A patient is prescribed metformin (Glucophage). Which side effect/adverse effect almost always occurs when clients take metformin (Glucophage)?
Fever.
Insomnia.
Bitter or metallic taste.
Seizures.
The Correct Answer is C
Choice A rationale:
Fever is not a common side effect of metformin. While it's possible for a minority of patients to experience a mild fever as their bodies adjust to the medication, it's not considered a typical or expected adverse effect.
Fevers typically occur due to infections or inflammation, and metformin does not directly cause either of these processes.
If a patient taking metformin develops a fever, it's crucial to rule out other potential causes, such as infections or other medications, before attributing it to metformin.
Choice B rationale:
Insomnia is also not a common side effect of metformin. In fact, some studies have suggested that metformin may even have a positive effect on sleep quality in some individuals.
While sleep disturbances can occur with any medication, they are not specifically associated with metformin.
If a patient experiences insomnia while taking metformin, it's essential to consider other potential factors, such as stress, anxiety, or other medications, that could be contributing to sleep problems.
Choice C rationale:
Bitter or metallic taste is a very common side effect of metformin, experienced by approximately 30-40% of patients. This taste disturbance is thought to be caused by metformin's interaction with taste receptors on the tongue.
The taste is often described as metallic, bitter, or similar to the taste of pennies.
While it can be unpleasant, it's generally not considered a serious side effect and does not usually require discontinuation of the medication.
Some strategies to manage the metallic taste include: Taking metformin with meals or snacks to mask the taste.
Chewing sugar-free gum or sucking on hard candy after taking the medication. Rinsing the mouth with water or mouthwash after taking the medication.
Switching to an extended-release formulation of metformin, which may have a less pronounced metallic taste.
Choice D rationale:
Seizures are a rare but serious side effect of metformin.
They are most likely to occur in patients with underlying kidney problems or those taking certain other medications that can interact with metformin.
If a patient taking metformin experiences a seizure, it's critical to seek immediate medical attention.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale:
Placing the tablet under the patient's nose is not an effective method of administering aspirin. Aspirin is not absorbed through the nasal mucosa.
This action would not provide any therapeutic benefit to the patient with a suspected myocardial infarction. It could potentially lead to aspiration of the tablet if the patient sneezes or coughs.
Choice B rationale:
Enteric-coated aspirin tablets are designed to dissolve in the intestines, not in the stomach. This delays the absorption of aspirin and its antiplatelet effects.
In a patient with a suspected myocardial infarction, it is crucial to achieve rapid absorption of aspirin to inhibit platelet aggregation and prevent further clot formation.
Therefore, enteric-coated aspirin is not appropriate in this situation.
Choice C rationale:
Chewing the aspirin tablet would indeed speed up its absorption. However, it also increases the risk of gastric irritation and bleeding.
Aspirin can be irritating to the stomach lining, and chewing it can exacerbate this effect.
This is particularly concerning in a patient with a suspected myocardial infarction, who may already be at risk for gastrointestinal bleeding due to decreased blood flow to the stomach.
Choice D rationale:
Giving the aspirin tablet with a small sip of water is the most appropriate action for the nurse to take in this situation. This allows for timely absorption of the aspirin while minimizing the risk of gastric irritation.
The water helps to dissolve the tablet and transport it to the stomach, where it can be absorbed into the bloodstream. It also helps to lubricate the esophagus and reduce the risk of the tablet becoming lodged in the throat.
Correct Answer is C
Explanation
Choice A rationale:
Norepinephrine is a potent vasoconstrictor, meaning it narrows blood vessels. It primarily acts on arteries, but it can also constrict veins to a lesser extent.
Its primary actions are to increase systemic vascular resistance and blood pressure.
It is often used in conditions such as shock to raise blood pressure and improve perfusion to vital organs.
It is not a vasodilator and would not be appropriate for a patient requiring dilation of both arteries and veins.
Choice B rationale:
Nitroglycerin is a vasodilator that primarily acts on veins. It relaxes the smooth muscle in the walls of veins, which allows them to dilate and hold more blood.
This reduces the amount of blood returning to the heart, which in turn lowers preload and reduces cardiac workload.
Nitroglycerin is often used to treat angina pectoris, a condition characterized by chest pain due to insufficient blood flow to the heart.
While it can also have some vasodilatory effects on arteries, its primary action is on veins.
Choice C rationale:
Nitroprusside sodium (Nitropress) is a potent vasodilator that acts on both arteries and veins. It directly relaxes smooth muscle in the blood vessel walls, leading to dilation.
It is a very powerful vasodilator and can rapidly lower blood pressure.
It is often used in hypertensive emergencies to quickly reduce blood pressure and improve cardiac function.
It is also used in conditions such as congestive heart failure and acute aortic dissection to reduce afterload and improve cardiac output.
Choice D rationale:
Lidocaine is a local anesthetic agent that is primarily used to block nerve conduction. It does not have any direct vasodilatory effects.
It is sometimes used in the treatment of cardiac arrhythmias, but its mechanism of action in this setting is not related to vasodilation.
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