A nurse is reviewing the medication administration record for a client who has cancer and is receiving morphine via a PCA pump. Which of the following prescriptions should the nurse clarify with the provider?

Ondansetron

Nalbuphine

Insulin glargine

Acetaminophen

Answer and Explanation

The Correct Answer is B

B) Nalbuphine: Nalbuphine is an opioid analgesic that acts on the central nervous system to relieve pain. When administered concurrently with morphine, there is a risk of additive respiratory depression and other opioid-related side effects, such as sedation and hypotension. Therefore, the nurse should clarify the prescription for nalbuphine with the provider to ensure that the combination of opioid medications is appropriate for the client's pain management. Additionally, nalbuphine has mixed agonist-antagonist properties and can precipitate withdrawal symptoms in clients who are physically dependent on full opioid agonists like morphine. Due to these potential interactions and safety concerns, it is essential for the nurse to obtain clarification from the provider before administering nalbuphine to the client receiving morphine via a PCA pump.

A) Ondansetron: Ondansetron is an antiemetic medication commonly prescribed to manage nausea and vomiting, which can be side effects of opioid analgesics like morphine. There are no significant contraindications or interactions between ondansetron and morphine, making it a suitable choice for adjunctive therapy in clients receiving PCA morphine for cancer pain.

C) Insulin glargine: Insulin glargine is a long-acting insulin analog used to control blood glucose levels in clients with diabetes mellitus. While clients with cancer may have comorbidities such as diabetes, the prescription for insulin glargine is unlikely to require clarification in the context of concurrent morphine use. However, the nurse should verify the client's current blood glucose levels and adjust the insulin dosage as needed based on the client's glycemic control.

D) Acetaminophen: Acetaminophen is a non-opioid analgesic commonly used to manage mild to moderate pain. When used in combination with opioids like morphine, acetaminophen can provide additive pain relief and may reduce the total opioid dosage required. There are no significant contraindications or interactions between acetaminophen and morphine, making it a suitable choice for adjunctive pain management in clients receiving PCA morphine for cancer pain.

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Correct Answer is B

Explanation

A) The client has an increased creatinine level: While an increased creatinine level may indicate renal impairment, it is not specific to a vancomycin infusion reaction. Elevated creatinine levels may occur due to various factors, including underlying kidney disease or dehydration.

B) The client is experiencing hypotension: This is the correct answer. Hypotension, or low blood pressure, can be a manifestation of a vancomycin infusion reaction. Vancomycin infusion reactions may include anaphylaxis or anaphylactoid reactions, which can lead to systemic vasodilation and subsequent hypotension.

C) The client's IV site is red and edematous: Redness ’nd edema at the IV site may indicate phlebitis or infiltration, which are local complications rather than systemic reactions to vancomycin infusion.

D) The client reports ringing in their ears: Ringing in the ears, also known as tinnitus, is a potential side effect of vancomycin, particularly with high doses or prolonged use. However, it is not specific to a vancomycin infusion reaction and may occur independently of the infusion process.

Correct Answer is ["324"]

Explanation

Here’s the calculation to find the filgrastim dosage the nurse should administer per day:

Client weight conversion:

We need the weight in kilograms (kg) for dosage calculation.
Conversion factor: 1 kg = 2.205 pounds
Client weight (kg) = 143 lb / 2.205 lb/kg = 64.86 kg (round to two decimal places for accuracy)
Dosage calculation:

Prescribed dosage: 5 mcg/kg/day
Client weight (kg): 64.86 kg (rounded value from step 1)
Daily filgrastim dose (mcg) = Dosage (mcg/kg/day) x Client weight (kg)
Daily filgrastim dose (mcg) = 5 mcg/kg/day * 64.86 kg = 324.3 mcg (round to nearest whole number as requested)
Therefore, the nurse should administer approximately 324 mcg of filgrastim per day.

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A nurse is reviewing the medication administration record for a client who has cancer and is receiving morphine via a PCA pump. Which of the following prescriptions should the nurse clarify with the provider?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is caring for a client who is receiving vancomycin by IV infusion over 30 min. Which of the following findings indicate the clien experiencing a vancomycin infusion reaction?

Correct Answer is B

Explanation

. A nurse is preparing to administer filgrastim 5 mcg/kg/day subcutaneous to a client who weighs 143 lb. How many mcg should the nurse administer per day? (Round the answer to the nearest whole number. Use a leading zero if it applies. Do not use a trailing zero.) _mcg

Correct Answer is ["324"]

Explanation

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