A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?
Pancrelipase 500 units/kg PO three times daily with meals
Pantoprazole 80 mg IV bolus twice daily
Initiate a low-residue diet
D Ambulate twice day
The Correct Answer is B
A. Pancrelipase 500 units/kg PO three times daily with meals: Pancrelipase is an enzyme replacement therapy used to aid in the digestion of fats, proteins, and carbohydrates in clients with pancreatic insufficiency. However, in acute pancreatitis, the pancreas is inflamed and typically unable to produce sufficient enzymes. Therefore, enzyme replacement therapy is not typically initiated during the acute phase of pancreatitis.
B. Pantoprazole 80 mg IV bolus twice daily: This is the correct answer. Pantoprazole is a proton pump inhibitor (PPI) that reduces gastric acid secretion. It is commonly prescribed in acute pancreatitis to decrease gastric acid production and reduce pancreatic enzyme activity, thereby promoting pancreatic rest and reducing further pancreatic inflammation and injury.
C. Initiate a low-residue diet: In acute pancreatitis, clients are typically kept NPO (nothing by mouth) initially to allow the pancreas to rest and inflammation to decrease. Once oral intake is resumed, a low-fat, easily digestible diet is usually recommended. However, the initiation of a low-residue diet is not typically indicated during the acute phase of pancreatitis.
D. Ambulate twice daily: While early ambulation is generally encouraged in hospitalized clients to prevent complications such as deep vein thrombosis and pneumonia, ambulation may be limited initially in clients with acute pancreatitis due to pain and discomfort. Ambulation is not typically a priority during the acute phase of pancreatitis; instead, pain management and supportive care are emphasized.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. While heparin and warfarin both work as anticoagulants, IV heparin is not typically used to increase the effects of warfarin or decrease the length of hospital stay. Heparin is often administered initially to rapidly achieve therapeutic anticoagulation while waiting for warfarin to reach its full therapeutic effect, but it is not intended to directly enhance the action of warfarin.
B. This statement is accurate and provides a clear explanation to the client. Warfarin, an oral anticoagulant, takes several days to achieve a therapeutic level in the bloodstream and to exert its anticoagulant effect. During this time, IV heparin is continued to prevent clot formation until the therapeutic level of warfarin is reached.
C. While both heparin and warfarin work to prevent blood clots, they do not directly dissolve existing clots. Rather, they prevent the formation of new clots and the growth of existing ones. This explanation does not fully address the client's question regarding why both medications are necessary.
D. Discontinuing IV heparin prematurely without reaching a therapeutic level of warfarin could increase the risk of thrombus formation or embolization. Therefore, discontinuing IV heparin should be done under the guidance of the provider based on the client's INR levels and the target therapeutic range for warfarin.
Correct Answer is D
Explanation
A. Instruct the client to stay in the same position for 2 min: While it is important for the client to remain in a supine position with the head tilted back slightly after instilling nasal decongestant drops, there is no need for the client to remain in the same position for a specific duration such as 2 minutes.
B. Tell the client to blow her nose gently before the instillation: Blowing the nose before instilling nasal decongestant drops is not necessary and may cause irritation to the nasal passages. The drops should be instilled directly into the nasal passages without prior blowing of the nose.
C. Assist the client to a side-lying position: There is no need to assist the client to a side-lying position for the administration of nasal decongestant drops. The drops are typically administered with the client in a seated or supine position with the head tilted back slightly.
D. Hold the dropper 2 cm (1 in) above the nares: This is the correct action. Holding the dropper approximately 2 cm (1 in) above the nares allows for precise instillation of the drops into the nasal passages without touching the dropper to the nares, which helps prevent contamination.
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