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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
Why is the term ‘fibrinolytic agent’, when applied to drugs such as streptokinase, a misnomer?
What are the uses of tranexamic acid?
What observations should be made in patients taking warfarin?
What are the antidotes to warfarin and heparin? How does each antidote work?
Jack McDuff is a 55-year-old man with stable angina. He has been using sublingual tablets of glyceryl trinitrate to manage his condition. In consultation with his doctor, he is changing formulations to the sublingual spray. What would you tell Jack regarding the difference between these two
Fred Jones is a 50-year-old man with diabetes mellitus. He has an erectile problem and would like to try sildenafil. What education do you offer Fred?
Neava Head, who has experienced a subarachnoid haemorrhage, is placed on a nimodipine infusion. She remains in a dark and quiet room. Ms Head complains to you of feeling nauseated.What measures can you implement to relieve her feeling of nausea? (Refer to Table 11.10 in Chapter 11 for futher
A 65-year-old patient is receiving nifedipine for the prophylactic treatment of angina. What education would you offer?
Explain why alprostadil must be injected locally and cannot be taken orally.
Nimodipine may cause hypotension, bradycardia and flushing. Explain the pharmacological reasons underlying these adverse effects.
Explain why nimodipine is the calcium channel blocker of choice in the treatment of cerebral ischaemia following a subarachnoid haemorrhage rather than another, such as verapamil.
Compare the effects of each of the following drugs/drug groups on nitric oxide levels: potassium channel openers, organic nitrates and sildenafil.
Account for the facial flushing, headache and reflex tachycardia that may be observed after organic nitrate administration in angina therapy.
Briefly outline the pathophysiology of the two types of angina pectoris and the aims of drug therapy.
Joe Fernando, a 50-year-old office executive, comes to the community health centre to have his antihypertensive medications reviewed. You find his blood pressure is 150/95 mmHg. What non-pharmacological measures would you suggest to Mr Fernando to reduce his blood pressure?
Rob Tussin is a 47-year-old with moderate essential hypertension. His hypertension is controlled well using the combination therapy of the thiazide diuretic hydrochlorothiazide and the angiotensin II antagonist candesartan.What are the advantages of the angiotensin II antagonists over the
A major adverse effect of the peripheral vasodilators is sodium and water retention. How would you assess this problem? What type of drug could be given to treat this problem?
Milo Georgialis suffers from congestive cardiac failure and hypertension. Which group or groups of antihypertensive drugs would be suitable for treatment of Mr Georgialis’s hypertension? Explain your answer.
Kristina Alevano, a 66-year-old patient, has just commenced taking a β1-antagonist as part of her antihypertensive programme. What observations would you make to evaluate the effectiveness of the treatment?
Margaret Jenner is 72 years old. Her hypertension is being controlled using an antihypertensive preparation containing hydrochlorothiazide and amiloride. What is the rationale for using this particular combination? What observations would you monitor closely during the early stages of her therapy?
Paulo Guaniasis, a 65-year-old retired patient, is receiving the angiotensin-converting enzyme (ACE) inhibitor captopril for his hypertension. What patient education would you offer Mr Guaniasis?
Eva Bernstein, aged 58 years, comments on how relieved she is now that her doctor has started her on the thiazide diuretic hydrochlorothiazide as part of her antihypertensive therapy: ‘Now I won’t have to worry about having food without salt. The water tablet will take care of it,’ she
For essential hypertension, describe the drug approach used in restoring blood pressure to acceptable levels.
Name the factors that influence the choice of antihypertensive drug.
Outline the non-pharmacological therapies used to control hypertension.
How do the effects of the angiotensin receptor antagonists differ from those of the angiotensinconverting enzyme (ACE) inhibitors?
What are the major vasoactive substances that influence blood pressure control, and in which direction is the influence of each (i.e. raise or lower blood pressure)?
What three factors determine blood pressure?
Define the three forms of hypertension.
