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
Explanation
A. Macrolides, such as azithromycin and erythromycin, have a low cross-reactivity with penicillin and are typically safe alternatives for those with penicillin allergies.
B. Sulfonamides are not structurally similar to penicillins and generally do not have cross-sensitivity issues with penicillin allergies.
C. Cephalosporins share a similar beta-lactam structure to penicillins, which can result in cross-sensitivity in some individuals with a penicillin allergy. For this reason, they should be avoided or used with caution in these clients.
D. Tetracyclines have a different structure from penicillins and are usually safe for clients with penicillin allergies.
Correct Answer is C
Explanation
A. Grapefruit juice does not have a known interaction with metronidazole and does not need to be avoided.
B. Dairy does not interfere with metronidazole's absorption or effectiveness, so it is not a contraindication.
C. Alcohol should be strictly avoided during and for at least 48 hours after metronidazole treatment, as it can cause a severe reaction, including nausea, vomiting, flushing, and rapid heart rate.
D. Tyramine-based foods do not interact with metronidazole, so they are not a contraindication for this medication.