The nurse is interviewing a new patient with diabetes who takes rosiglitazone (Avandia). Which information would the nurse anticipate resulting in the health care provider discontinuing the medication?
The patient has chest pressure when walking.
The patient's blood pressure is 154/92.
The patient's blood glucose is 86 mg/dL.
The patient reports a history of emphysema.
The Correct Answer is A
Rationale:
A. The patient has chest pressure when walking: Rosiglitazone is associated with an increased risk of myocardial ischemia and heart failure. Chest pressure with exertion suggests possible angina, making continuation of this medication unsafe and requiring discontinuation.
B. The patient's blood pressure is 154/92: Hypertension requires management, but it is not a direct contraindication for rosiglitazone. While blood pressure control is important in diabetes, this finding alone does not mandate stopping the drug.
C. The patient's blood glucose is 86 mg/dL: This is a normal fasting glucose level and indicates that diabetes is currently well controlled. It does not necessitate discontinuing rosiglitazone.
D. The patient reports a history of emphysema: Chronic lung disease is not directly affected by rosiglitazone use. While comorbidities require monitoring, emphysema is not a contraindication for the drug.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Rationale:
A. Observe the client carefully for signs of hypocalcemia: Monitoring for hypocalcemia is important after thyroidectomy due to possible parathyroid gland injury, but it is not a preventive measure for thyroid crisis in a client with hyperthyroidism.
B. Keep the client NPO: Keeping the client NPO is not related to preventing thyroid crisis. NPO status is typically ordered before surgery or certain procedures, but it does not help control the risk of thyroid storm in hyperthyroidism.
C. Provide a quiet, low-stimulus environment: Stress, overstimulation, and excitement can precipitate thyroid crisis in hyperthyroid clients. A quiet, low-stimulus environment helps reduce sympathetic nervous system activity, decreasing the likelihood of triggering a thyroid storm.
D. Administer aspirin as prescribed for any sign of hyperthermia: Aspirin should be avoided in hyperthyroidism because it can increase free thyroid hormone levels by displacing it from binding proteins. Acetaminophen is preferred for treating hyperthermia in this condition.
Correct Answer is D
Explanation
Rationale:
A. Avoid eating for 2 hr before exercise: Skipping food increases the risk of hypoglycemia during or after exercise, especially when insulin is active. A pre-exercise snack is often recommended if glucose levels are low or activity is prolonged.
B. Perform vigorous exercise when blood glucose is less than 100 mg/dL: Exercising with glucose below 100 mg/dL raises the risk of hypoglycemia. Clients should eat a carbohydrate snack before exercise if their glucose is under 100 mg/dL to maintain safe levels during activity.
C. Examine your feet weekly: Foot care is essential for diabetes management, but feet should be checked daily, not weekly. Daily inspection allows early detection of sores, blisters, or infections, which can prevent severe complications.
D. Do not exercise if ketones are present in your urine: The presence of ketones indicates insulin deficiency and potential diabetic ketoacidosis. Exercise in this state worsens hyperglycemia and ketosis, making it unsafe. Clients should avoid activity until glucose and ketone levels are controlled.
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