The nurse caring for a client with renal failure will question ...

[jlmhmf]

The nurse caring for a client with renal failure will question the use of a usual dose of which medication?
 
  1. Digoxin (Lanoxin)
  2. Cholestyramine (Questran)
  3. Fluvastatin (Lescol)
  4. Benzylpenicillin (penicillin G)

Question 2

The nurse caring for a client in renal failure should question an order for which drug?
 
  1. Ibuprofen (Advil) 800 mg three times daily
  2. Erythromycin (E-Mycin) 500 mg four times daily
  3. Aluminum hydroxide gel 30 mL every 4 hours as needed
  4. Acetylsalicylic acid (aspirin) 162 mg daily

[atrochim]

Answer to Question 1

Correct Answer: 1
Rationale 1: Digoxin has a narrow therapeutic index and is renally excreted. The dose should be reduced.
Rationale 2: Cholestyramine is not systemically absorbed and thus is not renally excreted.
Rationale 3: Fluvastatin undergoes greater than 95 hepatic excretion.
Rationale 4: Benzylpenicillin is not contraindicated for clients with renal failure.
Global Rationale: Digoxin has a narrow therapeutic index and is renally excreted. The dose should be reduced. Cholestyramine is not systemically absorbed and thus is not renally excreted. Fluvastatin undergoes greater than 95 hepatic excretion. Benzylpenicillin is not contraindicated for clients with renal failure.

Answer to Question 2

Correct Answer: 1
Rationale 1: Ibuprofen, an NSAID, is a nephrotoxic drug. Clients in renal failure have increased vulnerability to injury from nephrotoxic drugs.
Rationale 2: Erythromycin is not a nephrotoxic drug.
Rationale 3: Aluminum hydroxide gel is not a nephrotoxic drug.
Rationale 4: Acetylsalicylic acid is not nephrotoxic at low-to-usual doses.
Global Rationale: Ibuprofen, an NSAID, is a nephrotoxic drug. Clients in renal failure have increased vulnerability to injury from nephrotoxic drugs. Erythromycin and aluminum hydroxide gel are not nephrotoxic drugs. Acetylsalicylic acid is not nephrotoxic at low-to-usual doses.

[jlmhmf]

Excellent

[nyrave]

TYSM