A client exhibits muscular tremors, drooling, gait changes, and spasms. When reviewing the client's medication history, which would the nurse most likely find?
antipsychotic agent
antidiabetic agent
general anesthetic
anticholinergic agent
The Correct Answer is A
A. An antipsychotic agent, particularly first-generation antipsychotics, can cause extrapyramidal symptoms such as tremors, drooling, gait changes, and spasms due to their dopamine-blocking effects in the brain.
B. An antidiabetic agent does not typically cause these neurological symptoms; its primary effects are related to glucose metabolism.
C. A general anesthetic is used to induce unconsciousness and does not generally result in muscular tremors or drooling.
D. An anticholinergic agent can cause side effects like dry mouth and constipation but does not typically lead to the muscular symptoms described; in fact, it may reduce drooling.
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Correct Answer is B
Explanation
A. Rebound hypertension can occur if antihypertensive medications are abruptly stopped, but it is not a direct reason for switching from an ACE inhibitor to an angiotensin II receptor blocker.
B. A persistent cough is a well-known side effect of ACE inhibitors due to the accumulation of bradykinin. If the client experienced this side effect, it would likely prompt the healthcare provider to switch to an angiotensin II receptor blocker, which does not typically cause this issue.
C. A transient ischemic attack (TIA) would require urgent intervention but is not a reason for changing from an ACE inhibitor to an angiotensin II receptor blocker.
D. Non-adherence to ACE inhibitor treatment may lead to ineffective blood pressure control but would not directly justify a switch to a different class of medication.
Correct Answer is B
Explanation
A. Bruising and bleeding gums are not indicative of an allergic reaction, which would typically present with different symptoms such as rash, itching, or swelling. Administering antihistamines would not address the underlying issue.
B. The development of bruising and bleeding gums in a patient on heparin therapy suggests a bleeding complication, which is a known risk of anticoagulation therapy. The nurse should notify the healthcare provider to assess the situation and possibly adjust treatment or perform further evaluations.
C. While hypersensitivity reactions can occur with medications, the symptoms presented here are more aligned with bleeding complications than with hypersensitivity. Discontinuing heparin without consulting the provider could put the patient at risk for thromboembolic events.
D. The symptoms do not indicate an infection; therefore, initiating antibiotic therapy would not be appropriate in this context.