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1
Q

Pilocarpine eye drops, need for further teaching?

a. I will not drive for a while after I put the drops in
b. I know this med can cause local eye pain
c. I will stop using the drops as soon as my vision improves
d. i know this med can cause SEs in other areas of the body

A

c. I will stop using the drops as soon as my vision improves. Pilocarpine is used to tx open-angle glaucoma, a chronic condition w/progressive optic nerve damage w/eventual loss of vision. Pilocarpine indirectly reduces intraocular pressure by facilitating aqueous humor outflow and is used for long-term management. Ps should not drive as pilocarpine causes miosis (constriction) which decreases visual acuity. The med can also cause local eye pain or be absorbed systemically (causing bradyc, hypotension, bronchospasm, diarrhea, diaphoresis).

2
Q

Med hx for new Rx for allopurinol. Wotf meds will have a potential interaction?

a. Colchicine
b. Omeprazole
c. Nifedipine
d. Warfarin

A

d. Warfarin. Allopurinol is used to tx gout by reducing uric acid levels. The med works by inhibiting xanthine oxidase (which is an enzyme required for uric acid formation), thus reducing the formation of tophi and allowing join function to improve. Allopurinol inhibits hepatic drug-metabolizing enzymes, thereby delaying the inactivation of other drugs, thus p’s on warfarin should have their dosage reduced.

3
Q

Functions of the parasympathetic nervous system

A

slowing of HR, increased gastric secretions and motility, emptying of the bladder, focusing the eye for near vision, constricting the pupil (miosis), and contracting bronchial smooth muscle (bronchoconstriction)

4
Q

Functions of the sympathetic nervous system

A

Regulating the CV system, body temperature, and innervating the fight-or-flight response. These processes mean an increased HR/BP, shunting of blood away from (vasoconstriction) or towards (vasodilation) the skin and to skeletal muscles, dilating the bronchi to improve oxygenation, dilating the pupils (mydriasis), mobilizing stored energy, thereby providing glucose for the brain and fatty acids for muscles.

5
Q

Alpha-1 receptors of SNS

A

Alpha 1 receptors are located in the eyes, blood vessels, male sex organs, prostatic capsule and bladder. Activation of ocular receptors leads to mydriasis, blood vessel receptors lead to vasoconstriction, in male sex organs activation causes ejaculation, activation in bladder and prostatic receptors causes contraction of sphincter muscles.

6
Q

Alpha 2 receptors of SNS

A

Alpha 2 receptors are located on presynaptic nerve terminals, not on organs, thus they regulate NT release. When too much NE is secreted into the synaptic space, the Alpha 2 receptor can be activated by the NE and the outflow of further NE hormone will be stopped. This is a feedback loop mechanism

7
Q

Beta-1 receptors of the SNS

A

Beta 1 receptors are located in the heart and kidneys. Cardiac beta-1 receptor activation causes an increased HR, increased contractility, and increased velocity of impulse contraction through the AV node. Kidney B-1 receptor activation causes renin release, leading to the synthesis of angiotensin and subsequent vasoconstriction. Thus, Beta-1 receptors help to elevate BP

8
Q

Beta-2 receptors of the SNS

A

Beta-2 receptors are located in the heart, lungs, skeletal muscles, uterus, and liver. When activated, they respectively cause vasodilation, bronchodilation, enhanced muscle contractions, relaxation of uterine smooth muscle, and promote glycogenolysis in the liver, leading to increased BS levels.

9
Q

While caring for a p. taking enalapril and spironolactone for HF, wotf should the RN plan to mon. for?

a. hypokalemia
b. hyperkalemia
c. hypocalcemia
d. hypercalcemia

A

b. hyperkalemia. Enalapril is an ACE-inhibitor that can potentially increase K+ levels, while spironolactone is a K+ sparing diuretic. In combination, these drugs should be used cautiously to prevent hyperkalemia. These drugs should not be used with ARBs or aldosterone antagonists either, as they can also promote K+ retention. P’s should be instructed to avoid K+ supplements as well as salt substitutes

10
Q

Caring for liver transplant p. taking cyclosporine. WOTF lab findings indicates an AE?

a. WBC 8000/mm3
b. Serum creatinine 2.5mg/dL
c. Serum sodium 138 mEq/L
d. Platelet count 150,000

