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 A
Explanation
A. This statement is incorrect because many chronic illnesses are not curable. The goal of care for chronic illnesses is often to manage the condition, improve quality of life, and prevent complications, rather than achieving a complete cure.
B. This statement is accurate. Managing a chronic illness often requires significant time and effort, including medication adherence, lifestyle changes, and regular medical appointments.
C. The trajectory of a chronic illness can vary greatly between individuals, even those with the same condition. Factors such as genetics, lifestyle, and access to care can influence the course of the illness.
D. This statement is accurate. Educating the client and caregiver about the prescribed treatment plan is essential for optimal management of chronic illnesses. This includes understanding medication dosages, side effects, and lifestyle modifications.
Correct Answer is ["B","E"]
Explanation
A. Atorvastatin is a statin used primarily to manage hyperlipidemia (high cholesterol levels) and reduce cardiovascular risk. However, it is not specifically used to treat heart failure symptoms or manage acute exacerbations.
B. Furosemide is a loop diuretic commonly used to manage heart failure. It helps reduce fluid overload by promoting diuresis (increased urine production), which can help alleviate symptoms of heart failure such as edema and pulmonary congestion.
C. Methimazole is an antithyroid medication used to manage hyperthyroidism. It is not used to treat heart failure. Thyroid disorders can impact heart failure, but methimazole itself does not address the acute symptoms or underlying mechanisms of heart failure.
D. Apixaban is an anticoagulant (blood thinner) used to prevent blood clots in conditions like atrial fibrillation. However, it is not used specifically to manage acute heart failure symptoms.
E. Digoxin is a cardiac glycoside that can be used to manage heart failure, especially in patients with atrial fibrillation. It helps improve cardiac output and control heart rate. Digoxin can be useful in managing heart failure symptoms by enhancing the heart's contractility and controlling the heart rate.
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