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.
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
Insulin lispro is a rapid-acting insulin used to manage hyperglycemia in clients with diabetes mellitus. Its primary mechanism involves facilitating glucose uptake into cells and inhibiting hepatic glucose production. It does not directly mitigate the adverse effects, such as myelosuppression and gastrointestinal issues, associated with topotecan, a topoisomerase I inhibitor used in chemotherapy.
Choice B rationale
Granisetron is a serotonin 5-HT3 receptor antagonist, primarily used to prevent nausea and vomiting induced by chemotherapy. It works by blocking serotonin's action on vagal nerve terminals and in the chemoreceptor trigger zone in the brainstem. This action effectively controls a common and distressing adverse effect of topotecan, thereby improving client comfort and compliance.
Choice C rationale
Magnesium sulfate is an electrolyte replacement and smooth muscle relaxant. It is used in conditions like pre-eclampsia, eclampsia, and hypomagnesemia. Its physiological effects involve stabilizing neuronal excitability and reducing uterine contractions. It is not indicated for the management of topotecan's adverse effects, which predominantly involve myelosuppression and gastrointestinal toxicity.
Choice D rationale
Prednisone is a corticosteroid with potent anti-inflammatory and immunosuppressive properties. It is used to treat various conditions, including autoimmune disorders, allergic reactions, and some cancers. While it can reduce inflammation, it does not specifically target the common adverse effects of topotecan, such as myelosuppression and gastrointestinal disturbances.
Correct Answer is D
Explanation
Choice A rationale
Bronchospasm is a constriction of the airways, commonly seen in respiratory conditions like asthma. It is mediated by inflammatory responses and smooth muscle contraction in the bronchi. Acetazolamide, a carbonic anhydrase inhibitor, does not typically cause bronchospasm; its primary effects are on fluid and electrolyte balance and intraocular pressure.
Choice B rationale
Constipation is a common gastrointestinal symptom characterized by infrequent or difficult bowel movements. It can be caused by various factors, including dietary habits, medications, and underlying medical conditions. Acetazolamide's mechanism of action, involving inhibition of carbonic anhydrase, does not directly lead to constipation as a significant adverse effect.
Choice C rationale
Diplopia, or double vision, is a visual disturbance where a single object appears as two. It can result from ocular muscle weakness, nerve damage, or other neurological conditions. Acetazolamide's therapeutic effects are on aqueous humor production in the eye to reduce intraocular pressure, but diplopia is not a recognized adverse effect of this medication.
Choice D rationale
Acetazolamide is a carbonic anhydrase inhibitor that promotes the excretion of bicarbonate, sodium, potassium, and water. This diuretic action can lead to metabolic acidosis, hypokalemia (normal range: 3.5-5.0 mEq/L), and hyponatremia (normal range: 135-145 mEq/L) due to increased renal excretion, hence requiring close monitoring of electrolyte balance.
Whether you are a student looking to ace your exams or a practicing nurse seeking to enhance your expertise , our nursing education contents will empower you with the confidence and competence to make a difference in the lives of patients and become a respected leader in the healthcare field.
Visit Naxlex, invest in your future and unlock endless possibilities with our unparalleled nursing education contents today
Report Wrong Answer on the Current Question
Do you disagree with the answer? If yes, what is your expected answer? Explain.
Kindly be descriptive with the issue you are facing.