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statistics for nursing a practical approach
Fundamentals Of Pharmacology : An Applied Approach For Nursing And Health 2nd Edition Shane Hunt - Solutions
Your patient is ordered 400 ml whole blood to be run over 3 hours. How many dpm does this correspond to if a macro-drip is used?
Your patient is ordered 500 ml ‘stable plasma protein solution’ (SPPS) to be run over 2 hours. How many dpm are delivered if a micro-drip is used?
Your patient is ordered gentamicin 100 mg. Gentamicin is available as an 80 mg/2 ml formulation. How many millilitres will you need? The gentamicin is diluted to 50 ml and given over 60 minutes. What dpm will be delivered if a micro-drip is used?
Your patient is ordered 2 million units of penicillin to be made up to 80 ml and delivered in 30 minutes. To how many dpm does this correspond if a macro-drip is used?
Your patient is receiving a morphine infusion of 50 mg in 50 ml normal (isotonic) saline. The dose ordered is 3.5 mg/h. How many millilitres per hour are being delivered?
Your patient is on an ActrapidTM infusion of 60 units in 30 ml HaemaccelTM. The dose ordered is 5 units per hour.How many millilitres per hour would you dial up on the pump?
Your patient is ordered 20 ml phosphate ions IV. This is diluted to 100 ml via the IV burette and given over 1 hour.What dpm is required if a macro-drip is used?
Your patient is ordered 100 ml HaemaccelTM to run over 1 hour. What dpm is required if a macro-drip is used? As the patient’s blood pressure remains low (85/50 mmHg), a further 250 ml is ordered to run over 45 minutes. What dpm is required now?
Your patient has an infusion of 5% glucose 1000 ml running at a 24-hourly rate. Calculate the dpm if a macro-drip is used. Your patient is ordered vancomycin 500 mg to be given in 50 ml over 1 hour. What would be the dpm during this time?
Your patient is ordered gentamicin 120 mg. Gentamicin is available as an 80 mg/2 ml formulation. How many millilitres would you give? Gentamicin needs to be diluted in 60 ml and given over 1 hour. How many drops per minute (dpm) would be delivered if a macro-drip was used?
Your patient is receiving a potassium chloride infusion of 75 mmol in 500 ml 5% glucose, with the ordered volume being 40 ml/h. How many millimoles per hour is the patient receiving? Your patient’s serum potassium level is 4.1 mmol/l and she is ordered 10 mmol potassium chloride IV stat.
Your patient is receiving 25 000 units of heparin in 5% glucose 500 ml at 20 ml/h via a volumetric pump. How many units per hour is the patient receiving? The patient’s activated partial thromboplastin time (APTT) result comes back at 32 seconds and the heparin infusion is increased to 35 000
Your patient is receiving a morphine infusion consisting of 50 mg morphine in 500 ml 5% glucose via a volumetric pump. The dose ordered is 3 mg/h. How many millilitres per hour will be dialled up on the volumetric pump?
Your patient is on an ActrapidTM infusion 50 units in 100 ml 5% glucose running at 4 ml/h. How many units of Actrapid is the patient receiving per hour?
A patient is ordered 100 mg furosemide as a morning dose. You have at your disposal 20-mg and 40-mg strength of LasixTM. What would you administer?
Your patient is ordered 25 mg atenolol. You have available TenorminTM tablets that contain 50 mg atenolol. How many tablets would you give?
What are the storage requirements for eye drops once opened? (See Table 7.19 in Chapter 7 for assistance.)
In what kinds of patient are timolol eye drops contraindicated? Why?
Geoffrey Leichhardt is 28 years of age and has acquired immunodeficiency virus (AIDS). He has developed cytomegalovirus-induced retinitis and is being treated with the antiviral agent ganciclovir. Regular blood tests are ordered during therapy. Why? With what patient education do you provide
While in hospital, Roy Reuters, a 70-year-old patient, is ordered acetazolamide therapy for the treatment of glaucoma.With reference to acetazolamide’s mechanism of action, why would you monitor fluid balance and electrolyte levels?
For a patient leaving the medical clinic for home, the administration of a cycloplegic agent would result in a very anxious time. Why is this so?
Outline the procedures for administering eye drops and eye ointments. (See Table 7.3 in Chapter 7 for assistance.)
Briefly describe the mechanisms of action of the following drug groups used in glaucoma therapy:(a) diuretics;(b) anticholinergic mydriatics;(c) prostamide analogues;(d) beta-blockers;(e) α2 agonists;(f ) prostaglandins.
