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A nurse is caring for a client with many different medications who is newly prescribed acetazolamide.
What medications can interact with acetazolamide?
ï‚· High-dose aspirin (metabolic acidosis)
ï‚· Quinidine (can increase risk of toxic effects)
o Instruct client to notify provider of concurrent use and to watch for indications of toxicity,
such as decreased heart rate
ï‚· Lithium (decrease blood levels)
o Teach clients to watch for increased indications of mania. Monitor lithium levels regularly
ï‚· Phenytoin (increase osteomalacia)
o Teach clients to watch for bone pain or weakness and report symptoms to provider
ï‚· Sodium bicarbonate (increases risk of kidney stones)
o Question clients about use of sodium bicarbonate and other OTC antacids
A nurse is preparing to administer ipratropium by metered dose inhaler. What adverse effects should the
nurse instruct the client to monitor for?
ï‚· Local anticholinergic effects (dry mouth, hoarseness)
o Advise client to sip fluids and suck on sugar-free hard candies to control dry mouth
A client has a new prescription for salmeterol. The nurse is teaching the client about adverse effects of the
medication. What instructions should the nurse include in thus education?
ï‚· Tachycardia, angina
o Advise client to observe for chest, jaw or arm pain/palpitations and to notify provider if
they occur
o Instruct to check pulse and to report an increase of greater than 20-30/bpm
o Advise to avoid caffeine
o Dosage might need to be reduced
ï‚· Tremors
o Usually resolve with continued medication use
o Dosage might need to be reduced
A nurse is caring for a client prescribed the inhaled glucocorticoid beclomethasone (QVAR) for the
treatment of asthma. What is a potential adverse effect of this medication and what are two (2) teaching
points to discuss to address these adverse effects?
ï‚· Difficulty speaking, hoarseness, candidiasis
o Advise client to rinse mouth or gargle with water after use
o Advise client to monitor for redness, sores, or white patches and to report to provider if
they occur. Treat candidiasis with nystatin oral suspension
A client has a new prescription for an albuterol inhaler and a beclomethasone inhaler. What instructions
should the nurse include concerning use of these inhalers?
ï‚· Advise client to inhale the beta2-agonist (albuterol) BEFORE inhaling the glucocorticoid
(beclomethasone). The beta2-agonist promotes bronchodilation and enhances absorption of the
glucocorticoid
A nurse is administering gemfibrozil to a client with elevated cholesterol. Identify two (2) adverse effects
related to this medication.
ï‚· GI distress
ï‚· Gallstones
o Advise to observe for indications of gallbladder disease ( RUQ aches, pain, fat intolerance,
bloating)
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