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 C
Explanation
Choice A rationale
Rifampin is an antibiotic used to treat tuberculosis and other bacterial infections. It does not have a known interaction with St. John’s wort.
Choice B rationale
Furosemide is a diuretic used to treat fluid retention and high blood pressure. It does not have a known interaction with St. John’s wort.
Choice C rationale
Citalopram is a selective serotonin reuptake inhibitor (SSRI) used to treat depression. St. John’s wort can interact with SSRIs like citalopram, potentially leading to serotonin syndrome, a serious condition caused by excessive levels of serotonin in the brain.
Choice D rationale
Allopurinol is used to treat gout and kidney stones. It does not have a known interaction with St. John’s wort.
Correct Answer is C
Explanation
Choice A rationale
Crushing hydroxychloroquine tablets can alter the drug’s release and absorption, potentially leading to suboptimal therapeutic effects or increased side effects.
Choice B rationale
Discontinuing hydroxychloroquine when symptoms subside can lead to a flare-up of rheumatoid arthritis symptoms. It is important to continue the medication as prescribed to maintain disease control.
Choice C rationale
Regular eye exams are necessary while taking hydroxychloroquine because the medication can cause retinal toxicity, which can lead to vision changes or loss if not monitored and managed appropriately.
Choice D rationale
Taking a double dose of hydroxychloroquine can increase the risk of side effects and toxicity. It is important to take the medication as prescribed and not to double up on doses.