A nurse is caring for a client who has a systemic fungal infection and is receiving IV amphotericin B deoxycholate. During previous infusions, the client developed a fever and chills. Which of the following actions should the nurse take?
Apply a warming blanket prior to administration.
Infuse the medication over 1 hr.
Administer diphenhydramine prior to administration.
Monitor vital signs once per hour following administration.
The Correct Answer is C
Rationale:
A. Applying a warming blanket is not appropriate, as it may exacerbate the client's reaction to the infusion and is not a standard pre-medication strategy.
B. Infusing amphotericin B deoxycholate over 1 hour is too rapid; it is typically infused over 2-6 hours to minimize adverse effects.
C. Administering diphenhydramine prior to the administration of amphotericin B can help prevent or alleviate infusion-related reactions such as fever and chills, which the client experienced during previous infusions.
D. Monitoring vital signs once per hour following administration is insufficient; vital signs should be monitored more frequently during and immediately after the infusion to promptly detect and address any adverse reactions.
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Correct Answer is ["A","D","E"]
Explanation
Rationale:
A. Blurred vision is a common side effect of anticholinergic medications due to their effect on the eye muscles and pupil dilation.
B. Polyuria is not typically associated with anticholinergic medications; these medications may actually lead to urinary retention.
C. A productive cough is not an expected adverse effect of anticholinergic medications; instead, they may cause dry mucous membranes and a dry cough.
D. Tachycardia can occur as anticholinergic medications block the effects of acetylcholine on the heart, leading to increased heart rate.
E. Constipation is a well-known side effect of anticholinergic medications because they reduce gastrointestinal motility.
Correct Answer is D
Explanation
Rationale:
A. This statement is incorrect because the client should remove contact lenses before administering brimonidine and wait at least 15 minutes before reinserting them to ensure proper absorption and avoid irritation.
B. While some mild irritation can occur, it is not a desired effect and should not be expected; the nurse should clarify what level of irritation is considered normal.
C. This statement is incorrect as brimonidine is typically a long-term treatment for glaucoma, and clients should not stop using it without consulting their provider.
D. This statement is correct; brimonidine can cause changes in eye color, particularly in individuals with lighter colored eyes, and the client should be informed about this possibility.