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 A

Explanation

A. Diphenhydramine. Diphenhydramine is a first-generation antihistamine with anticholinergic properties that can increase the risk of central nervous system (CNS) depression when taken with haloperidol. Both drugs can cause sedation, confusion, and impaired coordination, increasing the risk of falls and other complications. Additionally, combining them can worsen extrapyramidal symptoms (EPS) or lead to anticholinergic toxicity, making it an unsafe combination.

B. Docusate sodium. Docusate sodium is a stool softener used to prevent constipation. Haloperidol can cause constipation as a side effect due to its anticholinergic properties, so docusate sodium is safe and may even be beneficial in preventing bowel complications.

C. Ibuprofen. Ibuprofen is a nonsteroidal anti-inflammatory drug (NSAID) used for pain and inflammation. While it does not have a direct interaction with haloperidol, it should be used with caution in clients with a history of gastrointestinal issues or kidney disease. However, it does not pose a significant risk when taken alongside haloperidol.

D. Glucosamine. Glucosamine is a dietary supplement used to support joint health. It does not interact with haloperidol and does not have sedative or CNS effects. Clients taking haloperidol can safely use glucosamine if needed.

A. Hemoglobin levels B. Iron levels C. Platelet count D. White blood cell count

Correct Answer is A

Explanation

A. Hemoglobin levels. Epoetin alfa stimulates erythropoiesis (red blood cell production) in clients with chronic renal failure, where natural erythropoietin production is impaired. The therapeutic effect of epoetin alfa is measured by monitoring hemoglobin (Hgb) levels to ensure adequate response without exceeding safe limits. Target Hgb levels should not exceed 11 g/dL, as higher levels increase the risk of thromboembolic events and hypertension.

B. Iron levels. While iron is necessary for red blood cell production, epoetin alfa does not directly affect iron levels. However, iron supplementation may be required if iron deficiency is present, as inadequate iron stores can limit the effectiveness of epoetin alfa therapy.

C. Platelet count. Epoetin alfa primarily affects red blood cell production and has no direct effect on platelet levels. Although polycythemia (excess red blood cells) can increase the risk of clot formation, platelet count is not the primary indicator of epoetin alfa’s therapeutic effects.

D. White blood cell count. Epoetin alfa does not impact white blood cell (WBC) production. Leukocyte production is regulated by different growth factors, and WBC monitoring is more relevant for conditions such as infections, chemotherapy-induced neutropenia, or bone marrow disorders.

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