A

B. Serum creat. 2.5. Cyclosporine is a powerful immunosuppressant and drug of choice to prevent transplant rejection. It does not cause bone marrow suppression, rather, the most common SEs are nephrotoxicity and infection. Other common SEs include htn, tremors, and hirsutism

11
Q

A p. informs the RN that he has a new Rx for timolol to tx glaucoma. WOTF in the p’s history should concern the RN?

a. the p. received levofloxacin for pneumonia
b. the p. has had conjunctivitis
c. the p. has a history of bradycardia
d. the p. reports that he is taking loratadine for allergies

A

c. the p. has a hx of bradycardia. Timolol is a nonselective beta-blocker that decreased aqueous humor production, thereby reducing IOP. Blockade of beta-1 receptors in the heart can lead to bradyc, and AV heart block, therefore beta-blocker use is CI’d for ps with a hx of these hrt problems. Likewise, beta-2 blockade in the lungs can cause bronchospasm.

12
Q

RN caring for p. w/myasthenia gravis and is in a cholinergic crisis. WOTF should the RN give?

a. naloxone
b. flumazenil
c. atropine
d. protamine

A

c. Atropine. P’s w/ myasthenia gravis are given neostigmine or other reversible acetylcholinesterase-inhibitors to prevent the breakdown of acetylcholine, improving skeletal muscle contractions. Toxic doses, however, cause excess ACh activity and neuromuscular blockade (respiratory paralysis). Atropine is a muscarinic antagonist, which prevents ACh from binding to these receptors, thus remedying the blockade. Naloxone is for opioid OD, flumazenil is for benzodiazepine OD, and protamine is for heparin OD

13
Q

RN finds that a p., who is receiving morphine IVPB, has shallow resps at a rate of 8/min. After stopping the infusion, the RN should?

a. monitor the p’s resps
b. administer naloxone
c. place the p in a supine position
d. monitor the p’s pain level

A

b. administer naloxone. The next appropriate action is to give the opioid antagonist to alleviate CNS/resp depression.

14
Q

P. receiving chemo and taking epoetin afla. WOTF lab tests will determine TE of this med?

a. bilirubin
b. albumin
c. prothrombin time
d. hemoglobin

A

d. hemoglobin. Epoetin alfa is used for p’s with anemia to stimulate red bone marrow and increase the production of RBCs. An increase in RBC production would yield a higher level of hemoglobin, the O2-carrying iron compound.

15
Q

RN preparing to give allopurinol to p w/gout and finds that atenolol was given, in error, on the previous shift. RN’s 1st action?

a. obtain the p’s BP
b. Contact the p’s HCP
c. inform the charge nurse
d. Complete an incident report

A

a. obtain the p’s BP. The first action is to monitor for SEs experienced by the patient. The next action is to inform the charge nurse and HCP, and finally complete an incident report.

16
Q

RN plans to give amoxicillin/clavulanic acid to a p. when the p. states she is allergic to penicillin. RN’s first action?

a. update the p’s EMR
b. notify the HCP
c. w/hold the med
d. inform the pharmacist of the allergy to penicillin.

A

c. w/hold the medication. Amoxicillin is a broad-spectrum penicillin, thus in order to prevent an allergic rxn the RN should w/hold the med. The RN should then update the p’s EMR and inform the pharmacist of the allergy.

17
Q

RN caring for p. w/UTI and RN anticipates a Rx for ciprofloxacin. WOTF indicates a CI?

a. I have tendonitis, so I haven’t been able to exercise
b. I have been a preschool teacher for 3 years
c. I take medicine for my thyroid
d. I am allergic to sulfa

A

a. “I have tendonitis so I haven’t been able to exercise.” Ciprofloxacin is a broad spectrum (bactericidal) fluoroquinolone used to tx most UTIs and enteritis. SEs of cipro include GI effects (n/v, diarrhea), CNS effects (dizz, h-ache), phototoxicity (severe sunburn), and tendon rupture. Tendon rupture can occur as fluoroquinolones disrupt the extracellular matrix of cartilage, thus, the drug is d/c’d at the 1st sign of tendon pain or swelling.

