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 C
Explanation
A. Metformin does not stimulate the pancreas to produce more insulin; that action is characteristic of sulfonylureas.
B. Metformin does not increase the absorption of glucose in the intestines; rather, it works by reducing the amount of glucose released into the bloodstream.
C. Metformin primarily decreases glucose production in the liver and improves insulin sensitivity in peripheral tissues, which helps lower blood sugar levels. This makes it effective for managing type 2 diabetes.
D. While metformin can have effects on fat metabolism, its primary action is not to decrease fat breakdown but to manage blood glucose levels.
Correct Answer is A
Explanation
A. Changing positions slowly is critical for older adults taking beta-adrenergic blockers and diuretics to prevent orthostatic hypotension, which can lead to lightheadedness or dizziness.
B. Reducing fluid intake is not advisable, as thiazide diuretics can lead to dehydration, and maintaining adequate fluid intake is essential for overall health and to avoid excessive urinary output.
C. Identifying and eliminating high-potassium foods is unnecessary unless there is a specific indication of hyperkalemia, particularly since thiazide diuretics do not typically cause potassium retention, and beta-blockers are not potassium-specific.
D. Expecting blood pressure to increase before it decreases is misleading; clients should see a gradual reduction in blood pressure with proper medication adherence, and any sudden increases should be reported.