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.
Cleanses the injection pen for re-use.
Cleans the injector pen for re-use.
The Correct Answer is C
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.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
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Correct Answer is D
Explanation
Guaifenesin is an expectorant that helps to loosen and thin mucus in the airways, making it easier to cough up. It is commonly used to manage symptoms of a chronic productive cough in conditions such as COPD.
Salmeterol and Tiotropium are both bronchodilators that help to open up the airways and improve breathing in COPD, but they are not specifically indicated for managing a chronic productive cough.
Prednisone is a corticosteroid that can help reduce inflammation in the airways and improve breathing in COPD exacerbations, but it is not typically used for managing a chronic productive cough.
Correct Answer is D
Explanation
Metoclopramide is a medication used to treat nausea and vomiting, including those caused by chemotherapy. However, it has a potential adverse effect of causing extrapyramidal symptoms (EPS), which are involuntary movements of the body, such as muscle spasms, twitching, or restlessness. These symptoms can be distressing for patients and can interfere with their quality of life. EPS can be a sign of tardive dyskinesia, a serious and irreversible neurological disorder.
Therefore, it is essential for the nurse to monitor the client for any signs of EPS and report them immediately to the healthcare provider to prevent further complications. Unusual irritability, diarrhea, and nausea are also potential adverse effects of metoclopramide, but they are not as concerning as EPS.
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