Nokea
A client in the initial phase of gout is prescribed colchicine. After administering the drug, the nurse would continue to monitor the client for which of the following?
- A. Stomatitis
- B. Stevens-Johnson syndrome
- C. Bone marrow depression
- D. Exfoliative dermatitis
Correct Answer: C
Rationale: The nurse needs to closely monitor the client for bone marrow depression, an adverse reaction of colchicine. Stomatitis, Stevens-Johnson syndrome, and exfoliative dermatitis are not adverse reactions of colchicine. Stomatitis is an adverse reaction of immunosuppressive drugs. Stevens-Johnson syndrome and exfoliative dermatitis are adverse reactions of allopurinol.
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A client is receiving hydroxychloroquine. Which of the following adverse reactions should the nurse immediately report to the primary health care provider? Select all that apply.
- A. Diarrhea
- B. Tinnitus
- C. Fever
- D. Visual changes
- E. Nausea
Correct Answer: B,C,D
Rationale: The nurse should report any of the following adverse reactions to the physician immediately if observed in a client taking hydroxychloroquine (Plaquenil): skin rash, fever, cough, easy bruising, visual changes, tinnitus, or hearing loss.
A nurse would monitor a client closely for increased CNS depressant effects when a skeletal muscle relaxant is used concomitantly with which of the following? Select all that apply.
- A. Antihistamine
- B. Oral contraceptives
- C. Alcohol
- D. Opiates
- E. Antidiabetic medications
Correct Answer: A,C,D
Rationale: The concomitant use of skeletal muscle relaxants and antihistamines, alcohol, opiates, or sedatives can result in increased CNS depressant effects.
A client with gout has not responded to the usual medications. The primary health care provider prescribes a pegloticase infusion. Based on the nurse's understanding of this drug, which nursing diagnosis would be most appropriate?
- A. Risk for Injury
- B. Acute Pain
- C. Impaired Comfort: Gastric Distress
- D. Risk for Allergic Response
Correct Answer: D
Rationale: When first-line treatments for gout are not successful, sometimes drugs that are more toxic may be prescribed, such as the pegloticase infusion. During the infusion the patient is closely monitored for the development of adverse reactions, in particular anaphylaxis. Should an anaphylactic reaction occur, the infusion center staff members are prepared to start resuscitative measures as emergency personnel are notified.
The primary health care provider prescribes adalimumab. The nurse would prepare to administer this drug by which route?
- A. Orally
- B. Intramuscularly
- C. Subcutaneously
- D. Intravenously
Correct Answer: C
Rationale: Adalimumab, a DMARD, is administered by subcutaneous injection. Abatacept and infliximab are examples of DMARDs that are administered IV. Methotrexate, sulfasalazine, and leflunomide are examples of DMARDs that can be given orally.
After teaching a client receiving leflunomide, the nurse determines that the teaching was successful when the client identifies which of the following as a possible adverse reaction? Select all that apply.
- A. Alopecia
- B. Hypotension
- C. Diarrhea
- D. Nystagmus
- E. Hematuria
Correct Answer: A,C
Rationale: Adverse reactions to leflunomide include hypertension, alopecia, rash, nausea, and diarrhea.