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Miriam Kinai. Polly Trennell. Jo Carol Claborn. Linda Anne Silvestri. Dr Skin. Test Bankia. Rare Clinical Vignettes. Headache and dizziness are effects of estrogen excess. Early or mid-cycle bleeding are effects of estrogen deficiency. All items are adverse reactions of the drug. However, apnea appearing during the first hour of drug infusion occurs in percent of neonates with congenital heart defects. Clinicians deciding to utilize alprostadil must be prepared to intubate and mechanically ventilate the infant. Careful monitoring for apnea or respiratory depression is mandatory.

In some institutions, elective intubation occurs prior to initiation of the medication. Answer C. Muscle aches, soreness, and weakness may be early signs of myopathy such as rhabdomyolysis associated with the HMG-CoA reductase class of antilipemic agents. This patient will need an immediate evaluation to rule out myopathy. Additional doses may exacerbate the problem. Exercise will not reverse myopathy and delays diagnosis. Levothyroxine, especially in higher doses, can induce hyperthyroid-like symptoms including tachycardia.

An agent that increases the basal metabolic rate would not be expected to induce a slow heart rate. Hypotension would be a side effect of bradycardia. Constipation is a symptom of hypothyroid disease. Lactic acidosis is the most dangerous adverse effect of metformin administration with death resulting in approximately 50 percent of individuals who develop lactic acidosis while on this drug. Metformin does not induce insulin production; thus, administration does not result in hypoglycemic events. Some nausea, vomiting, and diarrhea may develop but is usually not severe. NVD is not specific for metformin.

Metformin does not induce sleepiness.

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TCA overdose can induce seizures, but they are typically not life-threatening. TCAs do not cause an elevation in body temperature. TCAs do not cause metabolic acidosis. This solution has the same osmolarity as blood. Its use prevents red cell lysis. The solutions given in options 2 and 3 are hypotonic solutions and can cause red cell lysis.

The solution in option 4 may anticoagulate the patient and result in bleeding. Red blood cells contain antigens and antibodies that must be matched between donor and recipient. The blood products in options do not contain red cells. Thus, they require no cross-match. GVHD occurs when white blood cells in donor blood attack the tissues of an immunocompromised recipient. This process can occur within a month of the transfusion. Options 1 and 4 may be a thought, but the nurse must remember that immunocompromised transfusion recipients are at risk for GVHD.

The process of apheresis involves removal of whole blood from a donor. Within an instrument that is essentially designed as a centrifuge, the components of whole blood are separated. One of the separated portions is then withdrawn, and the remaining components are retransfused into the donor.

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Directed donation is collected from a blood donor other than the recipient, but the donor is known to the recipient and is usually a family member or friend. Allogeneic donation is collected from a blood donor other than the recipient. People older than 65 years use 43 percent of donated blood. This number is expected to increase as the population ages. Answer D. Options 1 and 3 are not therapeutic responses. The treatment in option 2 takes days and is not always able to prevent morbidity and mortality.

The product in option 1 is collected from a blood donor other than the recipient. The process in option 2 is also collected from a blood donor other than the recipient, but the donor is known to the recipient and is usually a family member or friend. Cross-matching significantly enhances compatibility.

It does not detect infection. This process eliminates white blood cell functioning, thus, preventing GVHD. Diphenhydramine HCl is an antihistamine. Option 2 will not prevent GVHD. Use of acetaminophen prevents and treats the common side effects of blood administration caused by the presence of white blood cells in the transfusion product: fever, headache, and chills.

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Hepatitis B is the most common infection spread via blood transfusion. Donors are screened by a questionnaire that includes symptoms. The donated blood is also tested for infection. The risk of infection with the agents in options 2 and 3 has decreased to approximately 1 in 2 million secondary to donor questioning and donor blood testing.

The incidence of West Nile viral transmission is unknown, but donor infection is still relatively rare. Type O, Rh negative blood has none of the major antigens and is safely administered to patients of all blood types. It is also known as the universal donor. A red blood cell transfusion is used to correct anemia in patients in which the low red blood cell count must be rapidly corrected. RBC transfusion will not correct a low platelet count.

RBC transfusion will not correct a low white blood cell count. Packed RBCs contain very little plasma and, thus, only a small amount of albumin. This amount will not correct low albumin levels. This is needed to utilize the correct type of donor blood and to match the donor product with the patient. Incompatible matches would result in severe adverse events and possible death.

The tests in options 1 and 3 are unnecessary. It does not determine donor blood compatibility with the patient. Large bore catheters prevent damage to blood components and are less likely to develop clotting problems than a small bore catheter. The nurse should determine the correct device without asking the patient what type has been used before or asking the physician which type he prefers and start the IV. A 25 percent solution contains one quarter of a gram per milliliter.

Thus, the nurse will administer 4 milliliters to provide a complete gram of albumin. The volume in option 1 would provide The nurse should determine the volume. It is unnecessary to seek the answer from the physician. A 25 percent solution is an acceptable product and can safely be used. Many chemotherapeutic drugs are vesicants highly active corrosive materials that can produce tissue damage even in low concentrations. Extravasations of a vesicant can result in significant tissue necrosis.

