A nurse is administering multiple morning medications on a busy ...

[Alainaaa8]

A nurse is administering multiple morning medications on a busy medical-surgical unit. Which drug-to-drug interaction should concern the nurse the most?
 
  a. Metoprolol (Lopressor) and insulin
  b. Enalapril (Vasotec) and insulin
  c. Atenolol (Tenormin) and spironolactone (Aldactone)
  d. Carvedilol (Coreg) and furosemide (Lasix)

Question 2

A 187-pound patient presents to the emergency department after a motor vehicle accident. The patient is confused, has a superficial cut on the head, a bruised abdomen, and a compound frac-ture of the right femur.
 
  The patient's vital signs are: P122/minute, R32/minute, BP100/51, and T99.0 F. Based on these findings, the nurse should prepare to administer which of the fol-lowing intravenous solutions? a. 0.9 NaCl
  b. D5W
  c. 3 NaCl
  d. D5NS

[Shshxj]

Answer to Question 1

A
Blockade of beta2 receptors in skeletal muscle and the liver can inhibit glycogenolysis. This effect can be dangerous for people with diabetes mellitus, because it can result in decreased blood glucose, which would be exacerbated by concurrent insulin administration with metoprolol.
Enalapril is not contraindicated with insulin; in fact, it may have a positive effect on renal func-tion, which often is affected by diabetes mellitus.
Atenolol and spironolactone are not contraindicated. A mild diuretic, such as spironolactone, typically is ordered with a beta blocker to prevent fluid overload.
Carvedilol and Lasix are not contraindicated. Diuretics often are ordered with beta blockers.

Answer to Question 2

A
Administration of an isotonic solution would be the correct action because of the expected loss in blood volume after the patient's accident and subsequent injuries.
D5W would be indicated for hypoglycemia.
3 NaCl would be indicated for hyponatremia.
D5NS would also be indicated if the patient had hypernatremia.

[Alainaaa8]

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