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. While sildenafil can cause erections, it does not typically lead to unwanted erections; it requires sexual stimulation to be effective.
B. An erection lasting longer than 6 hours, known as priapism, is a serious side effect and requires immediate medical attention, indicating the patient understands this risk.
C. Using nitroglycerin with sildenafil can lead to dangerous drops in blood pressure, and patients should be advised to avoid this combination.
D. Sildenafil should be taken about 30 minutes to 1 hour before sexual activity for best results, not just 5 minutes prior.
Correct Answer is A
Explanation
A. Asthma is a contraindication for cholinergic medications because these drugs can cause bronchoconstriction and may exacerbate respiratory conditions. Careful assessment is necessary before administration to ensure safety.
B. Hypertension is not a direct contraindication for cholinergic medications; they may not significantly affect blood pressure in most cases.
C. Alzheimer's disease is not a contraindication for cholinergic medications; in fact, cholinergic agents may be used to improve cognitive function in some patients with dementia.
D. Diarrhea is not a contraindication for cholinergic medications but may indicate excessive cholinergic activity; it should be monitored, but it does not prevent administration.