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A nurse in a primary care clinic is caring for a client.

Complete the following sentence by using the lists of options.

The client is most at risk for developing

due to their .
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"A"}

  • NSAID use. The client has been taking ibuprofen (an NSAID) twice daily while also receiving prednisone (a corticosteroid) for asthma exacerbation. Both NSAIDs and corticosteroids inhibit prostaglandin production, which normally protects the stomach lining. This combination increases the risk of gastric irritation, peptic ulcers, and gastrointestinal bleeding.
  • Recent immunization. The client received the influenza vaccine three days ago, but this does not significantly increase the risk of infection. The flu shot contains inactivated or weakened virus, meaning it cannot cause the flu. The client’s asthma may increase their risk of complications from the flu, but the vaccine helps reduce this risk rather than increasing it.
  • Weight gain. The client has gained 1.36 kg (3 lb) in one week, which is likely due to fluid retention from prednisone use. While long-term corticosteroid use can lead to Cushing syndrome, this condition develops over weeks to months of high-dose steroid therapy, not within a short period. Therefore, the client is at a higher risk of peptic ulcers rather than Cushing syndrome.
  • Cushing syndrome. Cushing syndrome results from chronic corticosteroid use leading to fat redistribution, muscle weakness, skin thinning, and hyperglycemia. However, this client is on a short-term tapering dose of prednisone, making Cushing syndrome unlikely at this stage.
  • Influenza. Although the client has asthma, which increases the risk of complications from respiratory infections, there is no indication that they have developed the flu. The flu shot helps prevent infection, and there are no reports of fever, body aches, or respiratory symptoms suggestive of influenza.
  • Peptic ulcers. The combination of NSAIDs and corticosteroids significantly increases the risk of peptic ulcer disease by weakening the stomach lining and promoting acid production. The client should be advised to monitor for signs of gastric irritation, such as abdominal pain, black stools, or nausea, and may require a proton pump inhibitor (PPI) like omeprazole for ulcer prevention.


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Related Questions

Correct Answer is D

Explanation

A. Anorexia. Anorexia is a common side effect of sulfasalazine and is usually mild. It occurs due to the drug’s gastrointestinal effects but does not require immediate intervention. Managing symptoms with dietary modifications or taking the medication with food can help alleviate discomfort.

B. Arthralgia. Joint pain (arthralgia) can develop as a side effect of sulfasalazine, sometimes due to a drug-induced lupus-like reaction. Although it can cause discomfort, it is not immediately life-threatening. Monitoring symptoms and adjusting treatment may help manage this condition.

C. Nausea. Nausea frequently occurs with sulfasalazine use and is typically mild. It is often dose-dependent and can be managed by taking the medication with meals. While persistent nausea may require adjustments, it is not a medical emergency.

D. Wheezing. Wheezing suggests a hypersensitivity reaction, which can lead to anaphylaxis, a life-threatening emergency. Sulfasalazine contains a sulfa component, which may trigger bronchospasm, angioedema, or respiratory distress. Immediate intervention, including discontinuing the drug and administering emergency treatment, is necessary.

Correct Answer is C

Explanation

A. Levothyroxine. Levothyroxine is used to treat hypothyroidism and does not have a significant interaction with furosemide. However, both medications require careful monitoring, as hypothyroidism can affect fluid balance, but they are not contraindicated together.

B. Cetirizine. Cetirizine is an antihistamine used to treat allergies and does not interfere with furosemide’s effects. While some antihistamines can cause mild fluid retention, this does not significantly impact furosemide therapy, making them safe to use together.

C. Lithium carbonate. Furosemide is a loop diuretic that increases sodium excretion. Since lithium is excreted through the kidneys in a sodium-dependent manner, a loss of sodium due to diuretic use can lead to reduced lithium excretion and toxic accumulation. Clients taking lithium should avoid diuretics unless absolutely necessary, and their lithium levels must be carefully monitored if diuretics are required.

D. Albuterol. Albuterol is a bronchodilator used for conditions like asthma and COPD. While both furosemide and albuterol can cause hypokalemia, this does not make them absolutely contraindicated. Instead, potassium levels should be regularly monitored, and supplementation may be needed if hypokalemia develops.

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