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 B
Explanation
Rationale:
A. A decreased pulse is not typically associated with pheochromocytoma. This condition is characterized by the excessive release of catecholamines, which usually leads to an increased heart rate.
B. Pheochromocytoma is a tumor of the adrenal medulla that causes excessive secretion of catecholamines, leading to episodic or sustained hypertension. Elevated blood pressure is a hallmark symptom of this condition.
C. Cold intolerance is more commonly associated with hypothyroidism and is not a typical finding in pheochromocytoma.
D. Decreased respiratory rate is not characteristic of pheochromocytoma; instead, clients may experience symptoms such as palpitations, sweating, and headaches due to the elevated catecholamine levels.
Correct Answer is D
Explanation
Rationale:
A. Children with Addison’s disease often require increased sodium intake, especially during periods of stress or illness, due to the lack of aldosterone.
B. Addison's disease typically causes fluid volume deficit rather than excess.
C. Addison's disease is more commonly associated with hypoglycemia rather than hyperglycemia.
D. Teaching the parents about cortisol replacement therapy is crucial, as this is the primary treatment for managing Addison’s disease. The child will need lifelong hormone replacement to compensate for the lack of cortisol.