When administering Phenytoin you should monitor?

Correct Answer: D

Rationale: In pharmacology, when administering Phenytoin, monitoring is crucial to ensure patient safety and effectiveness of treatment. The correct answer, "D) all of the above," is the most appropriate choice because monitoring all aspects listed - behavior, therapeutic blood levels, and for Steven Johnson syndrome - is essential in the care of a patient receiving Phenytoin. Monitoring behavior is important because Phenytoin can impact mood and cognition, so any changes in behavior could indicate a need for dosage adjustment or further evaluation. Monitoring therapeutic blood levels is critical as Phenytoin has a narrow therapeutic range, and levels outside this range can lead to toxicity or lack of efficacy. Monitoring for Steven Johnson syndrome is necessary as it is a severe, though rare, adverse reaction associated with Phenytoin that requires immediate intervention. Options A, B, and C are incorrect on their own because they each address only one aspect of monitoring Phenytoin administration. Focusing solely on behavior, blood levels, or Steven Johnson syndrome would be insufficient and could lead to missed opportunities for intervention or adverse outcomes. In an educational context, understanding the comprehensive monitoring requirements for medications like Phenytoin is vital for nursing students and practicing nurses. It emphasizes the importance of holistic patient care, pharmacological knowledge, and vigilance in recognizing and responding to potential complications. By mastering this concept, nurses can ensure safe medication administration and promote positive patient outcomes in clinical practice.

Correct Answer: C

Rationale: Antacids or antidiarrheals should be avoided for at least 4 hours after taking digoxin. These medications can interfere with the absorption of digoxin in the body, thereby reducing its effectiveness. By spacing out the administration of these medications, the risk of decreased digoxin absorption and potential impact on its therapeutic effects can be minimized. It is important for patients to follow this guidance to ensure optimal effectiveness of digoxin therapy.

Correct Answer: D

Rationale: The placenta is not a site for drug metabolism. Drug metabolism primarily occurs in the liver, gastrointestinal tract (GIT), skin, and kidney. The placenta serves as a barrier between the mother and fetus and is involved in nutrient and waste exchange but does not play a significant role in drug metabolism processes.

Correct Answer: B

Rationale: The ulcerogenic properties of aspirin are primarily caused by the inhibition of prostaglandin synthesis, particularly through the inhibition of the enzyme cyclooxygenase-1 (Cox-1). Prostaglandins play a crucial role in maintaining the protective mucus barrier in the stomach lining. When prostaglandin synthesis is inhibited, this protective barrier is compromised, leading to increased susceptibility to damage from the acidic gastric environment. The drug's acidity itself (Choice A), by irritating the stomach lining, can contribute to ulcer formation. Thromboxane inhibition (Choice B) is not directly related to the ulcerogenic properties of aspirin but is more associated with the drug's antiplatelet effects. Cox-1 inhibition (Choice D) is a key factor in aspirin-induced gastrointestinal injury as it disrupts the normal mucosal defense mechanisms.

Correct Answer: D

Rationale: St. John's wort is an herbal supplement that can interact with many medications, including venlafaxine (Effexor). When taken together, it can decrease the effectiveness of venlafaxine by increasing its metabolism, potentially leading to reduced therapeutic effects. This interaction can also increase the risk of side effects or adverse reactions. Therefore, the nurse should be concerned about the ingestion of St. John's wort when a patient is taking venlafaxine to ensure proper medication management and effectiveness. It is important for patients to inform healthcare providers about all supplements they are taking to prevent harmful interactions.