The nurse is administering a prescribed medication to neonatal client. Which factor is most likely to increase the risk for drug toxicity in this client?

The stomach acid has a lower pH level which results in increase absorption

The glomerular filtration rate (GFR) is increased causing rapid excretion

The liver enzyme system responsible for drug metabolism is not fully developed

The albumin levels are elevated due to rapid growth and protein binding is enhanced

Answer and Explanation

The Correct Answer is C

A) The stomach acid has a lower pH level which results in increased absorption: While it is true that neonates have a lower gastric pH, which could affect the absorption of certain medications, this factor does not directly increase the risk for drug toxicity. Lower pH may increase absorption for some drugs, but it is not as critical in neonates as the immaturity of other organs, such as the liver and kidneys, which are responsible for drug metabolism and excretion.

B) The glomerular filtration rate (GFR) is increased causing rapid excretion: In neonates, the glomerular filtration rate (GFR) is actually decreased, not increased. This leads to slower excretion of medications, which can increase the risk for drug toxicity, especially for drugs that rely on renal elimination. This decreased renal function can result in accumulation of the drug in the bloodstream, potentially leading to toxicity.

C) The liver enzyme system responsible for drug metabolism is not fully developed: The liver enzyme system in neonates is immature, which significantly impacts the metabolism of drugs. Enzymatic activity is critical for breaking down medications to their active or inactive forms. Due to the underdeveloped liver function, drugs may not be metabolized properly, leading to a longer half-life and an increased risk for drug toxicity. This is a key factor in the increased risk of toxicity in neonatal clients.

D) The albumin levels are elevated due to rapid growth and protein binding is enhanced: Neonates typically have lower albumin levels, not elevated levels. Albumin is crucial for binding medications, and lower levels in neonates can result in more free (unbound) drug circulating in the bloodstream, which can increase the risk of drug toxicity. Elevated albumin would theoretically reduce this risk, but this is not typically the case in neonates.

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Free Nursing Study Resources

Correct Answer is ["20"]

Explanation

1. Determine the concentration of the guaifenesin:

The label states 100 mg/5 mL.

2. Set up a proportion to find the volume (in mL) needed:

100 mg / 5 mL = 400 mg / x mL

3. Solve for x:

Cross-multiply: 100x = 400 * 5

100x = 2000

x = 2000 / 100

x = 20 mL

Answer: The nurse will administer 20 mL to the client.

A. Polyethylene Glycol B. Bisacodyl C. Senna D. Docusate Sodium

Correct Answer is D

Explanation

A) Polyethylene Glycol: Polyethylene glycol is a medication typically used to treat constipation by promoting bowel movements. While it can be useful in managing constipation, it is not commonly prescribed after a myocardial infarction. In this situation, the focus is more on medications that promote heart health, reduce cardiac workload, and prevent complications related to the heart attack.

B) Bisacodyl: Bisacodyl is a stimulant laxative used to relieve constipation. However, this medication is not typically prescribed immediately following a myocardial infarction. Stimulant laxatives can cause dehydration and excessive fluid shifts, which can be harmful to a client recovering from a heart attack. The focus would be on safer options for bowel management in this context.

C) Senna: Senna is also a stimulant laxative, used for relieving constipation. Similar to bisacodyl, it is not ideal for clients who have recently experienced a myocardial infarction due to its potential for causing dehydration and electrolyte imbalances, which could negatively affect heart function. A gentler approach to bowel management is preferred for these clients.

D) Docusate Sodium: Docusate sodium is a stool softener commonly prescribed to prevent constipation, especially in clients who have recently had a myocardial infarction. After a heart attack, it's important to avoid straining during bowel movements, as this could increase pressure on the heart. Docusate sodium helps soften stools and promotes smoother bowel movements without stimulating the gastrointestinal system in a way that would elevate cardiac stress. It is the most appropriate choice for this client.

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The nurse is administering a prescribed medication to neonatal client. Which factor is most likely to increase the risk for drug toxicity in this client?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The prescription reads for guaifenesin 400 mg PO every 4 hours as needed for congestion. Using the label below, how many mL will the nurse administer to the client? Enter a numeric value only. Answer to the nearest whole mL.

Correct Answer is ["20"]

Explanation

A client recently had a myocardial infarction. Which medication would the nurse anticipate the provider prescribing?

Correct Answer is D

Explanation

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