A nurse is monitoring a client who is taking captopril and has developed swelling of the lips and tongue. Which of the following actions should the nurse plan to take to manage this adverse medication reaction?
Administer a dose of subcutaneous epinephrine.
Advise the client not to consume grapefruit products.
Place warm compresses on both sides of the client's face.
Swab the client's oral mucosa with nystatin suspension.
The Correct Answer is A
A. Administer a dose of subcutaneous epinephrine.: The swelling of the lips and tongue is indicative of angioedema, a serious adverse reaction to captopril. Epinephrine is the first-line treatment for severe allergic reactions or angioedema to quickly counteract the swelling and prevent airway obstruction.
B. Advise the client not to consume grapefruit products.: Grapefruit can interact with some medications, but it is not related to the management of angioedema. This action would be more relevant for drugs metabolized by CYP3A4, not specifically for angioedema.
C. Place warm compresses on both sides of the client's face.: Warm compresses are not appropriate for angioedema and may not address the underlying issue. This action does not manage the immediate, potentially life-threatening reaction caused by captopril.
D. Swab the client's oral mucosa with nystatin suspension.: Nystatin is used for fungal infections of the oral mucosa, not for angioedema. This action does not address the adverse reaction related to captopril.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A) "I will offer my child apple juice instead of milk.": Offering apple juice instead of milk is not ideal for a toddler with failure to thrive. Milk is a better source of essential nutrients like calcium and vitamin D, which are important for growth and development. Juice can contribute to empty calories and should be limited.
B) "I should continue to feed my child when he pushes food out with his tongue.": This statement indicates an understanding of the importance of addressing feeding difficulties. In toddlers with Down syndrome, it is common to experience difficulties with feeding and swallowing. Continuing to offer food and using techniques to encourage eating, even when the child initially pushes food out, can help ensure adequate nutritional intake and support growth.
C) "I will provide his favorite food as a reward for good behavior.": Using food as a reward can lead to unhealthy eating habits and an association of food with behavior rather than hunger and nutrition. It’s better to use non-food rewards to encourage positive behavior.
D) "I should increase my child's vitamin A intake by feeding him raw carrot slices.": While vitamin A is important, raw carrots can be difficult for toddlers, especially those with developmental delays or oral-motor difficulties, to chew and swallow. Cooked carrots or other vitamin A-rich foods might be a safer option.
Correct Answer is D
Explanation
A) Herpes zoster
This condition, also known as shingles, is characterized by a painful, blistering rash that follows a nerve path. It typically presents as grouped vesicles rather than generalized edema and erythema, making it unlikely in this case.
B) Dermatophytosis
Commonly known as ringworm, this fungal infection usually causes a scaly, ring-shaped rash. It does not typically present with significant edema or erythema as seen with cellulitis, and tenderness is less common.
C) Contact dermatitis
This allergic or irritant reaction usually causes itching, redness, and rash after contact with a substance. While it can cause erythema and pain, it is less likely to cause the significant edema and tenderness observed in cellulitis.
D) Cellulitis
Cellulitis is a bacterial skin infection characterized by edema, erythema, tenderness, and pain. These symptoms align with the nurse’s findings, indicating an inflammatory response in the deeper layers of the skin, often requiring antibiotic treatment.
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