Nokea
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.
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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.
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.
During an intravenous infusion of magnesium, the nurse carefully monitors the patient for adverse effects. Which of these are adverse effects of intravenous magnesium administration? (Select all that apply.)
- A. Loss of tendon reflexes
- B. Nausea and vomiting
- C. Respiratory distress
- D. CNS depression
- E. Kidney stones
- F. Heart block
Correct Answer: A,C,D,F
Rationale: Adverse effects of magnesium are due to hypermagnesemia, which results in tendon reflex loss, difficult bowel movements, CNS depression, respiratory distress and heart block, and hypothermia. The other options are incorrect.
A patient with a history of alcohol abuse has been admitted for severe weakness and malnutrition. The nurse will prepare to administer which vitamin preparation to prevent Wernicke's encephalopathy?
- A. Vitamin B6
- B. Vitamin B1
- C. Vitamin B12
- D. Folic acid
Correct Answer: B
Rationale: Thiamine (vitamin B1) is necessary for the treatment of a variety of thiamine deficiencies, including Wernicke's encephalopathy. The other options are incorrect.