A patient admitted to the emergency department with abdominal ...

[waynest]

A patient admitted to the emergency department with abdominal pain tells the nurse he has been taking kava. Which of the following should be included in the nurse's evaluation of this patient? (Select all that apply.)
 
  a. Ask the patient to provide a urine sample to assess color.
  b. Check the sclera for yellowing.
  c. Listen to the apical rate for tachycardia.
  d. Ask the patient to provide a stool sample to assess color.
  e. Obtain serum liver function studies.

Question 2

The nurse in a prenatal clinic is working with a pregnant patient who takes multiple herbal supplements. Which herbal supplement taken by the patient would most concern the nurse?
 
  a. Blue cohosh, because it can induce uterine contractions
  b. Echinacea, because it can suppress immunity
  c. Ginkgo biloba, because it reduces blood flow
  d. Black cohosh, because it causes spontaneous abortion

[bdobbins]

Answer to Question 1

ANS: A, B, C, D
In 2002, the Centers for Disease Control and Prevention (CDC) issued a report outlining the association between kava and hepatotoxicity. In 11 cases, patients developed liver failure and required transplantation. Because this patient complained of abdominal pain, the nurse should further explore for signs of liver disease, such as brown urine, yellow sclera, and light-colored stools. Liver function tests should also be obtained to determine whether kava has affected the liver.
Tachycardia is not associated with kava use.

Answer to Question 2

ANS: A
Blue cohosh can induce uterine contractions and should not be taken by pregnant women. The greatest risk to the pregnant patient is uterine contractions.
Short-term use of echinacea does not cause immunosuppression.
Ginkgo biloba increases, not reduces, blood flow.
Black cohosh should not be taken in the first or second trimester of pregnancy because of its estrogenic effects. However, it is not known to cause spontaneous abortion.

[waynest]

TY

[bdobbins]

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