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. A history of hypertension is not a direct contraindication for propofol, although it should be monitored as part of overall management.
B. Benzodiazepine abuse/dependence does not contraindicate the use of propofol but may require careful assessment of sedation and anesthesia needs.
C. Propofol contains soy lecithin and egg phosphatide, making allergies to these products a significant contraindication, as they can lead to severe allergic reactions.
D. An allergy to latex is not a contraindication for propofol use but should be addressed in the overall anesthesia plan regarding equipment and supplies.
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.