Nokea
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.
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A client is prescribed entecavir, which is supplied as a buffered powder. The nurse instructs the client to mix the powder with which of the following?
- A. Fruit juice
- B. Applesauce
- C. Water
- D. Gelatin
- E. Milk
Correct Answer: C
Rationale: The client should be instructed to mix the buffered powder with 4 ounces of water (not juice), stir until it is dissolved, and then drink it immediately. Using any other substance such as fruit juice, applesauce, gelatin, or milk would be inappropriate.
A client is receiving antiretroviral therapy. Which adverse reactions would the nurse include in the teaching plan for this client? Select all that apply.
- A. Altered taste
- B. Peripheral numbness
- C. Oral candidiasis
- D. Rash
- E. Fever
Correct Answer: A,B,D,E
Rationale: Adverse reactions associated with antiretroviral drugs are nausea, vomiting, diarrhea, altered taste, headache, fever, chills, rash, and numbness and tingling in the circumoral area or peripherally or both. Oral candidiasis is not associated with antiretroviral therapy.
After teaching a group of nursing students about antiretroviral drugs, the instructor determines that the teaching was successful when the students identify that these drugs are used to treat which infections? Select all that apply.
- A. Hepatitis C virus (HCV)
- B. Human immunodeficiency virus (HIV)
- C. Acquired immunodeficiency syndrome (AIDS)
- D. Herpes simplex virus (HSV) 1
- E. Herpes simplex virus (HSV) 2
Correct Answer: B,C
Rationale: Antiretroviral drugs are used to treat HIV and AIDS.
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 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.