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The licensed practical/vocational nurse (LPN/VN) reinforces teaching a client about newly prescribed isoniazid (INH) for pulmonary tuberculosis. Which of the following statements by the client would require follow-up? A. "I will have to take this medication for three months." Choice A is correct. This statement requires follow-up because it is not accurate. Antitubculin medications must be taken for six to nine months to complete treatment and prevent resistance. If the client is at risk of poor treatment adherence, they may be ordered directly observed therapy where an individual supervises the client to take their medication. B. "I will need to have my blood drawn periodically to see if I am having an adverse effect to this medication." Choice B is incorrect. This statement is accurate and does not require follow-up because INH may cause hepatic injury and blood dyscrasias. The client will need periodic blood specimen collections to determine if they are experiencing anemia, transaminitis, or thrombocytopenia. C. "I will not be considered infectious if I have three consecutive negative sputum samples." Choice C is incorrect. The client will be considered noninfectious if they have three consecutive negative sputum tests for acid-fast bacilli (AFB). One of the sputum specimens must be collected in the morning. D. "This medication may make my hands and feet have numbness and tingling sensations." Choice D is incorrect. INH may cause a client to experience peripheral neuropathy, described as a pins and needles sensation. This is why a client is prescribed pyridoxine to attenuate these sensations. Additional Info โ INH is the first-line therapy for pulmonary tuberculosis. โ This agent is often combined with another antitubercular medication because of emerging drug resistance. โ Hepatotoxicity is the most common adverse effect of most antitubercular drugs. โ The client should immediately report signs of hepatotoxicity, such as jaundice and clay-colored stools. โ INH may cause a client to develop peripheral neuropathies. Pyroxidine (vitamin B6) is commonly prescribed to prevent this occurrence. The healthcare provider has ordered a vaccine for a client with substance use disorder, specifically intravenous (IV) drugs.
Which of the following vaccines would the licensed practical/vocational nurse (LPN/VN) prepare to administer to the client? A. Hepatitis A Choice A is incorrect. Hepatitis A is transmitted directly from person-to- person contact, such as fecal-oral transmission, or by ingesting contaminated food or water. B. Hepatitis B Choice B is correct. Hepatitis B can be spread through sex with an infected person, injection drug use, outbreaks in healthcare settings, and from an infected mother who transmits the infection to their infant at birth. C. Hepatitis C Choice C is incorrect. There is currently no vaccine available for Hepatitis C. Hepatitis C can infect people who are sharing needles or other paraphernalia used for injection drug use. D. Hepatitis D Choice D is incorrect. There is currently no vaccine available for Hepatitis D. Increased risk for becoming infected with hepatitis D includes infants born to mothers with hepatitis D, sex partners of individuals who are infected, people who are intravenous drug users, and caregivers and health care personnel who come into contact with blood or blood-contaminated body fluid of individuals who are infected. Additional Info โ Hepatitis A is a liver disease that can affect anyone. Vaccines are available to individuals who are at least 1 year old. Good hygiene and proper sanitation can help prevent the spread of this virus. โ Hepatitis C Infection can also occur when sharing razors, nail clippers, toothbrushes, or glucose monitor with an infected person. Getting tattoos or piercings with non-sterile instruments can infect an individual. Although uncommon, hepatitis C can also spread during sex with an infected person. โ Increased risk for becoming infected with hepatitis D includes infants born to mothers with hepatitis D, sex partners of individuals who are infected, people who are intravenous drug users, and caregivers and health care personnel who come into contact with blood or blood-contaminated body fluid of individuals who are infected โ Hepatitis E is commonly found in countries with poor sanitation. Most cases in the United States involve individuals who have recently traveled to other countries where there is no access to clean drinking water. Most cases
โI should take this medication one hour after meals.โ โI will remain upright for 30 minutes after taking this medicine.โ โThis medication will help with my peptic ulcer disease.โ "I know this medication works when my nausea and vomiting are gone." โI may dissolve this medication in warm water.โ Explanation Choices A, B, and D are correct. These statements are false and require further teaching. Sucralfate is a medication indicated in peptic ulcer disease. This medication should be taken one hour before meals as the medication will coat the ulcer allowing a client to eat meals without pain. The client is not required to be upright 30 minutes after taking this medication. This would be applicable instruction for a client prescribed a bisphosphonate. This medication has no indication for nausea and vomiting treatment. Appropriate treatment for nausea and vomiting would be ondansetron or metoclopramide. Choice C is incorrect. Sucralfate is a gastric fortifier intended to help with peptic ulcer disease. Choice E is incorrect. The pills are rather large and may be dissolved in water to improve the client's ability to swallow. Additional Info โ Sucralfate is a gastric fortifier intended to help with peptic ulcer disease. โ This medication should be taken one hour before meals and at bedtime. โ This medication allows the client to eat their meal without the pain of the ulcer. โ Constipation is the most common side-effect associated with this medication.