What type of blood test is recommended on a regular basis for a patient receiving simvastatin?
Julie Roberts is taking colestipol to treat her hypercholesterolaemia. She buys a nasal decongestant to alleviate the manifestations of an unpleasant cold. What will you tell her about the timing in taking both medications?
Yuri Makinov has been on colestyramine for 8 months. During his outpatient visit, he indicates to you that he has been experiencing nose bleeds. What do you think may be happening?
What evaluation would you perform to determine the effectiveness of a drug used to treat hypercholesterolaemia?
Rose Goldstein, a 50-year-old patient who is taking colestipol, complains of constipation. What measures can you recommend to alleviate this problem? (See Table 11.4 in Chapter 11 for assistance.)
Explain why low-density lipoprotein (LDL) is referred to as ‘bad cholesterol’ and high-density lipoprotein (HDL) as ‘good cholesterol’.
Why is diet alone usually not sufficient to reduce hyperlipidaemia?
Why are gall stones sometimes produced during bezafibrate therapy?
What is the main advantage of gemfibrozil over bezafibrate?
Why are drugs such as pravastatin and simvastatin referred to as HMG-CoA reductase inhibitors?
What types of fish are high in omega-3 fatty acids?
Why are the fatty acids in fish oils used in the treatment of hyperlipidaemias termed omega-3 marine triglycerides?
What general advice should be given to all patients on antihyperlipidaemic therapy?
Why is colestyramine sometimes used in the treatment of diarrhoea?
Blood coagulation problems have arisen during colestyramine therapy. Why?
Why is it often necessary to supplement the diet with some vitamins during colestyramine therapy?
(a) Colestyramine and colestipol are not absorbed from the gastrointestinal tract and yet are capable of lowering blood cholesterol levels. Why?(b) Why is colestyramine contraindicated in cholestasis?
If a local anaesthetic preparation is used topically in the nose or throat, what instructions would you provide the patient about eating and drinking?
How would you manage and care for a patient after administration of a spinal anaesthetic of bupivacaine?
After local anaesthesia of the nasopharyngeal area, how would you test the adequacy of a patient’s gag reflex?
What nursing care would you provide for a patient’s anaesthetised limb to prevent injury?
When considering the use of local anaesthesia for a vasectomy, would you use a local anaesthetic containing adrenaline? Why?
Cocaine is often abused by nasal sniffing. It is not used to desensitise the nasal mucosa. Why, therefore, is it abused?
Is there a relationship between the use of lidocaine as an antidysrhythmic and as a local anaesthetic?
What problems may present with local anaesthetic use?
What evaluation would you make of a patient after injection of a typical premedication?
Millie Rushton, a 52-year-old patient, has been admitted to hospital for an abdominal hysterectomy.On the evening before surgery, you explain the preoperative routine and what to expect after surgery. She asks you why she needs to have an injection before she goes to theatre. What would you say to
What is balanced anaesthesia? Provide a rationale for its use.
Why should vital signs be monitored closely after general anaesthesia?
Why is halothane normally given with nitrous oxide and oxygen?
What are the advantages of the shorter-acting intravenous anaesthetics?
Why is aspirin contraindicated in a patient who is taking warfarin following a heart-valve replacement?
Emily Hickey, a 75-year-old patient with rheumatoid arthritis, is ordered ibuprofen sustainedrelease tablets. She asks you whether she could crush the tablets and mix them with peanut butter before swallowing. What would be your reply to her, and why?
Nick Erbakan, a marathon runner, often uses a preparation containing methyl salicylate and aromatic compounds on a nagging calf injury. Why would you advise him to wash his hands before handling his baby son, James?
Tomichi Hashimoto, a 55-year-old executive director, takes aspirin 100 mg orally each morning for treatment of atherosclerosis. Explain how aspirin produces this effect.
Matilda Riggs, an 80-year-old patient with rheumatoid arthritis, complains of gastrointestinal irritation following ingestion of indometacin tablets. What alternative type of indometacin formulation would you recommend? How would this formulation assist in decreasing gastrointestinal irritation?
