A nurse is caring for an adolescent in an emergency department who was brought to the emergency department by their parent. The adolescent reports intermittent low-grade fever and anorexia. Manifestations presented a few days after having dental work performed. Now they are worse. The adolescent noticed shortness of breath with exertion today. The nurse reports the 2400 assessment findings to the provider. Which of the following should the nurse anticipate the provider will prescribe? For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.
Administer antibiotic therapy
Obtain an echocardiogram
Obtain blood cultures x3
Restrict dental hygiene
Perform strenuous exercise regimen twice a day
The Correct Answer is A
Choice A reason: Administering antibiotic therapy is an anticipated prescription for the client, as it can treat the possible bacterial infection that is causing the fever, anorexia, and shortness of breath. The client may have developed infective endocarditis, a serious condition that affects the heart valves and can lead to heart failure or stroke. Antibiotic therapy can help prevent further complications and reduce the risk of mortality.
Choice B reason: Obtaining an echocardiogram is an anticipated prescription for the client, as it can help diagnose the presence and severity of infective endocarditis. An echocardiogram is a noninvasive test that uses sound waves to create images of the heart and its structures. It can show if there is any damage to the heart valves, vegetation (clumps of bacteria and cells) on the valves, or signs of heart failure.
Choice C reason: Obtaining blood cultures x3 is an anticipated prescription for the client, as it can help identify the causative organism of the infection and guide the appropriate antibiotic therapy. Blood cultures are samples of blood that are taken from different sites and times and tested for the presence of bacteria or other microorganisms. They can confirm the diagnosis of infective endocarditis and determine the sensitivity and resistance of the bacteria to different antibiotics.
Choice D reason: Restricting dental hygiene is a contraindicated prescription for the client, as it can worsen the oral health and increase the risk of infection. Dental hygiene is important for preventing plaque and tartar buildup, which can harbor bacteria and cause dental caries, gingivitis, or periodontitis. These conditions can increase the risk of bacteremia (bacteria in the blood) and infective endocarditis. The nurse should teach the client to maintain good oral hygiene and use a soft-bristled toothbrush and gentle flossing.
Choice E reason: Performing a strenuous exercise regimen twice a day is a contraindicated prescription for the client, as it can increase the cardiac workload and exacerbate the symptoms of infective endocarditis. Strenuous exercise can cause tachycardia (fast heart rate), dyspnea (difficulty breathing), chest pain, and fatigue, which can worsen the condition of the heart and the valves. The nurse should advise the client to avoid strenuous exercise and limit physical activity to a level that does not cause symptoms.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
Choice A reason: Recurrent epigastric pain is not a complication of peptic ulcer disease, but rather a common symptom of it. Peptic ulcer disease is the erosion of the mucosal lining of the stomach or duodenum, which can cause pain, burning, or discomfort in the upper abdomen.
Choice B reason: Hyperactive bowel sounds are not a complication of peptic ulcer disease, but rather a normal finding in a child who has not eaten for a while. Hyperactive bowel sounds indicate increased peristalsis, which can be caused by hunger, stress, or infection.
Choice C reason: Yellowish-red emesis is a complication of peptic ulcer disease, as it indicates bleeding from the ulcer. Bleeding can occur when the ulcer erodes the blood vessels or the protective layer of the mucosa. Yellowish-red emesis means that the blood has been partially digested by the stomach acid, giving it a coffee-ground appearance.
Choice D reason: Melena stool is a complication of peptic ulcer disease, as it indicates bleeding from the ulcer. Melena stool is black and tarry, and it has a foul odor. It means that the blood has passed through the entire digestive tract, and has been altered by the intestinal bacteria and enzymes.
Correct Answer is B
Explanation
Choice A reason: This statement is incorrect because administering iron at bedtime can cause gastrointestinal upset and interfere with the child's sleep. Iron should be given between meals or one hour before meals for better absorption.
Choice B reason: This statement is correct because giving iron with orange juice or other foods rich in vitamin C can enhance iron absorption. Vitamin C helps convert iron into a form that is more easily absorbed by the body.
Choice C reason: This statement is incorrect because administering iron at mealtimes can reduce iron absorption. Iron can bind with certain substances in food, such as calcium, phytates, and tannins, and make it less available for the body.
Choice D reason: This statement is incorrect because giving iron with milk can decrease iron absorption. Milk contains calcium, which can interfere with iron absorption. Milk can also cause nausea and vomiting when taken with iron.
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