Absence of hydrochloric acid from the gastric juice. - ANSWER-Achlorydia
Dilates pupils
Causes photophobia
Used preoperatively for cataract
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Don't use in glaucoma
Atropine is an example
blocks parasympathetic nerve impulses; decreases oral and respiratory secretions (atropine, Artane) - ANSWER-anticholinergic
Decrease in deep tendon reflexes
Signs and symptoms of excess magnesium include tendon reflex loss, difficult bowel movements, central nervous system depression, respiratory distress, heart block, and hypothermia. - ANSWER-When administering intravenous magnesium sulfate, the nurse will monitor for which signs and symptoms of hypermagnesemia?
Cyanocobalamin is used to treat deficiency states of vitamin B12. The most common manifestation of untreated cyanocobalamin deficiency is pernicious anemia.Altered coagulation studies
Vitamin K is an essential nutrient for the synthesis of clotting factors, which takes place in the liver. It is also the antidote for warfarin (Coumadin), an oral anticoagulant. The administration of vitamin K enhances the coagulation process, thus minimizing a patient's risk for excessive bleeding. - ANSWER-Cyanocobalamin (vitamin B12) is indicated for the treatment of which condition?
Nausea and abdominal cramping
Megadoses of vitamin C can produce nausea, vomiting, headache, and abdominal cramps and will acidify the urine, which can result in the formation of cystine, oxalate, and urate renal stones. - ANSWER-Client teaching regarding the administration of vitamin C would include monitoring for which signs or symptoms that may indicate vitamin C toxicity?
Altered coagulation studies
Vitamin K is an essential nutrient for the synthesis of clotting factors, which takes place in the liver. It is also the antidote for warfarin (Coumadin), an oral anticoagulant. The administration of vitamin K enhances the coagulation process, thus minimizing a patient's risk for excessive bleeding. - ANSWER-A client receiving vitamin K MOST likely has which abnormal clinical finding?
Hyperparathyroidism
Vitamin D is contraindicated with hypercalcemia, a clinical manifestation of hyperparathyroidism. - ANSWER-The nurse would question a health care provider's prescription for vitamin D in a client with which condition?
"Can you tell me what vitamins you take and how many and how often?"
The nurse needs further information on the amount and type of vitamins the patient is taking. A client may develop hypervitaminosis or toxic level of vitamins if more than the recommended daily allowance is taken with certain vitamins. - ANSWER-The nurse is educating a client on vitamin supplementation. The client states, "I take a lot of vitamins every day to stay healthy." Based on knowledge and understanding of vitamin supplements, what is the nurse's best response?
Magnesium
Vitamin D
.Magnesium is an essential mineral for body functioning but at higher doses is used to manage complications of pregnancy, including preeclampsia and eclampsia, to treat seizures related to hypomagnesium levels. - ANSWER-Which mineral is essential for energy metabolism but may also be used in higher doses to treat certain seizures and preeclampsia?
Vitamin D
The human body requires vitamins in specific minimum amounts on a daily basis, and these can be obtained from both plant and animal food sources. In some cases, the body synthesizes some of its own vitamin supply. Supplemental amounts of vitamin B complex and vitamin K are synthesized by normal bacterial flora in the gastrointestinal tract. Vitamin D can be synthesized by the skin when the skin is exposed to sunlight. - ANSWER-What vitamin can be synthesized by the skin when exposed to sunlight but can also be supplemented as needed?
k,d,a, - ANSWER-What vitamins are MOST likely to lead to toxic levels, hypervitaminosis, when administered in megadoses? (Select all that apply.)
Deep vein thrombosis
The most serious adverse effects of the estrogens are thromboembolic events. A previous history would put the patient at increased risk. Uterine bleeding is an indication for estrogen therapy. A history of weight loss or dysmenorrhea would not be a contraindication for estrogen replacement therapy. - ANSWER-The nurse is assessing a patient who is prescribed estrogen replacement therapy. A history of which medical condition would be a contraindication to this therapy?
Space the medications 1 to 2 hours apart. Calcium supplements interfere with the absorption of bisphosphonates. Spacing the medications 1 to 2 hours apart helps prevent this interaction. The nurse does not replace the drug without consulting the primary health care provider. The nurse does not discontinue the calcium supplement, because it may affect the patient's health. Increasing the dose of bisphosphonate will not aid in absorption if it interacts with calcium - ANSWER-The clinical reports of a patient taking a bisphosphonate and calcium supplement indicate poor therapeutic levels of the bisphosphonate. Which changes in the medication administration will the nurse need to encourage the patient to implement?
1. "Discontinue the calcium supplement."
2. "Space the medications 1 to 2 hours apart."
3. "Replace the bisphosphonate with calcitonin."
4. "Obtain a prescription for increasing the bisphosphonate dose."
Oxytocin is a uterine stimulant that is used to induce uterine contractions for labor. Terbutaline is a medication used to arrest preterm labor. Methylergonovine is used to treat postpartum hemorrhage. Magnesium sulfate is used to treat gestational hypertension. - ANSWER-Which medication is used to induce labor?Oxytocin is a uterine stimulant that is used to induce uterine contractions for labor.
