed with HIV infection is receiving HAART. The client, who is alert and oriented, complains of anorexia, nausea, and vomiting. He has lost 10 pounds in the last 6 weeks. Additional assessment reveals pale, pink skin without any irritation or breakdown. He denies any complaints of pain. Which nursing diagnosis would the nurse identify as the priority for this client?
- A. Risk for Injury
- B. Risk for Imbalanced Nutrition: Less Than Body Requirements
- C. Risk for Impaired Skin Integrity
- D. Acute Pain
- E. Ineffective Coping
Correct Answer: B
Rationale: The client's complaints along with his weight loss strongly suggest a nursing diagnosis of Risk for Imbalanced Nutrition: Less Than Body Requirements as a priority. The client is alert and oriented, so his risk for injury is significantly low. There is no evidence of impaired skin integrity at present. However, this may become a concern if the client begins toæ??æ³? experience skin breakdown secondary to his poor nutritional status. The client denies any pain, so Acute Pain would be inappropriate. Ineffective Coping is not supported by the provided assessment data.
A patient who is being discharged needs to continue taking the zanamivir using a Diskhaler and a bronchodilator. Both the inhaler and the Diskhaler are prescribed at the same time. Which instruction would the nurse include in the teaching plan for the patient?
- A. Zanamivir should be taken every 6 hours.
- B. Use the bronchodilator before taking zanamivir.
- C. Zanamivir used with a bronchodilator causes orthostatic hypotension.
- D. Risk of disease transmission is minimal during therapy.
- E. Monitor for allergic reactions
Correct Answer: B
Rationale: The bronchodilator should be used before the zanamivir. The drug should be taken every 12 hours, not every 6 hours. The nurse should also inform the patient that treatment with this drug does not decrease the risk of transmission of the 'flu' to others. Zanamivir when used with a bronchodilator does not specifically cause orthostatic hypotension, though antivirals are known to affect the mental status of patients. Monitoring for allergic reactions is a general recommendation but not specific to this scenario.
Clients receiving antiretroviral drugs for HIV infection may continue to contract opportunistic infections. The nurse would be alert for which of the following when assessing the client during therapy? Select all that apply.
- A. Fever.
- B. Malaise
- C. Sore throat
- D. Lethargy
- E. Hypotension
Correct Answer: A,B,C,D
Rationale: The nurse's ongoing assessment of HIV-positive clients should include close monitoring for signs of infection such as fever, malaise, sore throat, or lethargy.
A nurse is providing care to a client receiving highly active antiretroviral therapy (HAART). The nurse would expect the client to receive which of the following antiretroviral agents? Select all that apply.
- A. Protease inhibitors
- B. Reverse transcriptase inhibitors
- C. Nonnucleoside reverse transcriptase inhibitors
- D. Entry inhibitors
- E. Integrase inhibitors
Correct Answer: A,B,C
Rationale: HAART includes three categories of antiretroviral drugs: protease inhibitors, reverse transcriptase inhibitors, and nonnucleoside reverse transcriptase inhibitors.