A nurse is assisting with the care of a client who is 24 hr postoperative following a cesarean birth. Which of the following prescriptions should the nurse clarify with the charge nurse?

Ketorolac 10mg PO every 6hr PRN pain

Ciprofloxacin 1000mg daily

0.45 % sodium chloride 1000mL-125mL/hr by continuous IV infusion

Magnesium hydroxide 60mL PO at bedtime

Answer and Explanation

The Correct Answer is D

A) Ketorolac 10mg PO every 6hr PRN pain: Ketorolac is a nonsteroidal anti-inflammatory drug (NSAID) that is commonly used for pain management after cesarean birth. However, it should not be used for more than 5 days due to potential renal side effects, gastrointestinal bleeding, and ulceration risks. A prescription for this drug 10mg every 6 hours could be appropriate if within the 5-day limit.

B) Ciprofloxacin 1000mg daily: Ciprofloxacin is an antibiotic often prescribed for certain infections. In a postoperative client, it might be prescribed for a urinary tract infection or another bacterial infection. The dose of 1000mg daily is within normal therapeutic ranges for many conditions, and there is no immediate reason to clarify it in the context of routine postoperative care.

C) 0.45% sodium chloride 1000mL-125mL/hr by continuous IV infusion: This IV fluid prescription specifies a normal saline solution at a moderate infusion rate of 125mL/hr, which is generally appropriate for postoperative fluid management. The administration of fluids is essential to prevent dehydration, maintain hydration, and promote healing in the postoperative period.

D) Magnesium hydroxide 60mL PO at bedtime: Magnesium hydroxide is commonly used as a laxative or antacid, but giving 60mL at bedtime raises a concern. Magnesium hydroxide has a significant laxative effect and can lead to dehydration, electrolyte imbalances, and excessive bowel movement. It is contraindicated in clients with impaired renal function, which is often a concern postoperatively, particularly in clients who may not be eating or drinking adequately. Additionally, in the immediate postoperative period following a cesarean, using a laxative in such a high dose could exacerbate the risk of discomfort, bloating, or diarrhea, and may not be necessary unless there is a specific indication for it.

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Correct Answer is B

Explanation

A) Prochlorperazine 25 mg rectal every 12 hr PRN nausea: Prochlorperazine is an antiemetic commonly used to treat nausea and vomiting. The prescription for prochlorperazine 25 mg rectal every 12 hours as needed (PRN) is appropriate for managing nausea in the postpartum period, especially if the client is unable to tolerate oral medications due to nausea. The route and dosage are typical for this medication, so there is no need for clarification.

B) Losartan 25 mg every 12 hr: Losartan is an angiotensin II receptor blocker (ARB) commonly used to treat hypertension. In the postpartum period, it is generally not recommended as first-line treatment due to the potential for hypotension and the effect of ARBs on renal function, especially in a client who may be postpartum and at risk for fluid shifts, blood loss, or other complications. Additionally, ARBs are usually contraindicated during pregnancy and should be used cautiously or avoided in the immediate postpartum period.

C) Docusate sodium 100 mg PO daily: Docusate sodium is a stool softener commonly prescribed postpartum to prevent constipation, which can be a common issue due to pain medications, decreased mobility, or dehydration. The dose of 100 mg daily is within the recommended range for adult patients and is generally safe for use in the postpartum period. There is no need for clarification on this prescription.

D) Ferrous fumarate 150 mg PO daily: Ferrous fumarate is an iron supplement commonly prescribed postpartum to prevent or treat iron-deficiency anemia, which can result from blood loss during delivery. The dosage of 150 mg daily is a typical and safe prescription to help replenish iron stores and support postpartum recovery. This is a standard prescription and does not require clarification.

Correct Answer is ["2"]

Explanation

Given:

Desired dose of citalopram: 20 mg

Concentration of citalopram solution: 10 mg/5 mL

Conversion factor: 1 tsp = 5 mL

Step 1: Calculate the volume of citalopram solution needed:

Volume of citalopram solution (mL) = Desired dose (mg) / Concentration (mg/mL)

Volume of citalopram solution (mL) = 20 mg / (10 mg / 5 mL)

Volume of citalopram solution (mL) = 20 mg / 2 mg/mL

Volume of citalopram solution (mL) = 10 mL

Step 2: Convert the volume to teaspoons:

Number of teaspoons = Volume of citalopram solution (mL) / Volume per teaspoon (mL/tsp)

Number of teaspoons = 10 mL / 5 mL/tsp

Number of teaspoons = 2 tsp

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A nurse is assisting with the care of a client who is 24 hr postoperative following a cesarean birth. Which of the following prescriptions should the nurse clarify with the charge nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is assisting with the admission of a client to the postpartum unit and is reviewing the client's prescribed medications. The nurse should clarify which of the following prescriptions with the provider?

Correct Answer is B

Explanation

Correct Answer is ["2"]

Explanation

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