A nurse is caring for a client who has hypertension and nephropathy due to type 2 diabetes mellitus. The nurse should expect to administer which of the following medications to slow the progression of the nephropathy?
Sitagliptin.
Glipizide.
Metoprolol.
Losartan.
The Correct Answer is D
Choice A rationale
Sitagliptin is a DPP-4 inhibitor used to manage blood sugar levels in type 2 diabetes but does not specifically slow the progression of nephropathy.
Choice B rationale
Glipizide is a sulfonylurea that helps control blood sugar levels but does not have a direct effect on slowing nephropathy progression.
Choice C rationale
Metoprolol is a beta-blocker used to manage hypertension but does not specifically target nephropathy progression.
Choice D rationale
Losartan is an angiotensin II receptor blocker (ARB) that helps manage hypertension and has been shown to slow the progression of nephropathy in patients with type 2 diabetes.
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Correct Answer is ["A","F"]
Explanation
Choice A rationale
Thrombocytopenia, a low platelet count, increases the risk of bleeding and hemorrhage when receiving heparin.
Choice B rationale
Neutropenia, a low white blood cell count, does not directly increase the risk of hemorrhage. It is more related to infection risk.
Choice C rationale
Hypokalemia, low potassium levels, does not directly indicate a risk for hemorrhage. It can cause other complications but not specifically bleeding.
Choice D rationale
Fever is not a direct indicator of hemorrhage risk. It may indicate infection or other inflammatory processes.
Choice E rationale
Hyperglycemia, high blood sugar levels, does not indicate a risk for hemorrhage. It is more related to diabetes management.
Choice F rationale
Dark stools can indicate gastrointestinal bleeding, which is a sign of hemorrhage.
Correct Answer is ["A","B","C","D","F"]
Explanation
Choice A rationale
Assessing the client’s gag reflex before offering oral intake is essential to prevent aspiration. The gag reflex may be diminished after moderate sedation and the use of local anesthetics during bronchoscopy.
Choice B rationale
Listening to the client’s breath sounds is important to detect any abnormalities, such as wheezing, crackles, or decreased breath sounds, which could indicate complications like bronchospasm or pneumothorax.
Choice C rationale
Monitoring the client’s oxygen saturation is crucial to ensure adequate oxygenation and detect any signs of respiratory distress or hypoxemia following the procedure.
Choice D rationale
Monitoring the client for manifestations of bleeding is necessary because bronchoscopy can cause trauma to the airways, leading to bleeding. Signs of bleeding may include hemoptysis or a drop in hemoglobin levels.
Choice E rationale
Assessing the client’s puncture site is not applicable in this context, as bronchoscopy does not involve a puncture site. This option is incorrect.
Choice F rationale
Observing the client for manifestations of a pneumothorax is important because bronchoscopy can occasionally cause a pneumothorax, especially if a biopsy is performed. Signs of pneumothorax include sudden chest pain, dyspnea, and decreased breath sounds on the affected side. .