A client is receiving tamsulosin for the management of urinary retention due to benign prostatic hyperplasia (BPH), Which instruction is most important for the nurse to provide?
Use a twice a week dosing schedule.
Take the medication early in the day.
Stand and sit up slowly.
Reduce daily fluid intake.
The Correct Answer is C
A) Tamsulosin is typically administered once daily, not on a twice-weekly dosing schedule. Instructing the client to adhere to the prescribed dosing frequency is essential for maintaining therapeutic blood levels of the medication and optimizing its effectiveness in managing urinary retention associated with benign prostatic hyperplasia (BPH).
B) While the timing of medication administration can impact its effectiveness, taking tamsulosin early in the day versus later in the day may not significantly affect its therapeutic action. The key consideration with tamsulosin is to maintain consistency in timing to ensure a steady plasma concentration of the drug.
C) Instructing the client to stand and sit up slowly is crucial because tamsulosin, as an alpha-blocker, can cause orthostatic hypotension, especially when first starting the medication or when increasing the dosage. By advising the client to change positions slowly, the nurse helps prevent falls and dizziness, which are common side effects associated with sudden drops in blood pressure.
D) Reducing daily fluid intake is not advisable, especially for a client with urinary retention. Maintaining adequate hydration is essential for overall health and urinary function. Tamsulosin works by relaxing the smooth muscles of the prostate and bladder neck, facilitating urine flow, but it does not directly affect fluid intake requirements.
Therefore, the most important instruction for the nurse to provide is to stand and sit up slowly to minimize the risk of orthostatic hypotension and associated complications.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A) Bronchitis: Methylphenidate, a central nervous system stimulant, is not contraindicated in clients with bronchitis. While caution may be warranted in individuals with respiratory conditions due to potential stimulant effects, bronchitis alone does not necessitate specific precautions or contraindications for methylphenidate use.
B) Diabetes mellitus: Methylphenidate use does not typically pose significant risks for individuals with diabetes mellitus. While stimulant medications may affect appetite and blood glucose levels, they are not contraindicated in clients with diabetes. Monitoring blood glucose levels may be prudent, but it is not the primary concern when reviewing the medical record before administering methylphenidate.
C) Hypertension: Reviewing the medical record for hypertension is essential before administering methylphenidate. Stimulant medications like methylphenidate can increase heart rate and blood pressure, potentially exacerbating hypertension or cardiovascular conditions. Clients with uncontrolled hypertension may require dose adjustments or alternative treatments to mitigate cardiovascular risks associated with methylphenidate use.
D) Hypercholesterolemia: Methylphenidate is not contraindicated in clients with hypercholesterolemia. While stimulant medications may have minor effects on lipid profiles, they are not typically considered significant enough to warrant specific precautions or contraindications in individuals with hypercholesterolemia.
Correct Answer is B
Explanation
A) Decreased blood urea nitrogen (BUN) is not a typical adverse effect of gentamicin. Gentamicin is primarily associated with nephrotoxicity (kidney damage), which would manifest as an increased BUN and serum creatinine rather than a decrease.
B) Hearing loss is a well-known adverse effect of gentamicin, particularly when the drug reaches high concentrations in the inner ear (ototoxicity). Gentamicin can cause irreversible damage to the cochlear and vestibular organs, leading to sensorineural hearing loss and balance disturbances.
C) Reports of photophobia are not typically associated with gentamicin. Photophobia (sensitivity to light) may occur with certain eye conditions or central nervous system disorders but is not a direct adverse effect of gentamicin.
D) A white blood cell count of 6,000/mm3 falls within the normal reference range, so it does not indicate an adverse effect of gentamicin. Gentamicin is not known to directly affect white blood cell count.
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