The nurse is caring for a client who has begun to take sertraline (Zoloft) for newly diagnosed depression. Which of the following conditions is associated with an overdose of this medication class?
Tardive Dyskinesia
Serotonin syndrome
Hypertensive Emergency
Extrapyramidal Syndrome
The Correct Answer is B
A. Tardive dyskinesia is primarily associated with long-term use of antipsychotics, not SSRIs like sertraline.
B. Serotonin syndrome is a serious condition that can occur with overdose or interaction of SSRIs, leading to symptoms such as agitation, confusion, rapid heart rate, and increased muscle tone.
C. Hypertensive emergency is not typically associated with SSRIs; it is more related to the use of MAOIs and certain foods.
D. Extrapyramidal syndrome is also primarily linked to antipsychotics rather than SSRIs and would not be a concern with sertraline use.
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Correct Answer is ["B","C","F"]
Explanation
A. Morphine administered intravenously bypasses the gastrointestinal tract and liver, avoiding the first-pass effect entirely.
B. Diphenhydramine in tablet form is absorbed through the gastrointestinal tract and undergoes significant first-pass metabolism in the liver, affecting its bioavailability.
C. Famotidine in tablet form is also subject to first-pass metabolism, which can reduce its effectiveness.
D. Nitroglycerin sublingual tablets are designed to bypass the first-pass metabolism by being absorbed directly into the bloodstream through the mucous membranes.
E. The same applies to nitroglycerin 10mg sublingual tablets; they also avoid the first-pass effect due to sublingual administration.
F. Acetaminophen is taken orally and undergoes first-pass metabolism in the liver, which can significantly affect its overall bioavailability.
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.