A patient with renal impairment is prescribed a medication that is primarily excreted by the kidneys. What adjustment should the nurse anticipate?
Administering the medication with meals only
No dose adjustment is required
Increasing the dose to ensure therapeutic effect
Decreasing the dose to prevent toxicity
The Correct Answer is D
Choice A reason: Administering the medication with meals only is not a valid adjustment for a medication that is primarily excreted by the kidneys. The food intake does not affect the renal clearance of the drug, unless it alters the pH of the urine or the blood flow to the kidneys. The nurse should follow the instructions on the medication label or the prescriber's order regarding the timing of the administration.
Choice B reason: No dose adjustment is required is an incorrect statement for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should consult with the prescriber or the pharmacist about the appropriate dose reduction or frequency change for the patient's level of renal function.
Choice C reason: Increasing the dose to ensure therapeutic effect is a dangerous and inappropriate adjustment for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should not increase the dose without the prescriber's order and should monitor the patient for signs of overdose or toxicity.
Choice D reason: Decreasing the dose to prevent toxicity is the correct and rational adjustment for a medication that is primarily excreted by the kidneys. The renal impairment can reduce the elimination of the drug and increase its concentration in the blood. This can cause adverse effects and toxicity. The nurse should consult with the prescriber or the pharmacist about the appropriate dose reduction or frequency change for the patient's level of renal function. The nurse should also monitor the patient for the therapeutic response and the adverse effects of the drug.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A reason: This is incorrect. Aspirin can be used to relieve headache, but that is not its main function in this context. Aspirin is prescribed to patients who have had a heart attack to reduce the risk of another one.
Choice B reason: This is incorrect. Aspirin can be used to reduce fever, but that is not its main function in this context. Aspirin is prescribed to patients who have had a heart attack to reduce the risk of another one.
Choice C reason: This is incorrect. Aspirin does not act as an antiviral. It has no effect on viral infections. Aspirin is prescribed to patients who have had a heart attack to reduce the risk of another one.
Choice D reason: This is correct. Aspirin prevents further clot formation by inhibiting the activity of platelets, which are blood cells that help form clots. Clots can block the blood flow to the heart and cause a heart attack. Aspirin reduces the chance of this happening by making the blood less sticky.
Correct Answer is B
Explanation
Choice A reason: Tinnitus is a rare side effect of Flexeril, which is a medication that relaxes the muscles and relieves pain and stiffness¹. Tinnitus is a ringing or buzzing sound in the ears that can be caused by various factors, such as ear infections, noise exposure, or certain medications. Flexeril does not affect the auditory system directly, but it can cause confusion or dizziness, which may worsen the perception of tinnitus.
Choice B reason: Drowsiness is the most common side effect of Flexeril, which is a medication that relaxes the muscles and relieves pain and stiffness¹. Drowsiness occurs because Flexeril has sedative and anticholinergic properties, which means that it blocks the action of acetylcholine, a neurotransmitter that regulates arousal and alertness. Flexeril can impair the mental and physical abilities, especially in elderly patients or those who take other medications that cause drowsiness¹. The nurse should educate the patient about the risk of drowsiness and advise them to avoid driving or operating machinery while taking Flexeril.
Choice C reason: Diarrhea is not a common side effect of Flexeril, which is a medication that relaxes the muscles and relieves pain and stiffness¹. Diarrhea is a condition that causes loose or watery stools, which can be caused by various factors, such as infections, food intolerance, or certain medications. Flexeril does not affect the gastrointestinal system directly, but it can cause dry mouth, nausea, or constipation, which may alter the bowel movements¹.
Choice D reason: Palpitations are not a common side effect of Flexeril, which is a medication that relaxes the muscles and relieves pain and stiffness¹. Palpitations are a sensation of rapid or irregular heartbeat, which can be caused by various factors, such as stress, anxiety, caffeine, or certain medications. Flexeril does not affect the cardiac system directly, but it can lower the blood pressure or interact with other medications that affect the heart rate, such as betablockers or antidepressants¹.
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