A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement?

Frequently assess the patient's blood pressure.

Observe the client for signs of gastric irritation.

Monitor electrocardiogram (ECG) continuously.

Assess for changes in level of consciousness.

Answer and Explanation

The Correct Answer is C

A. Frequently assess the client’s blood pressure: While monitoring blood pressure is important, it is not as critical as monitoring the ECG in cases of diltiazem overdose. Diltiazem is a calcium channel blocker that can lead to significant cardiac effects.
B. Observe the client for signs of gastric irritation: This is relevant for some medications, but in the case of diltiazem overdose, the primary concern is the potential for severe cardiac effects rather than gastric irritation.
C. Monitor electrocardiogram (ECG) continuously: Diltiazem overdose can lead to serious cardiac arrhythmias, such as bradycardia, AV block, or other conduction disturbances. Continuous ECG monitoring is crucial to detect these potentially life-threatening complications.
D. Assess for changes in level of consciousness: While important, changes in level of consciousness are secondary to the immediate need to monitor cardiac function closely in the context of diltiazem overdose.

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Correct Answer is A

Explanation

A) Teach the client self-injection skills for daily subcutaneous administration: Insulin glargine is a long-acting insulin that is typically administered once daily via subcutaneous injection. Teaching the client how to properly administer insulin injections is crucial for managing type 2 diabetes effectively. Proper technique and routine are essential for ensuring correct dosing and preventing complications.

B) Demonstrate how to select dose based on before-meal blood sugar readings: Insulin glargine is not used for adjusting doses based on pre-meal blood sugar readings; it provides a steady baseline of insulin coverage throughout the day. Dose adjustments for type 2 diabetes are generally not based on meal-time glucose readings with long-acting insulin.
C) Explain to the family how to inject this medication for severe hypoglycemia: Insulin glargine is used to maintain long-term glucose control and is not typically used in emergency situations like severe hypoglycemia. Emergency treatment for severe hypoglycemia generally involves glucose administration rather than insulin injections.
D) Provide information on increasing medication dosage if ketoacidosis occurs: Insulin glargine is not adjusted based on acute conditions such as ketoacidosis. Management of diabetic ketoacidosis involves more immediate insulin and fluid management strategies, and dosage adjustments should be guided by a healthcare provider, not based on routine discharge instructions.

A. Affirm the decision to use the medication when the symptoms start to worsen. B. Assess the patient's current mental status before deciding to support the decision. C. Confirm that the daughter is aware of the progressive nature of the disease. D. Explain that the drug should be used early in the course of the disease process.

Correct Answer is D

Explanation

A. Affirm the decision to use the medication when the symptoms start to worsen: Waiting to start rivastigmine until symptoms worsen may not be the best approach, as early intervention can be more beneficial in managing symptoms and slowing disease progression.
B. Assess the client’s current mental status before deciding to support the decision: While assessing the client's mental status is important, the immediate concern is to educate on the timing of medication use rather than evaluating the current state of the client.
C. Confirm that the daughter is aware of the progressive nature of the disease: It is important for the daughter to understand the progressive nature of Alzheimer's disease, but this does not directly address the timing for starting rivastigmine.
D. Explain that the drug should be used early in the course of the disease process: Rivastigmine, a cholinesterase inhibitor, is most effective when started early in the course of Alzheimer's disease. Early use can help manage symptoms more effectively and potentially delay progression.

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A male client with dementia is admitted to the emergency department (ED) because he accidentally self-administered several doses of diltiazem. Which intervention is most important for the nurse to implement?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

The nurse is planning discharge teaching for a client with type 2 diabetes mellitus who has a new prescription for insulin glargine. Which action should the nurse plan to include in the discharge teaching?

Correct Answer is A

Explanation

Correct Answer is D

Explanation

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