A nurse is caring for a client who is having difficulty voiding following surgery. The nurse notes palpable bladder distention. Which of the following medications should the nurse anticipate administering to the client?
Furosemide
Lorazepam
Bethanechol
Atropine
The Correct Answer is C
Rationale:
A. Furosemide is a diuretic that promotes urine production but is not indicated for treating bladder distention or urinary retention post-surgery.
B. Lorazepam is an anxiolytic medication and does not address urinary retention or bladder distention.
C. Bethanechol is a cholinergic agent that stimulates bladder contraction and is used to treat urinary retention. It helps to facilitate voiding in clients who have difficulty.
D. Atropine is an anticholinergic medication that can actually inhibit bladder contraction, making it inappropriate for this situation.
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Correct Answer is A
Explanation
Rationale:
A. Increase fluids while taking the medication: Amitriptyline is a tricyclic antidepressant that can cause anticholinergic side effects such as dry mouth and constipation. Increasing fluid intake helps to mitigate these effects and prevent dehydration and constipation.
B. Expect an elevation in blood pressure with initial doses of the medication: Amitriptyline can cause orthostatic hypotension rather than elevated blood pressure. Clients should be informed about the risk of dizziness or fainting.
C. Stop the medication immediately if urine becomes orange in color: Orange urine is not a common side effect of amitriptyline. Clients should not stop the medication without consulting their provider.
D. Take the medication in the morning: Amitriptyline has sedative effects and is typically taken at night to help manage sleep disturbances and reduce daytime drowsiness.
Correct Answer is C
Explanation
Rationale:
A. Magnesium 2.5 mEq/L: A magnesium level slightly above the normal range does not indicate an immediate need to discontinue clozapine, as this level is not related to the adverse effects of the drug.
B. Potassium 5.4 mEq/L: While elevated potassium levels can pose a health risk, this is not a direct indicator to discontinue clozapine. Potassium levels can be managed with other interventions.
C. WBC 2,500/mm³: Clozapine carries a risk of agranulocytosis, a condition where the white blood cell (WBC) count becomes dangerously low, leading to severe infection risk. A WBC count of 2,500/mm³ is below the normal range and indicates the need to discontinue clozapine immediately.
D. Sodium 134 mEq/L: A slightly low sodium level is not typically related to clozapine use and does not warrant discontinuation of the medication.