A nurse is preparing to administer memantine Nemanda to a patient ...

[geodog55]

A nurse is preparing to administer memantine Nemanda to a patient and notes a slight elevation in the patient's creatinine clearance level. What will the nurse expect the provider to order for this patient?
 
  a. Adding sodium bicarbonate to the pa-tient's drug regimen
  b. Continuing the memantine as ordered
  c. Discontinuing the memantine
  d. Reducing the dose of memantine

Question 2

A patient who is known to be a heavy drinker is brought to the emergency department with ataxia and confusion. The patient cannot remember the events of the previous day.
 
  The examina-tion reveals nystagmus, and the patient reports having double vision. The nurse will expect to administer which vitamin to this patient? a. Ascorbic acid (vitamin C) IV
  b. Intramuscular pyridoxine (vitamin B6)
  c. Intravenous thiamine (vitamin B1)
  d. Nicotinic acid (niacin) PO

[nothere]

Answer to Question 1

D
Patients with severe renal impairment may require a dosage reduction. Adding sodium bicarbo-nate would alkalinize the urine and increase memantine levels, causing toxicity. It is not neces-sary to discontinue or decrease the dose of the memantine with mild or moderate renal impair-ment.

Answer to Question 2

C
Alcoholics who are malnourished have a form of thiamine deficiency called Wernicke-Korsakoff syndrome, which is characterized by nystagmus, diplopia, ataxia, confusion, and short-term memory loss. Parenteral thiamine is indicated for treatment. Ascorbic acid is given to treat vita-min C deficiency, or scurvy. Pyridoxine is given for vitamin B6 deficiency, also common in al-coholics, but this patient does not have the symptoms of seborrheic dermatitis and peripheral neuropathy. Nicotinic acid is used for niacin deficiency, which is characterized by severe dry, rough skin.

[geodog55]

Excellent

[cam1229]

TYSM