Nokea
A client is receiving corticosteroids at a health care facility. The client is also receiving digoxin as treatment for heart failure. The nurse understands that which of the following is a possibility due to the interaction of these two drugs?
- A. Increased risk for toxicity
- B. Decreased muscle function
- C. Increased risk of hyperkalemia
- D. Decreased serum corticosteroid levels
Correct Answer: A
Rationale: The nurse should observe for an increased risk for digoxin toxicity when corticosteroids are given with digoxin. Decreased muscle function, hyperkalemia, and decreased serum corticosteroid levels are not associated with the interaction.
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A nurse is assessing a client who is receiving desmopressin therapy and suspects that the client is experiencing water intoxication. Which of the following would support the nurse's suspicions? Select all that apply.
- A. Drowsiness
- B. Headache
- C. Confusion
- D. Abdominal pain
- E. Diarrhea
Correct Answer: A,B,C
Rationale: Symptoms of water intoxication include drowsiness, listlessness, confusion, and headache (which may precede convulsions and coma). Abdominal pain and diarrhea are not associated with water intoxication.
A nurse is caring for a client with nocturnal enuresis. A physician has prescribed desmopressin acetate to the client. The nurse would assess the client for which of the following as a possible adverse reaction?
- A. Nasal congestion
- B. Breast tenderness
- C. Fluid retention
- D. Gynecomastia
Correct Answer: A
Rationale: The nurse should monitor for nasal congestion, abdominal cramps, headache, and nausea in the client as the adverse reactions to desmopressin acetate. When the client is administered gonadotropin, the nurse needs to monitor for fluid retention and gynecomastia as the adverse reactions to the drug. When choriogonadotropin alfa is administered to the client, the nurse should monitor for breast tenderness, ovarian overstimulation, and vasomotor flushes as the adverse reactions to the drug.
A nurse is educating a client and his family about vasopressin (DDAVP) for the treatment of diabetes insipidus. In addition to administration instructions, which of the following should the nurse discuss with the client and family? Select all that apply.
- A. Wearing a medical alert bracelet
- B. Monitoring the daily intake of fluids
- C. Avoiding sun exposure while using the drug
- D. Carrying extra doses with the client at all times
- E. Carrying liquids with the client at all times
Correct Answer: A,B,D,E
Rationale: In addition to administration instructions, the nurse should include the following: wear a medical alert bracelet, monitor the daily intake and output of fluids, avoid the use of alcohol, and carry extra doses and liquids with the client at all times.
The nurse should discontinue therapy and notify the physician if which of the following adverse reactions occurs in a client taking gonadotropin (Menopur).
- A. Abdominal pain
- B. Visual disturbances
- C. Auditory disturbances
- D. Ascites
Correct Answer: B
Rationale: If the patient complains of visual disturbances, the drug therapy is discontinued and the primary health care provider notified. An examination by an ophthalmologist is usually indicated. Abdominal pain and ascites are adverse reactions that may or may not require discontinuation of the drug. Auditory disturbances are not associated with this drug.
The nurse should educate a client receiving adrenocorticotropic hormone (ACTH) to report which of the following to the health care provider? Select all that apply.
- A. Malaise
- B. Sores that don't heal
- C. Otic irritation
- D. Fever
- E. Diarrhea
Correct Answer: A,B,D
Rationale: The nurse instructs a client receiving adrenocorticotropic hormone (ACTH) to report any of the following adverse reactions to the physician: sore throat, cough, fever, malaise, sores that don't heal, or redness or irritation of the eyes.