18
Q

Teaching r/t trimethoprim/sulfamethoxazole should include?

a. chew tablets thoroughly
b. take in the evening
c. drink 8 to 10 glasses of water daily
d. rise slowly from the bed in the morning

A

c. drink 8-10 glasses of water/day. TMP/SMZ is a sulfonamide antibiotic that works by inhibiting bacterial folic acid synthesis, which stops DNA replication. It is most commonly used to tx UTIs. AEs include steven-johnson syndrome, blood dyscrasias, kernicterus (in NBs), and crystalluria. Sulfonamides have low solubility and can precipitate out of urine to form crystals in the urinary system, causing obstruction/irritation. To minimize this risk, adults should maintain adequate I&O

19
Q

Methylphenidate for ADHD in school age p. WOTF indicates that interventions to minimize AEs were successful?

a. increase in BP
b. maintains age-appropriate wt.
c. increase in energy level
d. maintains pretherapy ability to focus

A

b. maintains age appropriate weight. A SE of all CNS stimulants is appetite suppression. To prevent cachexia and malnutrition, the child’s wt should be monitored

20
Q

Teaching r/t NPH insulin and regular insulin administration in the same syringe. RN should instruct the p. to take these steps in what order?

a. insert air into the NPH insulin into the syringe
b. insert air into the regular insulin into the syringe
c. draw up the NPH insulin into the syringe
d. draw up the regular insulin into the syringe

A

b. insert air into the NPH insulin vial.
a. insert air into the reg insulin vial.
d. draw up the reg insulin into the syringe
c. draw up the NPH insulin into the syringe

(acute before chronic, short before long)

21
Q

WOTF instructions should be given to a p. and family r/t Rx for fentanyl patches q72hr?

a. the HCP will Rx naloxone at home for resp depression
b. a stool softener should be taken on a daily basis
c. increased UOP should reported to the HCP
d. removing the patch will reverse the AEs within a few minutes

A

b. a stool softener should be taken on a daily basis. Transdermal fentanyl has the same AEs as other opioids and p’s should be instructed on how to manage them. Naloxone is only given in the hospital via IV. Urine retention, rather than polyuria, is an AE r/t morphine. AEs may persist for hours following patch removal owing to continued absorption from the skin.

22
Q

WOTF indicates the TE of pegfilgrastim in a p. w/cancer?

a. increased WBC count
b. increased Hgb
c. increased platelets
d. increased K+ level

A

a. increased WBC count. Pegfilgrastim is a leukopoietic growth factor used to stimulate bone marrow and increase the neutrophil count in p’s who have immunosuppression (often r/t chemo). AEs of pegfilgrastim include bone pain, leukocytosis, splenomegaly and splenic rupture with long term use (LUQ pain). P’s need CBC labs drawn q2weeks

23
Q

WOTF teachings should be included for a prefilled epi injector?

a. administer the med subcutaneously
b. massage the site for 10 seconds after injection
c. expect to administer three injections
d. store the auto-injector in the fridge

A

b. massage the site for 10 seconds after injection. Massaging the site promotes absorption of the drug. Other instructions include administering the drug intramuscularly, expect to administer one injection, then another if bronchospasm is untreated, and store the injectors at room temp. in a dark place.

24
Q

Lab results to monitor for the p. taking zidovudine?

a. magnesium
b. serum albumin
c. serum creatinine
d. hemoglobin

A

d. Hgb. Zidovudine - Retrovir is used to decrease HIV symptoms by inhibiting DNA synthesis and viral replication. AEs include bone marrow suppression (thus anemia), lactic acidosis, n/v, diarrhea, and hepatomegaly. The RN should monitor CBCs and give epoetin alfa for p’s that develop anemia

25
Q

Instructions for p. w/ new Rx for captopril?

a. take with food
b. consume foods low in tyramine
c. increase fiber intake
d. change positions slowly

A

d. change positions slowly, ACE inhibitors can cause ortho hypotension, which is usually confined to the 1st dose. Other instructions include taking the drug 1 hour AC to promote absorption. ACE inhibitors do not cause constipation or interact with tyramine

26
Q

Postop p. has received hydromorphone IV boluses q2h. WOTF findings should the RN attend to 1st?

a. constipation
b. hypotension
c. weakness
d. nausea

A

b. hypotension. ABC priorities- hydromorphone can cause CNS depression (leading to bradyc and hypotension) coma, and respiratory depression.

27
Q

RN should assess a p. on long-term prednisone txmt for wotf AEs?

a. edema
b. hypoglycemia
c. weight loss
d. drowsiness

A

a. edema- glucocorticoids can cause sodium and fluid retention, as well as hypokalemia. Educate p’s about fluid retention and signs of hypokalemia (muscle weakness, irregular pulses, cramps). Other AEs include hyperglycemia (diabetic p’s need higher doses of insulin/hypoglycemic agents), osteoporosis, adrenal insufficiency (Cushing’s), infection, and peptic ulcer disease.

