A nurse is collecting data from a client who is receiving sulfasalazine to treat ulcerative colitis. Which of the following findings should the nurse identify as an indication of an adverse effect of this medication?
Constipation
Tinnitus
Rash
Hypotension
The Correct Answer is C
Sulfasalazine is a disease-modifying anti-inflammatory medication commonly used to treat ulcerative colitis by reducing colonic inflammation. It is metabolized into active components that help suppress the inflammatory response in the gastrointestinal tract. However, because it contains a sulfonamide component, it is associated with hypersensitivity reactions and other systemic adverse effects. Nurses must closely monitor for early signs of allergic response and toxicity to prevent severe complications.
Rationale:
A. Constipation is not a typical adverse effect of sulfasalazine. Ulcerative colitis itself more commonly presents with diarrhea due to colonic inflammation and ulceration. Therefore, constipation would be inconsistent with both the disease process and the expected pharmacologic profile of the medication.
B. Tinnitus is not a known adverse effect of sulfasalazine. It is more commonly associated with medications such as salicylates or certain aminoglycoside antibiotics. Sulfasalazine does not typically affect auditory function, making this finding unrelated to its toxicity profile.
C. Rash is a significant adverse effect of sulfasalazine and may indicate a hypersensitivity reaction due to its sulfonamide component. Skin reactions can range from mild erythema to severe conditions such as Stevens-Johnson syndrome. Early recognition of rash is critical to prevent progression to life-threatening systemic reactions.
D. Hypotension is not commonly associated with sulfasalazine use. The drug does not significantly affect vascular tone or blood pressure regulation. If hypotension is present, it is more likely related to other clinical conditions such as fluid loss, sepsis, or concurrent medication effects rather than this medication.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is ["25"]
Explanation
Calculation:
- Identify the infusion rate and drop factor
Infusion Rate: 100 mL/hr
Drop Factor: 15 gtt/mL
- Convert hours to minutes
1 hour = 60 minutes
- Calculate the flow rate
Flow Rate (gtt/min) = (mL/hr × Drop Factor) ÷ 60
Flow Rate = (100 × 15) ÷ 60
Flow Rate = 1500 ÷ 60
= 25 gtt/min
Correct Answer is {"A":{"answers":"A,B"},"B":{"answers":"A,B"},"C":{"answers":"A"},"D":{"answers":"B"}}
Explanation
Preeclampsia and HELLP syndrome are hypertensive disorders of pregnancy that can present with elevated blood pressure and proteinuria; however, HELLP syndrome is a severe variant characterized by hemolysis, elevated liver enzymes, and low platelets. The client’s findings of severe hypertension, proteinuria, thrombocytopenia, and elevated liver enzymes suggest progression from preeclampsia toward HELLP syndrome. Accurate interpretation of laboratory and clinical findings is critical for preventing maternal and fetal complications.
Rationale:
• Platelet count: Thrombocytopenia can occur in severe preeclampsia due to endothelial damage and platelet consumption. In HELLP syndrome, low platelets are a defining feature because of microangiopathic hemolysis and platelet destruction. The client’s platelet count of 98,000/mm³ indicates significant platelet depletion. Therefore, this finding is consistent with both conditions, though more severe in HELLP.
• Alanine aminotransferase (ALT): Elevated ALT reflects hepatic involvement due to endothelial dysfunction and liver cell injury. In severe preeclampsia, liver enzymes may begin to rise as organ involvement progresses. In HELLP syndrome, elevated liver enzymes are a hallmark of hepatocellular damage. The client’s ALT of 40 units/L is elevated, supporting both disease processes.
• Blood pressure: Severe hypertension is a defining feature of preeclampsia and is required for diagnosis when accompanied by proteinuria or organ dysfunction. The client’s blood pressure readings (162/112 and 166/110 mm Hg) indicate severe preeclampsia. HELLP syndrome often occurs in the setting of preeclampsia, but blood pressure elevation alone is not specific to HELLP. Therefore, this finding is primarily associated with preeclampsia.
• Hemoglobin: Elevated hemoglobin in pregnancy can be associated with hemoconcentration due to plasma volume loss, which is often seen in preeclampsia progressing to HELLP syndrome. However, in HELLP syndrome, hemolysis is a defining feature and can alter hemoglobin levels as red blood cells are destroyed. The abnormal hemoglobin level in this context supports hemolysis-related changes consistent with HELLP.
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