{"id":511,"date":"2020-04-28T14:41:29","date_gmt":"2020-04-28T18:41:29","guid":{"rendered":"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/chapter-3-answer-key\/"},"modified":"2022-07-13T21:04:19","modified_gmt":"2022-07-14T01:04:19","slug":"chapter-3-answer-key","status":"publish","type":"chapter","link":"https:\/\/opentextbc.ca\/nursingpharmacology\/chapter\/chapter-3-answer-key\/","title":{"raw":"Chapter 3 Answer Key","rendered":"Chapter 3 Answer Key"},"content":{"raw":"

Chapter 3 Clinical Reasoning and Decision-Making Activities<\/h1>\r\nYou can review additional information regarding these answers in the corresponding section in which the Critical Thinking activities appear.\r\n

Activity Section 3.2a<\/h2>\r\nClient education regarding the importance of adhering to the prescribed medication regimen is vital to help prevent drug resistance.\u00a0 During client education, the nurse should emphasize the need to complete the full course of medication, in the dosages and frequencies prescribed, to treat the infection and prevent the dangers of drug resistance.\u00a0 In addition to client education, another solution used to prevent drug resistance in high-risk medications is called directly observed therapy (DOT).\u00a0 DOT is the supervised administration of medications to clients. Clients are required to visit a health-care facility to receive their medications or a health-care professional administers medications in the clients' homes or other designated location. DOT has been implemented worldwide for the treatment of tuberculosis (TB), and research has been shown it to be effective in treating infections successfully and preventing additional drug resistance.\r\n

Activity Section 3.5a<\/h2>\r\nThe administration of penicillin should be postponed for four hours because citrus juice can impede absorption of drugs like penicillin.\u00a0 The remaining doses of penicillin for the day should be rescheduled based on the time the breakfast dose was actually administered. Additionally, the client should be educated about avoiding citrus juice while taking penicillin, and the dietary department should be notified to remove citrus juice from the meal choices.\r\n

Activity Section 3.6a<\/h2>\r\nThe changes in the client's renal labs demonstrate decreased renal function.\u00a0 The prescribing provider should be notified prior to administering additional doses of cefazolin because the medication or the dosage will likely need to be revised based on the client's response.\r\n

Activity Section 3.7a<\/h2>\r\nThe nurse should check the progress notes in the electronic medical record to determine if anything is documented about John's allergies and the decision to use imipenem. If nothing is documented, then the nurse should notify the prescribing provider of the client's allergies to penicillin to confirm the appropriateness of this medication for John, document the provider's response in the medical record, and provide this information in the end-of-shift handoff report.\r\n

Activity Section 3.8a<\/h2>\r\nMonobactams are narrow-spectrum antibacterial medications used primarily to treat gram-negative bacteria like Pseudomonas aeruginosa.\u00a0 However, MRSA is a gram-positive bacteria, so aztreonam will not be effective in fighting this infection.\u00a0 The nurse should notify the prescribing provider of the results of the new culture report before administering the azotreonam.\r\n

Activity Section 3.9a<\/h2>\r\nThe nurse should review the other medications the client is taking.\u00a0 Trimethoprim-Sulfamethoxazole has many significant drug interactions, including oral diabetics.\u00a0 \u00a0This medication may increase hypoglycemic effects requiring closer monitoring of blood sugars.\u00a0 Additionally, the client's renal status should be verified before administration of trimethoprim-sulfamethoxazole because dose adjustment may be required.\r\n

Activity Section 3.10a<\/h2>\r\nThe nurse should immediately stop the medication and notify the provider regarding the new onset of tendon pain because this symptom indicates an adverse reaction of levofloxacin may be occurring.\r\n

Activity Section 3.11a<\/h2>\r\nThe nurse should notify the provider of the client's change condition because it may indicate an adverse effect of liver damage is occurring.\r\n

Activity Section 3.12a<\/h2>\r\nThe nurse should not administer the medication until the trough levels have been drawn.\u00a0\u00a0 The nurse should phone the lab and check on the status of the laboratory trough level.\r\n

Activity Section 3.13a<\/h2>\r\nThe client is under the age of six and is at risk for the adverse effect of teeth discoloration.\u00a0 The nurse should advocate for this client by notifying the prescribing provider of this concern and requesting an alternate medication.\r\n

