Question 26 1 out of 1 points a homeless man who is

 Question 26
1 out of 1 points
A homeless man who is well known to care providers at the local hospital has been admitted
to the emergency department after having a seizure outside a mall. The man is known to be a
heavy alcohol user and is malnourished with a very low body mass index. How are this
patient's characteristics likely to influence possible treatment with phenytoin?
Response
Feedback:
A protein deficit puts the patient at greater risk for having greater amounts of
free, active drug in the blood because less protein albumin is available for
binding than would normally be expected. Alcohol does not compete with
phenytoin for binding sites and the drug is not necessarily contraindicated
with recent alcohol intake, though alcohol does influence the metabolism of
phenytoin. Oral phenytoin would not significantly minimize the risk of
adverse effects.

 Question 27
1 out of 1 points
A nurse is providing care for a patient who suffered extensive burns to his extremities during
a recent industrial accident. Topical lidocaine gel has been ordered to be applied to the
surfaces of all his burns in order to achieve adequate pain control. When considering this
order, the nurse should be aware that
Response
Feedback:
Applying lidocaine preparations to severely traumatized mucosa (large skin
abrasions, eczema, and burns) can increase its absorption, which in turn
increases the risk of systemic toxicity. Intravenous lidocaine is not normally
used for analgesia. The destruction of nerve endings in a burn site does not
mitigate the need for topical pain control and lidocaine does not need to be
potentiated with another anesthetic.
 Question 28
1 out of 1 points
Morphine has been prescribed for a 28-year-old man with severe pain due to a back injury.
The nurse will advise the patient to avoid
Response
Feedback:
The nurse should advise the patient to avoid alcohol and any other CNS
depressants while taking morphine. These combinations can cause serious
respiratory depression and sedation. Vitamin C, fatty foods, and dairy
products are not known to interact with morphine.
 Question 29
1 out of 1 points
Nurs 6521 Pharmacology
A patient has a history of tonic-clonic seizures that have been successfully treated with
phenytoin (Dilantin) for several years. Phenytoin achieves a therapeutic effect by
Response
Feedback:
Phenytoin reversibly binds to sodium channels while they are in the inactive
state. This binding delays the return of the channel to an active state. Because
sodium can enter the cell to initiate an action potential only when the channels
are active, the time between action potentials is greatly lengthened, the
neurons cannot fire at an excessive rate, and excessive muscle contractions
that occur in grand mal-type seizures are prevented. Phenytoin does not
directly affect the function of calcium channels or levels of GABA and
glutamate.

 Question 30
1 out of 1 points
An elderly woman is slated for a hemiarthroplasty (hip replacement surgery) after falling and
breaking her hip on the stairs outside her home. The woman's pain in the time since her injury
has been severe, and her care team has been treating it with morphine. Which of the following
administration schedules is most likely to control the patient's pain?
Response
Feedback:
The use of long-acting analgesia combined with short-acting opioids for
breakthrough pain is a proactive pain management technique that maximizes
therapeutic benefit while minimizing the risks of adverse effects.
 Question 31