A patient is given a drug for the first time and develops shortness of breath. The patient’s heart rate is 76 beats per minute, the respiratory rate is 20 breaths per minute, and the blood pressure is 120/70 mm Hg. The nurse checks a drug administration manual to make sure the correct dose was given and learns that some patients taking the drug experience shortness of breath. The nurse will contact the provider to report what?
An idiosyncratic effect
A teratogenic effect
A side effect
This symptom is not related to the medication administration.
The Correct Answer is C
Choice A Reason:
An idiosyncratic effect is an unusual or unexpected reaction to a drug that is not related to the dose and is not a common side effect. These reactions are often due to genetic differences in metabolism or immune response. In this case, shortness of breath is a known reaction for some patients taking the drug, so it is not considered idiosyncratic.
Choice B Reason:
A teratogenic effect refers to a drug’s potential to cause developmental abnormalities in a fetus when taken by a pregnant woman. Since the patient is experiencing shortness of breath, which is a known reaction to the drug, this choice is not relevant to the situation.
Choice C Reason:
This is the correct answer. A side effect is a secondary, typically undesirable effect of a drug or medical treatment. Since the nurse found that shortness of breath is a known reaction for some patients taking the drug, it is classified as a side effect. The nurse should report this to the provider to ensure proper management and monitoring.
Choice D Reason:
The symptom of shortness of breath is related to the medication administration, as confirmed by the drug administration manual. Therefore, this choice is incorrect. The nurse must report the side effect to the provider for appropriate action.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A: Excretion
Excretion is the process by which drugs and their metabolites are eliminated from the body, primarily through the kidneys (urine), but also via bile, sweat, saliva, and other routes. While excretion is a crucial phase of pharmacokinetics, it is not directly impacted by the first pass effect. The first pass effect primarily involves the metabolism of a drug before it reaches systemic circulation, which occurs prior to the excretion phase.
Choice B: Metabolism
The first pass effect, also known as first-pass metabolism or presystemic metabolism, significantly impacts the metabolism phase of pharmacokinetics. This phenomenon occurs when a drug is metabolized at a specific location in the body, such as the liver or gut wall, before it reaches systemic circulation. As a result, the concentration of the active drug is reduced, affecting its bioavailability. The liver is the primary site for this metabolic process, where enzymes break down the drug, potentially leading to a significant reduction in its therapeutic effect.
Choice C: Distribution
Distribution refers to the process by which a drug is transported from the bloodstream to various tissues and organs in the body. This phase is influenced by factors such as blood flow, tissue permeability, and binding to plasma proteins. However, the first pass effect does not directly alter the distribution phase. Instead, it affects the amount of drug that enters systemic circulation, which in turn can influence the extent of distribution.
Choice D: Absorption
Absorption is the process by which a drug enters the bloodstream from its site of administration. This phase is crucial for determining the onset of a drug’s action. While the first pass effect occurs after absorption, it does not directly change the absorption phase itself. Instead, it affects the drug’s concentration after it has been absorbed and before it reaches systemic circulation.
Correct Answer is B
Explanation
Choice A Reason:
Oxygenation of the cells is a necessary process during reperfusion, but it is not the direct cause of reperfusion injury. The injury occurs due to the sudden influx of oxygen, which leads to the formation of reactive oxygen species (ROS) or free radicals. These free radicals cause oxidative stress and damage to the myocardial cells.
Choice B Reason:
Free radical formation is the primary mechanism behind reperfusion injury. When blood flow is restored to the ischemic myocardium, the sudden reintroduction of oxygen leads to the production of free radicals. These free radicals cause significant oxidative damage to the cell membranes, proteins, and DNA, exacerbating the injury to the heart tissue.
Choice C Reason:
An increased metabolic state can occur during reperfusion as the cells attempt to recover from ischemia. However, it is not the direct cause of reperfusion injury. The primary issue is the oxidative stress caused by free radicals, not the metabolic changes themselves.
Choice D Reason:
Lactic acid build-up is a consequence of anaerobic metabolism during the ischemic period, not a cause of reperfusion injury. During ischemia, cells switch to anaerobic metabolism, leading to lactic acid accumulation. However, once oxygen is reintroduced, the focus shifts to the oxidative damage caused by free radicals rather than lactic acid.
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