Module 1 Week 4 Pharmacology I of III

A 28-year-old pregnant client at 30 weeks gestation arrives at the labor and delivery unit with complaints of lower abdominal cramping and increased uterine activity. The healthcare provider diagnoses preterm labor and prescribes magnesium sulfate for tocolysis. Which of the following interventions should the nurse implement? Select all that apply. Monitor deep tendon reflexes (DTRs) once per shift. Assess maternal respiratory rate and urine output. Encourage the client to ambulate every two hours. Administer calcium gluconate if signs of toxicity occur. Monitor serum magnesium levels every 4-6 hours. Discontinue the infusion if the client complains of mild nausea.

A 29-year-old pregnant client at 28 weeks gestation is admitted with preterm contractions. The healthcare provider prescribes indomethacin as a tocolytic agent. The nurse is preparing to administer the medication and must consider potential adverse effects and contraindications. Which of the following findings would require the nurse to question the administration of indomethacin? Select all that apply. The client has well-controlled gestational diabetes. The client has a history of peptic ulcer disease. The client's amniotic fluid index is low. The client reports occasional mild headaches. The client has an allergy to nonsteroidal anti-inflammatory drugs (NSAIDs).

A 30-year-old pregnant client at 29 weeks gestation is admitted with preterm contractions. The healthcare provider prescribes nifedipine as a tocolytic agent. The nurse is preparing to administer the medication and must consider potential adverse effects and contraindications. Which of the following findings would require the nurse to question the administration of nifedipine? Select all that apply. The client has a history of hypotension. The client is receiving magnesium sulfate concurrently. The client has mild lower extremity edema. The client is taking beta-blockers for hypertension. The client reports occasional dizziness.

A client at 30 weeks gestation is receiving betamethasone to accelerate fetal lung maturity. Which assessment finding requires the nurse's immediate intervention?. The client reports mild muscle soreness at the injection site. The client's blood glucose level is 180 mg/dL. The client has bilateral lung crackles and complaints of shortness of breath. The client has a white blood cell count of 11,000/mm3.

A client at 38 weeks gestation in active labor receives an opioid analgesic for pain relief. Thirty minutes after administration, the nurse enters the room and finds the client exhibiting the following symptoms: respiratory rate of 10 breaths per minute, oxygen saturation of 91% on room air, blood pressure of 100/58 mmHg, fetal heart rate of 108 bpm with minimal variability, and mild but persistent late decelerations on the fetal monitor. Which action should the nurse take first?. Administer supplemental oxygen and reposition the client to improve uteroplacental perfusion. Administer naloxone as prescribed to reverse opioid-induced respiratory depression. Notify the provider immediately. Continue to monitor the fetal heart rate pattern and signs of fetal distress.

A nurse is caring for a client receiving oxytocin for labor induction. Which nursing interventions are essential to ensure maternal and fetal safety? Select all that apply. Monitor the client's blood pressure and heart rate every 2 hours. Assess the frequency, duration, and force of contractions every 30 minutes. Monitor fetal heart rate every 15 minutes and report any nonreassuring patterns. Administer oxytocin as a continuous bolus IV infusion. Keep magnesium sulfate readily accessible in case relaxation of the myometrium is necessary. Administer oxygen if prescribed in response to uterine hypertonicity or fetal distress. Do not leave the client unattended while oxytocin is infusing.

A nurse is providing care to a postpartum client experiencing excessive bleeding. The healthcare provider has ordered methylergonovine to be administered to control postpartum bleeding. The client has a history of chronic hypertension and had multiple episodes of elevated blood pressure during pregnancy. What is the priority nursing intervention before administering this medication?. Assess the client's uterine tone and amount of bleeding every 8 hours. Contact the health care provider before administration. Administer the medication as prescribed and continue monitoring blood pressure. Educate the client on the potential side effects of methylergonovine.

A nurse is preparing to administer phytonadione to a newborn. Which statements made by the newborn's parent requires further teaching?. "This medication helps my baby's blood clot properly.". "Since my baby is breastfed, they need this injection.". "My baby is born with enough vitamin K and doesn't need this shot.". "This injection will be given in my baby's buttocks.". "My baby will naturally get vitamin K from my placenta before birth.". "Vitamin K deficiency is not a concern unless my baby has symptoms of bleeding.". "Delaying the vitamin K shot is safe as long as my baby is monitored for bleeding.".

A pediatric nurse is preparing to administer intravenous (IV) medication to an infant. Which of the following nursing actions should be included in the plan of care? Select all that apply. Assess the IV site for signs of inflammation and infiltration before, during, and after medication administration. Flush the IV line with 3 to 20 mL of normal saline before and after medication administration. Administer IV medications using a micro drip set calibrated to deliver 10 drops (gtt)/mL. Utilize an electronic infusion pump to regulate and administer IV fluids and medications. Labeling the IV administration set is not necessary as long as it is documented in the medical record. Intermittent medication administrations are preceded and followed by a normal saline flush.

