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 ["A","C","D","E"]
Explanation
The nurse should plan to take the following actions:
A.Verify the prescription: Before administering any medication, the nurse must verify the prescription to ensure accuracy, appropriateness, and that it matches the provider's order.
Regarding option B, administering the medication at 1000, 1400, 1800, and 2200 may not be appropriate. The prescription states that ampicillin should be administered every 6 hours. The nurse should administer the medication at equally spaced intervals throughout the day. If the medication is prescribed every 6 hours, the appropriate administration times would be 0600, 1200, 1800, and 2400. However, the question does not provide sufficient information to determine the exact administration times, so option B cannot be definitively selected.
C. Assess the client for an allergy to penicillin: Since ampicillin is a penicillin-class antibiotic, it is essential for the nurse to assess the client for any history of allergies to penicillin or other beta-lactam antibiotics. A penicillin allergy could lead to a severe allergic reaction, so it is crucial to identify any potential allergies before administering the medication.
D. Document giving the medications: After administering the ampicillin, the nurse should document the administration in the client's medical record, including the time, dose, route, and any relevant observations or assessments.
E. Obtain a sputum for culture and sensitivity: The client's new prescription for ampicillin may be related to an infection. To ensure appropriate and effective treatment, obtaining a sputum specimen for culture and sensitivity is necessary. This will help identify the specific bacteria causing the respiratory infection and determine which antibiotics will be most effective in treating it.
Correct Answer is A
Explanation
The nurse should include the statement that rifampin can cause the client's urine to turn orange. Rifampin is an antibiotic commonly used to treat tuberculosis and other bacterial infections. One of its common side effects is discoloration of bodily fluids, including urine, saliva, sweat, and tears. This discoloration is harmless and is not a cause for concern. Informing the client about this side effect helps prevent unnecessary worry or alarm.
"You should take this medication with food" (B) is not specifically related to rifampin. However, taking rifampin with food can help reduce gastrointestinal side effects such as stomach upset or nausea.
"This medication can cause insomnia" (C) is not a common side effect of rifampin. Insomnia is more commonly associated with certain other medications or medical conditions.
"You should take a stool softener with this medication" (D) is not necessary for rifampin. Stool softeners are typically used to alleviate constipation, but rifampin does not commonly cause constipation as a side effect.
Therefore, the nurse should primarily include the statement that rifampin can cause the client's urine to turn orange.
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