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 A
Explanation
Rationale:
A. Desmopressin is a synthetic analog of antidiuretic hormone (ADH) and is used to reduce urine output in conditions like diabetes insipidus. Monitoring urine output is the primary way to assess the effectiveness of this medication. A decrease in urine volume indicates the medication is working effectively.
B. Pupillary response is not relevant in assessing the effectiveness of desmopressin.
C. Temperature monitoring is important in general patient care but does not directly relate to the effectiveness of desmopressin.
D. Apical heart rate is important to monitor in many scenarios but is not a direct indicator of desmopressin's effectiveness.
Correct Answer is C
Explanation
Rationale:
A. Coffee does not interact with glimepiride.
B. Milk is not contraindicated with glimepiride.
C. Alcohol should be avoided while taking glimepiride, as it can potentiate the hypoglycemic effects of the medication and may increase the risk of a severe drop in blood sugar levels.
D. Grapefruit juice is not known to have a significant interaction with glimepiride.