Question

A nurse is teaching a client about methotrexate. The nurse should instruct the client to monitor for which of the following as an adverse effect to the drug?

1) Nausea and vomiting
2) Headache
3) Muscle pain
4) Increased appetite

Answer 1

A nurse should instruct a client taking methotrexate to monitor for adverse effects like nausea and vomiting; methotrexate inhibits folic acid reductase, affecting DNA and RNA synthesis which can lead to symptoms such as fatigue.

Step-by-step explanation:

When teaching a client about methotrexate (Abitrexate®), a nurse should instruct them to monitor for a variety of adverse effects. Among these, the client should be particularly vigilant for symptoms such as nausea and vomiting, as well as other potential side effects like fever, cramps, loss of appetite, fatigue, and bloating. These symptoms can be persistent and may require treatment with medications such as trimethoprim-sulfamethoxazole.

Methotrexate works by inhibiting folic acid reductase, an enzyme involved in the synthesis of DNA and RNA. This action leads to a decrease in folic acid conversion and affects the production of purines and pyrimidines, which are necessary for cell replication. Due to this mechanism, methotrexate can cause adverse effects including damage to bone marrow and fatigue, which can manifest as weakness and lethargy in patients.