The nurse is preparing to administer promethazine (Phenergan) to a client who presents with acute vomiting. What information in the client's past medical history would alert the nurse to hold the medication?
Diabetes Mellitus
Chronic Kidney Disease
Iron Deficiency Anemia
Narrow-Angle Glaucoma
The Correct Answer is D
A. Diabetes Mellitus is not a contraindication for promethazine, although caution may be needed regarding metabolic control.
B. Chronic Kidney Disease does not specifically contraindicate the use of promethazine, but dosage adjustments may be necessary due to altered drug metabolism.
C. Iron Deficiency Anemia does not contraindicate the use of promethazine and would not raise significant concerns for its administration.
D. Narrow-Angle Glaucoma is a contraindication for promethazine due to its anticholinergic properties, which can increase intraocular pressure and worsen glaucoma.
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Correct Answer is B
Explanation
A. Cherries do not contain tyramine, which is the compound of concern for clients on MAOIs, so they can be included in the diet.
B. Cheddar cheese is high in tyramine, which can lead to hypertensive crises when consumed by clients taking MAOIs. Therefore, it should be eliminated from the diet.
C. Chicken is generally safe for clients on MAOIs as it does not contain significant amounts of tyramine.
D. Fresh fish is also safe to consume while on MAOIs as long as it is fresh and not aged, fermented, or spoiled, which could contain higher tyramine levels.
Correct Answer is A
Explanation
A. Hypokalemia increases the risk of digoxin toxicity because low potassium levels enhance digoxin's effects on the myocardium. Monitoring and correcting potassium levels is essential in clients on digoxin.
B. Hypophosphatemia is not directly linked to digoxin toxicity and is not a primary concern.
C. Hypocalcemia does not increase the risk of digoxin toxicity; in fact, hypercalcemia would be more concerning in terms of potential toxicity.
D. Hypernatremia does not have a significant effect on digoxin toxicity, so it is not a primary concern when assessing this medication’s safety.