A nurse has been administering mucolytic-like Hypertonic Nasal drops to an infant she has been caring for. How can she chart the effectiveness of this medication in her narrative note?
The infant tolerated the instillation of the nose drops without any shortness of breath or fever.
Saline nose drops inserted Infant cried a small amount
The infant tolerated the insertion of saline nose drops well
Saline nose drops were inserted into both nares.
Large random breath respirations 26/minute.
Correct Answer : A,C,D
"The infant's nasal congestion appeared to improve following the administration of hypertonic nasal drops. The infant tolerated the insertion of saline nose drops well, with no signs of distress or adverse reactions. The nasal passages appeared clearer after the instillation, and the infant's breathing appeared less congested. There was no significant increase in respiratory rate or other signs of respiratory distress observed. The intervention seemed to have a positive effect on the infant's nasal congestion."
This statement indicates that the mucolytic medication (hypertonic nasal drops) was administered and had a positive effect on the infant's nasal congestion. It also mentions that the infant tolerated the procedure well without any adverse reactions, such as shortness of breath or fever. The absence of distress or adverse symptoms and the observed improvement in nasal congestion indicate the effectiveness of the medication in the nurse's narrative note. The additional information about the saline nose drops and respiratory rate may not directly address the effectiveness of the mucolytic medication and can be documented separately if necessary.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Dry mouth is a common side effect of diphenhydramine, which is an antihistamine medication commonly used to relieve symptoms of allergies, including itching and rash. Chewing on sugarless gum or sucking on hard, sour candies can help stimulate saliva production and alleviate the discomfort of dry mouth.
A. "Administer the medication with food": While taking diphenhydramine with food may help reduce the risk of stomach upset, it does not directly address the dry mouth side effect.
B. "Discontinue the medication and notify your provider": Discontinuing the medication without consulting the healthcare provider is not recommended unless specifically instructed to do so. Dry mouth is a common side effect of diphenhydramine and can be managed with supportive measures.
C. "Place a humidifier at your bedside every evening": While using a humidifier can help add moisture to the air and potentially alleviate dryness in the environment, it is not a specific instruction for managing dry mouth caused by diphenhydramine.
Correct Answer is C
Explanation
Montelukast is a leukotriene receptor antagonist commonly used to manage asthma and allergic rhinitis. Its primary therapeutic effect is to improve respiratory symptoms by reducing inflammation and constriction of the airways. Therefore, an increased ease of breathing would be an expected outcome indicating that the medication is working effectively.
The other options are incorrect because:
A. The client's seizure threshold is reduced: Montelukast does not have any effect on the seizure threshold. This outcome is unrelated to the medication and may be indicative of a different condition or treatment.
B. The client experiences less muscle pain: Montelukast is not indicated for reducing muscle pain. This outcome is unrelated to the medication and may be indicative of a different condition or treatment.
D. The client's platelet count is increased: Montelukast does not have an effect on platelet count. This outcome is unrelated to the medication and may be indicative of a different condition or treatment.
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