A nurse is planning to administer olanzapine 10 mg IM to a client who has schizophrenia. Which of the following actions should the nurse take?

Administer the medication into the deltoid muscle.

Monitor the client for at least 3 hr after the injection.

Withhold the medication if the client reports hallucinations.

Instruct the client to expect difficulty sleeping

Answer and Explanation

The Correct Answer is B

A. Administer the medication into the deltoid muscle: Olanzapine is typically administered deep into the muscle to ensure proper absorption. However, the deltoid muscle may not be the preferred site for intramuscular injections of medications like olanzapine due to the risk of hitting the underlying radial nerve. The ventrogluteal or vastus lateralis muscles are often preferred sites for IM injections to reduce the risk of nerve damage.
B. Monitor the client for at least 3 hr after the injection: After administering olanzapine IM, the nurse should monitor the client closely for at least 3 hours to assess for any adverse reactions or side effects, such as sedation, hypotension, or extrapyramidal symptoms. This allows for early detection and prompt intervention if needed.
C. Withhold the medication if the client reports hallucinations: Olanzapine is an antipsychotic medication commonly used to treat schizophrenia and other psychotic disorders. Hallucinations are a symptom of schizophrenia, and olanzapine is often prescribed to help manage such symptoms. Withholding the medication solely based on the client reporting hallucinations would not be appropriate without further assessment and consideration of the overall treatment plan.
D. Instruct the client to expect difficulty sleeping: While olanzapine can cause sedation and may affect sleep patterns in some individuals, it is not a universal side effect for everyone. Providing anticipatory guidance about potential side effects is essential, but instructing the client to expect difficulty sleeping without individual assessment may lead to unnecessary anxiety or concerns.

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Correct Answer is C

Explanation

A. Intermittent abdominal pain following passage of bloody mucus: This description is more consistent with the symptoms of placental abruption, where there is painful bleeding with the passage of blood and mucus. Placenta previa typically presents with painless bleeding.
B. Increasing abdominal pain with a non-relaxed uterus: Increasing abdominal pain with a non-relaxed uterus suggests uterine irritability, which may be indicative of preterm labor rather than placenta previa. Placenta previa typically presents with painless bleeding.
C. Painless red vaginal bleeding: This finding is characteristic of placenta previa. Pain is typically absent or minimal with placenta previa, and the bleeding is bright red due to the richly oxygenated maternal blood flowing from the placental vessels.
D. Abdominal pain with scant red vaginal bleeding: While abdominal pain may occur in some cases of placenta previa, it is typically not the predominant symptom. Additionally, the bleeding associated with placenta previa is typically painless and can be more profuse than scant bleeding.

A. Live function tests B. Thyroid hormone assay C. Erythrocyte sedimentation rate D. Brain natriuretic peptide

Correct Answer is B

Explanation

A. Liver function tests: While lithium can affect liver function in some cases, routine liver function tests are not typically required before administering lithium. These tests are more relevant for medications metabolized by the liver.
B. Thyroid hormone assay: This is the correct action. Regular monitoring of thyroid function, including thyroid hormone levels, is essential for clients taking lithium, as lithium therapy can lead to hypothyroidism or exacerbate preexisting thyroid conditions. Checking thyroid function before administering lithium helps ensure the client's thyroid status is within the therapeutic range and identifies any abnormalities that may require intervention.
C. Erythrocyte sedimentation rate (ESR): ESR is a nonspecific marker of inflammation and is not directly relevant to monitoring lithium therapy. While lithium can affect renal function and electrolyte balance, ESR does not specifically assess these parameters.
D. Brain natriuretic peptide (BNP): BNP is a marker of cardiac function and is not routinely monitored in clients taking lithium. While lithium can have cardiovascular effects, routine BNP testing is not necessary before administering lithium. Monitoring for cardiovascular side effects of lithium typically involves assessing for symptoms such as arrhythmias or changes in blood pressure and heart rate.

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A nurse is planning to administer olanzapine 10 mg IM to a client who has schizophrenia. Which of the following actions should the nurse take?

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