A nurse is providing discharge instructions to the parent of a child diagnosed with impetigo. The child has multiple lesions, some of which are oozing, and the parent expresses concern about potential complications. Which of the following parental statements indicate an appropriate understanding of the prescribed pharmacologic treatment and preventive care? Select all that apply. "I will apply the prescribed topical antibiotic to the lesions as directed, even if they appear to be healing.". "If my child's symptoms improve, I can discontinue the oral antibiotic to minimize unnecessary medication exposure.". "Keeping my child's fingernails short and clean will help reduce the risk of spreading the infection to other areas.". "If my child's impetigo does not improve within 24 hours of topical anti-infective drugs, I should contact the healthcare provider.". "I should isolate my child from siblings and avoid sharing towels or bedding to prevent spreading the infection.". "If my child develops swelling in the face or dark-colored urine, I should notify the healthcare provider immediately.". "Skipping doses of the antibiotic is acceptable as long as my child's symptoms are improving.".

A pediatric client undergoing radiation therapy for cancer treatment has developed mucositis, myelosuppression, and significant skin irritation. The nurse is developing a care plan to address the client's symptoms. Which of the following interventions should the nurse implement? Select two correct answers. Administer antiemetics only when the client reports nausea. Use alcohol-based mouth rinses to prevent oral infections. Apply prescribed topical anesthetic to the oral mucosa as needed. Encourage the client to drink hot tea with honey to soothe the throat. Implement neutropenic precautions, including hand hygiene and limiting visitors. Recommend vigorous scrubbing of the skin to prevent infection in irradiated areas.

A nurse in the pediatric unit is caring for a 2-year-old child with a fever of 103°F (39.4℃). The healthcare provider has prescribed an antipyretic. What is the priority nursing intervention before administering the medication?. Remove excess clothing and blankets to help cool the child. Administer acetaminophen as prescribed and re-evaluate temperature in 30 minutes. Assess the child's hydration status and encourage oral fluid intake. Check the child's weight and calculate the appropriate medication dose.

A 10-year-old child is admitted to the emergency department with deep, labored respirations, lethargy, and a blood glucose level of 420 mg/dL. The child has been diagnosed with diabetic ketoacidosis (DKA). The nurse is preparing to initiate treatment. Which of the following interventions should be prioritized first?. Administer IV regular insulin to lower blood glucose levels. Start IV fluids with 0.9% normal saline to restore circulating volume. Administer IV potassium replacement to prevent hypokalemia. Administer IV dextrose once blood glucose reaches an appropriate level.

A nurse is managing the care of a child diagnosed with diabetic ketoacidosis (DKA). The healthcare provider has prescribed IV fluids and insulin therapy. Which of the following nursing interventions are appropriate? Select all that apply. Initiate IV fluid resuscitation with 0.9% normal saline after initiating the insulin drip. Administer IV regular insulin as a bolus dose to rapidly lower blood glucose. Monitor for signs of cerebral edema, such as altered mental status and headache. Assess serum potassium levels frequently. Discontinue IV dextrose infusion once blood glucose normalizes to prevent hyperglycemia. Ensure urine output is adequate before initiating potassium replacement therapy. Increase the insulin infusion rate if blood glucose does not decrease by more than 100 mg/dL per hour.

A nurse in the emergency department is caring for a 3-year-old child who has been vomiting for the past 12 hours. The child is lethargic, has sunken eyes, dry mucous membranes, tachycardia, and poor skin turgor. The healthcare provider has ordered fluid resuscitation. Which of the following orders should the nurse question? Select all that apply. Administer IV 0.9% normal saline via infusion pump. Administer IV 5% dextrose in water (D5W) at a maintenance rate. Give oral rehydration therapy with a pediatric electrolyte solution. Administer IV 0.45% saline with 5% dextrose at 20 mL/kg over 1 hour. Initiate an IV infusion of 0.9% normal saline at a slow maintenance rate. Administer IV 3% hypertonic saline as a rapid bolus.

A 2-year-old child has been diagnosed with Hirschsprung's disease and is experiencing severe abdominal distension, constipation, and bilious vomiting. The healthcare provider has prescribed pharmacologic therapy as part of the preoperative management plan. Which of the following medication orders should the nurse implement? Select all that apply. Administer rectal enemas as needed for constipation. Administer IV metronidazole as prescribed. Give oral polyethylene glycol (PEG) solution daily. Administer acetaminophen for pain as prescribed. Administer IV isotonic fluids as prescribed. Administer loperamide to manage diarrhea. Give prophylactic IV antibiotics as prescribed.

A 4-year-old child is brought to the emergency department with irritability, abdominal pain, and loss of appetite. The parents report that the child has been playing in an older home undergoing renovations and frequently puts objects in their mouth. Additionally, they mention that the family recently moved into an area with older plumbing systems. The child's blood lead level (BLL) is 52 mcg/dL, and the healthcare provider prescribes chelation therapy. Which of the following nursing interventions is the priority?. Assess the child's urine output and kidney function. Administer the prescribed chelating agent immediately. Encourage increased oral fluid intake to promote lead excretion. Educate the parents about potential side effects of chelation therapy.

