What adverse reaction does the nurse anticipate if a client takes nitroglycerin with sildenafil?
Hypotension
Bradycardia
Chest pain
Nausea
The Correct Answer is A
A. The combination of nitroglycerin and sildenafil can lead to severe hypotension due to the vasodilatory effects of both medications. This is the most critical adverse reaction the nurse should anticipate.
B. Bradycardia is not a direct effect of this combination; rather, hypotension is a more significant concern.
C. Chest pain may occur if hypotension leads to inadequate perfusion, but it is not a direct adverse effect of the drug interaction.
D. Nausea can occur with various medications, but it is not specifically linked to the interaction between nitroglycerin and sildenafil.
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Explanation
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B. Liver dysfunction primarily affects the metabolism and clearance of drugs rather than their distribution, although it may indirectly influence distribution by altering protein binding.
C. Peripheral vascular disease significantly impacts blood flow to the extremities, which can hinder the distribution of the antibiotic to the affected area (the left leg) where the cellulitis is present, leading to reduced drug efficacy.
D. Diverticulitis disease primarily affects the gastrointestinal system and would not directly influence the distribution of an antibiotic used to treat cellulitis in the leg.
Correct Answer is C
Explanation
A. Metformin does not stimulate the pancreas to produce more insulin; that action is characteristic of sulfonylureas.
B. Metformin does not increase the absorption of glucose in the intestines; rather, it works by reducing the amount of glucose released into the bloodstream.
C. Metformin primarily decreases glucose production in the liver and improves insulin sensitivity in peripheral tissues, which helps lower blood sugar levels. This makes it effective for managing type 2 diabetes.
D. While metformin can have effects on fat metabolism, its primary action is not to decrease fat breakdown but to manage blood glucose levels.