A patient receiving metoclopramide is also taking an antidepressant. What should the nurse monitor for?
Decreased appetite
Increased risk of serotonin syndrome
Elevated blood pressure
Enhanced antidepressant effects
The Correct Answer is B
A. Decreased appetite may occur but is not the most critical concern in this context.
B. The combination of metoclopramide, which can influence serotonin pathways, with certain antidepressants, especially SSRIs, increases the risk of serotonin syndrome, a potentially life-threatening condition.
C. While some antidepressants can influence blood pressure, monitoring for elevated blood pressure is not the primary concern with metoclopramide.
D. There is no evidence to suggest that metoclopramide enhances the effects of antidepressants; the focus should be on potential adverse interactions instead.
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Correct Answer is ["A","B"]
Explanation
A. The client's skin and eyes are visibly jaundiced is correct because jaundice indicates a buildup of bilirubin in the blood, which is a sign of liver dysfunction.
B. The client's AST and ALT levels are elevated is correct because elevated levels of these liver enzymes indicate hepatocellular injury, which is consistent with liver damage due to acetaminophen overdose.
C. The client's temperature is 102.5° F (39.2° C) is incorrect; while a fever can occur in various conditions, it is not specific for liver damage in this context.
D. The client has an elevated red blood cell count is incorrect; elevated red blood cell counts are not indicative of liver damage and may be related to other factors.
E. The client's eyes are sensitive to light is incorrect; photophobia is not a direct indicator of liver damage and is more related to other conditions.
Correct Answer is D
Explanation
A. The patient’s statement about the peak of NPH insulin being 6-12 hours is correct; it is important to know when to monitor for hypoglycemia.
B. Taking NPH before breakfast is appropriate, as it is typically given in the morning to provide coverage for meals throughout the day.
C. The duration of NPH insulin lasting for 12-18 hours is accurate, which is crucial for understanding how long the patient can expect blood glucose control.
D. NPH insulin should not be taken right before meals as it does not act quickly enough to cover immediate carbohydrate intake. Rapid-acting insulin is typically used for that purpose, indicating a need for further teaching.