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Which patient should be advised by the nurse to avoid over-the-counter cold and allergy preparations that contain phenylephrine?

A.

A 47-year-old female with hypertension

B.

A 52-year-old male with adult-onset diabetes

C.

A 17-year-old female with symptoms of an upper respiratory infection

D.

A 62-year-old male with gout

Answer and Explanation

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 B

Explanation

A. heart rate is not the primary concern when assessing the interaction between NSAIDs and loop diuretics.

B. blood pressure is correct; the combination of an NSAID and a loop diuretic can lead to fluid retention, potentially elevating blood pressure. Monitoring blood pressure is crucial in this context.

C. cognition is not directly impacted by the combination of these medications.

D. assessment for signs of bleeding is important when taking NSAIDs due to their effect on platelet function, but the more immediate concern is the potential fluid retention affecting blood pressure.

Correct Answer is A

Explanation

A. "There can be an unsafe reaction between your antidepressant and St. John's wort, which is why taking them both is discouraged." is correct; St. John's wort can reduce the effectiveness of SSRIs and may increase the risk of serotonin syndrome, making it vital for the nurse to address this safety concern.

B. "Herbal remedies often contain unknown doses of the desired ingredient, which can be dangerous." is a valid point, but it does not specifically address the interaction with the client’s current medication.

C. "It's very important that you not take the St. John's wort at the same time of day as your antidepressant." is misleading; the concern is not just about timing but about taking both together at all.

D. "It's very important that you comply with your prescribed treatment." while true, this response does not directly address the specific risks associated with combining St. John's wort and citalopram.

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