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.)
Peripheral edema.
Bradycardia.
Constipation.
Reports of blurred vision.
Reports of insomnia.
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 ["A","B","C","E"]
Explanation
Choice A rationale
Prednisone, a corticosteroid, can cause hypokalemia by increasing renal potassium excretion.
Choice B rationale
Torsemide, a loop diuretic, can lead to hypokalemia by promoting potassium loss through urine.
Choice C rationale
Polystyrene sulfonate is used to treat hyperkalemia, but it can cause hypokalemia as it removes potassium from the body.
Choice D rationale
A client taking spironolactone does not require monitoring for hypokalemia because spironolactone is a potassium-sparing diuretic. It helps the body retain potassium, so it is more likely to cause hyperkalemia (high potassium levels) than hypokalemia.
Choice E rationale
Hydrochlorothiazide, a thiazide diuretic, can cause hypokalemia by increasing potassium excretion in the urine.
Correct Answer is C
Explanation
Choice A rationale
A standing prescription is an order that applies to all patients who meet certain criteria and is not specific to a single administration. It is used for routine treatments and does not apply to a one-time pre-transfusion medication.
Choice B rationale
A stat prescription is an urgent order that requires immediate administration, typically within minutes. It is used for emergency situations and does not apply to a pre-transfusion medication given one hour before the procedure.
Choice C rationale
A single prescription is a one-time order for a specific medication to be given at a specific time. In this case, diphenhydramine 50 mg by mouth once, one hour prior to transfusion, fits the definition of a single prescription.
Choice D rationale
A PRN (pro re nata) prescription is an order for medication to be given as needed based on the patient’s condition. It is not applicable to a scheduled pre-transfusion medication.