A 59-year-old male patient has a long history of heavy alcohol ...

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A 59-year-old male patient has a long history of heavy alcohol use and was diagnosed with liver cirrhosis several months earlier. The patient's medical history includes numerous other health problems, including angina.
 
  When considering the use of nifedipine in the management of this patient's angina, what consideration should the nurse be aware of? A) The patient is likely to experience an increased effect of the medication.
  B) This patient will require a higher dose than a patient without this medical history.
  C) Nifedipine is contraindicated because it is highly hepatotoxic.
  D) The patient's increased albumin levels will negate the therapeutic effect.

Question 2

The nurse is providing care for a teenager with otitis media. When assessing the patient for potentially adverse effects of Cortisporin Otic, what question should the nurse ask?
 
  A) Have you developed a fever since you started to use the ear drops?
  B) Have you been getting any headaches since you started taking the drops?
  C) Has there been any blood that you've noticed in your outer ear?
  D) Have you noticed any loss of hearing since you started taking the drops?

[BUTTHOL369]

Answer to Question 1

A
Feedback:
In patients with cirrhosis, bioavailability of oral drugs is greatly increased and metabolism (of both oral and parenteral drugs) is greatly decreased. Both of these effects increase plasma levels of drug from a given dose (essentially an overdose).

Answer to Question 2

D
Feedback:
It is also necessary to assess the patient taking Cortisporin Otic for signs of hearing loss due to ototoxicity. Fever, bleeding, and headaches are not typical adverse effects.

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