A nurse is planning care for a client who has acute pancreatitis. Which of the following interventions should the nurse include in the client’s plan? (Select all that apply.)
Initiate insulin drip.
Monitor blood glucose levels.
Continue regular diet as tolerated.
Maintain NPO status until pain-free.
Manage acute pain.
Correct Answer : B,E
Choice A Reason:
Initiating an insulin drip is not a standard intervention for all clients with acute pancreatitis. This intervention is typically reserved for clients who develop hyperglycemia or diabetes as a complication of pancreatitis. Acute pancreatitis can affect the pancreas’ ability to produce insulin, but not all clients will require an insulin drip.
Choice B Reason:
Monitoring blood glucose levels is crucial for clients with acute pancreatitis because the pancreas plays a key role in regulating blood sugar. Inflammation or damage to the pancreas can lead to fluctuations in blood glucose levels, making regular monitoring essential to manage potential hyperglycemia or hypoglycemia.
Choice C Reason:
Continuing a regular diet as tolerated is not appropriate for clients with acute pancreatitis. These clients are typically kept NPO (nothing by mouth) to rest the pancreas and reduce the secretion of pancreatic enzymes, which can exacerbate inflammation and pain.
Choice D Reason:
Maintaining NPO status until the client is pain-free is a standard intervention for acute pancreatitis. This approach helps to rest the pancreas and prevent the release of digestive enzymes that can further inflame the pancreas. Once the client is pain-free and inflammation has subsided, a gradual reintroduction of oral intake can be considered.
Choice E Reason:
Managing acute pain is a critical aspect of care for clients with acute pancreatitis. Pain management can include medications such as opioids, as well as non-pharmacological interventions like positioning and relaxation techniques. Effective pain management improves the client’s comfort and can help reduce stress on the pancreas.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is D
Explanation
Choice A Reason:
Respiratory therapy is not typically required for clients with chronic kidney disease unless they have concurrent respiratory issues. CKD primarily affects the kidneys and related systems, so respiratory therapy is not a standard referral for these patients.
Choice B Reason:
Hospice care is generally reserved for clients with terminal illnesses who are nearing the end of life. While CKD can be a serious condition, many clients manage it with appropriate treatment and lifestyle changes. Therefore, hospice care is not a standard referral for newly diagnosed CKD patients.
Choice C Reason:
Occupational therapy may be beneficial for clients with CKD who experience difficulties with daily activities due to fatigue or other symptoms. However, it is not the most immediate or essential referral upon initial diagnosis.
Choice D Reason:
Dietary services are crucial for clients with chronic kidney disease. Proper nutrition can help manage symptoms, slow disease progression, and improve overall health. A dietitian can provide personalized dietary plans to ensure the client avoids foods that may exacerbate their condition and includes those that support kidney health.
Correct Answer is C
Explanation
Choice A Reason
“You are not contagious when lesions are healed.” This statement is incorrect. Genital herpes can still be contagious even when there are no visible lesions. The virus can be shed from the skin and transmitted to others even in the absence of symptoms.
Choice B Reason
“This infection is spread through the air.” This statement is incorrect. Genital herpes is not spread through the air. It is primarily transmitted through direct skin-to-skin contact, particularly during sexual activity.
Choice C Reason
“Stress can activate an outbreak.” This statement is correct. Stress is a known trigger for reactivation of the herpes simplex virus, leading to outbreaks of genital herpes. Other triggers can include illness, fatigue, and immune suppression.
Choice D Reason
“Antiviral drugs will cure the infection.” This statement is incorrect. While antiviral drugs can help manage symptoms and reduce the frequency of outbreaks, they do not cure the infection. The herpes simplex virus remains in the body and can reactivate.
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