Mr. H has HIV and is taking a protease inhibitor as part of his antiretroviral treatment. At his last visit he had a detectable HIV viral load, although he claimed to take all of his medications without missing any doses
He has been very adherent with his medications over the past several years, so you are concerned about other reasons for the increase in viral load. You ask about any new over-the-counter drugs or nutritional supplements he may be taking. He responds that he has been feeling a "little down" and decided to try St. John's Wort. You inform him that St. John's Wort: 1. Is a natural product which rarely have adverse effects.
2. Causes decreased absorption of protease inhibitors and should be avoided.
3. Has been reported to be helpful with depression and is better than taking chemicals.
4. Can be used in small amounts with few side effects.
1
Rationale: St. Johns Wort has been shown to decrease levels of protease inhibitors and contribute to treatment failure. Even all-natural products can cause adverse side effects or interactions with drugs or nutrients. Although there are some reports of successful treatment of depressive symptoms, natural supplements are rarely evaluated using controlled clinical trials, and so claims are usually based on anecdotal reports. Even a small amount may cause adverse effects.
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A nurse is planning care for a patient with an ethnic background different from her own. Which of the following would be the most appropriate goal?
a. Attempt, in a nonjudgmental way, to change the patient's ethnic beliefs. b. Strive to keep the ethnic background of the patient from influencing health needs. c. Encourage continuation of the patient's ethnic practices in the hospital setting. d. Adapt, as necessary, the ethnic practices to the patient's health needs.
A family with a newborn who is severely handicapped has many choices to make. Regardless of choices made, what would make this family be considered a vulnerable high-risk family?
A. All of the possible choices related to the situation have negative consequences. B. If an acute illness occurs in one of the child's caregivers, professional caregivers will have to be hired. C. Such families typically welcome someone else taking responsibility for them. D. The family will soon have a lifestyle of depending on others for resources.
Which type of diuretic would be recommended for a patient who was very sensitive to electrolyte imbalances and needs to self-administer the diuretic?
A. Amiloride B. Mannitol C. Torsemide D. Tolvaptan