A client with amyotrophic lateral sclerosis (ALS) has been taking riluzole for two weeks. The nurse notes that the client remains weak with observable muscle atrophy. Which action should the nurse take?

Document the assessment findings in the electronic health record.

Explain that the medication takes several weeks to reverse symptoms.

Advise the client to schedule an appointment for liver function tests.

Withhold the medication until the healthcare provider is notified.

Answer and Explanation

The Correct Answer is A

A. Document the assessment findings in the electronic health record: Riluzole is not curative for ALS; it only modestly slows disease progression. Continuing muscle weakness and atrophy are expected findings in ALS, even after starting treatment. Accurate documentation is appropriate because no immediate change in therapy is indicated based solely on these observations.

B. Explain that the medication takes several weeks to reverse symptoms: Riluzole does not reverse ALS symptoms. It may slightly prolong survival by slowing the progression of muscle weakness, but it does not regenerate lost function or reverse disease-related damage.

C. Advise the client to schedule an appointment for liver function tests: Riluzole can affect liver function and periodic monitoring is important, but muscle weakness alone does not directly signal liver problems. Unless there are signs of hepatotoxicity, there is no immediate need for unscheduled testing.

D. Withhold the medication until the healthcare provider is notified: There is no indication to withhold riluzole based on ongoing muscle weakness, as this is consistent with the natural course of ALS. Interrupting therapy without a clear medical reason could harm the client.

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Free Nursing Study Resources

Correct Answer is A

Explanation

A. Avoid the use of alcohol: Metronidazole can cause a disulfiram-like reaction when combined with alcohol, leading to severe nausea, vomiting, flushing, tachycardia, and hypotension. Clients must be strictly advised to avoid all forms of alcohol, including hidden sources like cough syrups, during treatment and for at least 48 hours after completing therapy.

B. Drink a liter of water daily: While staying hydrated is generally good for overall health, it's not a specific requirement directly related to the action or side effects of metronidazole for C. difficile colitis. Maintaining adequate fluid intake is important for managing diarrhea associated with the infection, but it's not a direct instruction tied to the medication itself.

C. Keep medication refrigerated: Metronidazole tablets or oral suspension do not require refrigeration; they should be stored at room temperature. Refrigeration is not necessary and could even alter the medication’s consistency or effectiveness.

D. Take one hour after eating: Metronidazole is generally better tolerated when taken with food to minimize gastrointestinal upset. Advising clients to take it after eating can help but is not mandatory nor the most crucial teaching point compared to alcohol avoidance.

A. Report the finding to the healthcare provider. B. Check the client's capillary glucose level. C. Advise the client to reduce the medication dose. D. Use a pulse oximeter to assess oxygen saturation.

Correct Answer is A

Explanation

A. Report the finding to the healthcare provider: Yellow discoloration of the skin, or jaundice, suggests possible liver dysfunction, which can occur with acetaminophen toxicity, especially if taken chronically or in high doses. Promptly reporting this finding is crucial so that further evaluation and intervention can be initiated to prevent worsening liver injury.

B. Check the client's capillary glucose level: Although liver dysfunction can eventually affect glucose metabolism, checking a capillary glucose level does not directly address the urgent concern of jaundice and potential hepatotoxicity related to acetaminophen use.

C. Advise the client to reduce the medication dose: Simply advising dose reduction without proper evaluation could delay diagnosis and treatment of potentially serious liver damage. A healthcare provider needs to assess the situation before any medication changes are made.

D. Use a pulse oximeter to assess oxygen saturation: Oxygen saturation monitoring is essential for respiratory or cardiac concerns but does not directly relate to jaundice or liver function. Therefore, it would not be the appropriate first action in this situation.

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A client with amyotrophic lateral sclerosis (ALS) has been taking riluzole for two weeks. The nurse notes that the client remains weak with observable muscle atrophy. Which action should the nurse take?

Nursing Test Bank

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