A client is prescribed ondansetron for nausea. When reviewing the client's medical history, which finding would concern the nurse?

Cerebral Vascular Accident

Depression

Glaucoma

Congestive Heart Failure

Answer and Explanation

The Correct Answer is C

A) Cerebral Vascular Accident (CVA): While a history of a CVA (stroke) is important to consider when prescribing medications, ondansetron is not contraindicated for clients with a history of CVA. The nurse would need to assess the client’s overall neurological status and risk factors but this condition is not an immediate concern for ondansetron use.

B) Depression: Ondansetron is not typically contraindicated in patients with depression. However, the nurse should be mindful of the potential for interactions with other medications the client may be taking for depression, but there is no direct contraindication between ondansetron and depression itself.

C) Glaucoma: This is the most concerning finding. Ondansetron can increase the risk of complications in clients with glaucoma, particularly narrow-angle glaucoma. Ondansetron has some serotonin receptor-blocking properties that can cause dilation of the pupil, which could increase intraocular pressure in clients with glaucoma. Therefore, this condition would require careful monitoring, and the nurse would need to consult with the healthcare provider before administering ondansetron to a client with glaucoma.

D) Congestive Heart Failure (CHF): While patients with CHF need to be monitored for fluid balance, ondansetron is not contraindicated in clients with CHF. The primary concern in these patients would be potential fluid retention or electrolyte imbalances, but this is generally not a direct concern for the administration of ondansetron itself.

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Correct Answer is D

Explanation

A) Metoprolol XL: Metoprolol XL (extended-release) should not be crushed. Crushing extended-release formulations can result in the rapid release of the drug, leading to an overdose or adverse effects due to the immediate release of the full dose. The nurse should advise the client to swallow this medication whole.

B) Ibuprofen EC (enteric-coated): Enteric-coated medications should not be crushed. The enteric coating is designed to protect the stomach lining by preventing the medication from being released in the stomach. Crushing the tablet would destroy this protective mechanism and could irritate the stomach lining, leading to discomfort or ulceration.

C) Morphine ER (extended-release): Extended-release formulations of morphine should never be crushed. Crushing extended-release formulations can lead to a potentially fatal overdose because it releases the entire dose of medication at once. This can cause respiratory depression and other life-threatening effects.

D) Acetaminophen: Acetaminophen in its regular tablet form can be safely crushed if needed. Crushing acetaminophen does not affect its effectiveness or safety, and it is a non-extended-release formulation, making it safe for manipulation when necessary, such as for clients with difficulty swallowing. However, it's essential to verify with the specific prescription, as acetaminophen is also available in extended-release formulations, which should not be crushed.

A. Shake bottle well, pull car outward and downward, instill drops. B. Shake bottle well, pull ear outward and upward, instill drops C. Warm bottle in hand pull ear outward and upward, instill drops D. Warm bottle in hand, pull ear outward and downward, instill drops

Correct Answer is C

Explanation

A) Shake bottle well, pull ear outward and downward, instill drops: This method is typically used for younger children, such as infants or toddlers, as the ear canal in younger children is more horizontal. However, this is not the appropriate method for a 12-year-old.

B) Shake bottle well, pull ear outward and upward, instill drops: This method is incorrect because the ear should be pulled outward and upward for a child under 3 years old, not for a 12-year-old.

C) Warm bottle in hand, pull ear outward and upward, instill drops: This is the correct method for a 12-year-old client. The ear should be pulled outward and upward to straighten the ear canal, allowing the drops to reach the deeper parts of the ear. Additionally, warming the bottle in your hands prevents discomfort that might arise from cold drops being instilled in the ear.

D) Warm bottle in hand, pull ear outward and downward, instill drops: This method is appropriate for children under 3 years old. For children older than 3 years, the ear should be pulled upward to open the ear canal.

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A client is prescribed ondansetron for nausea. When reviewing the client's medical history, which finding would concern the nurse?

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Naxlex Comprehensive Predictor Exams

Which prescribed medication can the nurse instruct the client to crush if needed?

Correct Answer is D

Explanation

You are administering an otic drop for an ear infection to a 12-year-old client. What is the proper method for otic drop instillation in this client?

Correct Answer is C

Explanation

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