The health care provider is considering the use of sumatriptan (Imitrex) for a 54-year-old male patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider?

The patient had a recent acute myocardial infarction.

The patient has had migraine headaches for 30 years.

The patient drinks 1 to 2 cups of coffee daily.

The patient has taken topiramate (Topamax) for 2 months.

Answer and Explanation

The Correct Answer is A

A. The patient had a recent acute myocardial infarction: Sumatriptan is contraindicated in patients with a history of myocardial infarction or coronary artery disease due to its vasoconstrictive effects, which could exacerbate ischemia or precipitate cardiovascular events.

B. The patient has had migraine headaches for 30 years: While the duration of migraine headaches is relevant to the patient's history, it is not as immediately concerning as a recent myocardial infarction when considering the use of sumatriptan.

C. The patient drinks 1 to 2 cups of coffee daily: While caffeine consumption may interact with sumatriptan and affect its efficacy or side effects, it is not as immediately concerning as a recent myocardial infarction.

D. The patient has taken topiramate (Topamax) for 2 months: While the use of topiramate may interact with sumatriptan, it is not as immediately concerning as a recent myocardial infarction. However, it is still important to report all medications the patient is taking to the healthcare provider.

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Correct Answer is ["B","D"]

Explanation

A. Furnish restraints at the bedside: Restraints are not indicated for clients with seizure disorders. In fact, restraints can increase the risk of injury during a seizure and should be avoided.

B. Keep an oxygen setup at the bedside: Oxygen may be necessary to support the client's respiratory function during and after a seizure. Having an oxygen setup readily available can ensure prompt administration if needed.

C. Place the bed in the lowest position: Lowering the bed can help prevent injury if the client
falls out of bed during a seizure. However, it is not always feasible or necessary to lower the bed to the lowest position, especially if the client has mobility limitations or other considerations.

D. Provide a suction setup at the bedside: Suctioning may be necessary to clear the airway and prevent aspiration if the client experiences excessive oral secretions or vomiting during or after a seizure.

E. Elevate the side rails near the head when the client is in bed: Elevating the side rails near the head can help prevent injury if the client thrashes or moves unpredictably during a seizure. However, it is essential to ensure that the client's head and neck remain adequately supported and that the side rails do not restrict access to the client during a seizure.

A. The patient's blood pressure (BP) is 144/90 mm Hg. B. The patient takes a diuretic because of a history of hypertension. C. The patient has atrial fibrillation and takes warfarin (Coumadin). D. The patient's speech is difficult to understand.

Correct Answer is C

Explanation

A. The patient's blood pressure (BP) is 144/90 mm Hg: While elevated blood pressure may contribute to the risk of intracerebral hemorrhage, the patient's current BP is not excessively high and may not be the most critical factor in this situation compared to other factors such as anticoagulant use.

B. The patient takes a diuretic because of a history of hypertension: While the patient's history of hypertension and diuretic use are relevant to their overall health status, they may not be the most immediate concern in the context of intracerebral hemorrhage.

C. The patient has atrial fibrillation and takes warfarin (Coumadin): This information is crucial as it indicates that the patient is anticoagulated, which can significantly impact the severity and management of intracerebral hemorrhage. Anticoagulant use increases the risk of bleeding and can worsen outcomes in cases of intracranial hemorrhage.

D. The patient's speech is difficult to understand: While difficulty with speech may indicate neurological impairment, it is not as immediately concerning as the patient's anticoagulant use, which increases the risk of bleeding complications and may require specific interventions such as reversal agents.

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The health care provider is considering the use of sumatriptan (Imitrex) for a 54-year-old male patient with migraine headaches. Which information obtained by the nurse is most important to report to the health care provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

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Explanation

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Correct Answer is C

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