A nurse is monitoring a client's response to receiving glipizide instead of guaifenesin. Which of the following actions should the nurse take?

Lower the head of the client's bed.

Check the client for urinary retention

Offer the client a carbohydrate snack.

Test the client's deep-tendon reflexes.

Answer and Explanation

The Correct Answer is C

A. Lower the head of the client's bed. There is no need to lower the client’s head of the bed in response to receiving glipizide instead of guaifenesin. Glipizide is an oral antidiabetic medication used to lower blood glucose, while guaifenesin is an expectorant for respiratory conditions. Lowering the head of the bed does not address the potential effects of receiving the wrong medication.

B. Check the client for urinary retention. Glipizide does not cause urinary retention. Instead, it stimulates insulin release to lower blood sugar. If hypoglycemia occurs due to an unintentional dose of glipizide, symptoms such as sweating, dizziness, confusion, or tremors are more concerning than bladder dysfunction.

C. Offer the client a carbohydrate snack. Since glipizide lowers blood glucose levels, administering it instead of guaifenesin could result in hypoglycemia, particularly in a client who does not have diabetes. The nurse should monitor for signs of low blood sugar, such as shakiness, confusion, diaphoresis, and dizziness, and provide a fast-acting carbohydrate (e.g., juice, crackers, or glucose tablets) if symptoms develop.

D. Test the client’s deep-tendon reflexes. Glipizide does not affect neuromuscular function or deep-tendon reflexes. While severe hypoglycemia can cause altered mental status or seizures, routine reflex testing is not necessary for monitoring the effects of an incorrect glipizide administration.

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Correct Answer is D

Explanation

A. Increased salivation. Tobramycin, an aminoglycoside antibiotic, does not cause increased salivation. It primarily affects the kidneys and auditory system, with no significant impact on saliva production. Increased salivation is more commonly associated with medications affecting the autonomic nervous system, such as cholinergic agents.

B. Bruising. While some antibiotics may impact platelet function, aminoglycosides like tobramycin do not commonly cause thrombocytopenia or increased bruising. Clients experiencing unexplained bruising should be evaluated for other underlying causes, such as coagulation disorders or concurrent medication use.

C. Joint pain. Joint pain is not a typical adverse effect of tobramycin. While some antibiotics, like fluoroquinolones, are associated with tendonitis or joint issues, aminoglycosides primarily affect the kidneys and inner ear, leading to nephrotoxicity and ototoxicity rather than musculoskeletal symptoms.

D. Tinnitus. Tobramycin is ototoxic and can cause tinnitus, hearing loss, or balance disturbances due to its toxic effects on the auditory and vestibular nerves. Clients receiving tobramycin should be monitored for early signs of ototoxicity, and the medication should be discontinued if symptoms develop to prevent permanent hearing damage.

A. Drowsiness B. Hypertension C. Polyuria D. Dependent edema

Correct Answer is A

Explanation

A. Drowsiness. Dimenhydrinate is an antihistamine that works by blocking histamine and acetylcholine receptors in the brain to prevent nausea and vomiting. A common adverse effect is drowsiness due to its sedative properties, which can impair alertness and coordination. Clients should be advised to avoid activities requiring mental alertness, such as driving, until they understand how the medication affects them.

B. Hypertension. Dimenhydrinate does not typically cause hypertension. Instead, it may lead to mild hypotension due to its sedative and anticholinergic effects. Clients with pre-existing hypertension should still monitor their blood pressure, but significant increases are uncommon.

C. Polyuria. Increased urination is not associated with dimenhydrinate use. Antihistamines, including dimenhydrinate, have anticholinergic properties, which can lead to urinary retention rather than increased urine output. Clients experiencing difficulty urinating should report this to their healthcare provider.

D. Dependent edema. Dimenhydrinate does not cause fluid retention or edema. Medications that contribute to edema typically involve hormonal, cardiovascular, or kidney-related effects, which are not mechanisms of dimenhydrinate. If a client develops unexplained edema, other underlying conditions should be investigated.

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Body System	Findings
Vital Signs/General History	Temperature 36.4° C (97.6° F), oral Heart rate 75/min Respiratory rate 16/min Blood pressure 100/74mm Hg Oxygen saturation 99% on room air Client is a vegetarian and takes a multivitamin daily Client reports having three to four alcoholic beverages a couple times per week
Integumentary	Skin color is consistent with genetic background. No rashes or lesions. The client varicose veins.
Cardiovascular/ Respiratory	S1 S2 auscultated. No murmurs. All peripheral pulses 2+ Lung sounds clear bilaterally
Gastrointestinal/Genitourinary	Abdomen soft, nontender. Normoactive bowel sounds in all 4 quadrants. Last bowel movement was 3 days ago. Voids four to five times a day. Urine is clear, yellow, and odourless. Last menstrual period was 3 months ago
Neurologic/Musculoskeletal	Alert and oriented to person, place, and time. Client takes diazepam as needed for anxiety. Client has full range of motion and is able to maintain flexion against resistance in all four extremities

A nurse is monitoring a client's response to receiving glipizide instead of guaifenesin. Which of the following actions should the nurse take?

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Naxlex Comprehensive Predictor Exams

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Correct Answer is D

Explanation

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Correct Answer is A

Explanation

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