A nurse is teaching a patient about the use of sildenafil [Viagra] for erectile dysfunction. Which statement by the patient indicates understanding of the teaching?
"This drug may cause me to have an erection when I don't want one."
"If my erection lasts longer than 6 hours, I should contact my provider."
"If I have chest pain with sildenafil, I can use my nitroglycerin as prescribed."
"I should take this drug 5 minutes before sexual activity."
The Correct Answer is B
A. While sildenafil can cause erections, it does not typically lead to unwanted erections; it requires sexual stimulation to be effective.
B. An erection lasting longer than 6 hours, known as priapism, is a serious side effect and requires immediate medical attention, indicating the patient understands this risk.
C. Using nitroglycerin with sildenafil can lead to dangerous drops in blood pressure, and patients should be advised to avoid this combination.
D. Sildenafil should be taken about 30 minutes to 1 hour before sexual activity for best results, not just 5 minutes prior.
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Correct Answer is B
Explanation
A. Discontinuing metformin 24 hours before a CT scan is longer than necessary and not standard practice.
B. It is generally recommended that metformin be held for at least 12 hours before the administration of IV contrast to reduce the risk of lactic acidosis, especially in clients with renal impairment.
C. Six hours is insufficient time to ensure the medication is cleared from the system, considering the potential risks.
D. Discontinuing metformin for 48 hours is overly cautious and not necessary unless there are complications that arise after the contrast is administered.
Correct Answer is ["C","E","F"]
Explanation
A. Rebound hypotension is more commonly associated with abrupt withdrawal of beta-blockers rather than a direct side effect, so it is not typically included as a side effect to expect while on the medication.
B. Vomiting is not a common side effect associated with propranolol; the nurse would not educate the client on this.
C. Bradycardia is a known side effect of propranolol, as it is a beta-blocker that decreases heart rate, so clients should be educated about monitoring their heart rate.
D. Tremors can be related to withdrawal from beta-agonists rather than propranolol, which may alleviate tremors in some individuals; thus, it's not a common side effect of the medication.
E. Propranolol can mask the symptoms of hypoglycemia (e.g., tachycardia), making it important for clients with diabetes to be aware of this potential effect.
F. Bronchoconstriction can occur in clients with reactive airway diseases, as propranolol non-selectively blocks beta receptors, so clients should be educated about this risk, especially if they have asthma or other pulmonary conditions.