A patient is admitted for acute renal failure and the nurse is monitoring their response to medications. Which pharmacokinetic principle does the nurse understand will most likely be affected in this patient?
Elimination
Metabolism
Distribution
Absorption
The Correct Answer is A
Choice A reason: Elimination is the process of removing a drug from the body, usually through the kidneys or the liver. Acute renal failure is a condition where the kidneys suddenly lose their ability to filter waste products and excess fluid from the blood. This can impair the elimination of drugs that are mainly excreted by the kidneys, leading to increased drug levels and potential toxicity. The nurse should monitor the patient's renal function and adjust the dose of drugs that are renally eliminated.
Choice B reason: Metabolism is the process of transforming a drug into one or more metabolites, usually by enzymes in the liver. Acute renal failure does not directly affect the metabolism of drugs, unless it causes liver damage or alters the blood flow to the liver. The nurse should monitor the patient's liver function and the levels of drugs that are metabolized by the liver.
Choice C reason: Distribution is the process of transferring a drug from the blood to the tissues and organs of the body. Acute renal failure can affect the distribution of drugs that are bound to plasma proteins, such as albumin. When the kidneys are damaged, they may leak protein into the urine, causing hypoalbuminemia (low levels of albumin in the blood). This can increase the amount of free or unbound drug in the blood, which may enhance the drug's effect or cause adverse reactions. The nurse should monitor the patient's serum albumin level and the effects of drugs that are highly protein bound.
Choice D reason: Absorption is the process of moving a drug from the site of administration to the bloodstream. Acute renal failure does not directly affect the absorption of drugs, unless it causes changes in the gastrointestinal tract, such as edema, bleeding, or motility disorders. The nurse should monitor the patient's gastrointestinal function and the bioavailability of drugs that are administered orally.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: This choice is incorrect because stomach distension and constipation are not common side effects of furosemide. They may be related to other causes, such as diet, fluid intake, or medication interactions. The nurse should assess the client's abdominal status and bowel habits and provide appropriate interventions, such as increasing fiber, fluids, or laxatives.
Choice B reason: This choice is incorrect because IV site irritation, redness, and pain are not specific side effects of furosemide. They may be caused by other factors, such as infection, infiltration, or phlebitis. The nurse should inspect the IV site and catheter and change them if needed. The nurse should also monitor the client's vital signs and blood cultures for signs of infection.
Choice C reason: This choice is correct because hearing loss or impairment is a rare but serious side effect of furosemide. It can occur due to damage to the inner ear or the auditory nerve. It may be temporary or permanent, depending on the dose and duration of furosemide therapy. The nurse should stop the infusion of furosemide and notify the provider immediately. The nurse should also assess the client's hearing and balance and provide safety measures.
Choice D reason: This choice is incorrect because frequent urination is an expected effect of furosemide. Furosemide is a diuretic that increases the excretion of water and electrolytes through the urine. It helps to reduce fluid overload and edema in clients with heart failure. The nurse should measure and record the client's intake and output and monitor the client's fluid and electrolyte status.
Correct Answer is ["A","B","E"]
Explanation
Choice A reason: Excessive urination is a sign of hyperglycemia because the body tries to flush out the excess glucose in the blood through the urine. This can also lead to dehydration and electrolyte imbalance.
Choice B reason: Excessive thirst is a sign of hyperglycemia because the body loses fluid and becomes dehydrated due to frequent urination. The thirst mechanism is activated to replenish the fluid loss.
Choice C reason: Diaphoresis is not a sign of hyperglycemia, but rather a sign of hypoglycemia (low blood sugar). Hypoglycemia can cause sweating, shakiness, anxiety, and confusion.
Choice D reason: Atrial fibrillation is not a sign of hyperglycemia, but rather a possible complication of hyperglycemia. Hyperglycemia can damage the blood vessels and the heart, increasing the risk of arrhythmias, such as atrial fibrillation.
Choice E reason: Excessive hunger is a sign of hyperglycemia because the body is unable to use the glucose in the blood for energy. The cells are starved of fuel, and the hunger signal is triggered to stimulate food intake..
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