A nurse is caring for a client who is receiving neostigmine. Which of the following manifestations should the nurse identify as an adverse reaction to the medication? (Select all that apply.)
Hypoactive bowel sounds
Sweating
Respiratory distress
Urinary retention
Bradycardia
Correct Answer : B,C,E
Neostigmine is a medication classified as an acetylcholinesterase inhibitor. It is commonly used to treat myasthenia gravis and to reverse the effects of non-depolarizing neuromuscular blocking agents used during surgery. Adverse reactions to neostigmine are related to its cholinergic effects, which result from increased acetylcholine levels in the body.
Let's go through the options:
A. Hypoactive bowel sounds: Neostigmine can actually increase gastrointestinal motility and may cause increased bowel sounds or even diarrhea, not hypoactive bowel sounds. Therefore, hypoactive bowel sounds are not an adverse reaction to neostigmine.
B. Sweating: Sweating is a cholinergic effect and can be an adverse reaction to neostigmine. Increased sweating is a common sign of cholinergic stimulation.
C. Respiratory distress: Respiratory distress can occur as an adverse reaction to neostigmine, particularly if the client has a history of asthma or other respiratory conditions. Neostigmine can cause bronchoconstriction and excessive secretions, leading to respiratory distress.
D. Urinary retention: Neostigmine is actually used to treat urinary retention by increasing bladder contraction. Therefore, urinary retention is not an adverse reaction to neostigmine.
E. Bradycardia: Bradycardia (slow heart rate) is a significant adverse reaction to neostigmine due to its cholinergic effects on the heart. Increased acetylcholine levels can lead to excessive stimulation of the vagus nerve, resulting in bradycardia.
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Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A client with a magnesium level of 3.2 mEq/L has a higher-than-normal magnesium level, indicating hypermagnesemia. The nurse should expect to administer calcium gluconate.
Calcium gluconate is the antidote for hypermagnesemia, as it works to antagonize the effects of magnesium on the body. By administering calcium gluconate, the nurse can help counteract the effects of excess magnesium and normalize the client's magnesium levels.
Let's go through the other options:
B. Calcitonin: Calcitonin is not used to treat hypermagnesemia. Calcitonin is a hormone that regulates calcium and phosphorus levels in the body. It is used in certain conditions, such as hypercalcemia (high calcium levels), but it is not indicated for hypermagnesemia.
C. Magnesium oxide: Magnesium oxide is a form of magnesium supplement, and it is not appropriate for a client with hypermagnesemia, as it would further increase the magnesium level, exacerbating the condition.
D. Magnesium sulphate: Magnesium sulfate is also not appropriate for a client with hypermagnesemia, as it would further elevate the magnesium levels in the body. Magnesium sulfate is often used to treat magnesium deficiency or as a tocolytic agent to prevent premature labor.
Correct Answer is D
Explanation
The nurse should report to the provider that the client is taking ginkgo biloba. Ginkgo biloba is an herbal supplement that can interact with clopidogrel and other antiplatelet medications. It may increase the risk of bleeding when taken concurrently with clopidogrel, which is an antiplatelet medication used to prevent blood clots after coronary artery stenting.
Let's go through the other options:
A. The client is taking acetaminophen: Acetaminophen is not known to have significant interactions with clopidogrel. It is a commonly used pain reliever and fever reducer and does not usually affect the antiplatelet activity of clopidogrel.
B. The client is taking valerian: Valerian is an herbal supplement often used as a sleep aid or to reduce anxiety. While there is limited evidence of significant interactions with clopidogrel, it is generally recommended to use caution when combining valerian with antiplatelet medications. However, it is not as concerning as ginkgo biloba in terms of potential bleeding risk.
C. The client is taking vitamin B6: Vitamin B6 is a water-soluble vitamin and is not expected to have significant interactions with clopidogrel. It is generally considered safe to use vitamin B6 with antiplatelet medications like clopidogrel.
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