Nokea
A patient has come to the clinic and been diagnosed with Lyme disease. The physician has ordered oral tetracycline. What is important for the nurse to include in the teaching plan about tetracycline? (Select all that apply.)
- A. Do not take the drug with anything high in sodium content to keep from producing a state of hypernatremia in the body.
- B. Do not take the drug with foods or other drugs that contain calcium.
- C. Avoid eating bananas at the same time you take this drug as the potassium content of the tetracycline can produce hyperkalemia in the body.
- D. Avoid exposure to the sun when taking this drug as it can turn your skin purple.
Correct Answer: B
Rationale: The antibiotic tetracycline is not absorbed from the gastrointestinal (GI) tract if calcium or calcium products (e.g., milk) are present in the stomach. It cannot be taken with iron products because a chemical reaction occurs preventing absorption. Although tetracycline can increase sun sensitivity, it does not turn the skin purple. Patients who take tetracycline do not need to avoid eating bananas or foods that are high in potassium.
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The client has a PRN prescription for loperamide hydrochloride (Imodium). The nurse understands that this medication is used for which condition?
- A. Constipation
- B. Abdominal pain
- C. An episode of diarrhea
- D. Hematest-positive nasogastric tube drainage
Correct Answer: C
Rationale: Loperamide is an antidiarrheal agent. It is used to manage acute and also chronic diarrhea in conditions such as inflammatory16inflammatory bowel disease. Loperamide also can be used to reduce the volume of drainage from an ileostomy. It is not used for the conditions in options 1, 2, and 4.
A nurse is assessing the patient's home medication use. After listening to the patient list current medications, the nurse asks what priority question?
- A. Do you take any generic medications?
- B. Are any of these medications orphan drugs?
- C. Are these medications safe to take during pregnancy?
- D. Do you take any over-the-counter medications?
Correct Answer: D
Rationale: It is important for the nurse to specifically question use of over-the-counter medications because patients may not consider them important. The patient is unlikely to know the meaning of orphan drugs unless they too are health care providers. Safety during pregnancy, use of a generic medication, or classification of orphan drugs are things the patient would be unable to answer but could be found in reference books if the nurse wishes to research them.
The nurse is reviewing the patient's medication orders and finds an order stating amoxicillin 250 mg every 8 hours. What would the nurse question regarding this order?
- A. Dose
- B. Route
- C. Frequency of administration
- D. Allowance for generic substitution
Correct Answer: B
Rationale: The order lacks the route (e.g., oral, IV), which is essential for safe administration.
A 68-year-old patient who must take antihistamines for severe allergies is planning a vacation to Mexico. The nurse will encourage the patient to:
- A. Avoid sightseeing during the hottest part of the day
- B. Discontinue the antihistamines if he becomes extremely restless
- C. Decrease the dosage of the drugs if he experiences excessive thirst
- D. Continue taking the antihistamines even if he begins to hallucinate
Correct Answer: A
Rationale: Antihistamines can decrease sweating by blocking cholinergic receptors, placing the patient at high risk for heat stroke. Avoiding the hottest part of the day will help prevent dehydration and heat prostration. Extreme restlessness could indicate Parkinson-like syndrome not usually associated with antihistamines. Excessive thirst is characteristic of hyperglycemia, and hallucinations are associated with drugs that affect neurologic functioning. Nurses should never tell patients to decrease or discontinue a drug unless the prescriber has instructed them to do so.
The first-line treatment for cough related to an upper respiratory tract infection (URI) in a 5-year-old child is:
- A. Fluids and symptomatic care
- B. Dextromethorphan and guaifenesin syrup (Robitussin DM for Kids)
- C. Guaifenesin and codeine syrup (Tussin AC)
- D. Chlorpheniramine and dextromethorphan syrup (Nyquil for Kids)
Correct Answer: A
Rationale: Fluids and symptomatic care are safest and recommended for URI cough in young children; cough suppressants are discouraged under 6.