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 ["C","E","F"]
Explanation
A. Rebound hypotension is more commonly associated with abrupt withdrawal of beta-blockers rather than a direct side effect, so it is not typically included as a side effect to expect while on the medication.
B. Vomiting is not a common side effect associated with propranolol; the nurse would not educate the client on this.
C. Bradycardia is a known side effect of propranolol, as it is a beta-blocker that decreases heart rate, so clients should be educated about monitoring their heart rate.
D. Tremors can be related to withdrawal from beta-agonists rather than propranolol, which may alleviate tremors in some individuals; thus, it's not a common side effect of the medication.
E. Propranolol can mask the symptoms of hypoglycemia (e.g., tachycardia), making it important for clients with diabetes to be aware of this potential effect.
F. Bronchoconstriction can occur in clients with reactive airway diseases, as propranolol non-selectively blocks beta receptors, so clients should be educated about this risk, especially if they have asthma or other pulmonary conditions.
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.