2
Ineffective contractions in a full term pregnancy
A patient whose pregnancy is full term but who has ineffective contractions is a suitable candidate for oxytocin therapy to augment the strength and increase the frequency of contractions. Vaginal bleeding in a patient near term is an obstetric emergency, and oxytocin is contraindicated, because it is likely to increase the bleeding, increase and strengthen the contractions, and cause fetal distress. Oxytocin is indicated for the induction of labor in a postterm patient, but the patient must have a soft cervix. In a patient with cephalopelvic disproportion, the fetus's head may be too large for the patient's pelvis; harm to both patient and fetus could occur if oxytocin were administered. - ANSWER-Which assessment finding indicates that a patient is a suitable candidate for oxytocin therapy?
1. Vaginal bleeding at 38 weeks' gestation
2. Ineffective contractions in a full term pregnancy
3. Absence of cervical ripening at 42 weeks' gestation
4. Radiographic confirmation of cephalopelvic disproportion
Correct 3 -To prevent endometrial cancer
To reduce the risk of endometrial hyperplasia or cancer, the concurrent use of a progestin for 10 to 14 days of the cycle is recommended for women with an intact uterus. Estrogens are administered to prevent complications from ovarian failure but not to treat ovarian cancer. Estrogen therapy raises recurrence risk if administered to patients with breast cancer. Vaginal cancer is treated with surgery or chemotherapy. - ANSWER-What is the purpose of giving estrogen therapy in combination with progestins?
1. To treat ovarian cancer
2. To treat breast cancer
3. To prevent endometrial cancer
4. Correct 3
To prevent endometrial cancer
3. Esterified estrogens
Esterified estrogens are a type of estrogen used in the treatment of hypogonadism. Megestrol is a synthetic progestin used to treat uterine bleeding. Alendronate is used to minimize bone loss in osteoporosis. Medroxyprogesterone is used to prevent pregnancy. - ANSWER-Which medication is used to treat hypogonadism?
1
Megestrol
2
Alendronate
3
Esterified estrogens
4
Medroxyprogesterone
The patient smokes cigarettes.
Smoking causes thrombosis in patients who undergo estrogen therapy. Thrombosis is not caused by a decrease in fluids. Herbal medicines such as St. John's wort decrease the estrogenic effect of drugs. The use of estrogen therapy with tricyclic antidepressants causes toxicity of the antidepressant. - ANSWER-The clinical report of a patient who is undergoing estrogen therapy indicates thrombosis. Which event may the nurse suspect as the cause of thrombosis?
1
The patient smokes cigarettes.
2
The patient's fluid intake is low.
3
The patient takes herbal supplements.
4
The patient takes tricyclic antidepressants.
Increases sperm production
Menotropins may be used to promote spermatogenesis in infertile men. They are used primarily for the promotion of ovulation in anovulatory female patients. They increase fertility and stimulate sperm production. This may often lead to enhanced libido. - ANSWER-What is the purpose of administering menotropins to a male patient?
1
Decreases libido
2
Decreases fertility
3
Increases sperm production
4
Depresses sperm production
Vertigo
Joint pain
Chest pain - ANSWER-Which clinical manifestations can be observed in a patient who is receiving teriparatide therapy? Select all that apply.
1. vertigo
2. joint pain
3. chest pain
4. hot flashes
5. loss of appetite
- ANSWER-Which has the greatest potential to increase the risk of thromboembolism in a patient taking norethindrone and ethinyl estradiol?
1
Sedentary lifestyle
2
Smoking heavily every day
3
Consumption of saturated fats
4
Increased body mass index (BMI)
Women taking oral contraceptives are at increased risk of thromboembolic events if they smoke heavily or have a history of thromboembolism; this higher risk is partially caused by an increase in circulating levels of clotting factors. A sedentary lifestyle and increased BMI elevate the risk of several health problems and can contribute to the development of thromboemboli, but that risk is secondary to the risk resulting from concurrent smoking and use of oral contraceptives. Consumption of saturated fats is likely to increase the risk of a thromboembolic event in a patient who takes an oral contraceptive, but not as much as smoking. - ANSWER-Which has the greatest potential to increase the risk of thromboembolism in a patient taking norethindrone and ethinyl estradiol?
1
Sedentary lifestyle
2
Smoking heavily every day
3
Consumption of saturated fats
4
Increased body mass index (BMI)
Follicle stimulating hormone initiates mentstrual cycle - ANSWER-Which of the following hormones initiates the cycle of events in the female ovary?
1
Antidiuretic hormone
2
Luteinizing hormone (LH)
3
Adrenocorticotropic hormone
4
Follicle-stimulating hormone
4
The patient is on antibiotic therapy.
Antibiotics reduce the effectiveness of oral contraceptives; hence, the nurse needs to instruct patients to use alternative birth control methods during antibiotic therapy. Diabetes does not reduce the effect of oral contraceptives. Hypertension may be an adverse effect of oral contraceptives. The effectiveness of anticonvulsants is reduced when taken with oral contraceptives. - ANSWER-A patient tests positive for pregnancy even though she has been taking oral contraceptives. What is a possible cause of this unintended pregnancy?
1
The patient has diabetes.
2
The patient has hypertension.
3
The patient is on an anticonvulsant
4
the patient is on antibiotics
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