28
Q

Monitor for wotf AEs in a p. taking diphenoxylate/atropine?

a. increased salivation
b. abd distention
c. tinnitus
d. petechiae

A

b. abd distention- Diphenoxylate/Atropine, or Lomotil, is used to slow GI motility, increase Na+ and fluid absorption in the intestine, and prevent diarrhea. Other AEs include blurred vision, dry mouth, urine retention and constipation (anticholinergic effects of atropine).

29
Q

Teaching p. with rheumatoid arthritis and new Rx for methotrexate. WOTF indicates understanding?

a. I should feel better in about a week
b. I will take this med each morning at breakfast
c. I should call my doctor if I develop sores in my mouth
d. I will have difficulty sleeping when I take this med

A

c. Sores in the mouth is a sign of stomatitis, indicating toxicity. Methotrexate is an immunosuppressant that slows joint degeneration. AEs include infection, hepatic fibrosis, bone marrow suppression, fetal death, and ulcerative stomatitis

30
Q

Txmt for opioid addiction?

a. bupropion
b. disulfiram
c. methadone
d. modafinil

A

c. methadone. Bupropion is used to tx nicotine addiction. Disulfiram is used to tx alcohol addiction, and modafinil is used to tx methamphetamine addiction.

31
Q

P. with cardiogenic shock is receiving dopamine. WOTF indicates effectiveness?

a. increased bp
b. decreased urinary output
c. decreased hr
d. increased respirations

A

a. increased bp. Dopamine is a catecholamine used to raise the bp in p’s experiencing shock. It also increases the HR and UOP.

32
Q

Teaching for spironolactone. WOTF is an AE of this med?

a. constipation
b. tinnitus
c. lethargy
d. blurred vision

A

c. lethargy is a sign of hyperkalemia. Spironolactone does not affect the GI system, does not cause ototoxicity, and does not cause vision problems.

33
Q

P. w/diabetes insipidus is to start taking desmopressin. Select all of options that the RN should monitor?

a. WBC count
b. urine specific gravity
c. liver enzymes
d. creatine clearance
e. serum osmolality

A

urine specific gravity, creatinine clearance and serum osmolality

34
Q

New Rx for lithium, Wotf OTC meds should the p. discontinue?

a. aspirin
b. ibuprofen
c. ranitidine
d. cetirizine

A

b. ibuprofen. NSAIDs can significantly increase lithium levels. Lithium SEs= GI distress, hand tremors, polyuria, wt gain, renal toxicity, hypothyroidism (long-term txmt), and F&E imbalances. P’s on lithium should avoid the use of diuretics, the use of nsaids, the use of TCAs, and the use of antihistamines

35
Q

P. scheduled for IV pyelography. WOTF food allergies places the p at risk for allergic rxn to contrast medium?

a. peanuts
b. bananas
c. shrimp
d. wheat

A

c. shrimp.

36
Q

WOTF drugs are used to tx TB? (Select all that apply)

a. Rifampicin
b. Mirtazapine
c. temazepam
d. infliximab
e. isoniazid

A

a. Rifampicin and e. Isoniazid.

37
Q

P. has been Rxd furosemide. For wotf findings should the rn w/hold the med?

a. bp 118/70
b. Na+ 140 mEq/L
c. Pulse 92
d. K+ 3.1 mEq/L

A

d. K+ 3.1 mEq/L. Furosemide is a non-potassium sparing diuretic and can cause further potassium excretion and hypokalemia

38
Q

RN caring for p. whose family reports she has taken large amts of diazepam. WOTF meds should the RN anticipate giving?

a. ondansetron
b. magnesium sulfate
c. flumazenil
d. protamine sulfate

A

c. flumazenil is the drug used to reverse benzodiazepine overdose.

39
Q

P. w/ sickle cell anemia is taking hydroxyurea. WOTF need to be reported to the HCP? (Select all that apply)

a. Hgb 4.2g/dL
b. hct 42%
c. RBC 4,700,000/mm3
d. Platelets 75,000/mm3
e. Neutrophils 1,400/mm3

A

a, d, and e. Hydroxyurea is a medication used to tx cancer and sickle cell anemia by increasing the production of fetal hgb (this decreases sickling and prolongs RBC life). The major AE is myelosuppression, which can reduce neutrophil, platelet, and reticulocyte counts. CBCs need to be monitored q2weeks. Hgb counts below 4.5 g/dL, platelet counts below 80,000, and neutrophil counts below 2000 cells/mm3 indicate toxic levels.

