A nurse is reviewing the medical record of a client who has a new prescription for verapamil. Which of the following findings in the client's medical record should the nurse identify as a contraindication for the administration of verapamil?
History of asthma
History of heart failure
Systolic BP 110 mm Hg
Blood creatinine 1.0 mg/dl
The Correct Answer is B
A. History of asthma: Verapamil is a calcium channel blocker and does not affect the airways or cause bronchospasm, unlike beta-blockers, which can exacerbate asthma.
B. History of heart failure: Verapamil has negative inotropic effects, meaning it decreases the strength of heart contractions. This can exacerbate heart failure, particularly in clients with reduced ejection fraction (systolic heart failure). It is generally contraindicated in clients with severe heart failure as it can worsen symptoms.
C. Systolic BP 110 mm Hg: While verapamil can cause a drop in blood pressure due to its vasodilatory effects, a systolic blood pressure of 110 mm Hg is not an absolute contraindication.
D. A blood creatinine level of 1.0 mg/dL is within the normal range (approximately 0.6–1.2 mg/dL for adults). Verapamil is not contraindicated in clients with normal renal function.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Smoking is a known risk factor for the development of aspirin-induced ulcers. It can increase the risk of gastrointestinal bleeding and compromise the integrity of the gastric mucosa. Smoking can also impair the healing process and increase the risk of complications associated with ulcers.
While the other factors mentioned in the options may have their own health implications, smoking is specifically associated with an increased risk of aspirin-induced ulcers. Therefore, the nurse should identify the client's smoking habit as a risk factor for the development of an aspirin-induced ulcer.
Correct Answer is D
Explanation
The client statement that indicates an understanding of the teaching is: "The medication can cause drowsiness."
Promethazine is an antihistamine medication commonly used to treat various conditions, such as allergies, motion sickness, and nausea. One of the most common side effects of promethazine is drowsiness or sedation. It has a significant sedative effect, and it is often used to induce sleep or manage insomnia in some cases.
Let's go through the other options:
A. "This medication can cause diarrhea": Diarrhea is not a common side effect of promethazine. While promethazine can cause certain gastrointestinal side effects like constipation or upset stomach, diarrhea is not typically associated with its use.
B. "The medication can cause increased salivation": Increased salivation is not a common side effect of promethazine. While some antihistamines can cause dry mouth, which is the opposite of increased salivation, promethazine does not usually cause excessive salivation.
C. "This medication can cause pupil constriction": Pupil constriction (miosis) is a potential side effect of some medications, but it is not commonly associated with promethazine. Promethazine is more likely to cause pupil dilation (mydriasis) rather than constriction.
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