Which form of glaucoma is the most common, and which form is responsive to drug therapy?
Briefly describe the pathophysiology of glaucoma.
Outline the complications resulting from the prolonged use of the following drug groups:(a) corticosteroids;(b) antimicrobials;(c) local anaesthetics.
Compare and contrast the following ophthalmic drug groups: miotics, cycloplegics and mydriatics.
Indicate the uses of the following drug groups in ophthalmology:(a) corticosteroids;(b) staining agents;(c) antimuscarinic agents;(d) α-adrenergic agonists;(e) local anaesthetics;(f ) muscarinic agonists.
Martha Bortiolis, a 15-year-old student, complains of pimples and blackheads on her face and back.As the community nurse who examines Martha, you recommend a benzoyl peroxide cream to treat the acne. How would you advise Martha on the use of the cream?
Judy Jones, a 35-year-old mother of two young children, is ordered a dithranol preparation to treat her psoriasis. With what patient education would you provide her for the application of dithranol?What extra care should she take when tending to her children?
Explain the precautions you would take for the patient in applying podophyllum for the treatment of genital warts.
As the emergency nurse, you are required to apply benzyl benzoate emulsion to Massimo Cino, a==75-year-old patient with pediculosis. How would you use this preparation?
Suggest further uses that could be investigated for imiquimod cream.
What non-pharmacological measures can be used to treat mild acne vulgaris?
Corticosteroid-containing creams may exacerbate acne. Why?
Acne often undergoes remission during pregnancy. Why?
Why will penicillin not be of much use in the treatment of acne?
Antiandrogenic drugs can be used in the treatment of acne. Why?
Why are oral contraceptives usually prescribed along with isotretinoin to women?
Explain the difference between an antiperspirant and a deodorant.
How can a lumbar sympathectomy help with severely sweaty feet?
Explain what is meant by PUVA therapy.
In the treatment of acne using tetracyclines, why is nystatin sometimes given concurrently?
Rubefacients produce local heat on application to the skin. How does this help in the treatment of strains and sprains?
What is a more common use of pyrimethamine?
What would be the purpose of the calcium folinate injections?
Why would treatment with sulfadiazine and pyrimethamine be commenced?
The symptoms and progress of Kaposi’s sarcoma can be ameliorated successfully by chemotherapy with such drugs as etoposide, vinblastine and/or bleomycin. They were withheld in RS’s case, even though his illness was not in its terminal stages. Why is treatment of Kaposi’s sarcoma in many
What was the most likely organism causing diarrhoea in RS in the September before his death? Most cases of diarrhoea are not treated with antibiotics. Why in this case was an antibiotic used immediately on diagnosis? What is the likely source of the organism causing the diarrhoea? What drug could
Why was pentamidine administered both intravenously and via the lungs directly? Why was pentamidine continually used in aerosol form by RS until near his death?
Why must care be taken in the use of Bactrim in elderly patients?
How does Bactrim control infections?
Bactrim can be used for many infections. What would be the purpose of using Bactrim in this case, and how can you be more or less certain of the cause of the infection?
Why, with BactrimTM, was a proprietary name used on the prescription while all other drugs were prescribed generically?MODULATION OF CELLULAR GROWTH AND PROLIFERATION
Why would isoniazid be prescribed? Why would pyridoxine be given concurrently? What could be prescribed instead of isoniazid? What are two major adverse effects of isoniazid therapy? What enzyme deficiency can cause problems with isoniazid therapy?
What does PPD stand for? Explain its use and the mechanism whereby the induration was produced. If the indurated area was about 4 mm in diameter, what would this mean?
Suggest why capsaicin cream was prescribed, and the probable cause of the condition.
Why was the prescription for the zidovudine withdrawn in February? Why was the change to didanosine and zalcitabine instituted at this time? What is the mechanism of action of these drugs?
What is an undesirable consequence of ketoconazole in male patients?
Why was ketoconazole introduced into RS’s drug regimen at this stage in his illness until the terminal stages of his illness?What is a likely reason for the use of the ketoconazole shampoo? What is the normal dosage protocol used with ketoconazole shampoo?
Why were amphotericin lozenges prescribed? Why should they be sucked slowly? What alternative drug could be used here?Why is amphotericin sometimes administered intrathecally?
Why were the zidovudine tablets replaced with syrup for the short period in February 2002?
What could be a reason for the use of cepacaine? Which ingredient in cepacaine would be pharmacologically active with regard to the most likely symptom that RS displayed, given that it was not due directly to a virus? Cepacaine can be used to suppress the symptoms of bacterial pharyngitis.How do we
What is the most likely reason for increasing Rodney’s dose of zidovudine after approximately 3 months?