40
Q

P. w/ Rx for warfarin. Wotf should RN report to HCP prior to administering the med?

a. INR of 5
b. K+ 4.5 mEq/L
c. Hgb 15 g/dL
d. aPTT of 38 seconds

A

a. INR of 5. Warfarin is a vit K antagonist/anticoagulant that decreases the production of clotting factors. It is used to prevent thromboses in susceptible patients. The INR monitors the PT ratio and is normally 0.8-1.2. However, for p’s taking warfarin, the INR should be at 2-3, or 3-4.5 based on the p’s condition. The INR should never be greater than 4.5. A hgb of 15, and an aPTT of 38 seconds is normal

41
Q

P. w/ hypercholesterolemia and a new Rx for rosuvastatin. WOTF should be included in teaching?

a. this med can cause muscle pain/tenderness
b. take this med w/an antacid to prevent GI distress
c. yeast infections are a common SE
d. increase intake of iron-rich foods while taking this med

A

a. Statin drugs can cause myopathy that can progress to fatal rhabdomyolysis. Statins are used primarily to lower LDL cholesterol to

42
Q

Wotf should RN include in teaching plan for tranylcypromine?

a. avoid eating citrus fruits while taking this med
b. move slowly when changing to standing position
c. include high-calorie snacks to prevent wt loss
d. discontinure taking this med if diarrhea develops

A

b. move slowly when changing positions. Tranylcypromine (Parnate), along with Phenelzine, Isocarboxazid, and selegiline are all MAOIs used to tx depression. They increase NE, serotonin, and dopamine levels in the CNS. AEs include- CNS stimulation, ortho hypo, and HTN crisis w/ingestion of tyramine containing foods. P’s cannot take sympathomimetics, TCAs, SSRIs, Antihypertensives or meperidine while on MAOIs

43
Q

Caring for several ps w/med allergies. WOTF indicates a med allergy?

a. I get tremors when I take albuterol
b. My felodipine levels got too high when I drank grapefruit juice
c. I need to monitor how many green vegetables I eat when I’m taking warfarin
d. I cannot take celecoxib bc of the rash I developed taking trimethoprim/sulfamethoxazole

A

d. Celecoxib is CI’d for p’s that have an allergic rxn to sulfonamides. Likewise, p’s with an allergy to thiazide or loop diuretics and oral hypoglycemic should not take SMZ-TMP.

44
Q

A p. tells the RN that he is allergic to penicillins. WOTF can the p. also have a hypersensitivity to?

a. cephalexin
b. digoxin
c. metronidazole
d. probenecid

A

a. cephalexin. Ps with penicillin allergies could also be cross-sensitive to cephalosporins

45
Q

WOTF should RN tell p. to monitor and report regarding a new Rx for sumatriptan?

a. chest pain
b. white patches on the tongue
c. bruising
d. insomnia

A

a. chest pain. Sumatriptan (and all other triptans) are serotonin receptor agonists. Sumatriptan is used to relieve migraine headaches by causing intracranial vasoconstriction and decreased perivascular inflammation. Coronary vasospasm is the major AE, which causes angina and could lead to an MI. Thus, triptans are CI’d for ps w/a hx of CAD, MI, HTN.

46
Q

Teaching r/t transdermal nitroglycerin. WOTF p. statements indicates need for further teaching?

a. I need to apply the patch to a hairless area
b. I will call my HCP if I have a headache
c. I will check my BP before applying the patch
d. I need to rotate the location of my patch

A

c. P’s are not required to check their bp prior to applying a new patch, however, they should be instructed to change positions slowly as ortho hypo can occur. Patches are applied to hairless areas in the am, stay on for 12 hours, and removed in the evening (this method prevents tolerance to the nitro, which can occur rapidly). Headaches are the most common, but transient, SE and p’s should be told to take Tylenol or aspirin. Rotation of sites helps prevent local skin irritation

47
Q

SL nitroglycerin tablets are Rx’d for p. What is the current recommended guidelines for terminating an acute anginal attack?

