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A nurse is performing an assessment on a client who has been taking verapamil as prescribed for two months. Which of the following findings should the nurse identify as adverse effects of this medication? (Select all that apply.)

A.

Peripheral edema.

B.

Bradycardia.

C.

Constipation.

D.

Reports of blurred vision.

E.

Reports of insomnia.

Question Solution

Correct Answer : A,B,C

Choice A rationale

 

Peripheral edema is a common adverse effect of verapamil. It occurs due to the vasodilatory effects of the medication, which can cause fluid retention in the extremities.

 

Choice B rationale

 

Bradycardia is an adverse effect of verapamil. It occurs because verapamil slows down the heart rate by blocking calcium channels in the heart.

 

Choice C rationale

 

Constipation is a common adverse effect of verapamil. It occurs due to the medication’s effect on smooth muscle relaxation, which can slow down gastrointestinal motility.

 

Choice D rationale

 

Reports of blurred vision are not a common adverse effect of verapamil. Blurred vision is not typically associated with this medication.

 

Choice E rationale

 

Reports of insomnia are not a common adverse effect of verapamil. Insomnia is not typically associated with this medication.


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Correct Answer is C

Explanation

Choice A rationale

Mannitol is an osmotic diuretic used primarily to reduce intracranial pressure (ICP) and treat cerebral edema. It does not affect thyroxine levels, which are related to thyroid function. Thyroxine levels are regulated by the thyroid gland and are not influenced by mannitol administration.

Choice B rationale

Mannitol is not used to correct atrial flutter. Atrial flutter is a type of arrhythmia that requires specific antiarrhythmic medications or procedures such as cardioversion. Mannitol’s primary action is to increase osmotic pressure in the kidneys, leading to diuresis and reduction of fluid in tissues, including the brain.

Choice C rationale

Mannitol is effective in reducing intracranial pressure by creating an osmotic gradient that draws fluid from the brain tissue into the bloodstream, which is then excreted by the kidneys. This reduction in intracranial pressure is a desired therapeutic outcome when treating conditions like cerebral edema.

Choice D rationale

Mannitol does not increase hemoglobin levels. Hemoglobin levels are influenced by factors such as red blood cell production and destruction, iron levels, and overall health status. Mannitol’s mechanism of action is related to fluid balance and diuresis, not hematopoiesis.

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.

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