Nokea
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.
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The nurse is preparing a plan of care for a client who is to receive antiviral therapy. Which nursing diagnoses would the nurse most likely include related to drug therapy? Select all that apply
- A. Acute Pain
- B. Risk for Impaired Skin Integrity
- C. Risk for Injury
- D. Risk for Imbalanced Nutrition
- E. Body Image Disturbances
Correct Answer: A,C,D,E
Rationale: Drug-specific diagnoses for antiviral drugs include Risk for Imbalanced Nutrition, Risk for Impaired Skin Integrity, Risk for Injury, Body Image Disturbance, and Acute Pain.
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 is being treated with saquinavir. The nurse would assess the patient for which of the following?
- A. Increase in patient's weight
- B. Evidence of liver dysfunction
- C. Photosensitivity
- D. Allergic skin reaction
- E. Diarrhea
Correct Answer: A
Rationale: Patients taking saquinavir experience redistribution of body fat, with the movement to the center of the body. The nurse should spend time with these patients, encouraging them to verbalize their feelings regarding this change in appearance. Taking saquinavir does not cause liver dysfunction, photosensitivity, allergic skin reactions, or diarrhea.
A patient presents to her primary health care provider for treatment of herpes simplex. While obtaining the medical history of the patient, the nurse discovers that the patient has respiratory problems and uses theophylline. The primary health care provider considers prescribing acyclovir as the drug for treatment until she reads the nursing history. The nurse understands that the primary health care provider decided against the use of acyclovir for which reason?
- A. Increases the risk for acyclovir toxicity
- B. Increases the risk of seizures in patients with respiratory problems
- C. Increases serum level of theophylline in patients taking theophylline
- D. Increased serum levels of antiviral valacyclovir
- E. Increases risk of respiratory distress
Correct Answer: C
Rationale: When patients receiving theophylline treatment are administered acyclovir, there is an increase in the serum level of theophylline, thus placing the client at risk for theophylline toxicity. The serum levels of acyclovir do not increase. Increased levels of valacyclovir occur if the patient is taking valacyclovir, not theophylline. Taking acyclovir with theophylline does not increase the risk of seizures or respiratory distress.
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.