Nokea
A patient is on vitamin D supplemental therapy. The nurse will monitor for which signs of toxicity during this therapy?
- A. Tinnitus
- B. Anorexia
- C. Diarrhea
- D. Hypotension
Correct Answer: B
Rationale: The toxic effects of vitamin D are those associated with hypercalcemia, such as weakness, fatigue, headache, anorexia, dry mouth, metallic taste, nausea, vomiting, abdominal cramps, ataxia, and bone pain. If not recognized and treated, these symptoms can progress to impairment of renal function and osteoporosis. The other options listed are not signs of vitamin D toxicity.
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A patient will be starting vitamin D supplements. The nurse reviews his medical record for contraindications, including which condition?
- A. Renal disease
- B. Cardiac disease
- C. Hypophosphatemia
- D. There are no contraindications to vitamin D supplements
Correct Answer: A
Rationale: Contraindications to vitamin D products include known allergy to the product, hypercalcemia, renal dysfunction, and hyperphosphatemia.
A patient will be receiving monthly injections of cyanocobalamin. The dose is 100 mcg/month IM. The medication is available in a strength of 1000 mcg/mL. Identify how many milliliters the nurse will draw up into the syringe. (Record answer using one decimal place.)
Correct Answer: 0.1 mL
Rationale: 1000 mcg : 1 mL :: 100 mcg : x mL. (1000 ?? x) = (1 ?? 100); 1000x = 100; x = 0.1 mL.
The nurse will prepare to give which preparation to a newborn upon arrival in the nursery after delivery?
- A. Vitamin B6
- B. Vitamin D
- C. Folic acid
- D. Vitamin K
Correct Answer: D
Rationale: Deficiency in vitamin K can be seen in newborns because of malabsorption attributed to inadequate amounts of bile. AquaMEPHYTON is given as a single intramuscular dose for infants upon arrival in the nursery.
A patient accidentally took an overdose of the anticoagulant warfarin (Coumadin), and the nurse is preparing to administer vitamin K as an antidote. Which statement about vitamin K is accurate?
- A. The vitamin K dose will be given intramuscularly.
- B. The patient will take oral doses of vitamin K after the initial injection.
- C. The vitamin K cannot be given if the patient has renal disease.
- D. The patient will be unresponsive to warfarin therapy for 1 week after the vitamin K is given.
Correct Answer: D
Rationale: When vitamin K is used as an antidote to warfarin therapy, the patient becomes unresponsive to warfarin for approximately 1 week after vitamin K administration. The use of vitamin K products is contraindicated in patients who are in the last few weeks of pregnancy and in patients with severe hepatic disease. Vitamin K is given subcutaneously and not intramuscularly when used to reverse warfarin effects.
The patient asks the nurse about taking large doses of vitamin C to improve her immunity to colds. 'It's just a vitamin, right? What can happen?' Which responses by the nurse are correct? (Select all that apply.)
- A. Vitamin C is harmless because it is a water-soluble vitamin.
- B. Large doses of vitamin C can cause nausea, vomiting, headache, and abdominal cramps.
- C. Keep in mind that if you suddenly stop taking these large doses, you might experience symptoms similar to scurvy.
- D. Studies have shown that vitamin C has little value in preventing the common cold.
- E. Vitamin C acidifies the urine, which can lead to the formation of kidney stones.
- F. Large doses of vitamin C may delay wound healing.
Correct Answer: B,C,D,E
Rationale: Vitamin C is usually nontoxic unless excessive dosages are consumed. Large doses (megadoses) can produce nausea, vomiting, headache, and abdominal cramps, and they acidify the urine, which can result in the formation of kidney stones. Furthermore, individuals who discontinue taking excessive daily doses of ascorbic acid can experience scurvy-like symptoms. Studies have shown that megadoses of vitamin C have little or no value as prophylaxis against the common cold. Vitamin C is required for several important metabolic activities, including collagen synthesis and the maintenance of connective tissue and tissue repair.