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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
State three ways in which resistance to antibiotics can be conferred on microbes.
Name three unwanted effects of antimicrobial therapy.
Antibiotic sensitivity testing of a sputum culture from Audrey Hepspa, a 26-year-old with a persistent respiratory tract infection, has revealed that the bacteria are sensitive to both penicillin G and a tetracycline. Assuming that Audrey is not allergic to either drug, which antimicrobial drug
Compare the following terms:(a) bactericidal and bacteriostatic drugs;(b) narrow- and broad-spectrum drugs.
State the four general mechanisms of action of antimicrobial agents.
Herb Elbs, a 78-year-old patient, is taking saw palmetto for benign prostate hypertrophy. How would you assess whether the therapy is producing some benefit?
What herbal medication could you recommend to a patient who experiences morning sickness during pregancy?
How would you evaluate the potential benefits of raw garlic in a patient who is taking it for atherosclerosis?
Joel Smith, a 55-year-old patient, has experienced ongoing problems with migraine headaches since adolescence. His medical practitioner recommends that a course of feverfew may help his condition.What aspects of patient education relating to the administration of feverfew would you talk over with
Marianna Rossito is a 28-year-old woman in the third trimester of her pregnancy. She has been experiencing difficulties with sleep due to the pressure of the fetus. Ms Rossito asks you about taking chamomile supplements to help with her problem. What would you advise?
Which is better and why – odourless garlic or pure garlic oil?
Explain the therapeutic value of phyto-oestrogens.
What is the evidence that supports the value of St John’s wort as an antidepressant?
Your patient, Sally Jacoona, develops severe diarrhoea following her enteral infusion. What measures would you take to treat the condition? What comfort measures would you provide for Ms Jacoona during her bouts of diarrhoea? (See Table 11.15 in Chapter 11 for assistance.)
How would you administer an enteral feed to prevent regurgitation or a large return of aspirate from the gastric tube?
In what kinds of patient are enteral feeds not suitable?
The doctor has ordered that the parenteral nutrition administered to Boris Makinshev over the past week can now be ceased. What would you do to prevent rebound hypoglycaemia?
Why is an enteral feed generally preferred over parenteral nutrition for a patient who is unable to tolerate food orally?
What measures would you take to prevent infection as a complication of parenteral nutrition?
How would you know whether a patient tolerates the enteral feed being administered?
Explain the difference between bolus enteral feeding and continuous infusion enteral feeding.
Why is tryptophan no longer used as a hypnotic?
Explain the difference between thed- and l-forms of naturally occurring compounds.
Explain the difference between the ferric and ferrous forms of iron. How would you evaluate the effectiveness of prescribed iron therapy?
Lee Chui-Yui, a 35-year-old patient, tells you that she often takes sodium chloride tablets during heat waves to replace fluid lost during sweating. What would be your response?
Explain whether calcium tablets are of benefit in a postmenopausal woman who has a predisposition to osteoporosis.
An 80-year-old patient takes frusemide 40 mg each morning, and one potassium supplement tablet in the morning and at night for congestive cardiac failure. She complains of a severe ‘tummy upset’, which you determine is due to the potassium supplement. What should she do to prevent this
What are the symptoms of hypokalaemia and hyperkalaemia?
What element acts as an antioxidant, and of which enzyme system is this element a part?
Arsenic and other poisonous minerals are found in human tissues. Does this mean they have biochemical roles?
What are the common names of vitamins B1, B2, B6 and B12? What are the uses of these vitamins?
What potential problem is associated with the administration of mega-doses of vitamin C in a patient who is also taking aspirin or sulphonamides?
As a midwife in the delivery suite, you are required to administer an intramuscular vitamin K preparation to Massoud Hussein, a newborn boy. Why is this preparation administered?
Jack Jones, a 22-year-old professional basketball player, takes 1 g vitamin C daily. What product education would you offer Mr Jones?
Alberto Ripaldi, a 55-year-old patient, is admitted to hospital with chronic liver disease. The doctor orders an intravenous infusion of 10% glucose with vitamin B complex and vitamin C. Why is this infusion administered?
Define the term ‘antioxidant’. Why are antioxidants of importance in the body?
Why is vitamin D deficiency uncommon in Australia?
Why is calciferol given to elderly patients by injection?
What is the difference between osteomalacia, osteoporosis and rickets?
Ascorbic acid is available as the free acid, sodium salt and calcium salt. Suggest what problems may be associated with each, if taken excessively. What advantage might the salts have over the free acid?
What food preparative processes are harmful to the ascorbic acid content of foods?
Why are multiple B vitamin deficiencies not unusual?
Why do individuals with an alcohol problem often become deficient in the B vitamins?
Why would one consider polar-bear liver to be poisonous?
Carotene is widespread in the plant kingdom. Would you expect mushrooms to be a good source?Why?
Why may patients on cholestyramine therapy have some vitamin deficiencies?
Why is it not advisable for a person who has just consumed a methylcellulose drink to go straight to bed?
Natalie Naylor, a 50-year-old woman, has commenced a course of orlistat as part of a combined weight-loss programme. What information would you provide Ms Naylor about preventing problems associated with orlistat?
Why do amphetamines lead to a decrease in appetite?
Why are amphetamines not indicated for use as anorexiants?
Why should anorectics not be taken for prolonged periods?
Why should bulk-forming agents be taken with plenty of water?
Why should a dietary fibre supplement be avoided in patients with coeliac disease?
