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?

Acetaminophen

Insulin gargine

Ondansetron

Naloxone

Answer and Explanation

The Correct Answer is D

A. Acetaminophen: This is a common pain reliever and fever reducer. Acetaminophen is often used alongside other medications, including opioids like morphine, to manage pain more effectively. It's typically safe to use with morphine and is not an immediate concern for clarification.

B. Insulin glargine: Insulin glargine is a long-acting insulin used to control blood sugar levels in individuals with diabetes. While it's important to monitor blood sugar levels in patients receiving opioids, especially if they have diabetes, insulin glargine itself doesn't directly interact with morphine or the PCA pump.

C. Ondansetron: Ondansetron is an anti-nausea medication commonly used to prevent nausea and vomiting, particularly associated with chemotherapy or surgery. Patients receiving morphine, especially those with cancer, may also be prone to nausea. Ondansetron helps manage this side effect and does not typically interact adversely with morphine.

D. Naloxone: Naloxone is an opioid antagonist used to rapidly reverse the effects of opioid overdose, including respiratory depression, caused by drugs like morphine. It's administered in emergency situations to counteract the potentially life-threatening effects of opioids. While naloxone is critical for opioid safety, its presence on the medication list requires clear understanding and specific instructions regarding its use, dosage, and administration protocols in case of opioid-related emergencies.

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Correct Answer is C

Explanation

A. "I should take this medication with 8 ounces of milk." This statement is incorrect. Calcium-containing substances, such as milk, can interfere with the absorption of iron. It's generally recommended to take iron supplements on an empty stomach or with vitamin C-containing foods to enhance absorption.
B. "I should take an antacid with this medication to prevent stomach upset." This statement is also incorrect. Antacids can reduce the absorption of iron. It's advisable to take iron supplements separately from antacids to optimize absorption.
C. "I should notify my provider if my stools turn black." (Correct Answer) This statement is correct. Iron supplements can cause stools to appear black or dark green. This is a common and harmless side effect related to the change in the color of iron in the gastrointestinal tract. However, it's important for the client to notify the healthcare provider to rule out any potential bleeding issues.
D. "I should stay upright for at least 15 minutes after taking this medication." This statement is not specific to ferrous gluconate. However, it may be relevant for medications that can cause esophageal irritation or reflux. In the case of ferrous gluconate, the primary concern is optimizing absorption by taking it on an empty stomach or with vitamin C-containing foods.

A. Potassium chloride 10 mEq/hr B. Bicarbonate by IV infusion C. Subcutaneous insulin injections D. 0.99% sodium chloride 15 mL/kg/hr

Correct Answer is D

Explanation

A. Potassium chloride 10 mEq/hr:
While potassium replacement is crucial in DKA, initiating it before fluid resuscitation can lead to further complications. Insulin administration can drive potassium back into cells, potentially causing hypokalemia. Fluid resuscitation helps address dehydration and electrolyte imbalances.
B. Bicarbonate by IV infusion:

Bicarbonate therapy is generally reserved for severe cases of acidosis, and its use in DKA is controversial. In this scenario, the blood glucose level is not significantly elevated, and the focus should be on fluid resuscitation and insulin administration.
C. Subcutaneous insulin injections:
While insulin is a critical component of DKA management, it should be administered intravenously for faster and more precise control of blood glucose levels. Subcutaneous insulin injections are not the initial route of administration in DKA.
D. 0.9% sodium chloride 15 mL/kg/hr:
This is the correct answer. The first step in DKA management is fluid resuscitation with isotonic saline (0.9% sodium chloride). The goal is to address dehydration, restore intravascular volume, and improve perfusion. Insulin therapy and other interventions follow fluid resuscitation.

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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

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Correct Answer is C

Explanation

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Correct Answer is D

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