A

P’s should be told to take 1 SL nitroglycerin tablet as soon as chest pain begins. If pain is unrelieved in 5 minutes, the p should call 911 or report to an ER (bc cont’d pain could mean MI). While awaiting emergency care, the patient can take another SL tab, and then a 3rd SL tab 5 minutes later

48
Q

Caring for p. taking isotretinoin for severe nodulocystic acne vulgaris. Before p. gets a refill, wotf tests will be required?

a. serum calcium
b. pregnancy test
c. 24 hr urine collection for calcium
d. Aspartate aminotransferase level

A

b. pregnancy test. Isotretinoin (Accutane) is highly teratogenic and is CI’d for pregnant women. It decreases sebum production and reduces sebaceous gland inflammation. The drug has no effect on urine or serum calcium levels, nor does it alter liver enzyme levels. Other AEs= epistaxis, infla of the eyes or lips, and facial pruritus. Before starting therapy, the p must have two negative pregnancy tests, then have one neg test result prior to each refill. The p must also use 2 forms of birth control

49
Q

P. w/HTN and Rx for lisinopril. Teaching should include for p. to monitor and report WOTF?

a. blurred vision
b. headache
c. facial flushing
d. dry cough

A

d. dry cough. The most common reason for discontinuing ACE inhibitor therapy is the dvlpmt of a persistent, dry cough. Cough occurs secondary to the accumulation of bradykinin and can develop into a life-threatening condition. Other SEs of ACE inhibitors include - first-dose hypotension, hyperkalemia, renal failure, fetal injury, and angioedema (life-threatening swelling of the tongue, glottis, and pharynx)

50
Q

P. w/DM is taking insulin lispro and is also Rx’d metoprolol for HTN. WOTF should the RN monitor for as an early indicator of hypoglycemia?

a. Sweating
b. Tachy-c
c. Anorexia
d. Polyuria

A

a. Sweating. Normally, a rapid decrease in serum glucose levels leads to activation of the SNS (tachy-c, palpitations, nervousness, sweating, vasoconstriction). The concurrent use of beta-blockers can mask the signs r/t SNS activation, mainly tachycardia (as they suppress the HR). Beta-blockers can also make insulin-induced hypoglycemia worse, thus the RN should monitor for other signs of hypoglycemia, like sweating

51
Q

P. is taking amitriptyline, wotf should the RN tell the p. to report?

a. diarrhea
b. cough
c. urinary retention
d. decreased libido

A

c. urinary retention. Amitriptyline is a TCA. TCAs work by blocking the reuptake of NE and serotonin NTs and intensifying their effects. However, TCAs also block receptors for acetylcholine and histamine. Bc of this action, they cause anticholinergic effects (dry mouth, blurred vision, photophobia, constipation, urine retention, and tachy-c). Other common SEs include sedation and ortho hypo. Cardiotoxicity is the most serious AE

52
Q

WOTF actions by a newly licensed nurse requires an incident report?

a. giving heparin to a p. with an aPTT of 70 seconds
b. digoxin to a p who has a hr of 92/min
c. regular insulin to a p. who has a BS of 250
d. isosorbide mononitrate to a p who has a BP 82/60

A

d. isosorbide mononitrate is a nitrate that acts on vascular smooth muscle to promote vasodilation, w/ primary SEs being headache, hypotension, and tachy-c. Bc this p’s BP is already extremely low, giving a nitrate requires an incident report. Option A is appropriate bc the aPTT is within therapeutic limits. B and C are also appropriate actions

53
Q

RN assessing an older p w/Alzheimer’s who is nonverbal and has experienced frequent falls. To determine whether the p is in pain, the RN should

a. ask the p’s home caregiver if the p is in pain
b. ask the p to rate his pain on a scale of 0-10
c. observe the p. for behavioral effects of pain
d. observe the p for visible signs of injury

A

c. observe the p. for behavioral effects of pain.

54
Q

Older p is Rx’d Gentamicin for an infection. WOTF p. statements indicates a SE that needs to be reported?

a. I have had diarrhea for several days
b. I have to turn the volume up on the TV to hear it
c. Im losing more hair than usual when I shower
d. My food seems to have a metallic taste to it

A

b. Loss of hearing is a sign of ototoxicity, an AE of Gentamicin therapy. Gentamicin is an aminoglycoside antibiotic that can also cause nephrotoxicity, neuromuscular blockade and neurologic disorders. Other aminoglycosides include amikacin, tobramycin, neomycin, streptomycin, paromormycin