ATI Video Case Study -- Safe Dosage

A nurse is admitting a client following a CT scan with contrast to diagnose the presence of renal calculi. The client has history of type 2 diabetes mellitus. The nurse should expect to withhold which of the following of the client's home medications? A. Simvastatin B. Metformin C. Losartan D. Omeprazole

B. Metformin Metformin is a biguanide that is used in the management of type 2 diabetes. To prevent the development of acute kidney injury, metformin is contraindicated for the client for 48 hr following the administration of contrast media. The nurse should expect that the provider will withhold the metformin and prescribe another medication, such as insulin, to provide glucose control in the interim. Simvastatin is a lipid-lowering agent used to treat clients who have or are at risk for atherosclerosis, a complication of diabetes mellitus. The nurse should expect a prescription to continue this medication. Losartan is an angiotensin II receptor blocker that is used to treat hypertension. For the client who has type 2 diabetes, it is also used to delay the development of diabetic nephropathy. The nurse should expect a prescription to continue this medication. Omeprazole is a proton-pump inhibitor used to treat gastroesophageal reflux disease. There is no contraindication to the continued use of omeprazole following a CT scan with contrast medium.

A nurse is conducting medication reconciliation for a client who is newly admitted to the facility. Which of the following actions should the nurse take first? A. Review a list of the client's medications with the pharmacist. B. Investigate discrepancies in medication dosages. C. Ask the client if they take herbal supplements. D. Reinforce education with the client.

C. Ask the client if they take herbal supplements. When using the nursing process, the first action the nurse should take is to assess the client by completing a comprehensive review of prescribed and over-the-counter medications, including any herbal and nutritional supplements the client takes. The nurse should obtain a comprehensive list in order to identify duplications, as well as any possible contraindications or interactions between medications.

A nurse is preparing to administer bumetanide to a client who has heart failure. For which of the following findings should the nurse withhold the medication and contact the provider? A. Potassium 3.6 mEq/L B. Heart rate 96/min C. Sodium 136 mEq/L D. BP 84/50 mm Hg

D. BP 84/50 mm Hg Bumetanide is a loop diuretic that decreases circulating fluid volume. It is useful in the treatment of pulmonary edema and heart failure. The nurse should monitor the client's BP and, if the client is hypotensive, the nurse should withhold the medication and notify the provider.

A nurse is admitting a client who has pneumonia and is reviewing the client's medication prescriptions. Which of the following medications should the nurse identify as the priority to administer? A. Clarithromycin B. Acetaminophen C. Guaifenesin D. Dextromethorphan

A. Clarithromycin A client who presents with community-acquired pneumonia should receive antibiotic treatment within the first 6 hr of admission. This limits complications such as sepsis and mortality. The greatest risk to the client is injury from infection. Therefore, the priority medication the nurse should administer is clarithromycin. Guaifenesin is a mucolytic that thins the secretions in the lungs. The nurse should administer guaifenesin to allow the client to successfully expectorate mucus. Dextromethorphan is a cough suppressant Acetaminophen is to increase the client's comfort and decrease the client's temperature if they have a fever

A nurse is reviewing the medical record of a client who is receiving furosemide. Which of the following findings should the nurse identify as an adverse effect of furosemide? A. Sodium 156 mEq/L B. Blood pressure 128/72 mm Hg C. Oliguria D. Hyperkalemia

C. Oliguria The nurse should recognize that oliguria is a manifestation of dehydration, which is an adverse effect of furosemide therapy. The nurse should recognize that 156 mEg/L is above the expected reference range for sodium; however, this is not an adverse effect of furosemide therapy. Hyponatremia, or a sodium level below 136 mEq/L, is an adverse effect of furosemide therapy. The nurse should recognize that a blood pressure of 128/72 mm Hg is within the expected reference range and is not an adverse effect of furosemide therapy. The nurse should recognize that hypokalemia, not hyperkalemia, is an adverse effect of furosemide therapy.