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 D
Explanation
Rationale:
A. Fluid intake may need to be monitored, but restricting fluids is not typically advised unless specifically directed by the healthcare provider due to complications like diabetes insipidus.
B. Avoiding deep breathing exercises is not recommended, as these exercises are important for preventing respiratory complications postoperatively.
C. Lying flat for 48 hours after surgery is incorrect; the head of the bed is usually elevated to decrease intracranial pressure and promote healing.
D. Avoiding blowing the nose and bending at the waist is crucial after transsphenoidal hypophysectomy to prevent increased intracranial pressure and avoid disrupting the surgical site, which could lead to complications such as cerebrospinal fluid leakage.
Correct Answer is A
Explanation
Rationale:
A. Injecting insulin into the abdominal area is appropriate as it is one of the preferred sites for insulin administration due to its consistent absorption.
B. Blood sugar readings should be taken before meals, not after, to determine the need for insulin and to manage blood glucose levels effectively.
C. Insulin does not allow for unrestricted consumption of high-sugar foods like ice cream; instead, a balanced diet is important to maintain stable blood glucose levels.
D. While weight reduction can help manage diabetes, it does not inherently cause hypoglycemia unless the client is taking insulin or other medications that lower blood glucose.