A nurse is caring for a client who is receiving neostigmine. Which of the following manifestations should the nurse identify as an adverse reaction to the medication? (Select all that apply.)

Hypoactive bowel sounds

Sweating

Respiratory distress

Urinary retention

Bradycardia

Answer and Explanation

Correct Answer : B,C,E

Neostigmine is a medication classified as an acetylcholinesterase inhibitor. It is commonly used to treat myasthenia gravis and to reverse the effects of non-depolarizing neuromuscular blocking agents used during surgery. Adverse reactions to neostigmine are related to its cholinergic effects, which result from increased acetylcholine levels in the body.

Let's go through the options:

A. Hypoactive bowel sounds: Neostigmine can actually increase gastrointestinal motility and may cause increased bowel sounds or even diarrhea, not hypoactive bowel sounds. Therefore, hypoactive bowel sounds are not an adverse reaction to neostigmine.

B. Sweating: Sweating is a cholinergic effect and can be an adverse reaction to neostigmine. Increased sweating is a common sign of cholinergic stimulation.

C. Respiratory distress: Respiratory distress can occur as an adverse reaction to neostigmine, particularly if the client has a history of asthma or other respiratory conditions. Neostigmine can cause bronchoconstriction and excessive secretions, leading to respiratory distress.

D. Urinary retention: Neostigmine is actually used to treat urinary retention by increasing bladder contraction. Therefore, urinary retention is not an adverse reaction to neostigmine.

E. Bradycardia: Bradycardia (slow heart rate) is a significant adverse reaction to neostigmine due to its cholinergic effects on the heart. Increased acetylcholine levels can lead to excessive stimulation of the vagus nerve, resulting in bradycardia.

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Correct Answer is ["18.8"]

Explanation

To calculate the rate at which the IV pump should deliver dopamine, we can follow these steps:

Step 1: Convert the weight of the client from pounds to kilograms.

220 lb ÷ 2.2 = 100 kg (rounded to the nearest whole number)

Step 2: Calculate the total dose of dopamine per minute.

5 mcg/kg/min × 100 kg = 500 mcg/min

Step 3: Convert the dose from micrograms (mcg) to milligrams (mg).

500 mcg/min ÷ 1000 = 0.5 mg/min

Step 4: Determine the infusion rate in milliliters per hour (mL/hr).

The total volume of the solution is 250 mL.

The total dose of dopamine is 400 mg.

So, the infusion rate is (0.5 mg/min ÷ 400 mg) × 250 mL = 0.3125 mL/min.

Step 5: Convert the infusion rate from mL/min to mL/hr.

0.3125 mL/min × 60 min/hr = 18.75 mL/hr (rounded to the nearest tenth).

Therefore, the nurse should set the IV pump to deliver 18.8 mL/hr (rounded to the nearest tenth).

A. Dabigatran B. Levothyroxine C. Isoproterenol D. Furosemide

Correct Answer is D

Explanation

Furosemide, a loop diuretic, is known to cause orthostatic hypotension as an adverse effect. It works by increasing urine output and reducing fluid volume, which can lead to a decrease in blood pressure when standing up, causing dizziness or lightheadedness.

Dabigatran (A) is an anticoagulant used to prevent blood clots and does not typically cause orthostatic hypotension as a side effect.

Levothyroxine (B) is a thyroid hormone replacement medication used to treat hypothyroidism. It does not usually cause orthostatic hypotension.

Isoproterenol (C) is a non-selective beta-adrenergic agonist that is primarily used for cardiac stimulation. It can cause tachycardia and palpitations, but orthostatic hypotension is not a common side effect.

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A nurse is caring for a client who is receiving neostigmine. Which of the following manifestations should the nurse identify as an adverse reaction to the medication? (Select all that apply.)

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Correct Answer is ["18.8"]

Explanation

A nurse is assessing a client who reports feeling dizzy while getting out of bed. The nurse suspects orthostatic hypotension related to a medication the client is taking Which of the following medications should the nurse identify as likely causing this adverse effect?

Correct Answer is D

Explanation

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