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 A
Explanation
A. A reduced plasma albumin level can lead to increased free drug levels in the bloodstream, raising the risk of drug toxicity, particularly for highly protein-bound medications.
B. Decreased therapeutic effects are less likely because the decrease in albumin can lead to higher free drug concentrations, which may actually increase effects rather than decrease them.
C. Altered drug absorption is generally not directly influenced by plasma albumin levels; it relates more to gastrointestinal factors.
D. Increased drug metabolism is not a direct consequence of lower albumin levels; instead, the concern is primarily about increased free drug concentrations and potential toxicity.
Correct Answer is A
Explanation
A. Lorazepam is a benzodiazepine commonly used to manage alcohol withdrawal symptoms, including seizures. It acts quickly to reduce anxiety and seizure activity.
B. Phenytoin is primarily used for seizure control in conditions such as epilepsy but is not the first-line treatment for alcohol withdrawal seizures.
C. Ethosuximide is specifically used for absence seizures and is not effective for alcohol withdrawal.
D. Gabapentin is sometimes used for neuropathic pain but is not indicated for acute alcohol withdrawal or seizure management.