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. Galantamine is a reversible acetylcholinesterase inhibitor and would not be effective in treating a cholinergic crisis.
B. Physostigmine is also a reversible acetylcholinesterase inhibitor and would not be suitable for reversing a cholinergic crisis.
C. Flumazenil is a benzodiazepine antagonist used to reverse benzodiazepine effects, not cholinergic crises.
D. Atropine is an anticholinergic medication that is effective in reversing the effects of excessive acetylcholine during a cholinergic crisis, making it the appropriate choice in this situation.
Correct Answer is C
Explanation
A. Beta blockers are used to manage blood pressure and heart rate but are not effective in reducing niacin-induced flushing.
B. Calcium channel blockers help to relax blood vessels but do not address the flushing side effect caused by niacin.
C. NSAIDs, like aspirin, can help reduce the flushing associated with niacin. This flushing occurs due to prostaglandin release, which NSAIDs can inhibit.
D. While fibric acid derivatives are used to lower cholesterol, they do not alleviate the flushing side effect of niacin.