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. Hypertension can affect drug distribution to some extent due to altered perfusion but is not the most significant factor impacting distribution, especially for a local condition like cellulitis.
B. Liver dysfunction primarily affects the metabolism and clearance of drugs rather than their distribution, although it may indirectly influence distribution by altering protein binding.
C. Peripheral vascular disease significantly impacts blood flow to the extremities, which can hinder the distribution of the antibiotic to the affected area (the left leg) where the cellulitis is present, leading to reduced drug efficacy.
D. Diverticulitis disease primarily affects the gastrointestinal system and would not directly influence the distribution of an antibiotic used to treat cellulitis in the leg.
Correct Answer is B
Explanation
A. Performing a blood sugar analysis is important, but in the case of sudden symptoms such as weakness, shakiness, and dizziness, it is crucial to act quickly to address the potential hypoglycemia without delay.
B. Having the client drink a 4-ounce glass of orange juice is the most appropriate initial response as it provides a quick source of glucose to alleviate symptoms of hypoglycemia, which is a common concern in clients with type 1 diabetes experiencing these symptoms.
C. Administering 1 ampule of 50% dextrose intravenously is an effective treatment for hypoglycemia but is typically reserved for severe cases where the patient is unable to consume oral glucose or is unconscious.
D. Administering 10 units of regular insulin subcutaneously would exacerbate the problem by lowering blood sugar further and is contraindicated in a patient experiencing hypoglycemic symptoms.