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. Topical ointment has a slower onset as it must be absorbed through the skin before it can exert its effects.
B. Sublingual nitroglycerin provides rapid relief of angina symptoms because it is absorbed quickly into the bloodstream through the mucous membranes in the mouth, allowing for an immediate effect.
C. Transdermal patches release nitroglycerin slowly over time, leading to a delayed onset of action.
D. Sustained-release formulations are designed for prolonged effects rather than rapid onset, making them slower to take effect compared to sublingual administration.
Correct Answer is C
Explanation
A. While liver failure may affect excretion indirectly, it primarily impacts metabolism more significantly.
B. Absorption is typically not directly affected by liver function, though it can be influenced by other factors.
C. The liver is crucial for drug metabolism; chronic liver failure impairs the liver's ability to metabolize medications effectively, leading to potential toxicity.
D. Distribution may be altered due to changes in plasma proteins or blood flow, but the most significant impact occurs in metabolism.