A patient with chronic kidney disease (CKD) is being evaluated for medication management. Which of the following medications should be avoided due to its potential nephrotoxic effects?
Atorvastatin
Losartan
Vancomycin
Aspirin
The Correct Answer is C
A. Atorvastatin: Atorvastatin is a statin used to manage cholesterol levels. It is generally safe for use in patients with CKD.
B. Losartan: Losartan is an angiotensin II receptor blocker (ARB) used to manage hypertension and protect the kidneys in diabetic nephropathy. It can be beneficial in CKD patients.
C. Vancomycin: Vancomycin is an antibiotic known to be nephrotoxic, especially in patients with compromised kidney function. It should be used with caution or avoided in patients with CKD.
D. Aspirin: While aspirin can have adverse effects on the kidneys at high doses, its nephrotoxic potential is lower than that of vancomycin. In low doses, aspirin is commonly used for cardiovascular protection, even in patients with CKD.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
A. Flush the T-tube with sterile water every 6 hours to maintain patency: T-tubes are generally not flushed unless prescribed by a healthcare provider because flushing can introduce bacteria and cause complications. Patency is typically maintained by gravity drainage alone.
B. Clamp the T-tube for 12 hours each day to reduce bile flow: Clamping the T-tube is not routinely recommended for such long periods unless directed by the healthcare provider. Clamping is usually done gradually, often for 1-2 hours, to assess the patient’s ability to tolerate bile drainage naturally before tube removal.
C. Secure the T-tube to the patient's gown to prevent accidental dislodgement: While securing the T-tube prevents accidental dislodgement, the tube should be taped to the skin rather than the gown, as attaching it to clothing can increase the risk of unintentional dislodgement with movement.
D. Maintain the drainage bag below the level of the abdomen to promote gravity drainage. This is the correct answer because positioning the drainage bag below the abdomen allows for gravity to assist in the flow of bile from the bile duct, preventing backup and promoting proper drainage.
Correct Answer is A
Explanation
A. Overdose: The patient has ingested a large quantity of unknown pills, leading to severe metabolic acidosis, high anion gap, and possible toxic accumulation. Dialysis is often indicated to clear toxins in the case of overdose, especially if renal function is impaired (as indicated by elevated creatinine).
B. Chronic Kidney Disease: While chronic kidney disease may eventually require dialysis, the acute overdose and metabolic acidosis are the more immediate concerns requiring urgent dialysis.
C. Hypertension: Hypertension may require management, but it is not the primary reason to initiate urgent dialysis in this scenario. The overdose and metabolic acidosis take precedence.
D. Dehydration: Dehydration alone does not necessitate dialysis. However, the overdose, metabolic acidosis, and renal impairment are the critical reasons for initiating dialysis.
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