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A nurse is caring for a client in the emergency department (ED)

Exhibits

Drag 1 medication and 1 client finding to fill in each blank in the following sentence.

The nurse should anticipate a provider prescription for

due to the client's .
Answer and Explanation

The Correct Answer is {"dropdown-group-1":"A","dropdown-group-2":"D"}

Rationale for Correct Choices:

  • Diltiazem: Diltiazem is a calcium channel blocker commonly used to control ventricular rate in atrial fibrillation. The client’s ECG confirms atrial fibrillation with rapid ventricular response, making rate control a priority to prevent hemodynamic instability.
  • Cardiac rhythm: The rapid, irregular heart rate documented on ECG is the primary finding necessitating medication intervention to prevent further complications such as decreased cardiac output or thromboembolism.

Rationale for Incorrect Choices:

  • Dopamine: Dopamine is a vasopressor used to support blood pressure in hypotension or shock. While the client’s BP is mildly decreased, the immediate concern is rapid atrial fibrillation rather than hypotensive crisis.
  • Furosemide: Furosemide treats fluid overload and edema but does not directly address the acute arrhythmia causing tachycardia and hemodynamic compromise.
  • Albuterol nebulizer: Albuterol is used for bronchospasm and respiratory distress related to airway constriction. The client has clear lung sounds, so this is not indicated.
  • Alprazolam: Alprazolam can reduce anxiety but does not manage the underlying atrial fibrillation or prevent cardiovascular complications.
  • Edema, blood pressure, anxiety, dyspnea: While these are relevant assessments, they are secondary to the urgent need to control the cardiac rhythm in acute atrial fibrillation.


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Related Questions

Correct Answer is A

Explanation

A. Dual-energy x-ray absorptiometry (Dexa scan): Dexa scans measure bone mineral density and are the standard tool for diagnosing osteoporosis and monitoring the effectiveness of treatments like alendronate. Changes in bone density over time indicate how well the medication is working.

B. Urine specific gravity: This test evaluates kidney function and hydration status but does not provide information about bone density or the effectiveness of osteoporosis therapy.

C. Lumbar puncture: A lumbar puncture assesses cerebrospinal fluid for neurological conditions. It has no role in evaluating osteoporosis treatment or bone health.

D. Hemoglobin A1C (Hb A1C): HbA1C measures average blood glucose over several months, used in diabetes management. It does not reflect changes in bone density or the impact of alendronate therapy.

Correct Answer is C

Explanation

A. Check the client's pulse oximetry level every 6 hr: Pulse oximetry provides valuable information on oxygen saturation, but checking only every 6 hours may not detect early respiratory depression caused by opioid PCA therapy.

B. Check the client's blood pressure every 4 hr: Blood pressure monitoring is important postoperatively, but opioid-induced respiratory depression is a more immediate risk in the first 24 hours of PCA use, so respirations take priority.

C. Check the client's respirations every 2 hr: Opioids administered via PCA can cause respiratory depression, especially in the first 24 hours. Monitoring respiratory rate frequently allows for early detection and intervention if hypoventilation occurs.

D. Assess the client's apical heart rate every 8 hr: While cardiac monitoring may be indicated for some clients, the apical heart rate is not the most critical assessment for PCA therapy. Respiratory function is the priority for detecting opioid-related complications.

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