Adverse Effects And Allergic Reactions - NCLEX Pn
- What adverse effect of warfarin requires immediate provider notification?
- Bleeding (hematuria, melena, uncontrolled bruising). Warfarin inhibits vitamin K-dependent clotting factors, increasing bleeding risk that necessitates urgent intervention to prevent hemorrhage.
- Which medication class commonly causes photosensitivity as an adverse effect?
- Tetracyclines. Tetracyclines increase skin sensitivity to UV light, leading to exaggerated sunburn reactions due to their phototoxic properties.
- Which symptom most strongly suggests a true penicillin allergy rather than a common side effect?
- Urticaria or wheezing. These symptoms indicate an IgE-mediated hypersensitivity reaction, unlike non-immune side effects such as gastrointestinal upset.
- What is angioedema, and why is it dangerous in allergic reactions?
- Deep tissue swelling; can obstruct the airway. Angioedema involves edema in deeper subcutaneous tissues, posing a risk of laryngeal swelling that can lead to fatal asphyxiation.
- What is the hallmark adverse effect of aminoglycosides that requires monitoring?
- Ototoxicity and nephrotoxicity. Aminoglycosides are known for damaging the ears and kidneys through direct toxicity to these organs, requiring regular monitoring of hearing and renal function.
- Which adverse effect is expected with nitroglycerin therapy and should be anticipated?
- Headache and hypotension. Nitroglycerin causes vasodilation, resulting in these symptoms as part of its therapeutic mechanism for angina relief.
- Which finding is most concerning for nephrotoxicity from a medication?
- Decreased urine output. Nephrotoxicity impairs renal filtration, leading to oliguria as an early indicator of kidney damage from medications.
- What is the most serious cutaneous adverse drug reaction with blistering and mucosal involvement?
- Stevens-Johnson syndrome/toxic epidermal necrolysis. Stevens-Johnson syndrome and toxic epidermal necrolysis are severe hypersensitivity reactions causing widespread skin and mucosal necrosis.
- What is the priority nursing action when Stevens-Johnson syndrome is suspected?
- Stop the suspected drug and notify the provider immediately. Immediate discontinuation of the offending drug is essential to halt progression of this potentially fatal hypersensitivity reaction.
- What is the first nursing action if a transfusion reaction is suspected?
- Stop transfusion, keep IV open with normal saline using new tubing. Halting the transfusion prevents further antigen exposure, and saline maintains vascular access without introducing additional risks.
- What is the most reliable early sign of an acute transfusion reaction during blood administration?
- Fever and chills with anxiety or back/chest pain. These symptoms indicate a hemolytic or febrile non-hemolytic reaction due to immune incompatibility during transfusion.
- Which symptom indicates a serious adverse effect of antipsychotics requiring urgent evaluation?
- Neuroleptic malignant syndrome (fever, rigidity, altered mental status). Neuroleptic malignant syndrome is a life-threatening reaction to antipsychotics involving dopamine blockade, leading to hyperthermia and muscle rigidity.
- Which adverse effect is most important to monitor with ACE inhibitors such as lisinopril?
- Angioedema (face, lips, tongue swelling). ACE inhibitors can inhibit bradykinin degradation, leading to angioedema that may compromise the airway.