A nurse is providing education to a client newly prescribed Sulfasalazine and Azathioprine for refractory ulcerative colitis. Which of the following statements by the client indicates that further teaching is required?
“I should avoid being outside in crowds while on these medications.”
“It may take several weeks for me to feel the effects of the medications.”
“I should notify my provider if I experience fevers.”
“I should go to the emergency room immediately if my urine turns orange.”
The Correct Answer is D
A. Avoiding crowds is appropriate, as both Sulfasalazine and Azathioprine can suppress the immune system, increasing the risk of infection.
B. It is correct that it may take several weeks for these medications to show effects, especially with Sulfasalazine. This is a reasonable statement.
C. Notifying the provider if the client experiences fevers is important because it could be a sign of infection, which is a potential side effect of Azathioprine, an immunosuppressive drug.
D. Orange urine is a common side effect of Sulfasalazine and is harmless. The client should not go to the emergency room for this symptom, as it is a known and expected side effect. Therefore, the statement about going to the emergency room indicates a need for further teaching.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is A
Explanation
A. Encouraging the client to change positions slowly, such as moving from lying to sitting and then to standing, helps to minimize the risk of orthostatic hypotension. This gradual change allows the body to adjust to positional changes without causing a sudden drop in blood pressure.
B. Encouraging vigorous exercise is not recommended for a client with hypovolemia as it could exacerbate the condition, potentially causing dizziness, fainting, or further lowering blood pressure.
C. Encouraging the client to stand for extended periods is not appropriate for a client at risk for orthostatic hypotension, as standing for prolonged periods can cause blood to pool in the lower extremities, increasing the risk of fainting or dizziness.
D. Encouraging the client to limit fluid intake is inappropriate for a client with hypovolemia. Adequate fluid intake is crucial to help restore blood volume and prevent hypotension.
Correct Answer is B
Explanation
A. Advising the client to add citrus juices and bananas is inappropriate because these are high in potassium and would further increase the already elevated potassium level, potentially worsening hyperkalemia.
B. Obtaining a 12-lead ECG is the correct action. A potassium level of 6.8 mEq/L is critically high and can cause life-threatening cardiac arrhythmias. An ECG can help identify hyperkalemia-related changes, such as peaked T waves, widened QRS complexes, or arrhythmias.
C. While obtaining a serum sodium level might provide additional information, it does not address the immediate risk posed by the elevated potassium level. The priority is assessing the cardiac effects of hyperkalemia.
D. Suggesting that the client use a salt substitute is incorrect, as many salt substitutes contain potassium chloride, which could worsen hyperkalemia.
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