NURS 317 Unit 7 Pharm Chapter 13 Flashcards
A school-aged child has been prescribed albendazole 15 mg/kg/day PO in divided doses, b.i.d. The child weighs 66 lbs and is 3’11” tall. How many milligrams of albendazole should the nurse administer for each dose of treatment?
__________ mg
225mg
Rationale:It is necessary first to convert the cliente administer for each dose of t ÷ 2.2 = 30 kg. 15 mg × 30 kg = 450 mg per day. The drug is in two divided doses, and 450 mg ÷ 2 = 225 mg. The client’s height is not included in this calculation.
After administering ivermectin, when should the nurse expect it will reach peak levels?
A) 24 hours
B) 4 hours
C) 2 hours
D) 30 minutes
B) 4 hours
Rationale:Ivermectin reaches peak levels in 4 hours.
Schistosomes invade tissue.
A) FALSE
B) TRUE
B) TRUE
Rationale:Schistosomiasis is an infection with a blood fluke, or schistosome, carried by snails and is commonly seen in tropical countries where the snail is the intermediary in the life cycle of the worm. Larvae burrow into the skin in fresh water and migrate throughout the human body, causing a rash and then symptoms of diarrhea and liver and brain inflammation.
A client who has had no previous contact with the healthcare system presents with elephantiasis of the lower legs. What helminthic infection should the nurse suspect?
A) Whipworm infection
B) Pinworm infection
C) Filariasis
D) Schistosomiasis
C) Filariasis
Rationale:Filariasis is associated with severe swelling of the hands, feet, legs, arms, scrotum, or breast, which is known as elephantiasis. Schistosomiasis is associated with a pruritic rash (swimmer’s itch). Whipworm infection is associated with colic and bloody diarrhea. Pinworm infection is associated with perianal itching.
What helminths should the nurse classify as nematodes? Select all that apply.
A) Platyhelminth
B) Threadworm
C) Schistosomiasis
D) Whipworm
E) Pinworm
B) Threadworm
D) Whipworm
E) Pinworm
Rationale:Nematodes are roundworms such as pinworms, whipworms, threadworms, Ascaris, or hookworms. A platyhelminth is a flatworm, while schistosomiasis results from a blood fluke carried by a snail.
Which complication of a client’s helminthic infection should lead the nurse to suspect that the client has a threadworm infection?
A) Anemia
B) Bloody diarrhea
C) Fever
D) Pneumonia
D) Pneumonia
Rationale:Pneumonia would be associated with a threadworm infection. Bloody diarrhea is associated with a whipworm infection. Anemia is associated with hookworm infections. Fever is not specific to threadworm infections
The nurse is caring for a client with a severe whipworm infection. Which of the nurse’s assessment findings would suggest complications of this helminthic infection?
A) Apathy and depression
B) Drowsiness and shortness of breath
C) Pallor and activity intolerance
D) Alopecia and fatigue
C) Pallor and activity intolerance
Rationale:Whipworms attach to the intestinal mucosa and suck blood, which can result in severe anemia and disintegration of the intestinal mucosa. None of the other listed findings is a known complication of whipworm infection.
A client is traumatized because the cestode that has been the cause of his or her helminthic infection has begun exiting the mouth. The client’s nurse should be aware that the client likely has what diagnosis?
A) Schistosomiasis
B) Tapeworm
C) Whipworm
D) Trichinosis
B) Tapeworm
Rationale:Tapeworm is a cestode, which can exit the nose or mouth. Trichinosis is a disease due to ingestion of a roundworm. Schistosomiasis is due to a platyhelminth or fluke. Whipworm is caused by a nematode or roundworm.
A client is suspected of having a helminthic infection. When reviewing the client’s history, what information may lead the nurse to suspect that the client has a tapeworm infection?
A) Eating unwashed vegetables
B) Recent wilderness camping
C) Consumption of sushi
D) Swimming in a fresh water lake
C) Consumption of sushi
Rationale:Tapeworms or cestodes enter the body as larvae that are found in undercooked fish or meat. Camping would not be a risk factor, since insect bites or dirt water are not causative factors. Ascaris occurs when a person ingests unwashed vegetables or other improperly washed foods grown in soil that contains roundworm eggs. Schistosomiasis occurs when a person swims in a fresh water pond or lake that has been contaminated with snail larvae.
A client is diagnosed with a threadworm infection. The nurse should anticipate administering what medication?
A) Praziquantel
B) Ivermectin
C) Mebendazole
D) Pyrantel
B) Ivermectin
Rationale:Ivermectin treats threadworm infections, which are also referred to as strongyloidiasis. Mebendazole is indicated for treatment of diseases cause by pinworms, roundworms, whipworms, and hookworms. Praziquantel is used for the treatment of schistosomes or flukes. Pyrantel is used to treat diseases caused by pinworms and roundworms.
The nurse has cared for several clients with helminthic infections over the past several months. What client would have required the closest monitoring for adverse effects of drug therapy?
A) A client who has a pork tapeworm and who is receiving albendazole
B) A pediatric client taking mebendazole for the treatment of hookworms
C) A client being treated with mebendazole for the treatment of roundworms
D) A client prescribed pyrantel for pinworm treatment
A) A client who has a pork tapeworm and who is receiving albendazole
Rationale:Mebendazole and pyrantel are generally well tolerated with comparatively few adverse effects. Renal failure and severe bone marrow depression are associated with albendazole, however, which is toxic to some human tissues. Patients taking this drug require careful monitoring.
When interviewing a client with a suspected worm infection, what assessment finding would best address the client’s risk of Ascaris?
A) “When was the last time that you ate pork?”
B) “Have you eaten any unwashed, fresh vegetables lately?”
C) “Have you been around mosquitoes the last few weeks?”
D) “Have you been swimming at all in the last few weeks?”
B) “Have you eaten any unwashed, fresh vegetables lately?”
Rationale:Consuming unwashed vegetables can lead to Ascaris. Ingestion of undercooked pork is associated with trichinosis. Swimming in contaminated water could lead schistosomiasis. A recent insect bite would be associated with filariasis or malaria.
Bone marrow suppression can occur with albendazole.
A) FALSE
B) TRUE
B) TRUE
Rationale:Bone marrow suppression can occur with albendazole, which is toxic to some human tissues. Patients taking this drug require careful monitoring.
A client can take an anthelmintic agent with food if GI upset occurs.
A) TRUE
B) FALSE
A) TRUE
Rationale:The nurse should provide anticipatory guidance that anthelmintics can cause GI upset and should be taken with food to reduce these effects.
A nurse is preparing to administer a client’s prescribed anthelmintic medication. What diagnostic results should provide the rationale for the team’s choice of medication?
A) Stool for ova and parasites
B) Stool for culture and sensitivity
C) Barium enema
D) Renal function studies
A) Stool for ova and parasites
Rationale:A stool culture specifically for ova and parasite is absolutely necessary for proper diagnosis and identification of the infecting worm. A routine stool culture looks for bacteria and would not identify the helminth involved. Renal function studies may be appropriate to establish a baseline, but they would not be as crucial as obtaining a stool culture for ova and parasite. This would not contribute to a diagnosis for a client with a suspected helminthic infection. A barium enema would not identify specific helminths.
