A nurse is reviewing the medication record for a client who has chronic kidney disease. Which of the following medications should the nurse identify as having the potential to cause nephrotoxicity?
Ondansetron
Diphenhydramine
Gentamicin
Omeprazole
The Correct Answer is C
Rationale:
A. Ondansetron is an antiemetic that does not typically cause nephrotoxicity and is generally safe for use in clients with chronic kidney disease.
B. Diphenhydramine is an antihistamine that does not have nephrotoxic effects and is commonly used for allergy symptoms or as a sleep aid.
C. Gentamicin is an aminoglycoside antibiotic that is known to be nephrotoxic, especially in clients with pre-existing kidney disease. It requires careful monitoring of kidney function and dosing adjustments to prevent kidney damage.
D. Omeprazole is a proton pump inhibitor used to treat gastroesophageal reflux disease (GERD) and does not typically cause nephrotoxicity, although long-term use has been associated with an increased risk of chronic kidney disease.
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Correct Answer is C
Explanation
Rationale:
A. Increasing carbohydrate intake is not recommended for clients with Cushing's disease as they are already at risk for hyperglycemia and weight gain due to the effects of excess cortisol.
B. Decreasing protein intake is not advisable because clients with Cushing's disease often suffer from muscle wasting and weakness. Adequate protein is necessary to help maintain muscle mass.
C. Clients with Cushing's disease should increase their intake of calcium and vitamin D because they are at risk for osteoporosis due to the effects of chronic corticosteroid exposure, which can lead to decreased bone density.
D. Clients with Cushing's disease often experience hypokalemia (low potassium levels), so limiting potassium-rich foods would not be beneficial. Instead, they should ensure adequate potassium intake.
Correct Answer is C
Explanation
Rationale:
A. Limiting walking episodes may reduce discomfort but does not address the underlying issue or potential complications.
B. While leg cramps can be common during pregnancy, calf pain could also indicate a more serious condition, such as deep vein thrombosis (DVT), and should not be dismissed as normal without further investigation.
C. Gathering further assessment data is crucial to determine the cause of the calf pain, as it may indicate DVT, a potentially life-threatening condition. The nurse should assess for other symptoms like swelling, redness, or warmth in the leg.
D. Instructing the client to elevate the legs may be appropriate for general discomfort, but without proper assessment, it may not be the correct intervention if DVT is present.