The nurse is caring for a client who is taking a bronchodilator. In what disease process should bronchodilators be used cautiously?
liver failure
renal failure
respiratory failure
heart failure
The Correct Answer is D
A. Liver failure does not have a direct contraindication with bronchodilators, though careful monitoring is needed.
B. Renal failure is not a direct contraindication for bronchodilator use; however, kidney function can affect drug metabolism and clearance.
C. Respiratory failure may necessitate bronchodilator therapy rather than caution, especially in conditions like COPD or asthma where bronchodilators are crucial for management.
D. Heart failure requires caution with bronchodilators because they can lead to increased heart rate and blood pressure, potentially exacerbating heart failure symptoms or leading to arrhythmias.
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Correct Answer is B
Explanation
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.
Correct Answer is C
Explanation
A. An increased risk for CNS depression is not typically associated with opioid agonist-antagonists; instead, these medications may produce a ceiling effect on sedation compared to full agonists.
B. Respiratory depression is more commonly associated with full opioid agonists rather than agonist-antagonists. Agonist-antagonists can sometimes counteract respiratory depression caused by full agonists.
C. Opioid withdrawal symptoms can occur when a client who is dependent on full agonist opioids is given an agonist-antagonist, as these medications can displace the agonist from receptors, leading to withdrawal.
D. Hypotension is a possible side effect of opioids but is not a specific concern with the use of agonist-antagonists in the context of opioid therapy.