The healthcare provider (HCP) prescribes pantoprazole for a client who experienced partial and full thickness burns. The client is questioning the nurse if this medication is necessary. Which action(s) should the nurse implement? Select all that apply.

May stop taking medication if no symptoms of GI discomfort.

Explain that pantoprazole may be taken with or without food.

Teach the client about risk of developing a Curling's ulcer.

Discuss the risk of gastric bleeding related to severe burns.

Tell how pantoprazole effectively heals ulcers.

Answer and Explanation

Correct Answer : B,C,D

A. May stop taking medication if no symptoms of GI discomfort: Pantoprazole is prescribed prophylactically in burn clients to prevent stress ulcers, not just to treat existing symptoms. Stopping it without medical advice could increase the risk of serious complications like gastric bleeding.

B. Explain that pantoprazole may be taken with or without food: Pantoprazole, a proton pump inhibitor (PPI), can be taken without regard to meals. Educating the client on flexible timing improves adherence and reduces confusion about the medication regimen.

C. Teach the client about risk of developing a Curling's ulcer: Severe burns increase the risk of Curling’s ulcer, a stress-related gastric ulcer. Explaining this risk helps the client understand the preventative role of pantoprazole in their overall care plan.

D. Discuss the risk of gastric bleeding related to severe burns: Gastric bleeding is a serious, potentially life-threatening complication associated with stress ulcers in burn patients. Teaching the client about this risk provides a clear rationale for continuing pantoprazole therapy.

E. Tell how pantoprazole effectively heals ulcers: While pantoprazole can treat ulcers, in this case it is prescribed to prevent ulcer formation rather than to heal an existing ulcer. The teaching should focus on prevention, not healing.

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Correct Answer is D

Explanation

A. Temperature of 100.8° F (38.2° C): A mildly elevated temperature in a post-transplant client may suggest infection or early rejection, both of which warrant monitoring. However, this is not a direct reason to withhold cyclosporine, which is essential for preventing organ rejection.

B. Elevated blood urea nitrogen (BUN): Elevated BUN could indicate impaired renal function, which should be monitored during cyclosporine therapy. However, this alone is not an urgent reason to withhold the medication without further evaluation of kidney function trends and symptoms.

C. Renal output of 120 mL/hour: This is a healthy urine output and suggests good renal perfusion and function. It does not present any contraindication to continuing cyclosporine and supports that the transplanted kidney is functioning well.

D. Blood pressure 180/98 mm Hg: Hypertension is a known side effect of cyclosporine and can become severe. A blood pressure this high, especially when accompanied by headache and blurred vision, suggests possible cyclosporine-induced hypertensive crisis or toxicity, and warrants immediate withholding of the medication and notification of the HCP.

A. Use relaxation techniques to reduce excessive anxiety. B. Avoid alcohol and other sedatives while taking the medication. C. Move slowly from a sitting position to a standing position. D. Stop taking the medication if intended effect is not immediate.

Correct Answer is D

Explanation

A. Use relaxation techniques to reduce excessive anxiety: Incorporating non-pharmacological strategies such as relaxation exercises complements lorazepam therapy and can improve anxiety management. This statement reflects appropriate understanding and safe self-care practices.

B. Avoid alcohol and other sedatives while taking the medication: Lorazepam is a central nervous system depressant, and combining it with alcohol or other sedatives can lead to respiratory depression, increased sedation, and potentially life-threatening effects. This is an important and accurate precaution.

C. Move slowly from a sitting position to a standing position: Orthostatic hypotension and dizziness are common side effects of benzodiazepines like lorazepam. Changing positions slowly helps minimize the risk of falls, especially in older adults or those sensitive to the medication.

D. Stop taking the medication if intended effect is not immediate: Lorazepam has a relatively quick onset, but stopping it abruptly without consulting a healthcare provider is unsafe and may lead to withdrawal symptoms including increased anxiety, insomnia, tremors, and even seizures. Clients must understand that medication adjustments require medical guidance.

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The healthcare provider (HCP) prescribes pantoprazole for a client who experienced partial and full thickness burns. The client is questioning the nurse if this medication is necessary. Which action(s) should the nurse implement? Select all that apply.

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client who had a kidney transplant last week is receiving cyclosporine. This morning the client reports experiencing a headache and blurred vision. Based on which assessment finding should the nurse withhold the medication until the healthcare provider (HCP) is notified?

Correct Answer is D

Explanation

A client with generalized anxiety disorder (GAD) receives a new prescription for lorazepam. Which statement provided by the client requires additional instruction by the nurse?

Correct Answer is D

Explanation

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