An older patient is starting a new medication that is metabolized in the liver and excreted by the kidneys. Which is the best assessment to monitor the patient's ability to tolerate the medication?
a. Liver function tests
b. Drug side effects experienced by the patient
c. Kidney function tests
d. Therapeutic drug levels
B
Adverse drug effects and medication interactions may be related to pharmacokinetics or the manner in which the body absorbs, distributes, metabolizes, and excretes a drug. The aging process is associated with changes in gastric acid secretion, which can alter ionization or solubility of a drug and hence its absorption. Medication distribution depends on body composition and on physiochemical drug properties. With advancing age, a patient's fat content increases, lean body mass decreases, and total body water decreases, which can alter drug disposition.
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An adult patient who has died from traumatic injuries is an organ donor. What should the nurse do when caring for this patient?
1. Maintain systolic blood pressure of 90 mmHg. 2. Keep oxygen saturation level at 75%. 3. Administer intravenous fluids to maintain a urine output of 25 mL per hour. 4. Perform external cardiac compressions to achieve a heart rate of 60 beats per minute.
As the school nurse, you receive a call from a mother who says her daughter has head lice. What information should you tell her?
1. Distinguish nits from dandruff. Nits are firmly attached to the hair shaft. 2. Treat with pediculicide shampoo and repeat in seven days. 3. Toys and clothes can be tied up in a bag for two weeks. 4. All of the above
Comparing the effects of oral and topical sympathomimetic agents, the nurse tells the patient
a. "The duration of action is longer for topical agents." b. "Systemic effects are more of a problem with oral agents." c. "Oral agents work more rapidly." d. "Topical agents are completely safe and therefore should be used by most patients."
A patient has been treated for severe contact dermatitis on both arms with clobetasol propionate cream. At a follow-up visit, the primary care NP notes that the condition has cleared. The NP should:
a. prescribe triamcinolone cream for 2 weeks. b. recommend continuing treatment for 2 more weeks. c. discontinue the clobetasol and schedule a follow-up visit in 2 weeks. d. discontinue the clobetasol and recommend prn use for occasional flare-ups.