The home health nurse observes a client self-administering an epinephrine injection using an auto-injector pen.

Which client action requires intervention by the nurse?

Administers onto the ﬂeshy outer thigh.

Inserts the injection pen through clothing.

Holding the pen in place for several seconds after injection

Cleans the injector pen for re-use.

None

Answer and Explanation

The Correct Answer is D

A. Administers onto the ﬂeshy outer thigh: This is the recommended site for epinephrine auto-injection because it allows for quick absorption into the bloodstream. The outer thigh is a large muscle area, which helps in the rapid distribution of the medication.

B. Inserts the injection pen through clothing: It is generally acceptable to inject epinephrine through clothing in an emergency situation. This practice ensures that there is no delay in administering the life-saving medication, which is crucial during an anaphylactic reaction.

C. Cleanses the injection pen for re-use: Epinephrine auto-injectors are designed for single use only. Reusing the pen can lead to contamination and reduced effectiveness of the medication. It is important to dispose of the used injector properly and obtain a new one for future use.

D. Holds the pen in place after injection: Holding the pen in place for a few seconds after injection ensures that the full dose of medication is delivered. This practice helps in maximizing the effectiveness of the treatment during an anaphylactic emergency.

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Correct Answer is A

Explanation

Lithium carbonate is a mood stabilizer commonly used to treat bipolar disorder. However, it has a narrow therapeutic index and requires careful monitoring of serum levels to avoid toxicity. One of the major concerns with lithium therapy is the potential for drug interactions and toxicity. NSAIDs such as ibuprofen and naproxen can increase lithium levels by reducing its excretion and can lead to lithium toxicity. Therefore, it is essential to instruct the client to eliminate the use of NSAIDs while taking lithium.

Option b) Avoid consuming all foods that contain iodine is incorrect because iodine is not contraindicated with lithium. However, excessive iodine intake can interfere with thyroid function, which can exacerbate mood instability.

Option c) Notify healthcare provider prior to dental procedures is not specific to lithium therapy and is a general precaution that patients with bipolar disorder should follow before any medical or dental procedures.

Option d) Monitor blood glucose levels daily is also not directly related to lithium therapy. While lithium can cause diabetes insipidus, which can lead to excessive thirst and urination, it does not typically aﬀect blood glucose levels.

A. Advice the client that the medication should start to work in about 30 minutes. B. Administer a stool softener/laxative at the same time as the analgesic. C. Instruct the client to request assistance when ambulating to the bathroom. D. Tell the client to notify the nurse if the pain is not relieved.

Correct Answer is C

Explanation

The correct answer is C. Instruct the client to request assistance when ambulating to the bathroom.

Choice A reason:

Advise the client that the medication should start to work in about 30 minutes.

While it is important to inform the client about the onset of action of the medication, this is not the highest priority. Codeine, an opioid, can cause dizziness and sedation, which increases the risk of falls. Therefore, safety measures take precedence over informing the client about the medication’s onset time.

Choice B reason:

Administer a stool softener/laxative at the same time as the analgesic.

Opioids like codeine can cause constipation, so administering a stool softener or laxative is a good practice. However, this action is not the highest priority when considering the immediate safety of the client. Ensuring the client’s safety from potential falls due to dizziness or sedation is more urgent.

Choice C reason:

Instruct the client to request assistance when ambulating to the bathroom.

This is the correct answer because codeine can cause dizziness, sedation, and orthostatic hypotension, increasing the risk of falls. Ensuring the client requests assistance when moving can prevent potential injuries, making it the highest priority nursing action.

Choice D reason:

Tell the client to notify the nurse if the pain is not relieved.

While it is important for the client to communicate about the effectiveness of pain relief, this is not the highest priority. The immediate concern is the client’s safety due to the sedative effects of codeine. Therefore, preventing falls and injuries takes precedence.

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The home health nurse observes a client self-administering an epinephrine injection using an auto-injector pen. Which client action requires intervention by the nurse?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A client with bipolar disorder admitted with severe depression and suicidal ideation receives a prescription for lithium carbonate, which instruction should the nurse provide to the client?

Correct Answer is A

Explanation

Which nursing action had the highest priority when administering a dose of codeine with acetaminophen to a client?

Correct Answer is C

Explanation

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The home health nurse observes a client self-administering an epinephrine injection using an auto-injector pen.

Which client action requires intervention by the nurse?