A nurse is contributing to the plan of care for a client who has a seizure disorder. Which of the following interventions should the nurse include in the plan? (Select all that apply.)
Provide a suction setup at the bedside.
Elevate the side rails when in bed.
Place a bite stick at the bedside.
Keep an oxygen setup at the bedside.
Furnish restraints at the bedside.
Correct Answer : A,B,D
A. Provide a suction setup at the bedside:
This is a relevant intervention as it ensures that suction equipment is readily available in case the client experiences excessive secretions or vomiting during or after a seizure. It helps maintain a clear airway and prevent aspiration.
B. Elevate the side rails when in bed:
Elevating the side rails can help ensure the client's safety during a seizure by preventing falls from the bed. It is a preventive measure to minimize the risk of injury.
C. Place a bite stick at the bedside:
Placing a bite stick at the bedside is not a recommended intervention. Bite sticks can potentially injure the patient's teeth or mouth during a seizure and are generally not recommended in current practice.
D. Keep an oxygen setup at the bedside:
This is an appropriate intervention as it ensures that oxygen is readily available in case the client experiences respiratory distress or hypoxia during or after a seizure. Oxygen therapy may be needed to support respiratory function.
E. Furnish restraints at the bedside:
Furnishing restraints at the bedside is not a recommended intervention for managing seizures. Restraints should only be used in exceptional circumstances when the client's safety or the safety of others is at risk and should be applied according to institutional policies and legal regulations.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. B6 (Pyridoxine):
Vitamin B6, also known as pyridoxine, is known to reduce the therapeutic effects of levodopa. It competes with levodopa for absorption in the gastrointestinal tract and can decrease the amount of levodopa that reaches the brain, thereby diminishing its effectiveness in treating Parkinson's disease symptoms.
B. A (Retinol):
Vitamin A, also known as retinol, is not typically associated with reducing the therapeutic effects of levodopa. Vitamin A plays important roles in vision, immune function, and cellular communication, but it does not interact with levodopa in a way that affects its therapeutic efficacy.
C. E (Alpha-Tocopherol):
Vitamin E, also known as alpha-tocopherol, is an antioxidant that plays a role in protecting cells from oxidative damage. While vitamin E supplementation is sometimes used in Parkinson's disease management for its potential neuroprotective effects, it is not known to reduce the therapeutic effects of levodopa.
D. K (Phylloquinone):
Vitamin K, also known as phylloquinone, is primarily involved in blood clotting and bone metabolism. It does not interact with levodopa in a way that reduces its therapeutic effects.
E. C (Ascorbic Acid):
Vitamin C, also known as ascorbic acid, is not known to reduce the therapeutic effects of levodopa. While vitamin C has various roles in the body, including antioxidant activity and immune function support, it does not interfere with levodopa absorption or efficacy.
Correct Answer is ["15"]
Explanation
To calculate the dose of phenytoin suspension, the nurse should use the following formula:
Dose (mL) = Desired dose (mg) / Concentration (mg/mL) x Volume (mL)
Plugging in the values from the question, we get:
Dose (mL) = 75 mg / (25 mg/5 mL) x 5 mL
Dose (mL) = 15 mL
Therefore, the nurse should administer 15 mL of phenytoin suspension to the patient
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