A nurse is reviewing the medication list of a client who has bipolar disorder. The client is taking lithium carbonate, haloperidol, and lorazepam. The nurse should monitor the client for which of the following adverse effects?
Extrapyramidal symptoms
Serotonin syndrome
Neuroleptic malignant syndrome
Lithium toxicity
The Correct Answer is C
A) Incorrect. Extrapyramidal symptoms (EPS), such as dystonia, akathisia, and tardive dyskinesia, are caused by dopamine antagonists, such as haloperidol. However, these symptoms are not related to the combination of medications that the client is taking.
B) Incorrect. Serotonin syndrome is a potentially life-threatening condition that results from excessive serotonin activity in the central nervous system. It is caused by serotonin-enhancing medications, such as antidepressants, opioids, and triptans. None of the medications that the client is taking have this effect.
C) Correct. Neuroleptic malignant syndrome (NMS) is a rare but serious condition that occurs due to dopamine blockade in the brain and peripheral tissues. It is caused by antipsychotic medications, such as haloperidol. The risk of NMS is increased when lithium carbonate is added to antipsychotic therapy, as lithium can potentiate the dopamine-blocking effect of antipsychotics.
D) Incorrect. Lithium toxicity is a condition that occurs when lithium levels exceed the therapeutic range of 0.6 to 1.2 mEq/L. It is caused by factors that affect lithium excretion, such as dehydration, renal impairment, drug interactions, and overdose. None of the other medications that the client is taking interact with lithium or affect its excretion.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A) Incorrect. The client should not avoid eating foods that are high in vitamin K, such as leafy green vegetables, because they can interfere with the anticoagulant effect of warfarin. The client should maintain a consistent intake of vitamin K and follow a balanced diet.
B) Correct. The client should use a soft-bristled toothbrush to prevent bleeding from the gums, which can occur due to the increased risk of bleeding caused by warfarin. The client should also avoid using dental floss and electric razors.
C) Correct. The client should monitor their blood pressure regularly at home, as warfarin can affect blood pressure and increase the risk of stroke or bleeding complications. The client should report any abnormal readings to their provider.
D) Correct. The client should report any signs of bruising or bleeding to their provider, as they may indicate an adverse reaction to warfarin or an overdose. The client should also report any signs of infection, such as fever, sore throat, or pus, as they may increase the risk of bleeding.
Correct Answer is B
Explanation
A) Incorrect. Diarrhea is a common side effect of amoxicillin, but it is not a sign of an allergic reaction. The nurse should advise the client to drink plenty of fluids and eat foods that are high in fiber to prevent dehydration and constipation. The nurse should also instruct the client to report severe or bloody diarrhea, as it may indicate a serious condition called pseudomembranous colitis.
B) Correct. Rash is a sign of an allergic reaction to amoxicillin, and it may indicate a hypersensitivity or anaphylactic reaction. The nurse should instruct the client to report any rash, itching, hives, or swelling to their provider immediately and stop taking the medication.
C) Incorrect. Headache is a common side effect of amoxicillin, but it is not a sign of an allergic reaction. The nurse should advise the client to take over-the-counter analgesics, such as acetaminophen or ibuprofen, to relieve headache pain.
D) Incorrect. Nausea is a common side effect of amoxicillin, but it is not a sign of an allergic reaction. The nurse should advise the client to take the medication with food or milk to reduce nausea and vomiting.
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