A client with diabetes has returned from the post-anesthesia care unit (PACU) after a below-the-knee amputation (BKA) of the left leg.
Which physician’s order should the nurse implement?
Administer morphine 2-4 mg IV prn for pain.
Apply a figure of 8 pressure dressing starting day two post-operatively.
Administer antibiotics as prescribed.
Apply ice to the stump for 60-90 minutes.
The Correct Answer is A
The correct answer is Choice A. After a below-the-knee amputation (BKA), pain management is crucial. Administering morphine 2-4 mg IV prn for pain is an appropriate physician’s order to implement. Pain can be severe after amputation, and effective pain management can improve patient comfort, reduce anxiety, and aid in recovery. Applying a figure of 8 pressure dressing starting day two post-operatively (Choice B) is not typically done after a BKA7. The operative dressing and splint should be maintained, and the wound should be kept clean, dry, and intact. Administering antibiotics as prescribed (Choice C) is important, but it is not the first action to take. Pain management is the priority immediately after surgery. Applying ice to the stump for 60-90 minutes (Choice D) is not typically done after a BKA7. The operative dressing and splint should be maintained, and the wound should be kept clean, dry, and intact.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
Choice A rationale
Trimethoprim-sulfamethoxazole is an antibiotic used to treat or prevent bacterial infections. One of the key instructions for patients taking this medication is to increase fluid intake to 3 to
4 liters per 24 hours. This is because the medication can crystallize in the urine, which can lead to kidney stones or damage if the patient is not adequately hydrated.
Choice B rationale
Spending time in the sun does not improve the metabolism of trimethoprim-sulfamethoxazole. In fact, the medication can make the skin more sensitive to the sun, increasing the risk of sunburn.
Choice C rationale
Taking Kaopectate daily to prevent diarrhea is not a standard instruction for patients taking trimethoprim-sulfamethoxazole. Diarrhea can be a side effect of the medication, but it should be managed under the guidance of a healthcare provider.
Choice D rationale
There is no specific instruction to take trimethoprim-sulfamethoxazole every morning at the same time as hydrochlorothiazide. The timing of medication administration should be determined by the healthcare provider based on the patient’s overall treatment plan.
Correct Answer is D
Explanation
Choice D rationale
Hyperosmolar Hyperglycemic Syndrome (HHS) is a serious complication of diabetes that occurs when blood sugar levels are extremely high. The primary treatment for HHS is intravenous fluids and insulin. Specifically, 0.9% saline solution IV is often used initially to restore volume and correct severe dehydration.
Choice A rationale
Administration of Glucagon is not the primary treatment for HHS. Glucagon is a hormone that raises blood glucose levels and would not be beneficial in a situation where blood glucose is already extremely high.
Choice B rationale
Dextrose 50% is a concentrated glucose solution and would not be appropriate in the treatment of HHS, where blood glucose levels are already dangerously high.
Choice C rationale
While IV fluids are a crucial part of the treatment for HHS, 0.45% Normal Saline (also known as half-normal saline) is a hypotonic solution and is not typically the first choice for fluid resuscitation in HHS. The preferred initial fluid is often 0.9% saline (normal saline), which is isotonic.
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