A nurse is caring for a client who has a new prescription for an ipratropium inhaler to control COPD bronchospasm.
For which of the following adverse effects should the nurse monitor?
Xerostomia.
Periorbital edema.
Bradycardia.
Dental caries.
The Correct Answer is A
Choice A rationale
Ipratropium is an anticholinergic bronchodilator that blocks muscarinic receptors in the bronchial smooth muscle, leading to bronchodilation. A common adverse effect of anticholinergic medications is reduced salivary gland secretion, resulting in xerostomia, or dry mouth, due to inhibition of parasympathetic stimulation.
Choice B rationale
Periorbital edema is not a typical adverse effect of ipratropium. This medication primarily targets muscarinic receptors in the respiratory tract. Edema, particularly around the eyes, is more commonly associated with allergic reactions or fluid retention from other medications.
Choice C rationale
Ipratropium, being an anticholinergic, primarily acts on M3 receptors in the lungs and has minimal systemic absorption, thus rarely causing bradycardia. In fact, anticholinergics can sometimes cause a mild increase in heart rate due to blockade of M2 receptors in the heart, but clinically significant changes are uncommon.
Choice D rationale
While xerostomia can contribute to dental issues over time due to reduced saliva's protective effects, dental caries is not a direct, acute adverse effect of ipratropium itself. It is a potential long-term complication of prolonged dry mouth, rather than a direct drug-induced effect to monitor immediately.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A rationale
A history of migraine headaches is not a contraindication for metformin. Metformin's primary mechanism involves reducing hepatic glucose production and improving insulin sensitivity in peripheral tissues. Migraine headaches are neurological conditions not directly influenced by or interacting adversely with metformin's metabolic actions.
Choice B rationale
Alcohol use disorder is a significant contraindication for metformin due to an increased risk of lactic acidosis. Alcohol consumption can impair hepatic lactate metabolism and increase lactate production, while metformin itself can elevate lactate levels. The combination markedly raises the likelihood of this severe metabolic complication.
Choice C rationale
A history of peptic ulcer disease is not a direct contraindication for metformin. While some gastrointestinal side effects like nausea or diarrhea can occur with metformin, these are generally not severe enough to preclude its use in patients with a history of peptic ulcer disease, especially if the ulcer is currently resolved.
Choice D rationale
Tobacco use is not a direct contraindication for metformin. While tobacco use is a risk factor for various health issues, including cardiovascular disease and complications of diabetes, it does not physiologically interact with metformin in a manner that would contraindicate its use. The primary concerns with tobacco are unrelated to metformin's metabolism or side effect profile.
Correct Answer is D
Explanation
Choice A rationale
Magnesium levels within the normal range of 1.3 to 2.1 mEq/L do not directly indicate a therapeutic response to sodium polystyrene sulfonate. This medication is primarily used to exchange potassium ions for sodium ions in the gastrointestinal tract, thus lowering serum potassium. Magnesium homeostasis is regulated independently, often by renal excretion and dietary intake, and is not a direct target of this drug.
Choice B rationale
Calcium levels within the normal range of 9 to 10.5 mg/dL do not indicate a therapeutic response to sodium polystyrene sulfonate. This medication does not significantly impact calcium metabolism. Calcium regulation involves parathyroid hormone and vitamin D, and is separate from the ion-exchange mechanism of sodium polystyrene sulfonate.
Choice C rationale
Sodium levels within the normal range of 136 to 145 mEq/L, while desirable, do not directly indicate a therapeutic response to sodium polystyrene sulfonate. Although the medication exchanges potassium for sodium, leading to a potential increase in serum sodium, the primary therapeutic goal is potassium reduction, and a normal sodium level alone does not confirm this.
Choice D rationale
A potassium level of 4.8 mEq/L, which falls within the normal range of 3.5 to 5 mEq/L, indicates a therapeutic response to sodium polystyrene sulfonate. This medication functions as a cation-exchange resin, binding to potassium ions in the intestine and facilitating their excretion, thereby lowering elevated serum potassium levels to a safe range.
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