A nurse is collecting data from a client who is taking prednisone and self-administers insulin daily. The nurse should identify that which of the following findings indicates a medication interaction?

Orthostatic hypotension

Hyperglycemia

Paresthesia

Jaundice

Answer and Explanation

The Correct Answer is B

A. Orthostatic hypotension. Prednisone does not typically cause orthostatic hypotension. Instead, corticosteroids can lead to fluid retention and hypertension due to their effects on sodium and water balance. Orthostatic hypotension is more commonly associated with medications such as diuretics or antihypertensives.

B. Hyperglycemia. Prednisone is a glucocorticoid that increases blood glucose levels by enhancing gluconeogenesis and reducing insulin sensitivity. This effect can make blood sugar more difficult to control in clients who take insulin, potentially requiring higher insulin doses to maintain glycemic control. Clients with diabetes or those taking insulin should closely monitor their blood glucose levels while on prednisone.

C. Paresthesia. Paresthesia (numbness or tingling) is not a common adverse effect of prednisone or a direct interaction with insulin. While uncontrolled diabetes can cause diabetic neuropathy, prednisone does not typically cause neurological symptoms like tingling.

D. Jaundice. Prednisone is not commonly associated with hepatotoxicity or liver dysfunction leading to jaundice. However, long-term corticosteroid use may increase liver enzyme levels, but it does not typically cause direct liver damage or bile obstruction. Jaundice would require evaluation for other underlying liver conditions.

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Correct Answer is C

Explanation

A. Levothyroxine. Levothyroxine is used to treat hypothyroidism and does not have a significant interaction with furosemide. However, both medications require careful monitoring, as hypothyroidism can affect fluid balance, but they are not contraindicated together.

B. Cetirizine. Cetirizine is an antihistamine used to treat allergies and does not interfere with furosemide’s effects. While some antihistamines can cause mild fluid retention, this does not significantly impact furosemide therapy, making them safe to use together.

C. Lithium carbonate. Furosemide is a loop diuretic that increases sodium excretion. Since lithium is excreted through the kidneys in a sodium-dependent manner, a loss of sodium due to diuretic use can lead to reduced lithium excretion and toxic accumulation. Clients taking lithium should avoid diuretics unless absolutely necessary, and their lithium levels must be carefully monitored if diuretics are required.

D. Albuterol. Albuterol is a bronchodilator used for conditions like asthma and COPD. While both furosemide and albuterol can cause hypokalemia, this does not make them absolutely contraindicated. Instead, potassium levels should be regularly monitored, and supplementation may be needed if hypokalemia develops.

A. Rash B. Diarrhea C. Nausea D. Metallic taste in mouth

Correct Answer is A

Explanation

A. Rash. A rash while taking allopurinol can indicate a serious hypersensitivity reaction, including Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN). These life-threatening conditions involve widespread skin blistering, mucosal involvement, and systemic symptoms. Immediate discontinuation of allopurinol and medical intervention are required to prevent severe complications.

B. Diarrhea. Mild gastrointestinal disturbances, including diarrhea, are common with allopurinol use. While bothersome, diarrhea is not life-threatening and can often be managed by adjusting the dose or taking the medication with food. It does not require immediate discontinuation unless severe or persistent.

C. Nausea. Nausea is a common, mild side effect of allopurinol that usually resolves with time or by taking the medication after meals. It is not an emergency and does not require urgent intervention unless accompanied by other concerning symptoms such as vomiting or severe abdominal pain.

D. Metallic taste in mouth. A metallic taste can occur with allopurinol use but is not harmful. It is a minor side effect that does not indicate toxicity or severe adverse reactions. Clients can be reassured that this effect is temporary and not a reason to stop the medication.

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A nurse is collecting data from a client who is taking prednisone and self-administers insulin daily. The nurse should identify that which of the following findings indicates a medication interaction?

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