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. Hydralazine is a vasodilator that does not directly replace ACE inhibitors and is not the preferred alternative for managing hypertension or heart failure.
B. Metoprolol is a beta-blocker that is used for different indications and is not a direct substitute for ACE inhibitors.
C. Furosemide is a loop diuretic used for fluid management, not as an alternative to ACE inhibitors.
D. Losartan is an angiotensin II receptor blocker (ARB) and serves as a suitable alternative to ACE inhibitors for patients who experience a cough from them, as ARBs do not typically cause this side effect.
Correct Answer is C
Explanation
A. Monitoring heart rate for bradycardia is not a primary concern with cyclobenzaprine; instead, it can cause drowsiness and sedation.
B. Naloxone is not necessary for cyclobenzaprine overdose, as it is not an opioid.
C. Cyclobenzaprine can cause sedation and impair cognitive function, so the nurse should emphasize that clients should not operate heavy machinery or motor vehicles until they know how the medication affects them.
D. Excessive salivation is not a common side effect of cyclobenzaprine; instead, dry mouth is more frequently reported.