A nurse is caring for a client who has HIV-1 infection and is prescribed zidovudine as part of antiretroviral therapy. The nurse should monitor the client for which of the following adverse effects of this medication?
Bone marrow suppression
Metabolic alkalosis
Hypoglycemia
Hyperkalemia
The Correct Answer is A
Choice A reason: Zidovudine, a nucleoside reverse transcriptase inhibitor, commonly causes bone marrow suppression, leading to anemia, neutropenia, or thrombocytopenia. It inhibits DNA synthesis in rapidly dividing bone marrow cells, reducing red blood cell, white blood cell, and platelet production. Monitoring complete blood counts is essential to detect these hematologic toxicities early and manage them appropriately.
Choice B reason: Metabolic alkalosis is not a known adverse effect of zidovudine. The drug primarily affects hematopoiesis and mitochondrial function, not acid-base balance. Metabolic alkalosis may occur in conditions like excessive vomiting or diuretic use, but zidovudine’s mechanism does not alter bicarbonate or pH levels, making this an unlikely complication.
Choice C reason: Hypoglycemia is not associated with zidovudine. The drug’s primary toxicities involve bone marrow and mitochondrial dysfunction, not glucose metabolism. Hypoglycemia may occur with other conditions or medications, like insulin, but zidovudine does not affect pancreatic function or glucose regulation, so monitoring for this is unnecessary in this context.
Choice D reason: Hyperkalemia is not a recognized side effect of zidovudine. The drug’s adverse effects center on hematologic and muscular systems, not electrolyte balance. Hyperkalemia may result from renal dysfunction or other medications, but zidovudine does not disrupt potassium homeostasis, so it is not a priority for monitoring in this patient.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A reason: Bradypnea, or slow respiratory rate, is not typical in hypovolemic shock. The body compensates for reduced blood volume by increasing respiratory rate (tachypnea) to enhance oxygen delivery to tissues. This compensates for decreased oxygen-carrying capacity due to blood loss. Bradypnea would indicate a failure of compensatory mechanisms, which is not characteristic of hypovolemic shock’s early stages.
Choice B reason: Hypotension is an expected finding in hypovolemic shock due to decreased blood volume, reducing cardiac output and systemic perfusion pressure. The body activates the sympathetic nervous system, causing vasoconstriction and tachycardia to compensate, but blood pressure remains low. This reflects inadequate circulating volume, leading to impaired tissue perfusion and potential organ dysfunction if untreated.
Choice C reason: Bradycardia is not typical in hypovolemic shock. The body responds to low blood volume with tachycardia to maintain cardiac output and tissue perfusion. Bradycardia may occur in late, decompensated shock due to severe hypoxia or myocardial depression, but it is not an expected finding in earlier stages, where sympathetic activation predominates.
Choice D reason: Increased urine output is not expected in hypovolemic shock. The kidneys respond to reduced blood volume by decreasing urine production through activation of the renin-angiotensin-aldosterone system, which promotes sodium and water retention. Oliguria (low urine output) is typical, as the body conserves fluid to restore intravascular volume and maintain blood pressure.
Correct Answer is B
Explanation
Choice A reason: Checking the client’s temperature hourly monitors for transfusion reactions but does not prevent them. Fever may indicate a reaction, but prevention relies on ensuring blood compatibility and proper administration. Monitoring is a reactive measure, not a proactive step to avoid mismatches or errors causing hemolytic or febrile reactions.
Choice B reason: Verifying the client’s identity and blood type with another nurse is critical to prevent transfusion reactions. Mismatched blood types cause hemolytic reactions due to antibody-mediated destruction of donor red cells. Double-checking ensures the correct blood unit is administered, preventing life-threatening immunological responses and ensuring patient safety during transfusion.
Choice C reason: Administering diphenhydramine may prevent mild allergic reactions to blood transfusions, such as hives, but it does not address severe hemolytic reactions caused by ABO incompatibility. It is not routinely given prophylactically unless the client has a history of allergic reactions, making it less critical than verifying blood compatibility.
Choice D reason: Infusing blood over 6 hours increases the risk of bacterial growth and hemolysis in the blood unit, as transfusions should typically be completed within 4 hours. Prolonged infusion does not prevent reactions and may cause complications, making it an incorrect action for ensuring safe transfusion practices.
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.