The nurse asks a client who is about to have a cardiac catheterization about any allergies. The client states, "I always get a rash when I eat shellfish." Which of the following is the priority nursing action?

Ask the client if any other foods cause such a reaction.

Notify the provider of the client's allergy.

Notify the dietary department of the client's allergy.

Atach a wrist band indicating the client's allergy.

Answer and Explanation

The Correct Answer is B

The priority nursing action is to notify the provider of the client's allergy because shellfish allergy may indicate an allergy to iodine, which is commonly used as a contrast dye in cardiac catheterization. This could cause a severe allergic reaction or anaphylaxis during the procedure, which could be life-threatening. The provider may need to order a diﬀerent type of contrast dye or premedicate the client with antihistamines or steroids to prevent an allergic reaction.

a. Ask the client if any other foods cause such a reaction is wrong because it is not the priority action and it does not address the potential risk of iodine allergy.

c. Notify the dietary department of the client's allergy is wrong because it is not relevant to the cardiac catheterization and it does not prevent an allergic reaction during the procedure.

d. Atach a wrist band indicating the client's allergy is wrong because it is not sufficient to alert the provider or the catheterization team of the client's allergy and it does not prevent an allergic reaction during the procedure.

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Correct Answer is C

Explanation

Performing neurovascular checks with vital signs is an important action to take following a cardiac catheterization accessed through the femoral artery, as it can help monitor for complications such as bleeding, hematoma, infection, thrombosis, or embolism. The nurse should assess the color, temperature, sensation, movement, and pulses of the aﬀected leg, as well as the blood pressure, heart rate, and oxygen saturation of the client.

Instructing the client to perform range-of-motion exercises to his lower extremities is not appropriate, as it can increase the risk of bleeding or dislodging the arterial sheath or closure device. The client should keep the aﬀected leg straight and avoid bending or lifting it for several hours after the procedure, or as directed by the provider.

Restricting the client's ﬂuid intake is not necessary, as ﬂuid intake can help prevent dehydration and contrast- induced nephropathy following a cardiac catheterization. The client should be encouraged to drink ﬂuids, unless contraindicated.

dAmbulating the client 1 hr following the procedure is not advisable, as it can cause bleeding, hematoma, or vascular injury. The client should remain on bed rest for 2 to 6 hours after the procedure, or as directed by the provider, and resume ambulation gradually and with assistance.

A. "I'll be glad when I can stop taking this medicine." B. "I have made an appointment to see my dentist next week." C. "I will notify my doctor before taking any other medications." D. "I know that I cannot switch brands of this medication."

Correct Answer is A

Explanation

Phenytoin is an anticonvulsant medication that is used to prevent and treat seizures. It works by stabilizing the electrical activity of the brain and reducing the spread of abnormal impulses. Phenytoin is usually taken for life or until the seizures are controlled by other means, such as surgery or diet. The client should not stop taking phenytoin without consulting their doctor, as this can cause withdrawal symptoms or increase the risk of seizures.

The other options are correct and indicate that the client understands the discharge teaching because:

"I have made an appointment to see my dentist next week." This statement is correct because phenytoin can cause gingival hyperplasia, which is an overgrowth of gum tissue that can lead to bleeding, infection, or difficulty chewing. The client should practice good oral hygiene and see their dentist regularly to prevent or treat this condition.

"I will notify my doctor before taking any other medications." This statement is correct because phenytoin can interact with many other medications, such as antibiotics, anticoagulants, oral contraceptives, or antacids. These interactions can aﬀect the blood levels and eﬀectiveness of phenytoin or the other medications, causing adverse eﬀects or reduced seizure control. The client should inform their doctor of any other medications they are taking or planning to take, including over-the-counter, herbal, or dietary supplements.
"I know that I cannot switch brands of this medication." This statement is correct because diﬀerent brands of phenytoin may have diﬀerent formulations or bioavailability, which can aﬀect the absorption and metabolism of the drug. Switching brands can cause changes in the blood levels and eﬀectiveness of phenytoin, leading to toxicity or reduced seizure control. The client should always use the same brand of phenytoin and check with their pharmacist if they notice any changes in the appearance or labeling of their medication.

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The nurse asks a client who is about to have a cardiac catheterization about any allergies. The client states, "I always get a rash when I eat shellfish." Which of the following is the priority nursing action?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

A nurse is planning care for a client following a cardiac catheterization accessed through his femoral artery. Which of the following actions should the nurse plan to take?

Correct Answer is C

Explanation

A nurse is performing discharge teaching for a client who has seizures and a new prescription for phenytoin. Which of the following statements by the client indicates a need for further teaching?

Correct Answer is A

Explanation

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