This topic contains a solution. Click here to go to the answer

Author Question: A patient with angina who is taking ranolazine Ranexa has developed a respiratory infection and a ... (Read 91 times)

SGallaher96

  • Hero Member
  • *****
  • Posts: 509
A patient with angina who is taking ranolazine Ranexa has developed a respiratory infection and a dysrhythmia. The provider has ordered azithromycin Zithromax for the infection and amlodipine for the dysrhythmia.
 
  A nursing student caring for this patient tells the nurse that the patient's heart rate is 70 beats per minute, and the blood pressure is 128/80 mm Hg. The nurse asks the student to discuss the plan for this patient's care. Which action is correct? a. Observe the patient closely for signs of respiratory toxicity.
  b. Question the order for azithromycin Zithromax.
  c. Report the patient's increase in blood pressure to the provider.
  d. Request an order for a different calcium channel blocker.

Question 2

A patient who takes aspirin for rheumatoid arthritis is admitted to the hospital complaining of headache and ringing in the ears. The plasma salicylate level is 300 mcg/mL, and the urine pH is 6.0 . What will the nurse do?
 
  a. Increase the aspirin dose to treat the pa-tient's headache.
  b. Notify the provider of possible renal tox-icity.
  c. Prepare to provide respiratory support, because the patient shows signs of over-dose.
  d. Withhold the aspirin until the patient's symptoms have subsided.



Related Topics

Need homework help now?

Ask unlimited questions for free

Ask a Question
Marked as best answer by a Subject Expert

Laurenleakan

  • Sr. Member
  • ****
  • Posts: 309
Answer to Question 1

B
Agents that inhibit CYP3A4 can increase levels of ranolazine and also the risk of torsades de pointes. Macrolide antibiotics, such as azithromycin, are CYP3A4 inhibitors. Respiratory toxicity is not an expected effect with this patient. The patient's blood pressure is not elevated enough to notify the provider. Amlodipine is the only CCB that should be used with ranolazine.

Answer to Question 2

D
This patient shows signs of salicylism, which occurs when ASA levels climb just slightly above the therapeutic level. Salicylism is characterized by tinnitus, sweating, headache, and dizziness. Tinnitus is an indication that the maximum acceptable dose has been achieved. Toxicity occurs at a salicylate level of 400 mcg/mL or higher. ASA should be withheld until the symptoms subside and then should be resumed at a lower dose. Increasing the dose would only increase the risk of toxicity. Signs of renal impairment include oliguria and weight gain, which are not present in this patient. This patient has salicylism, not salicylate toxicity, so respiratory support measures are not indicated.





 

Did you know?

Symptoms of kidney problems include a loss of appetite, back pain (which may be sudden and intense), chills, abdominal pain, fluid retention, nausea, the urge to urinate, vomiting, and fever.

Did you know?

In the ancient and medieval periods, dysentery killed about ? of all babies before they reach 12 months of age. The disease was transferred through contaminated drinking water, because there was no way to adequately dispose of sewage, which contaminated the water.

Did you know?

IgA antibodies protect body surfaces exposed to outside foreign substances. IgG antibodies are found in all body fluids. IgM antibodies are the first type of antibody made in response to an infection. IgE antibody levels are often high in people with allergies. IgD antibodies are found in tissues lining the abdomen and chest.

Did you know?

Multiple experimental evidences have confirmed that at the molecular level, cancer is caused by lesions in cellular DNA.

Did you know?

For pediatric patients, intravenous fluids are the most commonly cited products involved in medication errors that are reported to the USP.

For a complete list of videos, visit our video library