A nurse is caring for a client diagnosed with chronic renal disease. The nurse should recognize that which of the following medications is contraindicated for clients with chronic renal disease?

Docusate Sodium (Colace)

Acetaminophen (Tylenol)

Meperidine (Demerol)

Atorvastatin (Lipitor)

Answer and Explanation

The Correct Answer is C

A.   Docusate Sodium (Colace) is a stool softener and is not contraindicated in chronic renal disease.
B.   Acetaminophen (Tylenol) is generally safe for use in chronic renal disease, but dosing adjustments may be necessary based on renal function.
C.   Meperidine (Demerol) is contraindicated in clients with chronic renal disease because its metabolites can accumulate in renal impairment, leading to neurotoxicity and seizures. It is often replaced with alternative opioid analgesics like morphine or fentanyl in these patients.
D.   Atorvastatin (Lipitor) is a statin medication used to lower cholesterol levels and is generally safe in chronic renal disease, although dosing adjustments may be needed depending on the severity of renal impairment.

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Correct Answer is C

Explanation

A. "Increase your intake of grapefruit juice."

Grapefruit juice can interact with many medications, including colchicine, potentially increasing the risk of adverse effects or reducing its effectiveness. Therefore, it is not recommended to increase grapefruit juice intake while taking colchicine.

B. "Expect to have increased generalized bruising." Increased bruising is not a common side effect of colchicine.

C. "Monitor for muscle pain."

Colchicine is associated with myotoxicity, which can manifest as muscle pain or weakness. Therefore, the client should be instructed to monitor for signs and symptoms of muscle pain and report them promptly to their healthcare provider.

D. "Take this medication without food if nausea develops."

While colchicine can cause gastrointestinal side effects such as nausea and vomiting, taking it without food may exacerbate these symptoms. It is generally recommended to take colchicine with food to minimize gastrointestinal upset.

A. "High blood pressure reduces renal blood flow and harms the kidney tissue, causing this diagnosis." B. "Thickening of the kidney structures and gradual death of nephrons has caused this diagnosis." C. "Cysts compress renal tissue, which destroys the kidneys, causing this diagnosis." D. "Immune complexes form in the kidney tissue and produce inflammation, causing this diagnosis."

Correct Answer is A

Explanation

A. "High blood pressure reduces renal blood flow and harms the kidney tissue, causing this diagnosis." Chronic renal disease often develops as a complication of long-standing

hypertension. Persistent high blood pressure can damage the small blood vessels in the kidneys, reducing blood flow and causing kidney tissue damage over time.

B. "Thickening of the kidney structures and gradual death of nephrons has caused this diagnosis." This statement describes changes seen in conditions like diabetic nephropathy but is not specific to the development of renal disease in hypertension.

C. "Cysts compress renal tissue, which destroys the kidneys, causing this diagnosis." This statement describes the pathogenesis of polycystic kidney disease, not chronic renal disease due to hypertension.

D. "Immune complexes form in the kidney tissue and produce inflammation, causing this diagnosis." This statement describes the pathogenesis of glomerulonephritis, not chronic renal disease due to hypertension.

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A nurse is caring for a client diagnosed with chronic renal disease. The nurse should recognize that which of the following medications is contraindicated for clients with chronic renal disease?

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