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. Flumazenil is a benzodiazepine antagonist and is not indicated for anticholinergic overdose.
B. Atropine is an anticholinergic medication used to treat bradycardia and other conditions, but it would not be appropriate for treating an anticholinergic overdose, as it can worsen the symptoms.
C. Naloxone is an opioid antagonist and would not be effective in treating scopolamine overdose.
D. Physostigmine is a reversible cholinesterase inhibitor that can counteract the effects of anticholinergic agents, making it the appropriate choice for reversing scopolamine toxicity.
Correct Answer is C
Explanation
A. Risperidone is an atypical antipsychotic primarily used to treat schizophrenia and bipolar disorder, not first-line treatment for depression.
B. Haloperidol is a typical antipsychotic used mainly for acute psychosis and agitation, not for treating depression.
C. Paroxetine is a selective serotonin reuptake inhibitor (SSRI) that is widely recognized as a first-line treatment for depression due to its efficacy and relatively favorable side effect profile.
D. Clozapine is an atypical antipsychotic reserved for treatment-resistant schizophrenia and is not indicated for the treatment of depression.