A nurse is caring for a client who has major depression and a new prescription for citalopram.
Which of the following adverse effects is the priority for the nurse to report to the provider?

Weight loss.

Confusion.

Bruxism.

Insomnia.

Answer and Explanation

The Correct Answer is B

a. While weight changes can be concerning, they are not typically life-threatening and can occur as a common side effect of antidepressants, including citalopram. Monitoring is important, but it does not require immediate reporting.

b. This is the priority to report because confusion can indicate a serious reaction to the medication, such as serotonin syndrome, especially if it occurs in conjunction with other symptoms like agitation, hallucinations, or rapid heart rate. Confusion can also signal worsening mental status, which is critical for someone with major depression.

c. This refers to teeth grinding, which can occur with certain antidepressants. While it should be monitored and possibly addressed with interventions, it is generally not an immediate concern compared to confusion.

d. Sleep disturbances can be a side effect of citalopram and may need adjustment of treatment or recommendations for sleep hygiene, but they are not as urgent as confusion.

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Correct Answer is A

Explanation

Hyponatremia is a condition where the sodium level in the blood is too low, which can cause confusion, lethargy, seizures, and coma. A hypertonic solution is a fluid that has a higher concentration of solutes than the blood, which can help raise the sodium level and reduce the brain swelling caused by hyponatremia. Therefore, improved cognition indicates that the treatment is effective.

Choice B. Cardiac arrhythmias absent.

Cardiac arrhythmias are not a common symptom of hyponatremia unless it is severe or rapid in onset.

Therefore, their absence does not necessarily indicate that the treatment is effective.

Choice C. Decreased vomiting.

Vomiting can be a cause or a consequence of hyponatremia, depending on the underlying condition.

Decreased vomiting may indicate that the patient is less nauseated, but it does not reflect the sodium level or the brain status.

Choice D. Absent Chvostek’s sign.

Chvostek’s sign is a facial twitching that occurs when tapping on the cheek, which indicates hypocalcemia (low calcium level).

It is not related to hyponatremia or hypertonic solution.

Normal ranges for sodium are 135 to 145 mEq/L and for calcium are 8.5 to 10.5 mg/dL.

A. Discard the medication if it is yellow. B. Use a gravity flow set. C. Prime the tubing with 0.9% sodium chloride. D. Administer the medication over 2 hr.

Correct Answer is D

Explanation

The correct answer is d. Administer the medication over 2 hr.

Choice A reason: Discarding the medication if it is yellow is not necessary. The color of amphotericin B lipid complex does not indicate its effectiveness or safety.

Choice B reason: Using a gravity flow set is not specifically required for the administration of amphotericin B lipid complex. Gravity infusion can be used to administer fluids and drugs where the rate is not critical and serious adverse effects are not anticipated. However, the use of a gravity flow set is not specifically mentioned in the guidelines for administering amphotericin B lipid complex.

Choice C reason: Priming the tubing with 0.9% sodium chloride is not recommended for amphotericin B lipid complex. This is because amphotericin B lipid complex is incompatible with saline solutions and should be diluted only with 5% dextrose injection. Priming the tubing is a common practice in IV therapy to remove air from the tubing before attaching it to the patient.

Choice D reason: Administering the medication over 2 hr is the correct action. Amphotericin B lipid complex is typically administered over a longer period, often 2-6 hours. This allows for a slow and steady delivery of the medication, which can help to minimize potential side effects.

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A nurse is caring for a client who has major depression and a new prescription for citalopram. Which of the following adverse effects is the priority for the nurse to report to the provider?

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Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who has hyponatremia and is receiving an infusion of a prescribed hypertonic solution. Which of the following findings should indicate to the nurse that the treatment is effective?

Correct Answer is A

Explanation

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Correct Answer is D

Explanation

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A nurse is caring for a client who has major depression and a new prescription for citalopram.
Which of the following adverse effects is the priority for the nurse to report to the provider?