Why is zidovudine relatively non-toxic to humans?
Zidovudine is a prodrug. What does this term mean? Give three other examples of prodrugs used clinically for the following conditions:(a) insomnia;(b) hypertension;(c) Parkinson’s disease.
What is the mechanism of action of zidovudine?
Is the use of Latin abbreviations recommended today? Give reasons for your answer.
Define all the Latin prescription abbreviations used above.
What condition did RS have? What is its cause?
State four technical problems associated with gene therapy that limit the widespread use of this technique clinically.
For each of the following examples, indicate whether it is an ex-vivo or in-vivo procedure:(a) removing white blood cells from a person, introducing a gene into the cells in vitro, and then injecting those cells back into the person’s body;(b) administering, by inhalation, an aerosol containing
Describe the two types of gene therapy. Which form is ethically unacceptable, and why?
Define the term ‘gene therapy’.
Jennifer Pfiffer is 52 years old and is about to commence treatment with the alkylating agent cisplatin for bladder cancer. It is anticipated that she will develop severe neutropenia during therapy and so she will be treated with the granulocyte colony-stimulating factor (G-CSF) filgrastim. What
Martine de Tol is 42 years old. She has been diagnosed with breast cancer and is receiving therapy with the selective oestrogen receptor modulator (SERM) tamoxifen. Shortly after the commencement of treatment, she experiences bone pain. What advice would you offer Martine?
With Marcus’s therapy, changes in blood cell levels would be expected. Which specific blood-cell types would be affected? As a result, what complications would have to be monitored for closely?
Marcus Maas, 45 years old, is receiving cytotoxic drug therapy for lung cancer. What blood tests would be required during this treatment? Why?
Why is evaluation of fluid and electrolyte balance following cytotoxic therapy important?
Which body organs are particularly vulnerable to damage during cytotoxic drug therapy?
Stomatitis is a common problem following the administration of antineoplastic therapy. What comfort measures can you offer for this condition? (See Table 11.14 in Chapter 11 for assistance.)
State the immediate and delayed adverse effects generally associated with antineoplastic therapy.
Explain how tissue-specific drugs are useful in the treatment of cancer.
Compare and contrast cell-cycle-specific and cell-cycle-non-specific cytotoxic agents.
(a) Indicate the effectiveness of neoplastic therapy on cancerous cells in the G0 phase.(b) What therapeutic strategies could be employed to ensure that cancer cells entering and leaving the G0 phase intermittently are targeted?
Briefly describe the principle of selective toxicity in relation to neoplastic therapy.
Define the cell cycle and describe each of the major phases.
Fred Jamieson is a 75-year-old man in hospital for hip-replacement surgery. His doctor has advised him to be vaccinated for influenza before he is discharged from hospital. Fred confides to you that he would rather not because he has heard that you can catch the flu from the vaccine. How do you
What types of patient should avoid vaccines containing live viruses?
Why is a patient observed for approximately 20 minutes after administration of a vaccine?
Ronaldo Ricoletto, a 28-year-old labourer, comes into the emergency department after stepping on a rusty nail. What assessment would you make of Mr Ricoletto’s vaccination status? Explain.
Rachel Quinlan, a 32-year-old electrician, is prescribed ciclosporin after a successful heart transplantation for cardiomyopathy. What adverse effects of ciclosporin would you advise Ms Quinlan about? What patient education would you offer Ms Quinlan to protect herself against infection?
If a patient experiences an anaphylactic reaction after vaccination, what emergency drug would be administered? What other measures should be taken?
State the mechanism of action of each of the following immunosuppressants:(a) calcineurin inhibitors;(b) muromonab-CD3;(c) monoclonal antibodies;(d) the antiproliferative agent azathioprine;(e) etanercept.
In general, what adverse reactions would you expect after the administration of an immunomodulating agent derived from an animal source?
What is the principle underlying the action of vaccines?
What type of immunity (active or passive) does each of the following immunomodulating agents confer after administration?(a) vaccines;(b) antisera;(c) cytokines.
Outline the functions of the following immune cells:(a) macrophages;(b) basophils;(c) B-cells;(d) T-cells.
Parenteral amphotericin B therapy is associated with renal impairment as an adverse effect. What blood tests should be performed regularly during therapy in order to determine effects on renal function?
What non-pharmacological measures would you suggest for a patient with genital candidiasis? (See Table 11.16 in Chapter 11 for assistance.)
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