A male client who has been taking a high-dose of a nonsteroidal anti-inflammatory drug (NSAID) comes to the clinic reporting gastric pain and blood in his stool. The healthcare provider discontinues the NSAIDs and prescribes esomeprazole. Which information should the nurse include in this client's te’ching plan?

Notify the healthcare provider of the passage of black stools.

Call the clinic if diarrhea or headache occur when taking esomeprazole.

Once pain subsides, NSAID therapy can be resumed.

Resume a diet that consists of milk, cream, and bland foods.

Answer and Explanation

The Correct Answer is A

A) Notify the healthcare provider of the passage of black stools: This is the correct response. Black stools can indicate gastrointestinal bleeding, which is a serious adverse effect of NSAID use. It's im’ortant for the client to report this symptom promptly to the healthcare provider for further evaluation and management.

B) Call the clinic if diarrhea or headache occur when taking esomeprazole: While it's im’ortant to report any adverse effects of medication to the healthcare provider, diarrhea and headache are not specific to esomeprazole and may not warrant immediate attention unless severe or persistent.

C) Once pain subsides, NSAID therapy can be resumed: This statement is incorrect. The client should avoid NSAIDs in the future, as they are likely the cause of the gastric pain and gastrointestinal bleeding. Resuming NSAID therapy would increase the risk of recurrent bleeding.

D) Resume a diet that consists of milk, cream, and bland foods: This statement is incorrect. While bland foods may be easier to tolerate during acute gastric pain, they do not address the underlying issue of gastrointestinal bleeding. Additionally, dairy products like milk and cream may exacerbate symptoms in some individuals.

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Correct Answer is B

Explanation

A) Decreased blood urea nitrogen (BUN) is not a typical adverse effect of gentamicin. Gentamicin is primarily associated with nephrotoxicity (kidney damage), which would manifest as an increased BUN and serum creatinine rather than a decrease.

B) Hearing loss is a well-known adverse effect of gentamicin, particularly when the drug reaches high concentrations in the inner ear (ototoxicity). Gentamicin can cause irreversible damage to the cochlear and vestibular organs, leading to sensorineural hearing loss and balance disturbances.

C) Reports of photophobia are not typically associated with gentamicin. Photophobia (sensitivity to light) may occur with certain eye conditions or central nervous system disorders but is not a direct adverse effect of gentamicin.

D) A white blood cell count of 6,000/mm3 falls within the normal reference range, so it does not indicate an adverse effect of gentamicin. Gentamicin is not known to directly affect white blood cell count.

A. Obtain transportation to the emergency department. B. Increase Intake of fluids and high protein foods. C. Stop taking the medication Immediately. D. Avoid hazardous activities until symptoms subside.

Correct Answer is D

Explanation

A) Obtaining transportation to the emergency department may be unnecessary at this time. The client's sy’ptoms of fatigue and dizziness are likely side effects of the new medication, baclofen, and not indicative of a medical emergency. It's es’ential to assess the severity of symptoms and provide appropriate guidance before considering emergency care.

B) Increasing intake of fluids and high-protein foods may be beneficial for overall health but is not directly related to addressing the side effects of baclofen. While adequate hydration and nutrition are essential, this recommendation may not specifically address the client's sy’ptoms of fatigue and dizziness.

C) Stopping the medication immediately without consulting a healthcare provider is not advisable. Abruptly discontinuing baclofen can lead to withdrawal symptoms and a potential worsening of muscle spasticity. It's cr’cial for the client to discuss any concerns or side effects with their healthcare provider before making any changes to their medication regimen.

D) Advising the client to avoid hazardous activities until symptoms subside is the most appropriate action. Baclofen, as a muscle relaxant, can cause dizziness and fatigue, which may impair the client's ab’lity to safely engage in activities such as driving or operating machinery. By avoiding hazardous activities, the client can reduce the risk of injury or accidents while experiencing these side effects.

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Naxlex Comprehensive Predictor Exams

A male client has been receiving the antibiotic gentamicin sulfate, IV piggyback every 12 hours for several days. Which observation by the nurse indicates that the client may be experiencing an adverse effect of gentamicin? Reference Range: White Blood Cell [5000 to 10,000/mm3 (5 to 10 x 10%)]

Correct Answer is B

Explanation

A client with multiple sclerosis starts a new prescription, baclofen, to control muscle spasticity. Three days later, the client calls the clinic nurse and reports feeling fatigued and dizzy. Which instruction should the nurse provide?

Correct Answer is D

Explanation

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