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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.
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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 patient who is receiving antiretroviral therapy is about to be discharged. Which of the following precautions should the nurse instruct the patient to follow to reduce the effects of photosensitivity?
- A. Wear protective clothing when outside.
- B. Increase fluid intake.
- C. Avoid lights while indoors.
- D. Use tanning beds for tan.
- E. Apply sunscreen daily
Correct Answer: A
Rationale: The nurse should encourage the patient to wear protective clothing while going out in the sun to reduce the effect of photosensitivity. While increasing the fluid intake is recommended, it does not help combat the effects of photosensitivity. There is no need to avoid indoor lights as the skin becomes sensitive to sunlight but not indoor lights. The use of tanning beds should be avoided. Applying sunscreen daily is a good practice but was not listed as an option.
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).
The nurse is preparing a plan of care for a client being treated with an antiviral drug. Which outcome would the nurse most likely identify? Select all that apply.
- A. Client remains free of other medical conditions.
- B. Client demonstrates an optimal response to therapy.
- C. Client exhibits continual changes in vital signs.
- D. Client demonstrates ability to manage adverse reactions.
- E. Client verbalizes understanding of the therapeutic regimen.
Correct Answer: B,D,E
Rationale: Optimal response to therapy and meeting of client needs related to the management of adverse reactions and an understanding of the therapeutic regimen are outcomes that should be addressed by the nurse in the planning step of the nursing process. Continually changing vital signs would be inappropriate. Remaining free of other medical conditions would be unrealistic.
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.