A patient has been admitted after overdosing on acetaminophen. The nurse plans to monitor this patient for development of which complication related to the overdose?
Metabolic alkalosis
Kidney stones
Decreased urinary output
Acute hepatic necrosis
The Correct Answer is D
A. Metabolic alkalosis: Acetaminophen overdose does not typically cause alkalosis; the primary toxicity involves hepatic injury rather than disturbances in acid–base balance. Other conditions such as vomiting or diuretic use are more commonly associated with alkalosis, not acetaminophen toxicity.
B. Kidney stones: Kidney stones are not linked to acetaminophen overdose and generally occur due to dietary factors, dehydration, or metabolic imbalances. Acetaminophen toxicity affects the liver far more significantly than the renal system in most cases.
C. Decreased urinary output: While severe liver injury can eventually impact renal perfusion, decreased urine output is not the primary expected complication. It is a secondary effect that may occur later in fulminant liver failure but is not the main concern initially.
D. Acute hepatic necrosis: Acetaminophen overdose causes direct liver-cell injury due to toxic metabolite accumulation, leading to hepatic necrosis within 24–72 hours. Monitoring liver enzymes, coagulation status, and mental status is crucial to detect impending liver failure.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. Albuterol: The patient has already used a short-acting beta-2 agonist, so repeating albuterol may provide some relief but is unlikely to be sufficient for an acute exacerbation with persistent tachypnea and hypoxia. Additional interventions targeting severe airway inflammation may be required.
B. Theophylline: Theophylline is a bronchodilator used for long-term asthma management, not for immediate relief in acute severe exacerbations. Its slow onset and narrow therapeutic range make it inappropriate for emergency treatment in this scenario.
C. Epinephrine: Epinephrine is indicated in severe acute asthma or anaphylactic reactions when rapid bronchodilation is needed. It works on alpha and beta receptors to reduce airway edema, relax bronchial smooth muscle, and improve oxygenation. In the ER, epinephrine provides fast-acting relief for life-threatening airway obstruction.
D. Dexamethasone: Dexamethasone is a corticosteroid that reduces airway inflammation but has a delayed onset of action. While important for sustained management, it does not provide immediate relief for acute shortness of breath or hypoxia and is typically given alongside fast-acting agents.
Correct Answer is C
Explanation
A. Gout: Diltiazem does not affect uric acid metabolism, so it is not associated with gout. Monitoring for gout is unnecessary in patients taking this medication.
B. Chronic kidney disease: Diltiazem does not directly cause kidney damage, and routine monitoring for CKD is not a primary concern. Kidney function may be checked as part of general hypertension management but is not a specific adverse effect.
C. Heart failure: Diltiazem is a non-dihydropyridine calcium channel blocker that has negative inotropic effects, which can worsen pre-existing heart failure. Monitoring for signs of fluid retention, dyspnea, and decreased cardiac output is essential.
D. Hyperthyroidism: Diltiazem does not influence thyroid hormone levels, and hyperthyroidism is unrelated to its use. Monitoring for thyroid disease is not indicated solely due to diltiazem therapy.
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