A staff educator is reviewing medication dosages and factors that influence medication metabolism with a group of nurses at an in-service presentation. Which of the following factors should the educator include as a reason to administer lower medication dosages? (Select all that apply.)

Correct Answer: C

Rationale: In pharmacology, understanding medication dosages and factors influencing metabolism is crucial for safe and effective patient care. In this scenario, the correct answer is C) Liver failure. Liver failure can significantly impair the liver's ability to metabolize medications, leading to drug accumulation and potential toxicity. Lower medication dosages are necessary to prevent adverse effects in patients with liver dysfunction. A) Increased renal secretion is not a reason to administer lower medication dosages. Renal excretion primarily affects drug elimination rather than dosage adjustment based on metabolism. B) Increased medication-metabolizing enzymes would typically require higher medication dosages to achieve therapeutic levels due to increased metabolism rates, making this option incorrect. D) Peripheral vascular disease does not directly impact medication metabolism or necessitate lower dosages based on metabolic factors. In an educational context, nurses need to grasp the importance of individualized medication dosing based on factors like liver function to ensure patient safety and optimal treatment outcomes. Understanding these concepts equips nurses to provide accurate and personalized medication administration, especially in patients with liver impairment.

Correct Answer: C

Rationale: The correct answer is C. Changing positions slowly can help prevent orthostatic hypotension, a common adverse effect of tricyclic antidepressants like Amitriptyline. It is essential to educate the client to avoid sudden position changes to minimize the risk of dizziness and falls. Choices A, B, and D are incorrect. Therapeutic effects of Amitriptyline may not be noticeable for 1-3 weeks, so expecting them in 24 to 48 hours (choice A) is unrealistic. Discontinuing the medication abruptly can lead to withdrawal symptoms and should be done gradually under healthcare provider supervision, so choice B is incorrect. Amitriptyline can actually cause constipation, so decreasing dietary fiber intake would not be recommended to control diarrhea, making choice D incorrect.

Correct Answer: A

Rationale: In this scenario, option A, "I will increase my intake of potassium-rich foods," is the correct statement indicating an understanding of Prednisone therapy for Rheumatoid Arthritis. Prednisone is a corticosteroid that can lead to hypokalemia (low potassium levels) as a side effect. Therefore, increasing intake of potassium-rich foods helps counteract this potential side effect and maintain electrolyte balance. Option B, "I should take my medication with food," is a general instruction for many medications to reduce gastrointestinal upset. While it is a good practice, it does not specifically address Prednisone's unique requirements. Option C, "I will decrease my intake of calcium-rich foods," is incorrect. Prednisone can lead to osteoporosis with long-term use, so it is essential to maintain adequate calcium intake to support bone health. Option D, "I should avoid eating grapefruit while taking this medication," is not directly related to Prednisone. Grapefruit is known to interact with certain medications by affecting their metabolism in the body, but it is not a concern with Prednisone. Educationally, this question highlights the importance of patient education regarding medication therapy. Understanding the specific side effects, dietary considerations, and potential drug interactions associated with a medication like Prednisone is crucial for optimal treatment outcomes in patients with Rheumatoid Arthritis. It emphasizes the role of pharmacological knowledge in nursing practice to ensure safe and effective patient care.

Correct Answer: B

Rationale: The correct instruction for the nurse to include when educating a client with a new prescription for Atorvastatin to treat Hyperlipidemia is to avoid drinking grapefruit juice. Grapefruit juice can increase the blood levels of atorvastatin, leading to an elevated risk of serious side effects such as liver damage and muscle problems. It is essential for the client to be aware of this potential interaction and to follow the nurse's advice to avoid grapefruit juice while taking Atorvastatin.

Correct Answer: A

Rationale: In this scenario, the correct client statement indicating an understanding of the teaching is option A: "I should avoid drinking grapefruit juice." This statement shows an understanding of the potential drug interaction between Verapamil and grapefruit juice. Grapefruit juice can inhibit the metabolism of Verapamil, leading to increased drug levels in the body, which can potentiate the medication's effects and increase the risk of adverse reactions. Option B is incorrect because Verapamil is a calcium channel blocker that typically decreases heart rate, so the client should not expect an increase in heart rate while taking this medication. Option C is incorrect as Verapamil does not typically cause urine discoloration. Option D is also incorrect because experiencing headaches does not necessarily indicate that the client should stop taking Verapamil; it is important for the client to consult their healthcare provider before discontinuing any prescribed medication. Educationally, this question highlights the importance of understanding drug-food interactions, specifically the interaction between Verapamil and grapefruit juice. It emphasizes the need for clients to be informed about potential interactions to ensure the safe and effective use of medications to manage hypertension. Encouraging clients to ask questions and seek clarification from healthcare professionals can help prevent medication errors and optimize therapeutic outcomes.