Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?
A 47-year-old female with hypertension
A 52-year-old male with adult-onset diabetes
A 17-year-old female with symptoms of an upper respiratory infection
A 62-year-old male with gout
The Correct Answer is A
A. Phenylephrine is a decongestant that can raise blood pressure, making it contraindicated for individuals with hypertension. Advising a patient with hypertension to avoid phenylephrine is essential to prevent potential cardiovascular complications.
B. While patients with diabetes should be cautious about certain medications, phenylephrine is not specifically contraindicated in this condition.
C. A 17-year-old female with an upper respiratory infection typically does not have contraindications for phenylephrine unless there are underlying conditions not mentioned.
D. Gout does not have a direct contraindication for phenylephrine use, so the patient may not need to avoid it unless other health issues are present.
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Correct Answer is A
Explanation
A. Hypocalcemia is correct because esomeprazole, a proton pump inhibitor, can lead to decreased calcium absorption, resulting in low calcium levels, which can cause muscle cramps.
B. Hyperkalemia is incorrect; while potassium levels can be affected by various medications, muscle cramps are not typically associated with high potassium levels.
C. Hypercalcemia is incorrect as it refers to elevated calcium levels, which would not cause muscle cramps and could actually lead to muscle weakness rather than cramping.
D. Hyponatremia is incorrect; low sodium levels may cause other symptoms but are not specifically linked to muscle cramps in the same way as low calcium levels are.
Correct Answer is C
Explanation
A. It has a peak effect of 4-6 hours is incorrect; short-acting insulin typically peaks between 2 to 3 hours after administration.
B. It should be given once daily in the evening is incorrect; short-acting insulin is usually administered before meals, not as a once-daily dose.
C. It starts to take effect within 30 minutes to 1 hour after administration is correct; this timing is critical for managing blood glucose levels during meals.
D. It has a duration of action of 24 hours is incorrect; short-acting insulin usually has a duration of about 3 to 6 hours.