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 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 C
Explanation
A. Hypertension can affect drug distribution to some extent due to altered perfusion but is not the most significant factor impacting distribution, especially for a local condition like cellulitis.
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.