A nurse is reviewing the medication record for a client diagnosed with chronic kidney disease (CKD). Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?
Omeprazole
Ondansetron
Vancomycin
Diphenhydramine
The Correct Answer is C
A. Omeprazole: Not directly nephrotoxic, but long-term use has been associated with interstitial nephritis, although rarely.
B. Ondansetron: Generally safe in renal disease and not known to cause nephrotoxicity.
C. Vancomycin: Known nephrotoxic agent, especially with high trough levels or when used with other nephrotoxins; requires dose adjustment in CKD.
D. Diphenhydramine: Not nephrotoxic; primarily affects the CNS and anticholinergic systems.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Omeprazole: Not directly nephrotoxic, but long-term use has been associated with interstitial nephritis, although rarely.
B. Ondansetron: Generally safe in renal disease and not known to cause nephrotoxicity.
C. Vancomycin: Known nephrotoxic agent, especially with high trough levels or when used with other nephrotoxins; requires dose adjustment in CKD.
D. Diphenhydramine: Not nephrotoxic; primarily affects the CNS and anticholinergic systems.
Correct Answer is ["A","C","D","E"]
Explanation
A. Ensure NPO status: The client is kept NPO before the biopsy to reduce the risk of aspiration if sedation is used.
B. Administer diphenhydramine (Benadryl) prior to procedure: This is not routine for kidney biopsy unless the client has allergies or specific indications.
C. Obtain coagulation studies: Important to assess for bleeding risk because kidney biopsies have a high bleeding potential.
D. Verify informed consent: This is essential before any invasive procedure.
E. Collect a urine specimen prior to procedure: A pre-procedure urine sample is collected for baseline comparison.
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