Chapter 3

Question 1

role of nurse regarding drug toxicity (3)

Answer 1

Recognize adverse effects
Patient and family teaching
Responding to adverse effects - some can be countered with specific precautions, comfort measures

Question 2

2 types of side effects

Answer 2

Primary action - extension of desired effect - too much

Secondary action - effects in addition to desired effect

Question 3

define hypersensitivity

Answer 3

Excessive response to a drug

Question 4

hypersensitivity usually r/t

Answer 4

underlying condition

Question 5

define drug allergies

Answer 5

Occur when body forms antibodies to drug causing an immune response to it

Question 6

define cross-sensitivity + example

Answer 6

some drugs are similar enough to produce a reaction to both

cephalosporin and penicillin

Question 7

if a patient says they have a drug allergy, ask them…

Answer 7

what their response to drug is

Question 8

4 types of allergy

Answer 8

anaphylaxis
cytotoxic
serum sickness
delayed reaction

Question 9

explain anaphylaxis

Answer 9

Antibodies release histamines that cause mucous membrane swelling, constriction of airways

Question 10

s/s anaphylaxis

Answer 10

Hives, rash may be present at beginning

Increased BP, HR, panic, respiratory arrest

Question 11

admin _____ for anaphylaxis

Answer 11

epinephrine

Question 12

explain cytotoxic allergy

Answer 12

Antibodies attack antigens on cell sites, causing cell death

Question 13

s/s cytotoxic allergy

Answer 13

CBC (complete blood count) shows damage to blood cells, elevated liver enzymes, decreased renal function

Question 14

treatment for cytotoxic is ____

Answer 14

supportive; relief of symptoms

Question 15

explain serum sickness

Answer 15

Antibodies cause damage to tissues

Question 16

when may serum sickness occur

Answer 16

a week or more after exposure

Question 17

s/s serum sickness

Answer 17

Itchy rash, high fever, swollen lymph nodes, painful joints, edema of face and limbs

Question 18

admin ______ for serum sickness

Answer 18

antiinflammatory drugs - steriods

Question 19

explain delayed reaction allergy

Answer 19

Antibodies are bound to specific WBCs

Question 20

s/s delayed reaction

Answer 20

Rash, hives, swollen joints

Question 21

admin ______ for delayed reaction

Answer 21

antihistamines, steroids

Question 22

7 types of tissue/organ damage from drugs

Answer 22

dermatological
superinfections
blood dyscrasias
toxicity
electrolyte imbalances
sensory damage
neural damage

Question 23

examples of dermatological damage

Answer 23

rash
exfoliative dermatitis
Stevens-Johnson syndrome

Question 24

explain superinfections + example

Answer 24

Disruption of normal flora & overgrowth - Thrush

Question 25

explain blood dyscrasia

Answer 25

Bone marrow suppression due to drugs that cause cell death - often associated with chemo

Question 26

s/s of blood dyscrasia

Answer 26

anemia leukopenia thrombocytopenia pancytopenia

Question 27

protect blood dyscrasia patients from (2) and support...

Answer 27

infections bleeding bone marrow recovery

Question 28

2 types of drug toxicity (organs)

Answer 28

liver | kidney

Question 29

s/s liver injury

Answer 29

Fever, malaise, n/v, jaundice, darkening of urine, abdominal pain, elevated liver enzymes

Question 30

s/s renal injury

Answer 30

Elevated BUN (blood urea nitrogen), elevated creatinine, edema, electrolyte imbalances, decreased urinary output

Question 31

hypoglycemia cause ex

Answer 31

antidiabetic meds

Question 32

hyperglycemia cause ex

Answer 32

drugs that stimulate glycogenolysis | steroids

Question 33

hypokalemia cause ex

Answer 33

loop diuretics

Question 34

hyperkalemia cause ex

Answer 34

k-sparing diuretics

Question 35

s/s hypoglycemia

Answer 35

Fatigue, drowsiness, hunger, anxiety, h/a (headache), cold & clammy skin, tremors, tachycardia, confusion, unconsciousness

Question 36

s/s hyperglycemia

Answer 36

Polyuria, polydipsia, polyphagia, deep respirations (Kussmaul respirations), flushed skin, fruity breath

Question 37

hypokalemia = K

Answer 37

<3.5

Question 38

K > ___ is hyper

Answer 38

5

Question 39

s/s hypokalemia

Answer 39

weakness, numbness, tingling, muscle cramps, n/v/d, irregular heart rate

Question 40

s/s hyperkalemia

Answer 40

weakness, muscle cramps, numbness, tingling, bradycardia

Question 41

s/s eye damage

Answer 41

Blurred vision, vision changes, corneal damage, blindness

Question 42

ex drug that can cause retinal damage

Answer 42

Hydrocychloroquine

Question 43

s/s hearing damage

Answer 43

Dizziness, tinnitus, loss of balance, loss of hearing

Question 44

ex drug that can cause hearing damage

Answer 44

antibiotics

Question 45

s/s neural effects

Answer 45

Confusion, delirium, insomnia, drowsiness, hyper or hyporeflexia, respiratory depression, loss of consciousness

Question 46

block effects of ACh in parasympathetic NS

Answer 46

anticholinergic effects

Question 47

dopamine levels affected

Answer 47

parkinson-like syndrome

Question 48

anesthesia drugs may cause...

Answer 48

Neuropleptic malignant syndrome

Question 49

s/s anticholinergic effects

Answer 49

Dry mouth, constipation, urinary hesitancy, urinary retention, impotence, palpitations, tachycardia, decreased sweating

Question 50

s/s parkinson-like syndrome

Answer 50

Akinesia, muscular tremors, drooling, rigidity, akalthisia (restlessness)

Question 51

s/s neuropleptic malignant syndrome

Answer 51

Slow reflexes, high fever, HTN, tachycardia - may be fatal