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: Ridged abdomen is not an expected finding for an infant who has pyloric stenosis, as it indicates abdominal rigidity or guarding, which can be a sign of peritonitis or bowel obstruction. Pyloric stenosis is a narrowing of the pyloric sphincter, which causes gastric outlet obstruction and delayed gastric emptying.
Choice B reason: Red currant jelly stools are not an expected finding for an infant who has pyloric stenosis, as they indicate blood and mucus in the stools, which can be a sign of intussusception or necrotizing enterocolitis. Pyloric stenosis does not affect the lower gastrointestinal tract, and the infant may have constipation or dehydration due to vomiting.
Choice C reason: Projectile vomiting is an expected finding for an infant who has pyloric stenosis, as it occurs after feeding due to the increased pressure in the stomach and the inability to pass food into the duodenum. Projectile vomiting can cause weight loss, dehydration, electrolyte imbalance, and metabolic alkalosis.
Choice D reason: Distended neck veins are not an expected finding for an infant who has pyloric stenosis, as they indicate increased central venous pressure, which can be a sign of heart failure or superior vena cava syndrome. Pyloric stenosis does not affect the cardiovascular system, and the infant may have sunken fontanels or poor skin turgor due to dehydration.
Correct Answer is D
Explanation
Choice A reason: Offering the client a reward for agreeing to the treatment is not an appropriate action, as it does not respect the client's autonomy and may be seen as coercive or manipulative.
Choice B reason: Notifying the provider of the client's refusal and documenting it in the chart is a necessary action, but not the first one. The nurse should first attempt to educate the client and the parent and address their concerns and preferences.
Choice C reason: Initiating the treatment as per the parent's request and the provider's order is not an appropriate action, as it violates the client's right to informed consent and may cause harm or resentment.
Choice D reason: Educating the client and the parent about the benefits and risks of the treatment is the best action, as it provides them with the information they need to make an informed decision and shows respect for their values and beliefs.
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