A nurse is caring for a client who is receiving high-dose metalopramide. The nurse should monitor the client for which of the following adverse effects?
Black stools
Dry cough
Oral candidias
Tardive dyskinesia
The Correct Answer is D
A) Black stools: While black stools can be a potential side effect of gastrointestinal bleeding, it is not commonly associated with high-dose metoclopramide. This side effect is more commonly seen with medications such as aspirin or NSAIDs. Therefore, it is not the most pertinent adverse effect to monitor for with high-dose metoclopramide.
B) Dry cough: Dry cough is not a typical adverse effect of metoclopramide. Cough is more commonly associated with medications such as ACE inhibitors. Therefore, it is not the primary adverse effect to monitor for with high-dose metoclopramide.
C) Oral candidiasis: While oral candidiasis (oral thrush) can occur as a side effect of some medications, it is not commonly associated with metoclopramide. Oral candidiasis is more frequently seen with corticosteroids or antibiotics. Therefore, it is not the primary adverse effect to monitor for with high-dose metoclopramide.
D) Tardive dyskinesia: Tardive dyskinesia is a serious adverse effect associated with prolonged use of edicaopramide, especially at high doses. It is characterized by involuntary, repetitive movements of the face, tongue, or other parts of the body. Monitoring for signs and symptoms of tardive dyskinesia, such as repetitive facial grimacing or tongue protrusion, is crucial when administering high-dose metoclopramide to prevent this potentially irreversible condition. Therefore, this is the correct adverse effect to monitor for in clients receiving high-dose metoclopramide.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Respirations deep at a rate of 10/min: This finding indicates respiratory depression, which is a significant concern with morphine administration. Respiratory depression can lead to hypoxia and respiratory arrest, posing a life-threatening situation for the client. Therefore, it is the priority finding that requires immediate intervention, such as reducing the dose of morphine, administering naloxone (an opioid antagonist), or providing respiratory support.
B) Urinary output of 20 mL within 1 hr: While decreased urinary output may indicate potential renal impairment or dehydration, it is not as immediately life-threatening as respiratory depression. However, it should still be monitored and addressed appropriately.
C) Vomiting 30 mL of fluid: Vomiting can be a side effect of morphine but may not require immediate intervention unless it leads to aspiration or dehydration. Nonetheless, it should be closely monitored for complications.
D) Blood pressure 90/60 mm Hg: Hypotension can occur as a side effect of morphine due to its vasodilatory effects. While low blood pressure should be addressed, it is not as immediately life-threatening as respiratory depression. Monitoring and appropriate interventions, such as fluid administration or adjusting the dose of morphine, can be implemented to manage hypotension.
Correct Answer is B
Explanation
A) Administer the insulin within 20 min of preparing it: This statement is incorrect. Insulin should be administered immediately after mixing short-acting insulin with NPH insulin, but the 20-minute time frame is not accurate. It's crucial to follow the specific instruc’ions provided by the healthcare provider or the manufacturer for timing of administration.
B) Inject air into the vial to withdraw the short-acting insulin: This is the correct action. When mixing short-acting insulin with NPH insulin from two vials, the nurse should first inject air into the NPH insulin vial, withdraw the correct dose of air into the syringe, and then inject the air into the short-acting insulin vial. This prevents the creation of a vacuum in the vial and facilitates easier withdrawal of the medication.
C) Use two separate syringes to mix the insulin: Using two separate syringes is unnecessary and may increase the risk of dosing errors or contamination. Mixing insulin from two vials can be done using a single syringe by following proper aseptic technique and the correct sequence of steps.
D) Ensure the NPH insulin is drawn into the syringe first: This statement is incorrect. When mixing short-acting insulin with NPH insulin, the short-acting insulin should be drawn into the syringe first, followed by the NPH insulin. Drawing the NPH insulin first could lead to contamination of the short-acting insulin vial with NPH insulin, potentially altering its pharmacological properties.
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