A patient asks a nurse why a friend who is taking the same drug responds differently to that drug. The nurse knows that the most common variation in drug response is due to differences in each patient’s:

Choice A Reason:

Bronchoconstriction is the narrowing of the airways in the lungs due to the tightening of surrounding smooth muscle. This response is typically associated with conditions like asthma and is not a common reaction to acute stress. During stress, the sympathetic nervous system actually causes bronchodilation to increase airflow and oxygen delivery to the muscles.

Choice B Reason:

This is the correct answer. Increased glucose production is a typical response to acute stress. The body releases stress hormones like adrenaline and cortisol, which stimulate the liver to produce more glucose. This process, known as glycogenolysis, ensures that the body has enough energy to handle the stressor. This response is part of the “fight-or-flight” mechanism, preparing the body for immediate physical activity.

Choice C Reason:

Decreased cortisol release is not expected during acute stress. In fact, cortisol levels typically increase as part of the body’s stress response. Cortisol helps to mobilize energy stores, suppress inflammation, and support cardiovascular function. Therefore, this choice is incorrect.

Choice D Reason:

Bradycardia, or a slower than normal heart rate, is not a typical response to acute stress. Instead, the sympathetic nervous system increases heart rate (tachycardia) to ensure that more blood is pumped to vital organs and muscles. This helps the body to respond more effectively to the stressor.

Choice A Reason:

Discontinuing the drug at the first signs of toxicity might seem like a straightforward solution, but it is not always the best approach. Some drugs are essential for treating serious conditions, and stopping them abruptly can cause more harm than good. Instead, the nurse should monitor the patient closely and consult with the healthcare provider to adjust the dosage or switch to a safer alternative if necessary.

Choice B Reason:

Teaching the patient how to treat symptoms if they develop is important, but it is not sufficient on its own. While patient education is a crucial aspect of managing drug side effects, it should be part of a broader strategy that includes regular monitoring and medical supervision.

Choice C Reason:

Ensuring that complete blood counts are ordered periodically is a good practice, especially for drugs that can affect blood cells. However, this approach is too narrow. Toxic side effects can impact various organs and systems, so a comprehensive monitoring plan is necessary.

Choice D Reason:

This is the correct answer. Monitoring the function of all organs potentially affected by the drug is the most comprehensive and effective approach. This includes regular blood tests, liver function tests, kidney function tests, and other relevant assessments. By closely monitoring the patient’s organ functions, the healthcare team can detect early signs of toxicity and take appropriate action to prevent serious complications.