A nurse is administering drugs to a 70-year-old patient who has a reduced plasma albumin level. When assessing the patient for therapeutic outcomes of drug therapy, the nurse will also be careful to observe for
possible drug toxicity.
decreased therapeutic effects.
altered drug absorption.
increased drug metabolism.
The Correct Answer is A
A. A reduced plasma albumin level can lead to increased free drug levels in the bloodstream, raising the risk of drug toxicity, particularly for highly protein-bound medications.
B. Decreased therapeutic effects are less likely because the decrease in albumin can lead to higher free drug concentrations, which may actually increase effects rather than decrease them.
C. Altered drug absorption is generally not directly influenced by plasma albumin levels; it relates more to gastrointestinal factors.
D. Increased drug metabolism is not a direct consequence of lower albumin levels; instead, the concern is primarily about increased free drug concentrations and potential toxicity.
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Correct Answer is D
Explanation
A. Liver failure does not have a direct contraindication with bronchodilators, though careful monitoring is needed.
B. Renal failure is not a direct contraindication for bronchodilator use; however, kidney function can affect drug metabolism and clearance.
C. Respiratory failure may necessitate bronchodilator therapy rather than caution, especially in conditions like COPD or asthma where bronchodilators are crucial for management.
D. Heart failure requires caution with bronchodilators because they can lead to increased heart rate and blood pressure, potentially exacerbating heart failure symptoms or leading to arrhythmias.
Correct Answer is B
Explanation
A. Decreased appetite may occur but is not the most critical concern in this context.
B. The combination of metoclopramide, which can influence serotonin pathways, with certain antidepressants, especially SSRIs, increases the risk of serotonin syndrome, a potentially life-threatening condition.
C. While some antidepressants can influence blood pressure, monitoring for elevated blood pressure is not the primary concern with metoclopramide.
D. There is no evidence to suggest that metoclopramide enhances the effects of antidepressants; the focus should be on potential adverse interactions instead.