Exhibits

The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.

St. John's Wort

Corticosteroids

Fluconazole

Ibuprofen

Oral contraceptives

Answer and Explanation

Correct Answer : A,B,C,F

Choice A rationale: St. John's Wort is an herbal supplement that can interact with various medications, including insulin, and may alter blood glucose levels. It can reduce the effectiveness of insulin, leading to decreased blood glucose control. It is essential for the client to inform the healthcare provider about any use of St. John's Wort to adjust the insulin regimen accordingly.

Choice B rationale: Corticosteroids can increase blood glucose levels by promoting insulin resistance and inhibiting insulin action. Clients with diabetes may require adjustments in their insulin dosage while taking corticosteroids to prevent hyperglycemia.
Choice C rationale: Fluconazole is an antifungal medication that can affect blood glucose levels. It may increase the hypoglycemic effects of insulin, leading to lower blood glucose levels. The
client's insulin regimen may need to be adjusted while taking fluconazole.
Choice D rationale: Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) that does not typically have a direct impact on blood glucose levels in people with diabetes.
Choice E rationale: Epinephrine is a hormone that may transiently increase blood glucose levels in response to stress, but it is not a home medication that the client would be taking regularly.
Choice F rationale: Oral contraceptives, specifically combination hormonal contraceptives containing estrogen and progestin, can impact blood glucose levels. They may lead to insulin resistance and, in some cases, increase blood glucose levels. The healthcare provider may need to adjust the insulin dosage for better glycemic control.

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Correct Answer is A

Explanation

A. Scratchy throat: This symptom can indicate an allergic reaction, which can progress rapidly to more severe manifestations such as anaphylaxis. Anaphylaxis is a medical emergency that requires immediate intervention, including stopping the infusion and administering appropriate medications.

B. Pupillary constriction: This is not typically associated with an allergic reaction to medications like piperacillin-tazobactam. It is more commonly related to neurological conditions or the effects of certain drugs, such as opioids.

C. Hypertension: While elevated blood pressure can be concerning, it is not a common immediate reaction to piperacillin-tazobactam infusion. Hypertension could be related to other underlying conditions or stress but is not a primary reason to stop the infusion in this context.

D. Bradycardia: A slow heart rate is not a typical immediate response to an allergic reaction to antibiotics. Bradycardia can be caused by various factors, including medications, heart conditions, or electrolyte imbalances, but it is not directly linked to the infusion of piperacillin-tazobactam

A. Suggest that the client replace the leafy vegetables with a protein source such as nuts or beans. B. Advise the client that the healthcare provider needs to be made aware of her current diet. C. Commend the client for her healthy lifestyle and encourage her to continue her current diet habits. D. Confirm that her diet choices will help the medication be more effective in preventing blood clots.

Correct Answer is B

Explanation

Choice A rationale: this is not an appropriate response because while it may reduce the intake of vitamin K, suddenly changing the client's diet drastically may not be necessary. It is essential for the healthcare provider to make any necessary adjustments to the medication based on the client's diet.

Choice B rationale: Warfarin is an anticoagulant medication that works by inhibiting the formation of blood clots. It interacts with vitamin K, which plays a crucial role in the blood clotting process. Leafy green vegetables are rich in vitamin K, and their consumption can affect the effectiveness of warfarin. The nurse should advise the client to inform her healthcare provider about her vegetarian diet and the regular consumption of leafy green vegetables. The healthcare provider will then be able to adjust the warfarin dosage accordingly to ensure that the client receives the appropriate and consistent level of anticoagulation.

Choice C rationale: while a vegetarian diet can be healthy, the specific concern here is the potential impact of vitamin K-rich foods on warfarin therapy. It's essential to address this potential interaction rather than focusing solely on the overall healthy lifestyle.

Choice D rationale: Consuming large amounts of leafy green vegetables and vitamin K-rich foods may actually reduce the effectiveness of warfarin, leading to a decreased ability to prevent blood clots. Therefore, it is crucial to consult with the healthcare provider to manage the dosage appropriately.

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Exhibits The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.

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Naxlex Comprehensive Predictor Exams

The nurse initiates an infusion of piperacillin-tazobactam for a client with a urinary tract infection. Five minutes into the infusion, the client reports not feeling well. Which client manifestation should the nurse identify as a reason to stop the infusion?

Correct Answer is A

Explanation

A female client who is a vegetarian has a new prescription for warfarin. The client states she eats leafy green vegetables every day. How should the nurse respond?

Correct Answer is B

Explanation

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Exhibits

The nurse is preparing the client for discharge and discussing home medications. What home medications may affect the amount of insulin needed by the client? Select all that apply.