A nurse is planning teaching for a client and their family about home oxygen therapy. Which of the following information should the nurse plan to include in the teaching?

Use synthetic fabrics for the client’s bedding.

Apply petroleum jelly to soothe the mucous membranes.

Clean the equipment with an alcohol-based cleaning product.

Avoid using nail polish remover around the client.

Answer and Explanation

The Correct Answer is D

Nail polish remover contains acetone, which is a flammable substance that can ignite in the presence of oxygen. Using nail polish remover around the client can increase the risk of fire and burn injuries.

Choice A is wrong because synthetic fabrics can generate static electricity, which can also cause sparks and ignite oxygen.

The client’s bedding should be made of cotton or wool, which are natural fabrics that do not produce static electricity.

Choice B is wrong because petroleum jelly is a petroleum-based product that can react with oxygen and cause skin irritation or burns.

The client should use water-based moisturizers to soothe the mucous membranes.

Choice C is wrong because alcohol-based cleaning products are also flammable and can cause fires or explosions when exposed to oxygen.

The client should use mild soap and water to clean the equipment, and follow the manufacturer’s instructions for maintenance.

Some general safety tips for home oxygen therapy are:

Keep away from heat and flame, such as candles, matches, lighters, stoves, fireplaces, etc.
Do not smoke or allow others to smoke near the oxygen source
Do not use aerosols, vapor rubs, oils, or other products that contain flammable substances near the oxygen source
Store oxygen tanks or cylinders in a well-ventilated area away from direct sunlight and heat sources
Secure oxygen tanks or cylinders to prevent them from falling or rolling
Use the exact rate of oxygen prescribed by the doctor for each activity
Check the oxygen gauge or level regularly and call the medical supply company when it is low
Use a humidifier bottle if prescribed by the doctor to prevent dryness of the mucous membranes
Change the nasal cannula, mask, and tubing as instructed by the medical supply company to prevent

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Correct Answer is B

Explanation

Alteplase is a drug that dissolves blood clots by converting plasminogen to plasmin. It can be used for acute ischemic stroke, but it has some contraindications that depend on the indication and the type of administration of the drug. Some common contraindications for alteplase are hypersensitivity, active internal bleeding, a history of intracranial hemorrhage, bleeding disorders, and high blood pressure. Other contraindications may vary depending on the specific condition and the time window of treatment. Alteplase can cause serious or fatal bleeding as a side effect.

Choice A is wrong because a family history of malignant hypertension is not an absolute contraindication for alteplase, although uncontrolled hypertension (>185 mmHg SBP or >110 mmHg DBP) is.

Choice C is wrong because chronic obstructive pulmonary disease is not a contraindication for alteplase, although it may increase the risk of pulmonary hemorrhage.

Choice D is wrong because acute renal failure 6 months ago is not a contraindication for alteplase, although the current use of direct thrombin inhibitors or direct factor Xa inhibitors is.
Normal ranges for blood pressure are <120/80 mmHg for normal, 120-129/<80 mmHg for elevated, 130-139/80-89 mmHg for stage 1 hypertension, and ≥140/≥90 mmHg for stage 2 hypertension.
Normal ranges for platelet count are 150,000 to 450,000 platelets per microliter of blood.
Normal ranges for INR are 0.8 to 1.2 for people who are not taking blood thinners and 2 to 3 for people who are taking warfarin.
Normal ranges for aPTT are 25 to 35 seconds for people who are not taking blood thinners and 46 to 70 seconds for people who are taking heparin.

A. Send the unsigned informed consent form to the facility’s risk manager. B. Ensure that the client’s family supports the provider’s decision for surgery. C. Determine if the procedure is medically necessary for the client. D. Determine if the client’s healthcare surrogate is aware of the risks and benefits of the procedure.

Correct Answer is D

Explanation

A healthcare surrogate is a person who is authorized to make healthcare decisions for a client who is unable to do so. The nurse has a legal and ethical responsibility to ensure that the client’s surrogate has given informed consent for the surgery, which means that they have received adequate information about the procedure, its purpose, its risks, its benefits, and its alternatives.
Choice A is wrong because sending the unsigned informed consent form to the facility’s risk manager does not ensure that the client’s surrogate has given informed consent. The risk manager is not involved in the consent process and cannot authorize the surgery without the surrogate’s consent.
Choice B is wrong because ensuring that the client’s family supports the provider’s decision for surgery is not the same as obtaining informed consent from the surrogate.

The family may have different opinions or preferences than the surrogate, and the surrogate may not agree with the provider’s decision. The nurse should respect the surrogate’s autonomy and authority to make decisions for the client.
Choice C is wrong because determining if the procedure is medically necessary for the client is not the nurse’s role.
The provider is responsible for determining the medical necessity of the surgery and explaining it to the surrogate. The nurse should not question or interfere with the provider’s judgment unless there is evidence of negligence or malpractice.

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A nurse is planning teaching for a client and their family about home oxygen therapy. Which of the following information should the nurse plan to include in the teaching?

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