A nurse is assessing a client who is taking codeine 60 mg PO every 4 hr as necessary to suppress a cough.
Which of the following findings is the priority for the nurse to report to the provider?

Constipation.

Dry mouth.

Agitation.

Urinary retention.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Constipation is a very common and expected adverse effect of codeine due to its opioid effects on gastrointestinal motility, specifically by decreasing propulsive contractions. While it requires management, it is generally not the highest priority unless it leads to severe complications like impaction, making other acute symptoms more immediately concerning. Normal bowel frequency varies but ranges from three times daily to three times weekly.

Choice B rationale

Dry mouth, or xerostomia, is a common anticholinergic-like effect of opioid medications like codeine. While uncomfortable, it is typically a mild, non-life-threatening side effect. It can be managed with hydration and oral hygiene measures and does not represent an acute physiological threat requiring immediate reporting as a priority.

Choice C rationale

Agitation, especially in the context of opioid use, can be a sign of central nervous system excitation or an idiosyncratic reaction. It can indicate a paradoxical effect of the medication or an emerging adverse event that could escalate to more serious neurological complications, such as seizures or respiratory compromise if not promptly addressed.

Choice D rationale

Urinary retention is a known adverse effect of opioids due to their effect on bladder detrusor muscle tone and sphincter function. While it is important to monitor and manage, potentially requiring catheterization, it is generally not as immediately life-threatening as signs of central nervous system instability or respiratory compromise, making agitation a higher priority in the acute setting.

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Correct Answer is B

Explanation

Choice A rationale

Tuberculosis is a bacterial infection primarily affecting the lungs, caused by *Mycobacterium tuberculosis*. Didanosine is an antiretroviral medication, specifically a nucleoside reverse transcriptase inhibitor (NRTI), and as such, it does not possess antimicrobial activity against bacterial pathogens like *Mycobacterium tuberculosis*. Therefore, it is not indicated for treating tuberculosis.

Choice B rationale

Human immunodeficiency virus (HIV) is a retrovirus that attacks the body's immune system. Didanosine is an antiretroviral drug that inhibits the replication of HIV by interfering with the reverse transcriptase enzyme, which is crucial for the virus to convert its RNA into DNA. This mechanism of action effectively reduces the viral load and improves immune function in individuals with HIV infection.

Choice C rationale

Bacterial meningitis is an inflammation of the meninges, the membranes surrounding the brain and spinal cord, caused by various bacterial species. Didanosine is an antiviral agent specifically targeting retroviruses like HIV. It does not have any direct antibacterial properties or efficacy against the common bacterial pathogens responsible for meningitis, thus making it an inappropriate treatment.

Choice D rationale

Syphilis is a sexually transmitted infection caused by the bacterium *Treponema pallidum*. The primary treatment for syphilis is antibiotics, particularly penicillin. Didanosine, being an antiretroviral medication, does not exhibit any treponemicidal activity and is ineffective against *Treponema pallidum*. Therefore, it is not used in the treatment of syphilis.

A. The client is taking acetaminophen. B. The client is taking valerian. C. The client is taking vitamin B. D. The client is taking ginkgo biloba.

Correct Answer is D

Explanation

Choice A rationale

Acetaminophen is an analgesic and antipyretic that primarily inhibits prostaglandin synthesis in the central nervous system. It does not significantly interact with clopidogrel, an antiplatelet medication, regarding its antiplatelet activity or bleeding risk. Therefore, reporting acetaminophen use to the provider is generally not a high priority unless liver concerns exist.

Choice B rationale

Valerian is an herbal supplement commonly used for sleep and anxiety. It primarily interacts with gamma-aminobutyric acid (GABA) receptors in the brain. There is no significant scientific evidence or known pharmacokinetic interaction between valerian and clopidogrel that would necessitate reporting its use to the provider due to increased bleeding risk.

Choice C rationale

Vitamin B refers to a group of water-soluble vitamins crucial for various cellular metabolic processes. Generally, vitamin B supplements do not have a known significant interaction with clopidogrel that would alter its antiplatelet effect or increase bleeding risk. Therefore, taking vitamin B is not typically a concern to report.

Choice D rationale

Ginkgo biloba is an herbal supplement known for its antiplatelet properties due to its ability to inhibit platelet-activating factor. Concomitant use with clopidogrel, another potent antiplatelet agent, significantly increases the risk of bleeding. This synergistic effect on platelet aggregation warrants immediate reporting to the provider for assessment and potential dosage adjustments.

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A nurse is assessing a client who is taking codeine 60 mg PO every 4 hr as necessary to suppress a cough. Which of the following findings is the priority for the nurse to report to the provider?

Nursing Test Bank

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A nurse is assessing a client who is taking codeine 60 mg PO every 4 hr as necessary to suppress a cough.
Which of the following findings is the priority for the nurse to report to the provider?