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 D
Explanation
A. Epinephrine is primarily used for anaphylaxis and severe asthma attacks; it is not effective in reversing opioid overdose.
B. Protamine is an antidote for heparin, not for opioid overdose.
C. Flumazenil is a benzodiazepine antagonist and is not indicated for opioid overdose; it can potentially precipitate seizures in patients with mixed drug overdoses.
D. Naloxone is an opioid antagonist specifically indicated for reversing the effects of opioid overdose, including respiratory depression, making it the appropriate choice in this scenario.
Correct Answer is C
Explanation
A. Lithium is not considered addictive in the traditional sense, and it does not need to be discontinued after six months unless clinically indicated.
B. Diuretics are generally avoided in patients taking lithium due to the risk of lithium toxicity from altered renal clearance, rather than being a routine prescription for difficulty urinating.
C. Close monitoring of lithium levels is crucial to avoid toxicity and ensure therapeutic efficacy, making this statement correct and essential for the patient’s education.
D. While weight gain can occur with lithium therapy, it is not an indicator of lithium toxicity; symptoms of toxicity include nausea, tremors, and confusion rather than weight gain.