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. Bradycardia is not a common side effect of atorvastatin and would not necessarily require immediate reporting unless it is significantly low and symptomatic.
B. Dark-red urine could indicate the presence of myoglobinuria, which can occur due to rhabdomyolysis, a serious side effect of statins like atorvastatin that necessitates immediate medical attention.
C. Elevated HDL cholesterol is generally a positive finding and does not require reporting unless it is part of a larger adverse effect context.
D. A migraine headache, while concerning, is not a known side effect specifically associated with atorvastatin and may not require immediate intervention unless severe or persistent.
Correct Answer is B
Explanation
A. Discontinuing metformin 24 hours before a CT scan is longer than necessary and not standard practice.
B. It is generally recommended that metformin be held for at least 12 hours before the administration of IV contrast to reduce the risk of lactic acidosis, especially in clients with renal impairment.
C. Six hours is insufficient time to ensure the medication is cleared from the system, considering the potential risks.
D. Discontinuing metformin for 48 hours is overly cautious and not necessary unless there are complications that arise after the contrast is administered.