Frank Smits, 65 years old, is commencing therapy with allopurinol for his gout. As part of his preparation for administering this drug at home, you advise him to watch for any signs of excessive bleeding and the presence of blood in his stools and urine. Why? What action do you advise him to take
Anne Hemin, 45 years old, is receiving chemotherapy for an advanced lymphoma. She receives rasburicase therapy before and during the cancer treatment. What kind of drug is rasburicase and how does it work? What serious adverse effects should be monitored during rasburicase therapy?
Yang Sun-Young, a 50-year-old lecturer, is diagnosed with gout. He commences probenecid to treat his condition. What characteristics of his urine would you monitor? Explain.
Why should patients increase their fluid intake when taking antigout medications?
What patient education would you provide to prevent manifestations of gastric disturbance, a common adverse effect of antigout medications?
What dietary restrictions would you advise for a patient with gout?
Which of the above drugs have no role in the treatment of hyperuricaemia? Why?
For each of the drugs listed below, outline its role in the treatment of gout:(a) allopurinol;(b) colchicine;(c) sodium bicarbonate;(d) indomethacin.
For each of the following indicate, where possible, the grouping to which the drug belongs and briefly describe its respective mechanism of action:(a) allopurinol;(b) colchicine;(c) sodium bicarbonate;(d) indomethacin.
What is a tophus?
Compare and contrast the terms ‘hyperuricaemia’ and ‘gout’.
Joseph Binks is 72 years old and is about to commence flutamide therapy for his prostate cancer.What are the potential adverse reactions to this therapy? What patient education and support would you offer Joseph to prepare him for these effects?
Julie Smith, an 18-year-old student, visits the community health centre requesting a script for oral contraception. What assessment would you perform on Ms Smith? Provide rationales for your answer.
Brenda Locoid, 20 years old, visits the family-planning centre in which you are working. She is seeking advice about changing from an oestrogen–progestin contraceptive to a progestin-only contraceptive.What can you tell her about the advantages and disadvantages associated with such a change?
Why would you advise a patient not to smoke while taking the oral contraceptive pill?
Helen Van Der Graaf, a 25-year-old secretary, rings the family-planning clinic in a distressed state.She forgot to take her oral contraceptive tablet this morning and it is now mid-afternoon. What further information would you solicit from Ms Van Der Graaf? What would you advise her to do?
What precautions would you take when applying a corticosteroid cream to frail skin?
Carmella Fernandez, a 35-year-old patient with inflammatory bowel disease, commences prednisolone to alleviate some of the manifestations of her condition. What patient education would you offer Ms Fernandez?
State the common adverse effects associated with administration of the following gonadal hormones:(a) androgens;(b) progestins;(c) oestrogens.
Indicate the therapeutic uses of the following gonadal hormones:(a) oestrogens;(b) androgens;(c) progestins;(d) oestrogen–progestin combinations.
How can the serious adverse effects of corticosteroid therapy be avoided?
Name ten adverse effects associated with corticosteroid therapy and link each one to the physiological effects of this group.
List ten specific conditions in which the glucocorticoids are indicated.
Why is a fluid-balance chart maintained for a patient receiving desmopressin?
What assessment would you make to evaluate the effectiveness of somatropin?
Mary Zielinski, a 55-year-old patient, has diabetes insipidus. Is this the same as diabetes mellitus?What medication is used to control diabetes insipidus? Explain its action.
Dimitra Kiriakopoulos, a 35-year-old patient with infertility problems, is placed on clomifene in an attempt to stimulate ovulatory function. What patient education would you offer Ms Kiriakopoulos?
What is the major complication associated with using hormones extracted from cadavers?
Name the hormone(s) that each of the following endocrine agents mimics:(a) buserelin;(b) tetracosactride;(c) octreotide;(d) nafarelin.
For each of the following endocrine agents, name the target tissue it acts on:(a) bromocriptine;(b) follitropin;(c) tetracosactrin.
For each of the following hormones, indicate from which part of the pituitary gland it is released and its effects:(a) oxytocin;(b) prolactin;(c) follicle-stimulating hormone;(d) antidiuretic hormone.
Emma Doeline, aged 60 years, is about to take a trip from London to New York. As she is often affected by motion sickness, she buys an antihistamine preparation at the airport. How would you advise Ms Doeline to take the preparation?
What non-pharmacological measures would you provide for a patient suffering with nausea? (See Table 11.10 in Chapter 11 for assistance.)
Alberto Ripaldi, a 50-year-old patient, suffers from Menière’s disease. Why is metoclopramide not the most suitable antiemetic to administer? Which antiemetic would you administer instead?(Menière’s disease is a disorder of the labyrinth of the inner ear. Common manifestations of this
In a patient who is vomiting, what route of administration would you use for the antiemetic given?
Yavuz Olcay, a 60-year-old patient in your care, vomits after gastrointestinal surgery. You administer metoclopramide in an attempt to alleviate vomiting. What assessment would you undertake of Mr Olcay?
Explain the three ways in which the vomiting centre can be stimulated.
Why is it unwise for a car driver to take promethazine as a travel-sickness prophylactic?
Why is domperidone sometimes preferred as a dopamine antagonist over prochlorperazine?
What are the major adverse effects associated with phenothiazine use?
What type of antiemetic would be best for use in a patient with terminal carcinoma who is on morphine?
Why can the so-called bulk-forming laxatives sometimes be used to treat diarrhoea?
Why is atropine included with diphenoxylate in the preparation LomotilTM?
What would be a major problem from diphenoxylate overdose?
Why should liquid paraffin not be taken less than half an hour before lying down?
Why are paraffinomas so called?
Why should diarrhoea resulting from pseudomembranous colitis not be treated with loperamide?
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