Exhibits
The nurse reviews the post catheterization orders. Which two orders would the nurse question?
Give lactated Ringers IV at 66 mL/hr while NPO
Vital signs every 4 hours
Place the child on a continuous cardiopulmonary monitor
Admit to the pediatric floor for observation
NPO
Point of care blood glucose
Check pedal pulses every 4 hours
Correct Answer : A,F
A. Post-cardiac catheterization patients require careful monitoring of fluid intake to avoid fluid overload, which can stress the heart and lead to complications.
B. Monitoring vital signs every 4 hours is a standard procedure for a patient post-cardiac catheterization to ensure stability.
C. Continuous cardiopulmonary monitoring is also standard post-procedure to promptly detect any arrhythmias or other cardiopulmonary issues.
D. Admission to the pediatric floor for observation is appropriate for monitoring and ensuring the safety of the patient post-procedure.
E. Keeping the patient NPO (nothing by mouth) is standard until they are fully awake and alert post-anesthesia to prevent aspiration.
F. Point of care blood glucose: This order might be questioned as there is no indication from the history or notes that the child has a blood glucose issue. Monitoring blood glucose is not typically a standard post-cardiac catheterization order unless there is a specific concern for blood sugar levels.
G. Checking pedal pulses every 4 hours is important to ensure there is no compromise in circulation, especially after a procedure involving the heart.
H. Checking the dressing frequently is crucial to identify any signs of bleeding or infection early.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is B
Explanation
A. Monitoring for changes in stool color is important because itraconazole can rarely cause liver toxicity, which may manifest as changes in stool color (e.g., clay-colored stools). This statement demonstrates the client's understanding of the need for monitoring for potential adverse effects.
B. Taking itraconazole with antacids is incorrect because antacids can reduce the absorption of itraconazole. This statement requires correction by the nurse as it could potentially decrease the effectiveness of the medication.
C. Drinking grapefruit juice can increase the effects of itraconazole by inhibiting its metabolism, leading to higher blood levels of the medication. Therefore, this statement is incorrect and requires correction.
D. Reporting any difficulty with breathing is important as itraconazole can rarely cause severe allergic reactions or respiratory side effects. This statement demonstrates the client's
understanding of the need to report any concerning symptoms.
Correct Answer is D
Explanation
A. this is a syringe for administration of small amounts of fluids and medications
B. the syringe administers smaller volumes of IV fluids
C. connecting tubing for administration of IV fluids of peripheral access
D. Connecting tubing that can be used on implanted ports.
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