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

Answer and Explanation

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.

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Correct Answer is C

Explanation

A. Secure the restraints to the lowest bar of the side rail:
This is incorrect. Restraints should not be secured to the side rails of the bed because the client may injure themselves by attempting to climb over the side rail or if the bed adjusts, it can cause excessive pressure on the restrained limb.
B. Ensure four fingers under the restraints to prevent constriction:
This is incorrect. The nurse should be able to slide two fingers under the restraint to ensure it is not too tight, rather than four fingers. Restraining too loosely may allow the client to slip out, while restraining too tightly can cause tissue damage or compromise circulation.
C. Secure the restraints using a quick-release tie:
This is the correct action. Restraints should always have quick-release ties to allow for quick removal in case of an emergency or if the client needs to be repositioned or assisted. Velcro or buckle restraints with quick-release mechanisms are commonly used to ensure easy removal.
D. Anticipate removing the restraints every 4 hr:
While it's essential to regularly assess the need for continued restraint use and ensure restraints are not overly restrictive, there's no set time interval for removing restraints. Restraints should be removed as soon as they are no longer necessary to ensure the client's safety and comfort.

A. Utility B. Non-maleficence C. Paternalism D. Justice

Correct Answer is B

Explanation

Answer: B. Non-maleficence

Rationale:

A. Utility:
The principle of utility refers to actions that maximize the overall good or benefit for the greatest number of people. In this scenario, the nurse’s refusal to share the surgeon's medical diagnosis does not directly relate to maximizing benefits, so this principle is not applicable.

B. Non-maleficence:
Non-maleficence is the ethical principle that involves the obligation to avoid causing harm to others. By not disclosing the surgeon's medical diagnosis, the nurse is protecting the surgeon's privacy and confidentiality, thereby preventing potential harm that could arise from sharing sensitive health information without consent.

C. Paternalism:
Paternalism refers to making decisions for others with the belief that it is in their best interest, often overriding their autonomy. The nurse's action of withholding information is not based on deciding what is best for the other nurse but rather on adhering to confidentiality principles.

D. Justice:
Justice in healthcare refers to fairness in the distribution of resources and treatment. The situation does not pertain to equitable treatment or allocation of resources, so this principle is not relevant in this context.

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A nurse is admitting a client who has acute pancreatitis. Which of the following provider prescriptions should the nurse anticipate?

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