A nurse is talking with a client who has a new prescription for an ipratropium inhaler to treat exercise-induced bronchospasm.
Which of the following client statements should the nurse report to the provider?
“I hope this new medication won’t make my high blood pressure worse.”.
“I want to keep using my albuterol when I feel like I need it.”.
“I am allergic to atropine.”.
“I usually have a glass of red wine with dinner.”.
The Correct Answer is C
Choice A rationale
Ipratropium inhalers can potentially increase heart rate and blood pressure, but this is not a common side effect. The concern about high blood pressure is valid but not as critical as an allergy to atropine.
Choice B rationale
Using albuterol with ipratropium is common practice for managing bronchospasm. There is no contraindication for using both medications together.
Choice C rationale
An allergy to atropine is significant because ipratropium is chemically related to atropine. This could lead to a severe allergic reaction.
Choice D rationale
There are no known interactions between ipratropium and alcohol. However, it is always best to consult with a healthcare provider regarding alcohol consumption while on medication.
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Correct Answer is B
Explanation
Choice A rationale
Monitoring for weight gain is not a primary concern with pramlintide. Pramlintide is an amylin analog used to control postprandial blood glucose levels. Weight gain is not a typical side effect of pramlintide; instead, it may cause weight loss due to its effects on appetite suppression and delayed gastric emptying.
Choice B rationale
Monitoring for hypoglycemia for 3 hours after pramlintide administration is crucial. Pramlintide can increase the risk of insulin-induced hypoglycemia, especially in patients with type 1 diabetes. This is because pramlintide slows gastric emptying and suppresses glucagon secretion, which can lead to lower blood glucose levels.
Choice C rationale
Injecting pramlintide in the upper arm is not recommended. Pramlintide should be administered subcutaneously in the abdomen or thigh, not the upper arm, to ensure proper absorption and effectiveness.
Choice D rationale
Administering pramlintide 30 minutes prior to a meal is incorrect. Pramlintide should be administered immediately before meals to help control postprandial blood glucose levels effectively.
Correct Answer is B
Explanation
Choice A rationale
Methimazole does not typically cause constipation. It is used to treat hyperthyroidism by inhibiting the production of thyroid hormones.
Choice B rationale
A sore throat can be a sign of agranulocytosis, a serious side effect of methimazole that involves a dangerously low white blood cell count. Patients are advised to contact their provider if they experience a sore throat.
Choice C rationale
While monitoring weight is important for patients with hyperthyroidism, it is not a specific instruction related to methimazole use.
Choice D rationale
Methimazole should be taken regularly as prescribed, not on an as-needed basis.