A nurse is caring for a client who has a ventricular dysrhythmia and a new prescription for amiodarone.
Which of the following interventions should the nurse include in the client's plan of care?
Schedule the client for a hearing screening twice per year.
Remind the client to report an increase in appetite.
Instruct the client to have liver enzyme testing periodically.
Monitor the client for the development of manic behavior.
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A rationale
Constipation is not a commonly associated adverse effect of ciprofloxacin. Fluoroquinolones primarily impact gastrointestinal motility through alterations in gut flora and direct irritation, often leading to diarrhea or abdominal discomfort rather than constipation. The drug's mechanism does not typically promote slowed bowel movements or decreased peristalsis.
Choice B rationale
Weight gain is not a typical adverse effect of ciprofloxacin. Fluoroquinolones do not directly influence metabolic pathways or fluid retention in a manner that would lead to increased body mass. Adverse effects are usually related to gastrointestinal disturbances, neurological effects, or musculoskeletal issues.
Choice C rationale
Phototoxicity is a significant adverse effect of ciprofloxacin, a fluoroquinolone antibiotic. This occurs due to the drug's ability to absorb ultraviolet radiation, leading to a photochemical reaction that damages skin cells. This damage can manifest as severe sunburn, blistering, or rash upon exposure to sunlight.
Choice D rationale
Bradycardia is not a recognized adverse effect of ciprofloxacin. While some antibiotics can rarely affect cardiac conduction, ciprofloxacin's primary cardiovascular concerns relate more to QT prolongation and potential arrhythmias, not typically a decrease in heart rate. Its mechanism does not directly depress sinoatrial node function.
Correct Answer is B
Explanation
Choice A rationale
Gingival hyperplasia is an overgrowth of gum tissue, often associated with certain medications like phenytoin or cyclosporine. It is caused by an increase in the number of fibroblasts and collagen deposition in the gingiva. Haloperidol, an antipsychotic, primarily affects dopamine receptors in the brain and does not cause gingival hyperplasia.
Choice B rationale
Haloperidol is a first-generation antipsychotic that blocks D2 dopamine receptors in the brain. This blockade, particularly in the nigrostriatal pathway, can lead to extrapyramidal symptoms (EPS) such as acute dystonia, parkinsonism (including muscle rigidity, bradykinesia, and tremor), and akathisia. Muscle rigidity is a common manifestation of drug-induced parkinsonism.
Choice C rationale
Polyuria is the excessive production of urine, often a symptom of diabetes mellitus or insipidus. It results from impaired water reabsorption in the kidneys. While some medications can affect fluid balance, haloperidol's primary pharmacological action on dopamine receptors does not directly induce polyuria as a typical adverse effect.
Choice D rationale
Bruising, or ecchymosis, results from bleeding under the skin, often due to trauma or coagulation disorders. It is caused by extravasation of blood from capillaries into surrounding tissues. Haloperidol does not affect coagulation factors or platelet function and is not associated with increased bruising as a direct adverse effect.
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