Nokea
An injection of penicillin into a penicillin-sensitized person may lead to death due to:
- A. absence of histamine
- B. a Shwartzman's reaction
- C. release of enzymes from polymorphonuclear leukocytes
- D. constriction of bronchioli and drop in blood pressure
Correct Answer: B
Rationale: A Shwartzman's reaction is a severe inflammatory response that occurs when a person who has previously been sensitized to penicillin is re-exposed to the drug. This exaggerated response can lead to widespread activation of inflammatory mediators and is characterized by endotoxin-induced intravascular coagulation. This can result in a cascade of events leading to tissue damage, organ failure, and potentially death. It is different from a typical allergic reaction mediated by histamine release or constriction of bronchioli and drop in blood pressure. Additionally, the release of enzymes from polymorphonuclear leukocytes is not directly related to the fatal outcome of a penicillin injection in a sensitized individual.
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Heparin is classified under what class?
- A. Laxative
- B. ACE inhibitor
- C. Anti-convulsant
- D. Antithrombotic
Correct Answer: D
Rationale: Heparin is classified as an antithrombotic agent. It is a medication that helps prevent blood clot formation by inhibiting the activity of certain clotting factors in the blood. Heparin is commonly used in the treatment and prevention of conditions such as deep vein thrombosis, pulmonary embolism, and during certain medical procedures to prevent clot formation. It is not classified as a laxative, ACE inhibitor, or anti-convulsant based on its mechanism of action and therapeutic use.
The patient accidentally takes too much of the prescribed warfarin (Coumadin) and is readmitted to the hospital with bleeding. Which drug can the nurse anticipates administrating?
- A. Protamine sulfate
- B. Alteplase (Activase, Cathflo Activas
- D. Reteplase (Retavas
Correct Answer: D
Rationale: Warfarin, also known as Coumadin, is an anticoagulant medication that works by inhibiting the production of clotting factors in the liver, specifically factors II, VII, IX, and X. In the event of warfarin overdose, which can lead to excessive bleeding, the antidote is vitamin K. Vitamin K promotes the production of these clotting factors and helps reverse the effects of warfarin. Therefore, in this situation, the nurse can anticipate administering vitamin K to the patient to help stop the bleeding caused by the excess warfarin in the system.
For the patient taking acetaminophen, what should the nurse do? (Select all that apply.)
- A. Monitor routine liver enzyme tests.
- B. Encourage the patient to check package labels of over-the-counter drugs to avoid overdosing.
- C. Report side effects immediately, as toxicity can cause severe hepatic damage.
- D. Teach the female patient that oral contraceptives can increase the effect of acetaminophen.
Correct Answer: D
Rationale: Acetaminophen is metabolized in the liver, and excessive doses can lead to hepatotoxicity. Routine monitoring of liver enzymes is essential to detect early signs of liver damage. Patients should also be educated to check the acetaminophen content in over-the-counter medications to avoid accidental overdose. Reporting side effects promptly is crucial, as acetaminophen toxicity can cause severe and potentially fatal liver damage. While oral contraceptives can affect drug metabolism, they do not significantly increase the effects of acetaminophen. Therefore, the correct actions are to monitor liver enzymes, educate about over-the-counter medications, and report side effects.
A child was brought to the emergency room complaining of right upper quadrant abdominal pain, nausea, and vomiting. Upon the interview of the nurse to the mother, the client has been taking a long-
- A. Which of the following medications should be readily available?
- B. naltrexone (ReVi
- C. urea (Ureaphil)
- D. acetylcysteine (Mucomyst)
Correct Answer: A
Rationale: The presentation of right upper quadrant abdominal pain, nausea, and vomiting in a child with a history of taking a long-acting formulation of valproic acid (Depakene) is concerning for valproic acid overdose. Valproic acid toxicity can lead to liver damage, which may present with symptoms such as abdominal pain, nausea, and vomiting. In cases of valproic acid overdose, acetylcysteine (Mucomyst) is commonly used as a treatment to help prevent or reduce liver damage by replenishing glutathione stores and acting as a reactive oxygen species scavenger. Therefore, acetylcysteine should be readily available in this scenario to initiate prompt treatment and potentially prevent severe liver injury.
A nurse is caring for a patient who is taking Digoxin. The nurse should instruct the patient to monitor and report which of the following adverse e昀昀ects? ( select all the apply)
- A. Fatigue
- B. Constipation
- C. Anorexia
- D. Rash
Correct Answer: A
Rationale: A. Fatigue: Digoxin, a medication commonly used to treat heart conditions, can cause side effects such as fatigue. Patients taking Digoxin should monitor and report any unusual fatigue or weakness to their healthcare provider.