Which commonly prescribed is does the nurse identify as ototoxic?

Ondansetron and Metoclopramide

Aspirin and ibuprofen

Metoprolol and Furosemide

Pantoprazole Docusate Sodium

Answer and Explanation

The Correct Answer is B

A) Ondansetron and Metoclopramide:
Ondansetron is an antiemetic used to prevent nausea and vomiting, and Metoclopramide is a medication that promotes gastric emptying and is often used to treat nausea and gastroesophageal reflux. Neither of these medications are typically associated with ototoxicity. Ototoxicity is more commonly seen with medications that affect the inner ear or auditory pathways, particularly those that are used in high doses or over extended periods.

B) Aspirin and ibuprofen:
Both aspirin (a nonsteroidal anti-inflammatory drug, NSAID) and ibuprofen are associated with ototoxicity, especially when used in high doses or over prolonged periods. Ototoxicity from NSAIDs can result in symptoms such as tinnitus (ringing in the ears) or even hearing loss. This occurs due to their impact on the cochlea and auditory nerve.

C) Metoprolol and Furosemide:
Metoprolol is a beta-blocker used for managing hypertension, heart failure, and other cardiovascular conditions, and Furosemide is a diuretic often used to treat conditions such as heart failure and edema. Neither of these drugs is typically associated with ototoxicity. However, high doses of furosemide, particularly when given rapidly or intravenously, may be associated with transient hearing loss.

D) Pantoprazole and Docusate Sodium:
Pantoprazole is a proton pump inhibitor (PPI) used to treat gastrointestinal issues like acid reflux and ulcers. Docusate sodium is a stool softener used to treat constipation. Neither of these medications is known to cause ototoxicity. These drugs generally do not affect hearing or the auditory system.

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Correct Answer is A

Explanation

A) Urine output of 0.5-1 mL/kg/hr:
This is a positive outcome during fluid resuscitation for burn patients. Adequate urine output is a key indicator of proper renal perfusion and fluid balance. A urine output of 0.5-1 mL/kg/hr is considered optimal for burn patients during the first 24-48 hours of resuscitation. It suggests that the kidneys are receiving sufficient blood flow and that the patient is responding appropriately to the fluids being administered.

B) Serum sodium level 149 mEq/L (normal 135-145):
A serum sodium level of 149 mEq/L is high and indicates hypernatremia, which is a common complication of excessive fluid resuscitation, particularly with the use of crystalloids. Hypernatremia can lead to cerebral edema, altered mental status, and other severe complications. Therefore, this finding would suggest improper fluid management and would not be considered a positive outcome.

C) Blood pressure 82/54:
A blood pressure of 82/54 is hypotensive, which is concerning in a burn patient. Hypotension indicates inadequate tissue perfusion, potentially leading to shock and organ failure. While low blood pressure may occur in the initial stages of resuscitation due to the rapid shifts in fluid, a sustained low blood pressure is not a positive outcome.

D) Heart rate 124 beats per minute:
A heart rate of 124 beats per minute is tachycardic and suggests that the patient is compensating for hypovolemia or inadequate circulatory volume, possibly due to insufficient fluid resuscitation. Although an elevated heart rate may occur as a compensatory mechanism in the initial stages of burn resuscitation, sustained tachycardia indicates ongoing volume depletion or inadequate perfusion and is not an ideal outcome.

A. Measure heart chamber pressures to assess for heart failure B. Determine cardiac output during the procedure. C. Evaluate the extent of the occlusion of the coronary arteries involved D. Prevent extensive myocardial damage

Correct Answer is D

Explanation

A) Measure heart chamber pressures to assess for heart failure:
Measuring heart chamber pressures is an important diagnostic tool in assessing heart failure, but it is not the primary goal in the case of a STEMI (ST-Elevation Myocardial Infarction). In STEMI, the primary goal is to identify and treat the blockage in the coronary arteries that is causing the heart attack.

B) Determine cardiac output during the procedure:
Cardiac output is a useful measurement for assessing heart function, but it is not the main focus during the treatment of STEMI. While monitoring cardiac output may be part of the overall care, the urgent priority in STEMI management is to restore blood flow to the affected myocardial tissue as quickly as possible to minimize damage, not to measure cardiac output.

C) Evaluate the extent of the occlusion of the coronary arteries involved:
While evaluating the extent of coronary artery occlusion is part of the process during a cardiac catheterization, the immediate priority for a patient with STEMI is to treat the blockage, not just evaluate it. While the angiogram will reveal the blockage, the treatment goal is to restore perfusion to the affected area of the heart through procedures such as balloon angioplasty or stent placement.

D) Prevent extensive myocardial damage:
This is the correct answer. The main goal of treatment for STEMI is to prevent extensive myocardial damage. In a STEMI, the coronary artery is blocked, depriving the heart muscle of oxygen, which can cause significant damage or death of the myocardial tissue. The most effective way to limit the extent of damage is to restore blood flow as quickly as possible, often through emergent procedures like percutaneous coronary intervention (PCI) or fibrinolytic therapy.

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Which commonly prescribed is does the nurse identify as ototoxic?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is caring for patient with severe, major burns who is receiving fluid resuscitation per protocol. Which of the following assessments indicate positive outcome?

Correct Answer is A

Explanation

A client admitted to the Emergency Department with a suspected STEM. The nurse anticipates that this client will be immediately prepared for the cardiac catheterization laboratory as the goal of treatment is to:

Correct Answer is D

Explanation

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