A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client’s history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation on the advice of a friend.
Which information is most significant about this finding?
The client probably used this herb to treat depression.
Wort can decrease plasma concentrations of the cyclosporine.
Ingestion of wort can reduce the client’s intake of sodium.
Adding the herb can decrease the need for corticosteroids.
Adding the herb can decrease the need for corticosteroids.
The Correct Answer is B
Cyclosporine is an immunosuppressive medication commonly used to prevent graft rejection after organ transplantation. St. John's Wort is known to induce cytochrome P450 enzymes, which can increase the metabolism and decrease the effectiveness of many medications, including cyclosporine. This interaction can lead to decreased plasma concentrations of cyclosporine, which can increase the risk of graft rejection. Therefore, it is important to advise the client to discontinue the use of St. John's Wort and inform their healthcare provider about any herbal or supplement use to prevent potential interactions with prescribed medications. Options a, c, and d are not directly related to the client's current condition and are not as significant as option b.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Gentamicin sulfate is an aminoglycoside antibiotic that can cause ototoxicity, which is damage to the inner ear leading to hearing loss or balance problems. Therefore, a decrease in hearing is an indication that the client may be experiencing an adverse effect of gentamicin.
Option b, decreased blood urea nitrogen, is not an adverse effect of gentamicin, but it may indicate improvement in kidney function, which can be a positive outcome of treatment.
Option c, a white blood cell count of 6,000/mm3 (6x109/L), is within the normal range and is not necessarily an adverse effect of gentamicin.
Option d, photophobia, is not a common adverse effect of gentamicin and may indicate a different condition or medication effect.
Correct Answer is C
Explanation
Baclofen is a muscle relaxant medication used to treat muscle spasticity, which is a condition that causes muscles to become stiff and rigid. It works by reducing the activity of nerves in the brain and spinal cord that cause muscle spasms.
Option a, using stool softener as needed, is appropriate because baclofen can cause constipation as a side effect.
Option b, avoiding ingestion of alcohol, is also appropriate because alcohol can increase the sedative effects of baclofen and cause drowsiness or dizziness.
Option d, taking medication with meals, is recommended because it can help reduce stomach upset and nausea that may occur as a side effect of the medication.
Option c, discontinuing the medication when spasms cease, is incorrect because muscle spasticity is a chronic condition, and baclofen is used to manage symptoms over a prolonged period. Discontinuing the medication abruptly can cause withdrawal symptoms and exacerbate the spasticity. Therefore, the nurse should educate the client to take the medication as prescribed by the healthcare provider and not discontinue it without medical advice.
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