A client with seasonal allergies takes diphenhydramine at bedtime to help their symptoms. The client develops low hemoglobin low white blood cell counts which is otherwise unexplained. What type of reaction is the client experiencing?
Hypersensitivity reaction
Paradoxical reaction
Idiosyncratic reaction
Anti-cholinergic reaction
The Correct Answer is C
A) Hypersensitivity reaction: A hypersensitivity reaction typically involves an immune response where the body reacts to a substance as if it were harmful, leading to symptoms like rashes, swelling, or difficulty breathing. However, low hemoglobin and low white blood cell counts are not typical signs of a hypersensitivity reaction. This would involve more common allergic symptoms like itching or swelling, rather than hematologic changes.
B) Paradoxical reaction: A paradoxical reaction refers to when a medication causes an effect opposite to the expected result. For example, a sedative causing agitation instead of sleepiness. While a paradoxical reaction can involve unexpected effects, the hematologic changes (low hemoglobin and white blood cell counts) in this scenario do not align with this type of response.
C) Idiosyncratic reaction: An idiosyncratic reaction is an unusual or unexpected response to
a medication that is not related to the drug's pharmacologic properties or the dose given. It may be related to genetic factors or other individual differences in how a person metabolizes or responds to the drug. The low hemoglobin and low white blood cell counts in this case are unusual effects of diphenhydramine and suggest an idiosyncratic response, where the client’s body is reacting in an unexpected way to the medication.
D) Anti-cholinergic reaction: Anti-cholinergic reactions are typically related to symptoms caused by the blocking of acetylcholine, such as dry mouth, blurred vision, urinary retention, or constipation. While diphenhydramine has anti-cholinergic properties, the symptoms described (low hemoglobin and white blood cell counts) are not typical of an anti-cholinergic reaction.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["250"]
Explanation
Identify the total volume:
The client is ordered to receive 1000 mL of 0.9% saline.
Identify the infusion time:
The infusion time is 4 hours.
Set up the calculation:
We need to find out the IV pump rate in mL/hr. We can use the following formula:
(Total volume) / (Infusion time) = IV pump rate
4. Plug in the values and calculate:
(1000 mL) / (4 hours) = 250 mL/hr
Correct Answer is D
Explanation
A) Polyethylene Glycol: Polyethylene glycol is a medication typically used to treat constipation by promoting bowel movements. While it can be useful in managing constipation, it is not commonly prescribed after a myocardial infarction. In this situation, the focus is more on medications that promote heart health, reduce cardiac workload, and prevent complications related to the heart attack.
B) Bisacodyl: Bisacodyl is a stimulant laxative used to relieve constipation. However, this medication is not typically prescribed immediately following a myocardial infarction. Stimulant laxatives can cause dehydration and excessive fluid shifts, which can be harmful to a client recovering from a heart attack. The focus would be on safer options for bowel management in this context.
C) Senna: Senna is also a stimulant laxative, used for relieving constipation. Similar to bisacodyl, it is not ideal for clients who have recently experienced a myocardial infarction due to its potential for causing dehydration and electrolyte imbalances, which could negatively affect heart function. A gentler approach to bowel management is preferred for these clients.
D) Docusate Sodium: Docusate sodium is a stool softener commonly prescribed to prevent constipation, especially in clients who have recently had a myocardial infarction. After a heart attack, it's important to avoid straining during bowel movements, as this could increase pressure on the heart. Docusate sodium helps soften stools and promotes smoother bowel movements without stimulating the gastrointestinal system in a way that would elevate cardiac stress. It is the most appropriate choice for this client.
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