A client has a new prescription for diclofenac, a nonsteroidal anti-inflammatory drug (NSAID). Which information in the client’s history is of greatest concern to the nurse in monitoring the client’s response to this medication?
Osteoarthritis.
Migraine headaches.
Chronic alcoholism.
Type 2 diabetes mellitus.
The Correct Answer is C
Choice A Reason:
Osteoarthritis is a common condition treated with NSAIDs like diclofenac. While it is important to monitor for potential side effects, osteoarthritis itself does not pose a significant concern in the context of diclofenac use. The medication is often prescribed to manage the pain and inflammation associated with osteoarthritis.
Choice B Reason:
Migraine headaches are also treated with NSAIDs, including diclofenac. While it is essential to monitor for side effects, migraines do not present a significant concern regarding the use of diclofenac. The medication can help alleviate the pain associated with migraines.
Choice C Reason:
Chronic alcoholism is of greatest concern when prescribing diclofenac. Alcohol can increase the risk of gastrointestinal bleeding and liver damage, both of which are potential side effects of NSAIDs. Combining alcohol with diclofenac can exacerbate these risks, making it crucial for the nurse to monitor the client closely and provide appropriate guidance.
Choice D Reason:
Type 2 diabetes mellitus requires careful management, but it is not the primary concern when prescribing diclofenac. While it is important to monitor for potential interactions and side effects, diabetes itself does not significantly increase the risks associated with diclofenac use compared to chronic alcoholism.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
A digoxin level of 1.1 ng/mL is within the therapeutic range of 0.8 to 2.6 ng/mL. Therefore, this value does not require immediate reporting to the healthcare provider. Monitoring digoxin levels is important to avoid toxicity, but this specific level is considered safe.
Choice B Reason:
A potassium level of 3.2 mEq/L is below the normal range of 3.5 to 5.0 mEq/L. Hypokalemia (low potassium levels) can increase the risk of digoxin toxicity, as digoxin and potassium compete for the same binding sites on the Na+/K+ ATPase pump. Low potassium levels can enhance the effects of digoxin, leading to potentially dangerous cardiac arrhythmias. Therefore, this value should be reported immediately.
Choice C Reason:
A creatinine level of 0.8 mg/dL is within the normal range of 0.5 to 1.1 mg/dL. This value indicates normal kidney function, which is important for the excretion of digoxin. Therefore, this value does not require immediate reporting.
Choice D Reason:
A sodium level of 135 mEq/L is just below the normal range of 136 to 145 mEq/L. While slightly low, this value is not critically abnormal and does not pose an immediate threat. It should be monitored, but it does not require urgent reporting to the healthcare provider.
Correct Answer is C
Explanation
Choice A Reason:
Bronchitis is a condition that affects the respiratory system, and while it is important to monitor, it is not a primary concern when administering phenylephrine. Phenylephrine is a decongestant that works by narrowing the blood vessels in the nasal passages, which can help relieve congestion but does not directly impact bronchitis.
Choice B Reason:
Diarrhea is a gastrointestinal condition that, while uncomfortable, does not significantly interact with phenylephrine. It is important to manage and monitor, but it does not pose a direct risk when taking phenylephrine.
Choice C Reason:
Hypertension is a significant concern when administering phenylephrine. Phenylephrine can increase blood pressure by causing vasoconstriction. For clients with hypertension, this can exacerbate their condition and lead to serious cardiovascular complications. Therefore, it is crucial to report this condition to the healthcare provider before administering the medication.
Choice D Reason:
Edema, or swelling, can be a symptom of various underlying conditions, including heart failure or kidney issues. While it is important to monitor, it is not as directly impacted by phenylephrine as hypertension. However, any underlying condition causing edema should be considered when administering medications.
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