Administration into a large vein is optimal. Dosing depends on the drug. IV chemotherapeutic agents are not administered at home. They are given in an outpatient or clinic setting if not given during hospitalization. Microorganisms that infect CVADs are often coagulase-negative staphylococci, which can be eliminated by antibiotic administration through the catheter. If unsuccessful in eliminating the microorganism, the CVAD must be removed.

In this case however, the antibiotics are given to eradicate microorganisms from the CVAD. The third option would not occur. Prepare for these nursing pharmacology questions with these quizzes:. This set of NCLEX practice questions includes not only dosage calculations but also metric conversions. Better get your calculators ready! Save my name, email, and website in this browser for the next time I comment. Notify me of follow-up comments by email. Notify me of new posts by email.

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Log into your account. Sign up. Password recovery. Forgot your password? Get help. Create an account. Please wait while the activity loads. If this activity does not load, try refreshing your browser. Also, this page requires javascript. Please visit using a browser with javascript enabled. If loading fails, click here to try again. Your answers are highlighted below. Question 1. Question 1 Explanation:. Toxic doses of acetaminophen deplete hepatic glutathione, resulting in accumulation of the intermediate agent, quinine, which leads to hepatic necrosis. Prolonged use of acetaminophen may result in an increased risk of renal dysfunction, but a single overdose does not precipitate life-threatening problems in the respiratory system, renal system, or adrenal glands.

Question 2. Question 2 Explanation:. Viruses, such as herpes simplex or varicella-zoster, present a risk of disseminated infection. Question 3. In infants and children, the side effects of first generation over-the-counter OTC antihistamines, such as diphenhydramine Benadryl and hydroxyzine Atarax include:. Question 3 Explanation:.

Question 4. Question 4 Explanation:. Ibuprofen adverse effects include GI irritation and bleeding, and in toxic doses, both renal and hepatic failure are reported.

Dosage Calculations - Nursing Drug Calculations - Med Math: Everything You Need To Know!

Question 5. Question 5 Explanation:. Question 6. Question 6 Explanation:. Question 7. Question 7 Explanation:. IgA, the second most common serum Ig is found in secretions tears, saliva, colostrum, and mucus. Question 8. Question 8 Explanation:. Question 9. Question 9 Explanation:. Oral contraceptives have been associated with an increased risk of stroke, myocardial infarction, and deep vein thrombosis.

Question Question 10 Explanation:. Question 11 Explanation:. Question 12 Explanation:. Question 13 Explanation:.

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Question 14 Explanation:. Question 15 Explanation:. Cris asks the nurse whether all donor blood products are cross-matched with the recipient to prevent a transfusion reaction. Question 16 Explanation:.

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A month after receiving a blood transfusion an immunocompromised male patient develops fever, liver abnormalities, a rash, and diarrhea. Question 17 Explanation:. Question 18 Explanation:. Question 19 Explanation:. After two days of antibiotics, he is severely neutropenic. Question 20 Explanation:. Question 21 Explanation:. Question 22 Explanation:. Question 23 Explanation:. Pre-medicating the patient with diphenhydramine hydrochloride Benadryl and acetaminophen Tylenol will prevent any transfusion reactions or side effects.

The patient is at minimal risk receiving this product since it is the first time he has been transfused with type O, Rh negative blood. Question 24 Explanation:.

Question 25 Explanation:. Question 26 Explanation:. A male patient needs to receive a unit of whole blood. A small catheter to decrease patient discomfort. The type of IV device the patient has had in the past, which worked well. Question 27 Explanation:. Question 28 Explanation:. Question 29 Explanation:. To prevent infiltration of the peripheral line.

To reduce the pain and discomfort associated with antibiotic administration in a small vein. To lessen the chance of an allergic reaction to the antibiotic. Question 30 Explanation:. Once you are finished, click the button below. Any items you have not completed will be marked incorrect. Get Results. You have completed. You have not finished your quiz. If you leave this page, your progress will be lost. Adrenal Glands 2. A contraindication for topical corticosteroid usage in a male patient with atopic dermatitis eczema is: A.

In infants and children, the side effects of first generation over-the-counter OTC antihistamines , such as diphenhydramine Benadryl and hydroxyzine Atarax include: A. Eggs B. Shellfish C. Soy D. Type I reactions are immediate hypersensitivity reactions and are mediated by: A. The most serious form of bone marrow toxicity is: A. Serious adverse effects of oral contraceptives include: A. The most serious adverse effect of Alprostadil Prostin VR pediatric injection administration in neonates is: A.

You instruct him to: A. Constipation Somnolence The most serious adverse effect of tricyclic antidepressant TCA overdose is: A. Metabolic acidosis.

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Cardiac arrhythmias. The nurse is aware that the following solutions is routinely used to flush an IV device before and after the administration of blood to a patient is: A. Heparin sodium The nurse would suspect this patient has: A. The nurse knows this process is called: A. Nurse Bryan knows that the age group that uses the most units of blood and blood products is: A. The nurse responds: A. The nurse teaches the person that the safest blood product is: A. The nurse teaches him that approximately 1 in , patients contract: A. The nurse knows that: A.