A nurse at a provider's office is collecting data from a client who reports taking pseudoephedrine for sinus problems. The nurse should recognize that which of the following conditions from the client's history places the client at risk for harm while taking pseudoephedrine?
Overweight
Migraine headaches
Eczema
Hypertension
The Correct Answer is D
A. Overweight. While weight can affect medication metabolism, it does not specifically increase risk with pseudoephedrine.
B. Migraine headaches. Migraine headaches are not contraindicated with pseudoephedrine, although some stimulants can increase headaches.
C. Eczema. Pseudoephedrine does not typically affect eczema.
D. Hypertension. Pseudoephedrine is a decongestant that can increase blood pressure, so it should be used with caution in clients with hypertension.
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Correct Answer is B
Explanation
A. Creatine kinase-myocardial band (CK-MB) test: While CK-MB is also a marker of myocardial injury, it is less specific than troponin and can be elevated in other conditions, such as muscle injury.
B. Troponin T test. The Troponin T test is highly specific and sensitive for myocardial injury and is considered the gold standard for diagnosing a myocardial infarction. Troponin levels rise within hours of cardiac muscle injury and remain elevated for days, providing an early and reliable indicator of cardiac muscle damage.
C. Brain natriuretic peptide (BNP) test. BNP levels are used to assess heart failure and do not indicate acute cardiac muscle injury.
D. Creatine kinase (CK) test. CK measures overall muscle injury, not specific to cardiac muscle.
Correct Answer is D
Explanation
A. Schedule deep tissue massage with physical therapy. Massaging the area is contraindicated in cases of suspected deep vein thrombosis (DVT), as it can dislodge the clot, leading to a pulmonary embolism.
B. Monitor Homan's sign. Homan’s sign (pain in the calf upon dorsiflexion) is no longer considered a reliable or safe assessment for DVT due to the risk of dislodging a clot.
C. Obtain platelet aggregation studies. Platelet aggregation studies are not specific to diagnosing a DVT; instead, imaging is preferred.
D. Arrange for a venous duplex ultrasound. A venous duplex ultrasound is a non-invasive test that can confirm the presence of a DVT in the affected extremity.