A patient is prescribed metformin (Glucophage). Which side effect/adverse effect almost always occurs when clients take metformin (Glucophage)?

Fever.

Insomnia.

Bitter or metallic taste.

Seizures.

Answer and Explanation

The Correct Answer is C

Choice A rationale:

Fever is not a common side effect of metformin. While it's possible for a minority of patients to experience a mild fever as their bodies adjust to the medication, it's not considered a typical or expected adverse effect.

Fevers typically occur due to infections or inflammation, and metformin does not directly cause either of these processes.

If a patient taking metformin develops a fever, it's crucial to rule out other potential causes, such as infections or other medications, before attributing it to metformin.

Choice B rationale:

Insomnia is also not a common side effect of metformin. In fact, some studies have suggested that metformin may even have a positive effect on sleep quality in some individuals.

While sleep disturbances can occur with any medication, they are not specifically associated with metformin.

If a patient experiences insomnia while taking metformin, it's essential to consider other potential factors, such as stress, anxiety, or other medications, that could be contributing to sleep problems.

Choice C rationale:

Bitter or metallic taste is a very common side effect of metformin, experienced by approximately 30-40% of patients. This taste disturbance is thought to be caused by metformin's interaction with taste receptors on the tongue.

The taste is often described as metallic, bitter, or similar to the taste of pennies.

While it can be unpleasant, it's generally not considered a serious side effect and does not usually require discontinuation of the medication.

Some strategies to manage the metallic taste include: Taking metformin with meals or snacks to mask the taste.

Chewing sugar-free gum or sucking on hard candy after taking the medication. Rinsing the mouth with water or mouthwash after taking the medication.

Switching to an extended-release formulation of metformin, which may have a less pronounced metallic taste.

Choice D rationale:

Seizures are a rare but serious side effect of metformin.

They are most likely to occur in patients with underlying kidney problems or those taking certain other medications that can interact with metformin.

If a patient taking metformin experiences a seizure, it's critical to seek immediate medical attention.

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Correct Answer is A

Explanation

Choice A rationale:

Calcium gluconate is the antidote for magnesium sulfate toxicity. It directly counteracts the effects of magnesium on the neuromuscular system, cardiovascular system, and central nervous system. It is essential to have calcium gluconate readily available at the bedside of any client receiving magnesium sulfate, as toxicity can occur quickly and without warning.

Mechanism of action:

Calcium gluconate competes with magnesium for binding sites on cell membranes and proteins. It displaces magnesium from these sites, thereby restoring normal cellular function.

Calcium gluconate also enhances calcium influx into cells, which further counteracts the effects of magnesium. Indications for use in magnesium sulfate toxicity:

Respiratory depression (respiratory rate <12 breaths per minute) Loss of deep tendon reflexes

Seizures

Cardiac arrhythmias (including heart block and cardiac arrest) Hypotension (systolic blood pressure <90 mmHg)

Dosage and administration:

The typical dose of calcium gluconate for magnesium sulfate toxicity is 1 gram (10 mL of a 10% solution) given IV push over 3- 5 minutes.

This dose may be repeated as needed, depending on the severity of the toxicity and the client's response to treatment. Nursing considerations:

Monitor the client's vital signs, respiratory status, and deep tendon reflexes closely during magnesium sulfate infusion and after administration of calcium gluconate.

Have a crash cart and code equipment readily available in case of cardiac arrest. Document the administration of calcium gluconate and the client's response to treatment.

A. To provide moisture. B. To prevent chemical conjunctivitis. C. To prevent infection. D. To treat infection.

Correct Answer is C

Explanation

Choice A rationale:

Erythromycin ointment does not have moisturizing properties. Its primary purpose is to prevent bacterial infection, not to provide moisture to the eyes.

While some ointments may have a slight moisturizing effect, this is not the main reason for using erythromycin ointment in newborns.

If moisture is the primary concern, other products specifically designed to lubricate the eyes would be more appropriate.

Choice B rationale:

Chemical conjunctivitis is typically caused by exposure to irritants such as chlorine in swimming pools or strong chemicals. Erythromycin ointment is not effective in preventing chemical conjunctivitis.

In fact, it could potentially worsen the irritation if used in cases of chemical conjunctivitis.

If chemical conjunctivitis is suspected, flushing the eyes with water or saline solution and seeking medical attention would be the appropriate course of action.

Choice D rationale:

Erythromycin ointment is an antibiotic, but it is not typically used to treat active infections in newborns.

If a newborn has a suspected eye infection, a healthcare provider would likely prescribe a different antibiotic eye drop or ointment that is more effective in treating the specific infection.

However, erythromycin ointment can be used as a prophylactic measure to prevent eye infections, which is why it is commonly administered to newborns shortly after birth.

Choice C rationale:

Erythromycin ointment is primarily used to prevent eye infections in newborns.

It is effective against a variety of bacteria that can cause conjunctivitis, including Neisseria gonorrhoeae (the bacteria that causes gonorrhea) and Chlamydia trachomatis (the bacteria that causes chlamydia).

These bacteria can be passed from the mother to the baby during childbirth, and if left untreated, they can cause serious eye infections that can lead to vision loss.

By applying erythromycin ointment to the newborn's eyes shortly after birth, the risk of these infections can be significantly reduced.

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A patient is prescribed metformin (Glucophage). Which side effect/adverse effect almost always occurs when clients take metformin (Glucophage)?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which of the following would the nurse have readily available for a client who is receiving magnesium sulfate to treat severe preeclampsia?

Correct Answer is A

Explanation

The nurse is instilling erythromycin ointment to the lower lid of the newborn’s eyes. Why is this medication being given to the newborn?

Correct Answer is C

Explanation

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