A nurse is caring for a client who has a new diagnosis of adrenal insufficiency. Which of the following prescriptions should the nurse anticipate from the provider?
Phenytoin.
Calcitonin.
Buspirone.
Fludrocortisone.
The Correct Answer is D
Choice A rationale
Phenytoin is an anticonvulsant used to control seizures and is not indicated for the treatment of adrenal insufficiency.
Choice B rationale
Calcitonin is used to treat conditions like osteoporosis and hypercalcemia, not adrenal insufficiency.
Choice C rationale
Buspirone is an anxiolytic used to treat anxiety disorders and is not used for adrenal insufficiency.
Choice D rationale
Fludrocortisone is a synthetic corticosteroid that is used to replace aldosterone in patients with adrenal insufficiency. It helps maintain sodium balance and blood pressure.
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Correct Answer is C
Explanation
Choice A rationale
Ipratropium inhalers can potentially increase heart rate and blood pressure, but this is not a common side effect. The concern about high blood pressure is valid but not as critical as an allergy to atropine.
Choice B rationale
Using albuterol with ipratropium is common practice for managing bronchospasm. There is no contraindication for using both medications together.
Choice C rationale
An allergy to atropine is significant because ipratropium is chemically related to atropine. This could lead to a severe allergic reaction.
Choice D rationale
There are no known interactions between ipratropium and alcohol. However, it is always best to consult with a healthcare provider regarding alcohol consumption while on medication.
Correct Answer is B
Explanation
Choice A rationale
Monitoring for weight gain is not a primary concern with pramlintide. Pramlintide is an amylin analog used to control postprandial blood glucose levels. Weight gain is not a typical side effect of pramlintide; instead, it may cause weight loss due to its effects on appetite suppression and delayed gastric emptying.
Choice B rationale
Monitoring for hypoglycemia for 3 hours after pramlintide administration is crucial. Pramlintide can increase the risk of insulin-induced hypoglycemia, especially in patients with type 1 diabetes. This is because pramlintide slows gastric emptying and suppresses glucagon secretion, which can lead to lower blood glucose levels.
Choice C rationale
Injecting pramlintide in the upper arm is not recommended. Pramlintide should be administered subcutaneously in the abdomen or thigh, not the upper arm, to ensure proper absorption and effectiveness.
Choice D rationale
Administering pramlintide 30 minutes prior to a meal is incorrect. Pramlintide should be administered immediately before meals to help control postprandial blood glucose levels effectively.