A nurse is caring for a client who is prescribed diphenhydramine to relieve pruritus. The client asks the nurse how he can minimize the daytime sedation he is experiencing. Which of the following responses should the nurse give?
"Distribute the doses evenly throughout the day!"
"Gradually decrease the dose once tolerance to the effect is reached."
"Take the medication with meals."
"Take most of the daily dose at bedtime."
The Correct Answer is D
Diphenhydramine is an antihistamine medication that can cause sedation as a side effect. Taking most of the daily dose at bedtime can help minimize daytime sedation. By taking the medication closer to bedtime, the sedative effects are more likely to occur during sleep, reducing the impact of sedation during waking hours.
The other options mentioned are not effective strategies to minimize daytime sedation caused by diphenhydramine:
A. "Distribute the doses evenly throughout the day": This approach may lead to a consistent level of sedation throughout the day and may not effectively minimize daytime sedation.
B. "Gradually decrease the dose once tolerance to the effect is reached": Gradually decreasing the dose of diphenhydramine is not a recommended strategy for minimizing daytime sedation. It is important to follow the prescribed dose and consult with a healthcare provider before making any changes to the medication regimen.
C. "Take the medication with meals": Taking diphenhydramine with meals may help reduce the risk of stomach upset but does not directly address the issue of daytime sedation.
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Naxlex Comprehensive Predictor Exams
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Correct Answer is C
Explanation
Prednisone is a corticosteroid medication commonly used to treat asthma and other inflammatory conditions. When taken for a prolonged period at higher doses, it can suppress the body's natural production of cortisol, a hormone produced by the adrenal glands. Abruptly stopping prednisone after long-term use can lead to adrenocortical insufficiency, also known as adrenal insufficiency or adrenal crisis.
Adrenocortical insufficiency occurs because the body's adrenal glands need time to resume normal cortisol production after being suppressed by prednisone. Gradually reducing the dose of prednisone allows the adrenal glands to gradually increase their cortisol production, minimizing the risk of adrenal insufficiency.
Rebound pulmonary congestion, hyperglycemia, and severe dehydration are not specific adverse effects associated with discontinuing prednisone. However, it is important for clients who have been taking prednisone to follow their healthcare provider's instructions regarding the tapering schedule and any potential risks or side effects.
Correct Answer is C
Explanation
A medication error refers to any preventable event that may cause or lead to inappropriate medication use or patient harm. In this case, the nurse administering a double dose of medication due to a failure to cut the pill in half is a medication error. It involves the administration of an incorrect dose, which can potentially result in harm or adverse effects for the patient.
The other situations mentioned do not necessarily indicate medication errors. A patient developing hives after starting an IV antibiotic could have an allergic reaction, and appropriate actions should be taken to address the reaction. A patient complaining of severe pain still present after receiving pain medication may require further assessment and intervention to manage their pain effectively. A patient refusing her morning medication is not a medication error but rather a patient's right to refuse treatment, and appropriate documentation and communication should be done in such situations.
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