A female client starts a new prescription, oxybutynin, for symptoms of an overactive bladder. The client tells the nurse that she is training to run in a half-marathon. Which instruction should the nurse emphasize?
Keep skin and eyes covered to protect from sun injury.
Avoid crowds to help prevent acquiring infections.
Wear padding to protect from bruising if a fall occurs.
Take measures to avoid dehydration and overheating.
The Correct Answer is D
Choice A Reason:
While keeping skin and eyes covered to protect from sun injury is generally good advice, it is not specifically related to the use of oxybutynin. Oxybutynin can reduce sweating, which increases the risk of overheating and dehydration, especially during physical activities like running a half-marathon. Therefore, this advice, while useful, is not the most critical in this context.
Choice B Reason:
Avoiding crowds to help prevent acquiring infections is important for overall health, especially for individuals with compromised immune systems. However, this advice is not directly related to the use of oxybutynin or the specific risks associated with its use during physical exercise. The primary concern with oxybutynin is its effect on sweating and body temperature regulation.
Choice C Reason:
Wearing padding to protect from bruising if a fall occurs is a precaution that might be relevant for individuals at risk of falls or injuries. However, this advice does not address the specific risks associated with oxybutynin use during physical exercise. The main concern is the potential for overheating and dehydration due to reduced sweating.
Choice D Reason:
Taking measures to avoid dehydration and overheating is the most critical instruction for a client using oxybutynin while training for a half-marathon. Oxybutynin can decrease sweating, making it harder for the body to cool down during exercise. This can lead to heat stroke or severe dehydration. The nurse should emphasize the importance of staying hydrated, taking breaks, and avoiding excessive heat to prevent these serious complications.

Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
Choice A Reason:
A digoxin level of 1.1 ng/mL is within the therapeutic range of 0.8 to 2.6 ng/mL. Therefore, this value does not require immediate reporting to the healthcare provider. Monitoring digoxin levels is important to avoid toxicity, but this specific level is considered safe.
Choice B Reason:
A potassium level of 3.2 mEq/L is below the normal range of 3.5 to 5.0 mEq/L. Hypokalemia (low potassium levels) can increase the risk of digoxin toxicity, as digoxin and potassium compete for the same binding sites on the Na+/K+ ATPase pump. Low potassium levels can enhance the effects of digoxin, leading to potentially dangerous cardiac arrhythmias. Therefore, this value should be reported immediately.
Choice C Reason:
A creatinine level of 0.8 mg/dL is within the normal range of 0.5 to 1.1 mg/dL. This value indicates normal kidney function, which is important for the excretion of digoxin. Therefore, this value does not require immediate reporting.
Choice D Reason:
A sodium level of 135 mEq/L is just below the normal range of 136 to 145 mEq/L. While slightly low, this value is not critically abnormal and does not pose an immediate threat. It should be monitored, but it does not require urgent reporting to the healthcare provider.
Correct Answer is D
Explanation
Choice A reason:
Applying warm compresses to the legs can help relieve muscle cramps, but it is not the most urgent intervention. Muscle cramps can be a sign of electrolyte imbalances, which are common side effects of furosemide. However, the presence of palpitations and tiredness suggests a more serious issue that needs immediate attention.
Choice B reason:
Monitoring intake and output is important for patients on furosemide to assess fluid balance and kidney function. However, this action does not address the immediate concern of potential cardiac issues indicated by palpitations and tiredness.
Choice C reason:
Raising the head of the bed can help alleviate respiratory symptoms such as a cough, but it does not address the potential cardiac complications. The presence of palpitations and tiredness suggests that cardiac monitoring is a higher priority.
Choice D reason:
Placing the client on cardiac monitoring is the most critical action. Furosemide can cause electrolyte imbalances, leading to arrhythmias and other cardiac issues. Given the symptoms of palpitations and tiredness, immediate cardiac monitoring is essential to detect and manage any potential life-threatening arrhythmias.
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