The psychiatric nurse knows that which of the following medications are often used in the treatment of panic disorders? Select all that apply. Amitriptyline Amobarbital Diazepam Phenelzine Fentanyl Explanation Choices A, C, and D are correct. Panic disorder is a category of anxiety disorder. It is characterized by intense feelings of immediate apprehension, fearfulness, terror, or impending doom. It is accompanied by increased autonomic nervous system activity. Panic attacks usually last less than 10 minutes. However, many clients may describe them as seemingly โendless.โ ๏ท Amitriptyline is an antidepressant that is also used to treat panic disorder. ๏ท Diazepam is a benzodiazepine that is used to treat anxiety, insomnia, and panic. ๏ท Phenelzine is an MAOI that is used to treat social anxiety, depression, and panic disorder. Choice B is incorrect. Amobarbital is a barbiturate that is used for sedation and to treat insomnia. Choice E is incorrect. Fentanyl is an opioid used to treat acute pain. Additional Info โ Licensed practical/vocational nurse (LPN/VN), should be able to recognize the symptoms of a panic attack, which may include rapid heartbeat, sweating, trembling, shortness of breath, chest pain, dizziness, and a feeling of impending doom or loss of control. Identifying these symptoms promptly allows for timely intervention and reassurance. โ LPN/VNs should be mindful of potential triggers for panic attacks, such as undergoing medical procedures. Efforts should be made to create a calm and comfortable environment to reduce the risk of triggering panic attacks. โ Certain procedures, such as blood draws, injections, or imaging scans, may evoke feelings of vulnerability, fear of pain, or a loss of control, leading to heightened anxiety and panic. The nurse is reinforcing teaching to staff about the use of warfarin. The nurse uses which medical conditions as examples of diagnosis that may lead to the use of warfarin. Deep vein thrombosis (DVT) History of bleeding disorders
โ The most common side effect of warfarin is an increased risk of bleeding. Clients must be aware of signs of bleeding, such as unusual bruising, prolonged bleeding from minor cuts, or blood in the urine or stools, and seek medical attention if they occur. โ Warfarin requires careful management during situations that may affect the client's INR levels, such as changes in diet, medication adjustments, or surgery. Close communication with healthcare providers is crucial in such cases. Clients taking warfarin should wear a medical alert bracelet or carry an identification card indicating their medication use in emergencies. The licensed practical/vocational nurse (LPN/VN) has reinforced teaching to a client scheduled for an injection of dulaglutide for diabetes mellitus (type two). Which of the following statements by the client would require follow-up? A."I should tell my doctor if I experience abdominal pain and vomiting." B."I should take this medication within one hour of eating a meal." C."If this medication works, I should notice a reduction in my hemoglobin A1C (HbA1c)." D."I will receive this medication once a week. Explanation Choice B is correct. Dulaglutide is a long-acting glucagon-like-peptide- (GLP-1) agonist which is administered once a week and has no peak. The client does not need to take this injection with a meal because it has no peak. This statement is incorrect and requires follow-up. Choice A is incorrect. Dulaglutide may adversely cause pancreatitis. Cardinal features of pancreatitis include abdominal pain and vomiting, which may lead to dehydration. This statement is correct and does not require follow-up. Choice C is incorrect. The client is experiencing a therapeutic outcome if their HbA1c decreases. HbA1C is performed every 3-4 months. The higher the value, the more hyperglycemic episodes the clients experienced. This statement is correct and does not require follow-up. Choice D is incorrect. Dulaglutide is dosed once a week. The once-weekly dosing is an attractive feature of this medication because it promotes secretion of endogenous insulin to improve glycemic control. This medication is given subcutaneously. Additional Info โ Dulaglutide is not an insulin. It is a GLP-1 agonist, also called "incretin- mimetic." It helps the pancreas secrete insulin in the setting of hyperglycemia and decreases glucagon, thereby, promoting better glycemic control in diabetics.
โ Dulaglutide is dosed weekly and administered subcutaneously. โ Weight loss has been reported with this drug, which is an attractive feature of this medication. โ This medication does not require the client to take this medication with food because it is long-acting and has a negligible risk for hypoglycemia. โ Pancreatitis, acute kidney injury, headache, and upper respiratory infection are the adverse reactions associated with this medication.
