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","C","E","F"]
Explanation
A. Bruising is typically related to anticoagulant effects or blood disorders and not directly tied to the desired effects of PTU.
B. Improved sleep is an indicator that hyperthyroidism symptoms, such as insomnia, are being managed effectively.
C. A decrease in anxiety can suggest effective management of hyperthyroidism, as anxiety is a common symptom of this condition.
D. Weight loss or inability to gain weight is usually a symptom of hyperthyroidism, so this statement would indicate that PTU is not achieving the desired effect.
E. A return to regular menstruation can indicate improved thyroid function, as hyperthyroidism can disrupt menstrual cycles.
F. Reduced heart rate and the absence of palpitations suggest effective management of hyperthyroidism symptoms, indicating the drug is having the desired effect.
Correct Answer is D
Explanation
A. Galantamine is a reversible acetylcholinesterase inhibitor and would not be effective in treating a cholinergic crisis.
B. Physostigmine is also a reversible acetylcholinesterase inhibitor and would not be suitable for reversing a cholinergic crisis.
C. Flumazenil is a benzodiazepine antagonist used to reverse benzodiazepine effects, not cholinergic crises.
D. Atropine is an anticholinergic medication that is effective in reversing the effects of excessive acetylcholine during a cholinergic crisis, making it the appropriate choice in this situation.