A 3-year-old child is brought to the emergency department after the mother reports that the child ingested an unknown amount of acetaminophen three hours ago. The child is currently conscious and has stable vital signs. The healthcare provider is considering treatment options. Which of the following interventions is most appropriate?. Administer activated charcoal and hold N-Acetylcysteine. Administer IV N-Acetylcysteine immediately and do not use activated charcoal. Administer activated charcoal first, then administered N-Acetylcysteine. Monitor the child for symptoms and wait until laboratory values confirm toxicity.

A nurse is caring for a 6-year-old child who was brought to the emergency department after the mother found an open bottle of acetylsalicylic acid (aspirin) near the child, who had an unusual odor on their breath. The child's symptoms include nausea, vomiting, and lethargy, raising concerns about potential aspirin toxicity. The healthcare provider has ordered diagnostic tests and treatment interventions. Based on the nurse's understanding of aspirin toxicity, which of the following interventions are appropriate? Select all that apply. Administer activated charcoal within the first 2 hours of ingestion. Give an antipyretic such as ibuprofen to reduce fever. Administer sodium bicarbonate intravenously to enhance salicylate excretion. Delay treatment until the child exhibits severe symptoms. Administer oxygen as a priority to manage respiratory failure risk. Administer IV potassium to correct suspected hypokalemia while waiting for lab results. Perform gastric lavage with sterile water if ingestion occurred 6 hours ago. Prepare the child for dialysis if severe toxicity persists despite medical treatment.

A nurse is supervising a new graduate nurse who is administering an ophthalmic antibiotic to a child with bacterial conjunctivitis. Which of the following actions observed by the preceptor nurse would require intervention? Select all that apply. The new graduate nurse instructs the client to tilt their head back and look upward before administration. The new graduate nurse instills the prescribed eye drops directly onto the cornea. The new graduate nurse pulls down the lower eyelid to create a conjunctival sac before administration. The new graduate nurse touches the tip of the medication bottle to the client's eyelashes while instilling the drops. The new graduate nurse applies gentle pressure to the inner canthus after administering the eye drops. The new graduate nurse allows the client to blink multiple times immediately after administration to spread the medication.

A nurse is supervising a new graduate nurse who is administering otic antibiotic drops to a 4-year-old child diagnosed with otitis externa. Which of the following actions by the new graduate requires intervention by the supervising nurse? Select all that apply. The new graduate pulls the pinna down and back before administering the ear drops. The new graduate warms the ear drops by holding the bottle in their hand for a few minutes before administration. The new graduate instructs the child to remain in a side-lying position for 5 minutes after administration. The new graduate places the dropper tip directly inside the ear canal to prevent medication loss. The new graduate gently massages the tragus after instilling the medication. The new graduate advises the parent that the child can resume swimming at least 24 hours after starting antibiotic therapy.

A nurse is caring for a 4-year-old child diagnosed with epiglottitis. The healthcare provider has prescribed medications to manage the child's condition. Which of the following medication orders are appropriate? Select all that apply. Administer intravenous (IV) broad-spectrum antibiotics as prescribed. Administer acetaminophen or ibuprofen IV to reduce fever and throat pain. Perform an oral temperature assessment before administering antipyretics. Administer IV corticosteroids as prescribed to reduce airway inflammation. Prepare to administer racemic epinephrine via nebulizer to relieve stridor. Initiate IV fluids first, while establishing an adequate airway. Administer Heliox as prescribed to reduce airway resistance and work of breathing.

A nurse is preparing to administer an antibiotic to a 6-month-old infant diagnosed with sepsis. The prescription states ceftriaxone 500 mg IV every 12 hours. Upon reviewing the infant's weight and the recommended pediatric dosage guidelines, the nurse notices the prescribed dose exceeds the safe limit for the child's weight. What is the nurse's priority action?. Administer the medication as it was prescribed following doctor's order. Recalculate the safe dose and administer only the correct amount. Call the healthcare provider to clarify the prescription before administering. Ask another nurse to verify the calculation before proceeding.

A 2-year-old child with severe dehydration is prescribed IV potassium chloride (KCI) 20 mEq/L in maintenance fluids. The UAP reported a decrease in the urinary output in the past 6 hours. What is the priority action?. Administer the prescribed potassium chloride as ordered. Notify the healthcare provider and hold the potassium chloride. Encourage oral fluid intake to promote urine output before administering potassium. Assess the client immediately.

A nurse is supervising a student nurse administering medications to a 7-year-old child with asthma. The supervising nurse intervenes when observing which of the following medication administration errors? Select all that apply. The student nurse administers an albuterol inhaler without shaking it first. The student nurse asks the child to swallow a chewable montelukast tablet whole. The student nurse compares the medication order with the electronic MAR before administration. The student nurse administers liquid prednisone using a household teaspoon. The student nurse instructs the child to rinse their mouth after using a corticosteroid inhaler. The student nurse administers the right medication but in the wrong formulation (tablet instead of liquid).