Activity Section 3.14a<\/h2>\r\nOseltamivir should be administered within the first 24-48 hours of the onset of influenza symptoms.\u00a0 The client may have already passed the window for maximum therapeutic effectiveness of oseltamivir.\u00a0 The provider should be notified regarding the onset of symptoms to clarify the prescription.\r\n

Activity Section 3.15a<\/h2>\r\nIf there are no signs of improvement from the prescribed medication therapy, the nurse should notify the provider.\r\n

Activity Section 3.16a<\/h2>\r\nIn order to prevent malaria, the CDC recommends clients should take antimalarial medications for four weeks after leaving the infected area.\u00a0 The nurse should provide additional client education to the client regarding this recommendation and evaluate for client understanding.\r\n

Activity Section 3.17a<\/h2>\r\nMetronidazole is commonly used to treat C-diff.\u00a0 The medication must be given by mouth for the indication of a gastrointestinal infection like C-diff.\r\n

Activity Section 3.18a<\/h2>\r\nThe nurse should provide education regarding the use of the medication, as well as ways to prevent re-infection. Methods to prevent reinfection include using proper handwashing, washing all fruits and vegetables, and wearing shoes in the barn or where animals and their feces are present.\r\n

Activity Section 3.19a<\/h2>\r\nThe nurse should explain that directly observed therapy (DOT) means the administration of this medication will be supervised to ensure all doses are taken as prescribed to be sure the infection is treated properly and drug resistance does not develop. The client will be required to visit a health-care facility to receive their medications or a health-care professional will administer the medication in the client's home or other designated location.\r\n

Activity Section 3.20a<\/h2>\r\nThe nurse should not administer the vancomycin until after the trough level is drawn.\u00a0 The nurse should call the lab to request prioritization of completing the trough level.","rendered":"

Chapter 3 Clinical Reasoning and Decision-Making Activities<\/h1>\n

You can review additional information regarding these answers in the corresponding section in which the Critical Thinking activities appear.<\/p>\n

Activity Section 3.2a<\/h2>\n

Client education regarding the importance of adhering to the prescribed medication regimen is vital to help prevent drug resistance.\u00a0 During client education, the nurse should emphasize the need to complete the full course of medication, in the dosages and frequencies prescribed, to treat the infection and prevent the dangers of drug resistance.\u00a0 In addition to client education, another solution used to prevent drug resistance in high-risk medications is called directly observed therapy (DOT).\u00a0 DOT is the supervised administration of medications to clients. Clients are required to visit a health-care facility to receive their medications or a health-care professional administers medications in the clients’ homes or other designated location. DOT has been implemented worldwide for the treatment of tuberculosis (TB), and research has been shown it to be effective in treating infections successfully and preventing additional drug resistance.<\/p>\n

Activity Section 3.5a<\/h2>\n

The administration of penicillin should be postponed for four hours because citrus juice can impede absorption of drugs like penicillin.\u00a0 The remaining doses of penicillin for the day should be rescheduled based on the time the breakfast dose was actually administered. Additionally, the client should be educated about avoiding citrus juice while taking penicillin, and the dietary department should be notified to remove citrus juice from the meal choices.<\/p>\n

Activity Section 3.6a<\/h2>\n

The changes in the client’s renal labs demonstrate decreased renal function.\u00a0 The prescribing provider should be notified prior to administering additional doses of cefazolin because the medication or the dosage will likely need to be revised based on the client’s response.<\/p>\n

Activity Section 3.7a<\/h2>\n

The nurse should check the progress notes in the electronic medical record to determine if anything is documented about John’s allergies and the decision to use imipenem. If nothing is documented, then the nurse should notify the prescribing provider of the client’s allergies to penicillin to confirm the appropriateness of this medication for John, document the provider’s response in the medical record, and provide this information in the end-of-shift handoff report.<\/p>\n

Activity Section 3.8a<\/h2>\n

Monobactams are narrow-spectrum antibacterial medications used primarily to treat gram-negative bacteria like Pseudomonas aeruginosa.\u00a0 However, MRSA is a gram-positive bacteria, so aztreonam will not be effective in fighting this infection.\u00a0 The nurse should notify the prescribing provider of the results of the new culture report before administering the azotreonam.<\/p>\n

