A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?

Administer a PRN dose of an antianxiety drug.

Obtain orthostatic blood pressure readings.

Notify the healthcare provider.

Collect a capillary glucose level.

Answer and Explanation

The Correct Answer is C

Choice A reason:

Administering a PRN dose of an antianxiety drug might seem like a reasonable action if the tremors are related to anxiety. However, without a clear indication that anxiety is the cause of the tremors, this action could mask the underlying issue and delay appropriate treatment. It is essential to identify the root cause of the tremors before administering any medication.

Choice B reason:

Obtaining orthostatic blood pressure readings is a useful assessment for determining if the client has orthostatic hypotension, which can cause dizziness and fainting. However, this action is not directly related to the complaint of hand tremors. While it is a good practice to monitor vital signs, it does not address the immediate concern of tremors caused by pregabalin.

Choice C reason:

Notifying the healthcare provider is the most appropriate action. Tremors can be a side effect of pregabalin12. The healthcare provider needs to be informed to evaluate the severity of the side effect and decide whether to adjust the medication dosage or switch to an alternative treatment. This ensures that the client receives the most appropriate care and avoids potential complications.

Choice D reason:

Collecting a capillary glucose level is important for clients with diabetes or those at risk of hypoglycemia or hyperglycemia. However, there is no indication in the scenario that the client has diabetes or that blood glucose levels are related to the tremors. Therefore, this action is not directly relevant to the client’s current complaint.

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Correct Answer is B

Explanation

Choice A reason:

Insomnia is a known side effect of St. John’s wort. While it can be bothersome, it does not typically require further instruction beyond standard advice on managing insomnia. Patients should be advised to take the medication earlier in the day to minimize sleep disturbances.

Choice B reason:

St. John’s wort can interact with hormonal contraceptives, reducing their effectiveness and increasing the risk of unintended pregnancy. This interaction occurs because St. John’s wort induces the enzymes that metabolize contraceptive hormones, leading to lower levels of these hormones in the body. Therefore, it is crucial to instruct the client to use an additional form of contraception to prevent pregnancy.

Choice C reason:

Sensitivity to the sun, or photosensitivity, is a documented side effect of St. John’s wort. Patients should be advised to use sunscreen and wear protective clothing when exposed to sunlight. While this side effect requires caution, it does not necessitate further instruction beyond these preventive measures.

Choice D reason:

Using hard candy to alleviate dry mouth is a common and effective strategy. St. John’s wort can cause dry mouth, and sucking on sugar-free hard candy can help stimulate saliva production. This advice is appropriate and does not require further instruction.

A. Potassium. B. Calcium. C. Phosphate. D. pH.

Correct Answer is C

Explanation

Choice A reason:

Calcium acetate is not used to lower potassium levels. Potassium levels in the blood are typically managed through dietary restrictions, medications like potassium binders, and dialysis in patients with CKD. The normal range for blood potassium levels is 3.5 to 5.2 mEq/L for adults.

Choice B reason:

Calcium acetate can increase calcium levels in the blood, not decrease them. It is important to monitor calcium levels to avoid hypercalcemia, which can lead to complications such as vascular calcification and cardiac issues. The normal range for blood calcium levels is 8.6 to 10.2 mg/dL.

Choice C reason:

Calcium acetate is used to lower phosphate levels in patients with CKD. It works by binding to dietary phosphate in the intestines, forming insoluble calcium phosphate that is excreted in the stool. This helps prevent hyperphosphatemia, a common issue in CKD patients. The normal range for blood phosphate levels is 2.5 to 4.5 mg/dL.

Choice D reason:

Calcium acetate does not directly affect blood pH levels. Blood pH is regulated by the kidneys and lungs, and the normal range is 7.35 to 7.45. While CKD can affect acid-base balance, calcium acetate’s primary role is to manage phosphate levels.

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A client who is receiving pregabalin for fibromyalgia complains of tremors in the hands. Which action should the nurse implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A female client with mild depression reports to the nurse that she recently started taking St. John’s wort. Which information provided by the client requires further instruction?

Correct Answer is B

Explanation

A client with chronic kidney disease (CKD) is receiving calcium acetate 667 mg PO. A decrease in which blood value indicates to the nurse that the medication is having the desired effect?

Correct Answer is C

Explanation

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