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 C
Explanation
Choice A rationale
Amiodarone is known to cause various adverse effects, but ototoxicity leading to hearing impairment is not a commonly reported or significant side effect. The primary concerns with amiodarone involve pulmonary, thyroid, hepatic, and ocular toxicities. Therefore, routine hearing screenings are not a standard intervention in the care plan for clients on amiodarone.
Choice B rationale
An increase in appetite is not a recognized or common adverse effect associated with amiodarone. Amiodarone can cause gastrointestinal side effects such as nausea, vomiting, and anorexia, but an increased appetite is not typically observed. Monitoring for such a symptom would not be a priority in the client's plan of care.
Choice C rationale
Amiodarone is extensively metabolized by the liver and is known to cause hepatotoxicity, ranging from asymptomatic transaminase elevation to severe hepatitis and cirrhosis. Therefore, periodic monitoring of liver enzyme levels (e.g., AST, ALT, alkaline phosphatase) is crucial to detect early signs of liver injury and adjust treatment if necessary. Normal AST levels are typically 10-40 U/L, and ALT levels are 7-56 U/L.
Choice D rationale
While some medications can cause psychiatric disturbances, manic behavior is not a commonly reported or characteristic adverse effect of amiodarone. The central nervous system effects of amiodarone are more likely to include peripheral neuropathy, ataxia, and tremors. Monitoring for manic behavior is not a standard intervention for clients on amiodarone therapy.
Correct Answer is C
Explanation
Choice A rationale
Sodium bicarbonate is used to treat metabolic acidosis or certain drug overdoses, but it does not directly address hypocalcemia, which is the underlying cause of a positive Trousseau's sign. Its primary action is to increase systemic pH, not calcium levels.
Choice B rationale
Magnesium sulfate is administered for magnesium deficiencies, pre-eclampsia, or certain arrhythmias. While magnesium deficiency can sometimes exacerbate hypocalcemia, it is not the primary treatment for Trousseau's sign, which specifically indicates low calcium.
Choice C rationale
Calcium gluconate is the appropriate medication to administer for a positive Trousseau's sign, as this sign indicates hypocalcemia (low serum calcium levels). Calcium gluconate directly replenishes calcium, correcting the neuromuscular excitability caused by insufficient extracellular calcium.
Choice D rationale
Potassium chloride is given to treat hypokalemia (low potassium levels). While electrolyte imbalances can be complex, a positive Trousseau's sign is specifically indicative of hypocalcemia, not hypokalemia, and potassium administration would not resolve the underlying issue.
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