A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement?

Frequently assess the patient's blood pressure.

Observe the client for signs of gastric irritation.

Monitor electrocardiogram (ECG) continuously.

Assess for changes in level of consciousness.

Answer and Explanation

The Correct Answer is C

A. Frequently assess the client’s blood pressure: While monitoring blood pressure is important, it is not as critical as monitoring the ECG in cases of diltiazem overdose. Diltiazem is a calcium channel blocker that can lead to significant cardiac effects.
B. Observe the client for signs of gastric irritation: This is relevant for some medications, but in the case of diltiazem overdose, the primary concern is the potential for severe cardiac effects rather than gastric irritation.
C. Monitor electrocardiogram (ECG) continuously: Diltiazem overdose can lead to serious cardiac arrhythmias, such as bradycardia, AV block, or other conduction disturbances. Continuous ECG monitoring is crucial to detect these potentially life-threatening complications.
D. Assess for changes in level of consciousness: While important, changes in level of consciousness are secondary to the immediate need to monitor cardiac function closely in the context of diltiazem overdose.

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Correct Answer is A

Explanation

A) Coronary artery disease: It is crucial to assess for a history of coronary artery disease (CAD) before administering sumatriptan, as the medication is a serotonin receptor agonist that can cause vasoconstriction of coronary arteries. This can increase the risk of serious cardiovascular events, such as heart attack or stroke, particularly in clients with preexisting CAD.

B) Seasonal allergic rhinitis: While seasonal allergic rhinitis may be a concern for other medications due to potential allergic reactions or interactions, it is not directly related to the administration of sumatriptan. This condition does not pose a significant risk with the use of sumatriptan.

C) Type 2 diabetes mellitus: Although type 2 diabetes mellitus is an important consideration in the overall health management of a client, it is not the most critical condition to assess before administering sumatriptan. However, if the client has diabetes with associated complications like cardiovascular disease, this would increase concern for using sumatriptan.

D) Irritable bowel syndrome: Irritable bowel syndrome (IBS) is a gastrointestinal disorder that typically does not influence the decision to administer sumatriptan. While IBS may affect a client’s comfort or medication regimen, it does not present the same immediate risks as coronary artery disease when using sumatriptan.

A. Gout. B. Sepsis. C. Myocardial infarction. D. Rheumatoid arthritis.

Correct Answer is C

Explanation

A. Gout: Aspirin is not typically used for treating gout. Gout is commonly treated with medications like allopurinol or colchicine, and nonsteroidal anti-inflammatory drugs (NSAIDs) are used selectively.
B. Sepsis: Aspirin is not a primary treatment for sepsis. Sepsis is usually treated with antibiotics, fluid resuscitation, and supportive care.
C. Myocardial infarction: Aspirin is beneficial for preventing further myocardial infarctions (heart attacks) in patients with a history of cardiovascular events or at high risk. It works by inhibiting platelet aggregation, thereby reducing the risk of blood clot formation that can lead to heart attacks.
D. Rheumatoid arthritis: Although aspirin can be used for symptomatic relief in rheumatoid arthritis due to its anti-inflammatory properties, it is not the primary treatment. Other medications, such as disease-modifying antirheumatic drugs (DMARDs) and nonsteroidal anti-inflammatory drugs (NSAIDs), are typically used.

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A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement?

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