Activity Section 3.9a<\/h2>\n

The nurse should review the other medications the client is taking.\u00a0 Trimethoprim-Sulfamethoxazole has many significant drug interactions, including oral diabetics.\u00a0 \u00a0This medication may increase hypoglycemic effects requiring closer monitoring of blood sugars.\u00a0 Additionally, the client’s renal status should be verified before administration of trimethoprim-sulfamethoxazole because dose adjustment may be required.<\/p>\n

Activity Section 3.10a<\/h2>\n

The nurse should immediately stop the medication and notify the provider regarding the new onset of tendon pain because this symptom indicates an adverse reaction of levofloxacin may be occurring.<\/p>\n

Activity Section 3.11a<\/h2>\n

The nurse should notify the provider of the client’s change condition because it may indicate an adverse effect of liver damage is occurring.<\/p>\n

Activity Section 3.12a<\/h2>\n

The nurse should not administer the medication until the trough levels have been drawn.\u00a0\u00a0 The nurse should phone the lab and check on the status of the laboratory trough level.<\/p>\n

Activity Section 3.13a<\/h2>\n

The client is under the age of six and is at risk for the adverse effect of teeth discoloration.\u00a0 The nurse should advocate for this client by notifying the prescribing provider of this concern and requesting an alternate medication.<\/p>\n

Activity Section 3.14a<\/h2>\n

Oseltamivir should be administered within the first 24-48 hours of the onset of influenza symptoms.\u00a0 The client may have already passed the window for maximum therapeutic effectiveness of oseltamivir.\u00a0 The provider should be notified regarding the onset of symptoms to clarify the prescription.<\/p>\n

Activity Section 3.15a<\/h2>\n

If there are no signs of improvement from the prescribed medication therapy, the nurse should notify the provider.<\/p>\n

Activity Section 3.16a<\/h2>\n

In order to prevent malaria, the CDC recommends clients should take antimalarial medications for four weeks after leaving the infected area.\u00a0 The nurse should provide additional client education to the client regarding this recommendation and evaluate for client understanding.<\/p>\n

Activity Section 3.17a<\/h2>\n

Metronidazole is commonly used to treat C-diff.\u00a0 The medication must be given by mouth for the indication of a gastrointestinal infection like C-diff.<\/p>\n

Activity Section 3.18a<\/h2>\n

The nurse should provide education regarding the use of the medication, as well as ways to prevent re-infection. Methods to prevent reinfection include using proper handwashing, washing all fruits and vegetables, and wearing shoes in the barn or where animals and their feces are present.<\/p>\n

Activity Section 3.19a<\/h2>\n

The nurse should explain that directly observed therapy (DOT) means the administration of this medication will be supervised to ensure all doses are taken as prescribed to be sure the infection is treated properly and drug resistance does not develop. The client will be required to visit a health-care facility to receive their medications or a health-care professional will administer the medication in the client’s home or other designated location.<\/p>\n

Activity Section 3.20a<\/h2>\n

The nurse should not administer the vancomycin until after the trough level is drawn.\u00a0 The nurse should call the lab to request prioritization of completing the trough level.<\/p>\n","protected":false},"author":90,"menu_order":3,"template":"","meta":{"pb_show_title":"on","pb_short_title":"","pb_subtitle":"","pb_authors":[],"pb_section_license":""},"chapter-type":[],"contributor":[],"license":[],"class_list":["post-511","chapter","type-chapter","status-publish","hentry"],"part":506,"_links":{"self":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/511","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters"}],"about":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/types\/chapter"}],"author":[{"embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/users\/90"}],"version-history":[{"count":3,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/511\/revisions"}],"predecessor-version":[{"id":1313,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/511\/revisions\/1313"}],"part":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/parts\/506"}],"metadata":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapters\/511\/metadata\/"}],"wp:attachment":[{"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/media?parent=511"}],"wp:term":[{"taxonomy":"chapter-type","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/pressbooks\/v2\/chapter-type?post=511"},{"taxonomy":"contributor","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/contributor?post=511"},{"taxonomy":"license","embeddable":true,"href":"https:\/\/opentextbc.ca\/nursingpharmacology\/wp-json\/wp\/v2\/license?post=511"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}