Adverse Drug Reactions and Side Effects > Pharmacology
Exam Review
Causes and risk factors
Total Questions : 7
Showing 7 questions, Sign in for moreA nurse is caring for a client who has a history of allergic reactions to penicillin. The client is prescribed cefazolin for a wound infection. Which of the following actions should the nurse take before administering the medication?
Explanation
Rationale: Cefazolin is a cephalosporin, which has a cross-sensitivity with penicillin. Therefore, the nurse should ask the client about any previous reactions to cephalosporins before administering the medication. This can help identify clients who are at risk of developing an allergic reaction to cefazolin.
B) is incorrect because administering an antihistamine is not a preventive measure for an allergic reaction, but rather a treatment for mild symptoms. Antihistamines do not prevent anaphylaxis, which is a life-threatening reaction that requires immediate intervention.
C) is incorrect because monitoring the client's vital signs for 15 minutes after the injection is not enough to detect an allergic reaction, which can occur up to 72 hours after exposure. The nurse should monitor the client for signs and symptoms of an allergic reaction throughout the course of therapy.
D) is incorrect because diluting the medication with normal saline does not reduce the risk of an allergic reaction, but rather the risk of phlebitis, which is inflammation of the vein. Phlebitis is a common adverse reaction to cefazolin, but it is not related to allergy.
A client is admitted to the emergency department with signs of anaphylaxis after being stung by a bee. The nurse should expect to administer which of the following medications first?
Explanation
Rationale: Epinephrine is the first-line medication for anaphylaxis, which is a severe allergic reaction that can cause bronchoconstriction, hypotension, and shock. Epinephrine acts as a bronchodilator and a vasoconstrictor, reversing the effects of histamine and other mediators released during anaphylaxis.
B) is incorrect because diphenhydramine is an antihistamine that can help relieve itching, hives, and urticaria, but it does not reverse bronchoconstriction or hypotension. Diphenhydramine can be given as an adjunct therapy after epinephrine.
C) is incorrect because albuterol is a beta2 agonist that can help relieve bronchospasm, but it does not affect blood pressure or other systemic effects of anaphylaxis. Albuterol can be given as an adjunct therapy after epinephrine.
D) is incorrect because hydrocortisone is a corticosteroid that can help reduce inflammation and prevent delayed reactions, but it does not have an immediate effect on anaphylaxis. Hydrocortisone can be given as an adjunct therapy after epinephrine.
A nurse is teaching a client who has a new prescription for warfarin about potential drug interactions. Which of the following over-the-counter medications should the nurse instruct the client to avoid?
Explanation
Rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that can increase the risk of bleeding when taken with warfarin, which is an anticoagulant. NSAIDs inhibit platelet aggregation and interfere with warfarin metabolism, leading to increased levels of warfarin and prolonged prothrombin time (PT) and international normalized ratio (INR).
A) is incorrect because acetaminophen is an analgesic and antipyretic that does not affect platelet function or warfarin metabolism. However, high doses or chronic use of acetaminophen can increase INR and cause liver toxicity, so the nurse should advise the client to limit acetaminophen intake and monitor liver function tests.
C) is incorrect because loratadine is an antihistamine that does not interact with warfarin or affect bleeding. Loratadine can be used safely by clients who have allergies and are taking warfarin.
D) is incorrect because calcium carbonate is an antacid and a calcium supplement that does not interact with warfarin or affect bleeding. However, calcium carbonate can interfere with the absorption of other medications, so the nurse should instruct the client to take it at least 2 hours before or after other medications.
A nurse is reviewing the medication list of a client who has hypertension and diabetes mellitus. The client reports experiencing a dry cough for several weeks. The nurse should identify that this adverse reaction is most likely caused by which of the following medications?
Explanation
Rationale: Lisinopril is an angiotensin-converting enzyme (ACE) inhibitor that can cause a dry, persistent cough as a common adverse reaction. The cough is due to the accumulation of bradykinin, which is a vasodilator and an inflammatory mediator that is normally degraded by ACE. The cough usually resolves after discontinuing the medication.
B) is incorrect because metformin is an antidiabetic agent that does not cause a cough as an adverse reaction. The most common adverse reactions of metformin are gastrointestinal disturbances, such as nausea, vomiting, diarrhea, and abdominal pain.
C) is incorrect because atenolol is a beta blocker that does not cause a cough as an adverse reaction. The most common adverse reactions of atenolol are bradycardia, hypotension, fatigue, and dizziness.
D) is incorrect because glipizide is a sulfonylurea that does not cause a cough as an adverse reaction. The most common adverse reactions of glipizide are hypoglycemia, weight gain, and skin rash.
A nurse is preparing to administer amoxicillin to a client who has a respiratory infection. The client states that he is allergic to penicillin and shows the nurse a medical alert bracelet. Which of the following actions should the nurse take?
Explanation
Amoxicillin is a penicillin derivative that has a high cross-reactivity with penicillin. Therefore, the nurse should hold the medication and notify the provider of the client's allergy. The provider may prescribe an alternative antibiotic that belongs to a different class, such as a macrolide or a fluoroquinolone.
A) is incorrect because administering the medication as prescribed and monitoring for signs of an allergic reaction can put the client at risk of developing a serious or life-threatening reaction, such as anaphylaxis. The nurse should not administer any medication that the client is allergic to.
C) is incorrect because asking the client about the type and severity of his allergic reaction to penicillin is not enough to prevent an allergic reaction to amoxicillin. Even if the client had a mild reaction to penicillin in the past, he may have a severe reaction to amoxicillin in the present. The nurse should avoid giving any medication that has cross-sensitivity with penicillin.
D) is incorrect because administering an antihistamine before giving the medication to prevent an allergic reaction is not a safe or effective practice. Antihistamines do not prevent anaphylaxis, which is a life-threatening reaction that requires immediate intervention. Antihistamines can also mask some signs of an allergic reaction, such as itching and hives, making it harder to detect and treat.
A nurse is assessing a client for risk factors of anaphylaxis. Which of the following factors should the nurse consider?
No explanation
A client asks the nurse about the risk factors associated with allergic reactions to medications. Which response by the nurse is correct?
Explanation
Correct answer: Option D. Previous exposure to a medication is a significant risk factor for developing an allergic reaction. Sensitization to a particular medication can occur after the initial exposure, leading to an allergic response upon subsequent use.
Incorrect choices:
Option A: Age and gender are not direct risk factors for developing allergic reactions to medications.
Option B: Body weight is not directly related to the risk of allergic reactions to medications.
Option C: Dietary preferences may affect other aspects of health but are not directly associated with the risk of allergic reactions to medications.
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