Edgar Siodmark, a 25-year-old patient, complains of pain following removal of a toenail. What type of analgesic would you advise, and why? What analgesics would be contraindicated, and why?
Why are full blood counts performed routinely on patients undergoing therapy with the slow-acting drugs used in the treatment of rheumatoid arthritis?
What are two major adverse effects of hydroxychloroquine?
What advantage would the use of an indometacin topical spray have over oral therapy in treating the pain of a pulled muscle?
Why are salicylates often present in liniments for sports injuries?
Indometacin and other non-steroidal anti-inflammatory drugs are often administered rectally, and yet stomach ulcers can still occur. Why?
Why could paracetamol prove to be problematic if given to an alcoholic patient?
What are three advantages of aspirin over paracetamol?
What are three advantages of paracetamol over aspirin?
Why are asthmatic people usually not able to take aspirin?
What is meant by ‘buffered aspirin’?
A bottle of aspirin tablets is labelled ‘Aspirin 300 mg’, yet on being weighed the tablet is 360 mg.Would this be correct?
List five disadvantages of aspirin use.
Why would aspirin be an unsuitable analgesic after a tonsillectomy?
What changes in vital signs would indicate to you that a patient’s pain is resolving after a morphine injection?
According to drug legislation, to what schedule do most narcotic analgesics belong? What implications does this schedule have for administration of narcotic analgesics?
Soo Ling, a 15-year-old netballer, has been taking a preparation containing paracetamol and codeine to provide pain relief for her right knee. After visiting the community health centre, she complains of not having opened her bowels for 3 days. What is the cause of the constipation? What action
Provide a rationale for the use of pethidine instead of morphine following gastrointestinal surgery.
Amilia Jayasinghe has just undergone a hip replacement. She has received morphine 10 mg intravenously for pain relief. Over the course of half an hour, her blood pressure drops to 80/60 mmHg from 110/80 mmHg, and her respiration rate drops to 12 from 15 breaths/min. What actions would you take?
A patient on morphine may have difficulty in reading a telephone directory. Why?
Itch may develop after the injection of morphine. Why?
What is meant by ‘cross-tolerance’?
What precautions must be taken when naloxone is used as an antidote for morphine overdose?
Why is methadone, itself an addictive drug, used in the treatment of heroin addiction?
Why is prochlorperazine sometimes administered with opiate drugs?
Pentazocine may precipitate withdrawal symptoms in a morphine addict. Why?
Why does naloxone affect the efficacy of acupuncture in the control of pain?
Suggest why football players have been known to continue playing after having cracked a bone, normally a very painful event.
Jack Jobbins, an 8-year-old boy, is prescribed methylphenidate for the treatment of attention deficit disorder (ADD). How would you evaluate Jack to determine whether there is clinical improvement from the treatment?
Differentiate between attention deficit disorder (ADD) and attention deficit hyperactivity disorder(ADHD).
Why do drug abusers commonly take amphetamines?
A common adverse effect of lamotrigine is rash. What patient education would you offer to alleviate the discomfort associated with the rash? (See Table 11.8 in Chapter 11 for assistance.)
Tammy Edsel is a 60-year-old resident in a nursing home. She has recently suffered a series of strokes. She has developed spasticity of the right arm. Tammy is taking dantrolene for the spasticity and is suffering from severe diarrhoea. What action would you take in this situation?
Leonora Alexandro is a 40-year-old patient with multiple sclerosis. After commencement on orphenadrine, she complains to you about developing a dry mouth. What action would you take?(See Table 11.9 in Chapter 11 for assistance.)
Francis McHenry, 53 years old, has developed partial seizure epilepsy as a consequence of a serious head injury. His seizures have not been controlled well with carbamazepine and sodium valproate.His doctor adds lamotrigine and later gabapentin to his therapy. His seizures are now controlled
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