The nurse is caring for a patient who has diabetes and complains of chronic, burning leg pain even when taking oxycodone (OxyContin) twice daily. Which prescribed medication is the best choice for the nurse to administer as an adjuvant to decrease the patient's pain?

Acetaminophen (Tylenol)

Gabapentin (Neurontin)

Hydrocodone-Acetaminophen (Norco)

Aspirin

Answer and Explanation

The Correct Answer is B

Choice A reason: This statement is false. Acetaminophen (Tylenol) is not the best choice for the nurse to administer as an adjuvant to decrease the patient's pain, as acetaminophen is a mild analgesic that works by inhibiting the synthesis of prostaglandins, which are involved in inflammation and pain. Acetaminophen is not very effective for chronic, burning leg pain, which is likely caused by diabetic neuropathy, a nerve damage condition that affects the sensation and function of the legs.

Choice B reason: This statement is true. Gabapentin (Neurontin) is the best choice for the nurse to administer as an adjuvant to decrease the patient's pain, as gabapentin is an anticonvulsant that works by modulating the activity of calcium channels, which are involved in transmitting pain signals from the nerves to the brain. Gabapentin is effective for chronic, burning leg pain, as it can reduce the intensity and frequency of neuropathic pain.

Choice C reason: This statement is false. Hydrocodone-Acetaminophen (Norco) is not the best choice for the nurse to administer as an adjuvant to decrease the patient's pain, as hydrocodone-acetaminophen is a combination of an opioid analgesic and a mild analgesic that works by binding to opioid receptors in the brain and spinal cord, and by inhibiting the synthesis of prostaglandins, respectively. Hydrocodone-acetaminophen is not very effective for chronic, burning leg pain, as it can cause tolerance, dependence, and addiction, and can also interact with oxycodone, which the patient is already taking.

Choice D reason: This statement is false. Aspirin is not the best choice for the nurse to administer as an adjuvant to decrease the patient's pain, as aspirin is a nonsteroidal anti-inflammatory drug (NSAID) that works by inhibiting the synthesis of prostaglandins, which are involved in inflammation and pain. Aspirin is not very effective for chronic, burning leg pain, as it can cause gastrointestinal bleeding, ulcers, and kidney damage, and can also interact with other medications that the patient may be taking, such as anticoagulants or antiplatelets.

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Correct Answer is C

Explanation

Choice A reason: I will always need to take hydrocortisone pills is a correct statement. Hydrocortisone is a synthetic form of cortisol, a hormone that is normally produced by the adrenal glands. After a bilateral adrenalectomy, the patient will have no adrenal glands and will need to take hydrocortisone pills for life to replace the missing hormone.

Choice B reason: I have a way to inject hydrocortisone in case of emergency is also a correct statement. Hydrocortisone injections are used to treat acute adrenal crisis, a life-threatening condition that can occur when the patient has low cortisol levels due to stress, illness, injury, or surgery. The patient should have an emergency kit with hydrocortisone injections and instructions on how to use them.

Choice C reason: I will stop taking hydrocortisone when I feel better is an incorrect statement. This indicates a need for further education regarding medications after a bilateral adrenalectomy. The patient should never stop taking hydrocortisone without consulting their doctor, as this can cause severe symptoms of adrenal insufficiency, such as low blood pressure, low blood sugar, weakness, fatigue, and confusion.

Choice D reason: I have nausea or vomiting often is a statement that requires further assessment by the nurse. Nausea or vomiting can be signs of inadequate or excessive hydrocortisone dosage, or other complications after a bilateral adrenalectomy. The nurse should monitor the patient's vital signs, blood glucose, electrolytes, and weight, and report any abnormal findings to the doctor. The patient may need to adjust their hydrocortisone dose or take other medications to manage their symptoms.

A. Metabolic acidosis B. Metabolic alkalosis C. Respiratory acidosis D. Respiratory alkalosis

Correct Answer is A

Explanation

Choice A reason: Metabolic acidosis is a condition where the blood pH is lower than normal, due to an excess of acids or a loss of bases in the body. Jo is most at risk of developing metabolic acidosis, because of the high blood glucose level. High blood glucose can cause diabetic ketoacidosis, a complication of Type 1 Diabetes, where the body breaks down fat for energy and produces ketones, which are acidic substances. Ketones can accumulate in the blood and lower the pH, causing symptoms such as nausea, vomiting, abdominal pain, fruity breath, and confusion.

Choice B reason: Metabolic alkalosis is a condition where the blood pH is higher than normal, due to an excess of bases or a loss of acids in the body. Jo is not likely to develop metabolic alkalosis, because of the high blood glucose level. Metabolic alkalosis can be caused by conditions such as vomiting, diuretic use, or excessive antacid intake, which can increase the bicarbonate level or decrease the chloride level in the blood. These conditions are not related to Jo's diabetes.

Choice C reason: Respiratory acidosis is a condition where the blood pH is lower than normal, due to an accumulation of carbon dioxide in the body. Jo is not prone to developing respiratory acidosis, because of the high blood glucose level. Respiratory acidosis can be caused by conditions that impair the lung function, such as asthma, chronic obstructive pulmonary disease (COPD), or pneumonia, which can reduce the ventilation and increase the carbon dioxide level in the blood. These conditions are not related to Jo's diabetes.

Choice D reason: Respiratory alkalosis is a condition where the blood pH is higher than normal, due to a loss of carbon dioxide in the body. Jo is not susceptible to developing respiratory alkalosis, because of the high blood glucose level. Respiratory alkalosis can be caused by conditions that increase the breathing rate, such as anxiety, fever, or hyperventilation, which can reduce the carbon dioxide level in the blood. These conditions are not related to Jo's diabetes.

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The nurse is caring for a patient who has diabetes and complains of chronic, burning leg pain even when taking oxycodone (OxyContin) twice daily. Which prescribed medication is the best choice for the nurse to administer as an adjuvant to decrease the patient's pain?

Nursing Test Bank

Naxlex Comprehensive Predictor Exams

Which patient statement indicates a need for further education regarding medications after a bilateral adrenalectomy?

Correct Answer is C

Explanation

Jo is a client with Type 1 Diabetes. Jo has a blood glucose level of 644 mg/dL. The nurse interprets that this client is most at risk of developing which type of acid-base imbalance?

Correct Answer is A

Explanation

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