A client is being discharged and will start long-term oral prednisone for chronic asthma treatment. The client should monitor for which of the following adverse effects of this medication?

Correct Answer: A

Rationale: In this scenario, the correct answer is A) Weight gain. Prednisone is a corticosteroid medication commonly used to treat asthma due to its potent anti-inflammatory properties. Weight gain is a common adverse effect of long-term corticosteroid use. Corticosteroids can cause fluid retention, increased appetite, and redistribution of body fat, leading to weight gain. Option B) Nervousness is incorrect because corticosteroids like prednisone are more likely to cause mood changes such as irritability or mood swings rather than nervousness. Option C) Bradycardia is incorrect as corticosteroids are more likely to cause tachycardia or irregular heartbeats as adverse cardiovascular effects rather than bradycardia. Option D) Constipation is incorrect as corticosteroids are more likely to cause gastrointestinal issues such as increased appetite, weight gain, or indigestion rather than constipation. Educationally, it is important for healthcare providers and patients to be aware of the potential adverse effects of medications like prednisone to monitor and manage them effectively to ensure optimal treatment outcomes for chronic conditions like asthma. Monitoring for weight gain can help prevent complications associated with long-term corticosteroid use, such as metabolic disturbances and cardiovascular risks.

Correct Answer: B

Rationale: In this scenario, the correct answer is B) Presence of red blood cells in the urine. Gentamicin is an antibiotic known for its nephrotoxic and ototoxic effects. The presence of red blood cells in the urine, also known as hematuria, can indicate kidney damage or nephrotoxicity caused by gentamicin. This adverse reaction can lead to further complications if not addressed promptly. Option A) Blood pressure 160/90 mm Hg is not directly related to the potential adverse reaction of gentamicin. While monitoring blood pressure is essential during treatment, this finding is not specific to gentamicin toxicity. Option C) Urine output of 35 mL/hr could indicate renal impairment, which is a concern with gentamicin use, but it is not as indicative of nephrotoxicity as the presence of red blood cells in the urine. Option D) Respiratory rate of 22/min is not typically associated with adverse reactions to gentamicin. Changes in respiratory rate are more commonly linked to respiratory conditions or other medications, not specifically gentamicin. Educationally, understanding the potential adverse effects of medications is crucial for safe and effective patient care. Pharmacology education emphasizes the importance of monitoring patients for signs of drug toxicity to prevent serious complications. In the case of gentamicin, being vigilant for symptoms like hematuria can help healthcare providers intervene early and prevent further harm to the patient.

Correct Answer: B

Rationale: The activated partial thromboplastin time (aPTT) is the laboratory value used to monitor the effectiveness of heparin therapy. The aPTT should be maintained at 1.5 to 2 times the normal level to ensure therapeutic anticoagulation. Monitoring aPTT helps healthcare providers adjust heparin doses to achieve the desired anticoagulant effects and prevent complications such as bleeding or clotting.

Correct Answer: A

Rationale: The correct instruction for a client prescribed furosemide is to take the medication in the morning. Furosemide, a diuretic, is best taken in the morning to prevent nocturia, which is excessive urination at night. Taking it earlier in the day can help reduce disruptions to sleep patterns. Therefore, advising the client to take furosemide in the morning is crucial for optimal therapeutic effects.

Correct Answer: A

Rationale: In the context of a client with heart failure, it is crucial to avoid sodium phosphate laxatives. Sodium phosphate can lead to electrolyte imbalances, particularly hyperphosphatemia, which can exacerbate heart failure by increasing the workload on the heart. This can further compromise the client's cardiac function and lead to fluid retention, worsening heart failure symptoms. Psyllium, bisacodyl, and polyethylene glycol are safer options for individuals with heart failure. Psyllium is a bulk-forming laxative that can help regulate bowel movements without impacting electrolyte balance. Bisacodyl is a stimulant laxative that acts directly on the colon and is typically safe for heart failure patients in moderation. Polyethylene glycol is an osmotic laxative that works by drawing water into the colon, but it does not significantly impact electrolyte levels. Educationally, this question highlights the importance of understanding the potential adverse effects of medications in specific patient populations. It reinforces the need for healthcare providers to consider comorbidities and tailor treatment plans to ensure the safety and well-being of patients with complex medical conditions like heart failure. This knowledge is crucial for nursing students and healthcare professionals to provide optimal care and prevent complications in vulnerable patient populations.