The nurse is caring for a 45-year-old female patient who is in ...

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The nurse is caring for a 45-year-old female patient who is in chronic renal failure. What cholinergic drug is contraindicated for this patient?
 
  A) Neostigmine
  B) Pyridostigmine
  C) Edrophonium
  D) Galantamine

Question 2

The nurse is caring for a patient in a state of shock. The family asks the nurse why the patient is so sick. What is the nurse's best response?
 
  A) The patient probably has an infection that is making him look so sick.
  B) The coronary arteries are not supplying adequate blood flow to the myocardium.
  C) The pumping action of the ventricles is diminished, resulting in blood backing up in his lungs.
  D) Low blood pressure means inadequate supply of oxygen to the body's tissues.

[JaynaD87]

Answer to Question 1

D
Feedback:
Drugs used to treat Alzheimer's disease are metabolized in the liver and excreted in the urine, so caution should be used in the presence of hepatic or renal dysfunction, which could interfere with the metabolism and excretion of the drugs. Dosage adjustments may be needed for neostigmine, edrophonium, and pyridostigmine if the patient has renal disease but they are not contraindicated.

Answer to Question 2

D
Feedback:
The pressure of the blood in the arteries needs to remain relatively high to ensure that blood is delivered to every cell in the body and to keep the blood flowing from high-pressure to low-pressure areas. The pressure can fall dramaticallythis is called hypotensionfrom loss of blood volume or from failure of the heart muscle to pump effectively. Severe hypotension can progress to shock and even death as cells are cut off from their oxygen supply. An infection would result in septic shock. Many types of shock exist. Inadequate supply of oxygen via the coronary arteries results in a myocardial infarction. Reduced pumping action of the heart is called heart failure.

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