The health care provider prescribes scopolamine for a client who is planning to take cruise and is concerned about motion sickness. What information in the past medical history would serve as a contraindication for this medication?

Peptic ulcer

Asthma

Heart disease

Glaucoma

Answer and Explanation

The Correct Answer is D

A) Peptic ulcer: Scopolamine is an anticholinergic medication that works by blocking acetylcholine, which can reduce nausea and motion sickness. While scopolamine can have anticholinergic effects that may slightly reduce gastric motility, it is not directly contraindicated in clients with a history of peptic ulcer. The medication does not significantly exacerbate the condition of peptic ulcers.

B) Asthma: While scopolamine can have anticholinergic effects that may lead to dry mouth and slight airway narrowing, it is not contraindicated in clients with asthma. However, the nurse should be cautious and monitor the client for any signs of respiratory distress, as anticholinergic medications can cause some bronchial smooth muscle relaxation, which could theoretically worsen asthma symptoms. It is not an absolute contraindication.

C) Heart disease: Scopolamine is not specifically contraindicated for individuals with heart disease, although caution should be used in patients with cardiovascular conditions due to its potential effects on heart rate and blood pressure. However, heart disease itself is not a direct contraindication for the use of scopolamine.

D) Glaucoma: Scopolamine is an anticholinergic medication, and anticholinergics can increase intraocular pressure. This is especially dangerous for clients with narrow-angle glaucoma, as the medication can exacerbate the condition, leading to a potential acute glaucoma attack. Therefore, individuals with a history of glaucoma, particularly narrow-angle glaucoma, should avoid scopolamine.

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Correct Answer is C

Explanation

Here’s the step-by-step process:

After the first half-life (1 half-life), 50% of the initial drug is left.

200 mg → 100 mg (half is eliminated, 100 mg remains).

After the second half-life (2 half-lives), 50% of the remaining drug is eliminated again.

100 mg → 50 mg (half of 100 mg is eliminated, 50 mg remains).

After the third half-life (3 half-lives), 50% of the remaining drug is eliminated again.

50 mg → 25 mg (half of 50 mg is eliminated, 25 mg remains).

A. Failed communication B. Dose miscalculation C. Lack of client education D. Poor distribution practices

Correct Answer is B

Explanation

A) Failed communication: While communication errors can lead to medication mistakes, in this specific scenario, there is no mention of poor communication. The prescription is clear, and the issue is more likely related to the accuracy of the prescribed dose or the nurse’s understanding of it, making "failed communication" a less likely source of error in this case.

B) Dose miscalculation: This is the most likely source of potential error. The medication is ordered as 0.9 mg of ondansetron IV, which is an unusual dosage because the typical dose of ondansetron IV for nausea is usually 4 mg or 8 mg. A dose of 0.9 mg is very specific and could easily be miscalculated, especially if the nurse is not familiar with this specific dosage form or if there’s any confusion regarding the intended dose. This could lead to an error either in preparation or administration of the medication.

C) Lack of client education: While client education is important for many aspects of treatment, it’s not directly related to the potential medication error in this scenario. The nurse’s concern should focus on the accuracy of administering the prescribed dose correctly, not the client’s understanding of the medication.

D) Poor distribution practices: Poor distribution practices may affect the availability or storage of medications, but this is not the likely source of error in this case. The concern here is more about the correct dosage and potential for miscalculation, rather than issues related to drug distribution or storage.

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The health care provider prescribes scopolamine for a client who is planning to take cruise and is concerned about motion sickness. What information in the past medical history would serve as a contraindication for this medication?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The client receives one dose of 200 mg of a medication. How much drug is in the body at 3 half-lives?

Correct Answer is C

Explanation

A client is ordered .9mg ondansetron, IV, PRN q6 hours for nausea. The nurse anticipates which of the following sources to cause potential medication error?

Correct Answer is B

Explanation

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