A nurse is caring for a 43-year-old female client who reports abdominal pain.
For each potential provider's order, click to specify if the potential order is anticipated or contraindicated for this client.
Begin broad spectrum IV antibiotics.
Transfuse 1 unit of packed red blood cells.
Prepare client for endoscopic retrograde cholangiopancreatography.
Administer morphine sulfate IV push for pain.
The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"B"},"C":{"answers":"A"},"D":{"answers":"B"}}
1. Begin Broad Spectrum IV Antibiotics Anticipated
The client's symptoms, including right upper quadrant pain, nausea, vomiting, jaundice, fever, and elevated white blood cell count, suggest a potential infection or inflammation in the abdominal area, possibly related to the biliary system (e.g., cholecystitis or cholangitis). Broad-spectrum antibiotics are commonly used to treat infections that could be causing these symptoms, especially if the exact pathogen is not yet identified. The elevated white blood cell count further supports the likelihood of an infection.
2. Transfuse 1 Unit of Packed Red Blood Cells Contraindicated
There is no indication from the provided information that the client has anemia or a significant drop in hemoglobin that would necessitate a blood transfusion. The hemoglobin level is 15.1 g/dL, which is within normal limits. Blood transfusion would typically be considered if there was evidence of significant blood loss or anemia, neither of which is indicated by the client’s current lab results.
3. Prepare Client for Endoscopic Retrograde Cholangiopancreatography (ERCP) Anticipated
The symptoms described, including right upper quadrant pain radiating to the right shoulder, jaundice, and the dark amber urine, are suggestive of biliary tract involvement, such as gallstones causing obstruction or infection. ERCP is a diagnostic and therapeutic procedure used to visualize and treat conditions of the bile ducts and pancreatic ducts. Given the symptoms and clinical presentation, preparing the client for an ERCP to assess and potentially address issues in the biliary system is appropriate.
4. Administer Morphine Sulfate IV Push for Pain Contraindicated
The client has a documented allergy to morphine. Administering morphine could lead to an allergic reaction and is therefore contraindicated. Alternative pain management options should be considered, such as non-opioid analgesics or other opioid medications that the client is not allergic to.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"C"}
Explanation
Myasthenia Gravis
Myasthenia Gravis (MG) is an autoimmune disorder characterized by weakness and rapid fatigue of voluntary muscles. Key features include fluctuating muscle weakness that typically worsens with activity and improves with rest, bilateral ptosis (drooping of the eyelids), and difficulty with swallowing and speaking. The fact that the client's facial muscle strength is better in the morning and worsens throughout the day is a hallmark of MG. The edrophonium (Tensilon) test is specifically used to diagnose MG by temporarily improving muscle strength.
Antibodies at the neuromuscular junction
Myasthenia Gravis is caused by the presence of autoantibodies that target acetylcholine receptors at the neuromuscular junction, leading to impaired communication between nerves and muscles. This is consistent with the described symptoms and the use of the edrophonium (Tensilon) test to diagnose the condition.
Correct Answer is D
Explanation
A. Ethnicity alone is not a known risk factor for ALS. ALS has a relatively uniform incidence across different ethnic groups. Studies have not demonstrated a significant correlation between ALS and being of Asian descent specifically.
B. There is limited evidence suggesting that consuming well water could be associated with an increased risk of ALS, particularly if the well water is contaminated with certain toxins or heavy metals. However, this is not a widely established risk factor and is less directly linked to ALS compared to other known risk factors.
C. Working in agriculture has been identified as a potential risk factor for ALS. Agricultural workers are often exposed to various environmental toxins, pesticides, and herbicides, which have been associated with an increased risk of developing ALS. This occupational exposure is considered a significant risk factor for the disease.
D. Military veterans are known to have an increased risk of developing ALS. Several studies have shown that veterans, particularly those who served in combat or were exposed to specific environmental hazards during their service, have a higher incidence of ALS compared to the general population.
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