A patient taking an anxiolytic reports feeling drowsy and unsteady.
What should the nurse advise the patient to do while on this medication? Select all that apply.
Advise the patient to increase their fluid intake.
Instruct the patient to avoid driving or operating heavy machinery.
Advise the patient not to drink alcohol.
Discontinue the medication immediately.
Encourage the patient to engage in light exercise.
Correct Answer : B,C
Choice A rationale
While adequate fluid intake is important for overall health, it does not directly counteract the sedative or unsteady side effects of an anxiolytic medication. Increasing fluid intake will not improve drowsiness or unsteadiness caused by central nervous system depression, and it is not a standard or effective nursing intervention for these specific adverse effects.
Choice B rationale
Anxiolytics, particularly benzodiazepines, are central nervous system depressants that cause drowsiness and impair coordination and judgment. Due to the sedative effects and potential for unsteadiness and ataxia, it is crucial to advise patients to avoid activities that require alertness and precise motor skills, such as driving or operating heavy machinery, to prevent accidents.
Choice C rationale
Alcohol and anxiolytics are both central nervous system depressants. Taking them together has a synergistic effect, meaning their combined depressive effects are greater than the sum of their individual effects. This can significantly increase the risk of severe drowsiness, respiratory depression, and even coma or death. Patients must be warned to avoid alcohol completely.
Choice D rationale
Abruptly discontinuing an anxiolytic, especially a benzodiazepine, can lead to severe withdrawal symptoms, including rebound anxiety, insomnia, tremors, and even seizures. The medication should not be stopped immediately by the patient without consulting a healthcare provider. The dose should be tapered slowly under medical supervision to prevent these dangerous effects.
Choice E rationale
While light exercise can be beneficial for mood and anxiety, it is not a primary or safe recommendation for a patient experiencing drowsiness and unsteadiness due to anxiolytic medication. Engaging in physical activity while feeling unsteady could increase the risk of falls and injury. The priority is to ensure the patient's safety by avoiding risky activities.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A rationale
Abruptly stopping nitroglycerin is not the correct first action. The headache and dizziness are common side effects due to its vasodilatory action. Stopping the medication without assessment can leave the patient vulnerable to ongoing chest pain, and the provider needs to be aware of the patient’s hemodynamic response to the drug.
Choice B rationale
Giving an extra dose of nitroglycerin would exacerbate the patient's symptoms and could lead to a life-threatening drop in blood pressure. The severe headache and dizziness are signs of systemic vasodilation, and a further dose would intensify this effect, increasing the risk of severe hypotension and syncope.
Choice C rationale
Alcohol consumption is contraindicated with nitroglycerin as it can intensify the vasodilatory and hypotensive effects, worsening the dizziness and increasing the risk of a severe drop in blood pressure. The combination could lead to syncope, falls, and dangerously low blood pressure.
Choice D rationale
Nitroglycerin's primary mechanism is vasodilation, which can cause a drop in blood pressure. The patient's headache and dizziness are classic symptoms of hypotension. Assessing blood pressure provides crucial data for the healthcare provider to determine if the patient is experiencing a significant hypotensive event and whether the medication dose needs adjustment or discontinuation. A normal BP is (90/60 mmHg to 120/80 mmHg).
Correct Answer is B
Explanation
Choice A rationale
Blood glucose levels are not a primary concern for patients taking antithyroid drugs, which are used to treat hyperthyroidism. While thyroid dysfunction can influence blood glucose, monitoring is not a routine part of antithyroid drug therapy. Blood glucose monitoring is essential for patients with diabetes mellitus, which is a separate endocrine disorder from hyperthyroidism.
Choice B rationale
Antithyroid drugs, such as methimazole and propylthiouracil, can cause a serious and rare adverse effect called agranulocytosis, which is a severe reduction in the number of granulocytes, a type of white blood cell. A complete blood count (CBC) is essential to monitor for this life-threatening condition by checking the white blood cell (WBC) count, particularly the neutrophil count. Normal WBC count is 4.5 to 11.0 × 10³ cells/mcL.
Choice C rationale
Serum calcium levels are primarily monitored in conditions related to parathyroid hormone and calcium metabolism, such as hypoparathyroidism or hyperparathyroidism. Antithyroid medications do not directly affect serum calcium levels. Monitoring serum calcium is not a routine part of the management of a patient on antithyroid drugs.
Choice D rationale
The lipid profile, which includes cholesterol and triglycerides, is not routinely monitored for patients on antithyroid drugs. While hyperthyroidism can affect lipid metabolism, antithyroid drugs themselves do not have a significant or primary effect on lipid levels that requires routine monitoring.
Choice E rationale
Serum sodium levels are not a primary concern when a patient is taking antithyroid medications. Hyponatremia or hypernatremia can be caused by various other conditions, such as dehydration, kidney disease, or certain diuretics, but it is not a direct or common side effect of antithyroid drugs.
Choice F rationale
Serum potassium levels are not routinely monitored for patients taking antithyroid drugs. Hyperkalemia or hypokalemia can be caused by various other conditions, such as kidney disease or diuretic use, but it is not a primary or common side effect of antithyroid drugs.
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