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
People with Type 1 diabetes have little or no insulin that can be released. This is because their pancreatic β-cells, which produce insulin, are destroyed by an autoimmune process. Without insulin, glucose cannot be taken up into cells to be used for energy. Oral antihyperglycemic agents work by increasing the release of insulin or increasing the body’s sensitivity to insulin, so they are not effective in Type 1 diabetes where there is an absolute insulin deficiency.
Choice B rationale
The cost of oral antihyperglycemic agents is not the primary reason they are not used in Type 1 diabetes. The main issue is the lack of insulin production, which these medications cannot address.
Choice C rationale
People with Type 1 diabetes do not typically have resistance to their endogenous insulin. Insulin resistance is more commonly associated with Type 2 diabetes.
Choice D rationale
While hypoglycemia can occur with the use of some antihyperglycemic agents, this is not the primary reason these medications are not used in Type 1 diabetes. The main issue is the absolute deficiency of insulin.
Correct Answer is C
Explanation
Choice A rationale
While it might seem that smaller doses of both drugs could be used when they are prescribed together, this is not the primary reason for using heparin and warfarin together. Both drugs have different mechanisms of action and are used for their unique therapeutic effects.
Choice B rationale
The combination of heparin and warfarin does not facilitate thrombolysis more quickly. Thrombolysis is the process of breaking down clots, and while these medications can prevent the formation of new clots, they do not actively break down existing ones.
Choice C rationale
Heparin and warfarin are often used together in the treatment of thrombophlebitis because they provide different benefits. Heparin acts quickly to prevent further clotting and allows the body to naturally break down existing clots. Warfarin, on the other hand, takes several days to become effective. Therefore, heparin is used to provide immediate anticoagulation until the warfarin becomes effective.
Choice D rationale
While it’s true that the combination of heparin and warfarin provides immediate anticoagulation, this is primarily due to the action of heparin. Warfarin takes several days to become effective, so it does not contribute to the immediate anticoagulant effect.
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