The nurse is working on a neurosurgery unit. The patient calls the desk to complain that his arm is really burning and feels hot. The patient is receiving IV phenytoin for his grand mal seizures. What is the nurse's best action?
Call the health carer provider immediately to change the medication to oral.
Continue the infusion and reassure the patient.
Flush the line with 10 mL of normal saline and continue the infusion.
Discontinue the IV and restart the IV infusion in a different site
The Correct Answer is D
A. Call the health care provider immediately to change the medication to oral.
Changing the medication to oral may not address the immediate issue of the burning sensation and feeling of heat at the IV site. This option focuses on changing the route of administration rather than addressing the current discomfort.
B. Continue the infusion and reassure the patient.
Continuing the infusion without addressing the patient's discomfort could lead to potential complications, and it is important to prioritize patient comfort and safety. Reassurance alone may not be sufficient if there is an issue with the IV site.
C. Flush the line with 10 mL of normal saline and continue the infusion.
While flushing the line with normal saline is a good practice to ensure patency, it may not resolve the issue if there is ongoing irritation or infiltration at the site. Continuing the infusion without addressing the patient's complaint might lead to further discomfort.
D. Discontinue the IV and restart the IV infusion in a different site.
This is the best action. Discontinuing the IV allows the nurse to assess the current site for signs of infiltration or irritation. Restarting the IV in a different site addresses the immediate issue, ensuring that the medication is delivered safely and effectively.
Nursing Test Bank
Naxlex Comprehensive Predictor Exams
Related Questions
Correct Answer is C
Explanation
A. As requested by the patient.
Administering the drug only when requested by the patient may not provide adequate prophylaxis against chemotherapy-induced nausea and vomiting. These medications are often prescribed on a schedule to prevent symptoms rather than treating them reactively.
B. 1 hour after chemotherapy administration.
Waiting until 1 hour after chemotherapy administration may not cover the full period during which nausea and vomiting are likely to occur. The administration schedule for antiemetics is often more extended to provide better coverage.
C. The night before the treatment, the day of the treatment, and for 24 hours after the treatment.
This is the correct choice. Administering phenothiazine antiemetics according to this schedule helps ensure continuous coverage during the critical period when chemotherapy-induced nausea and vomiting are most likely to occur.
D. The day of treatment.
Administering the drug only on the day of treatment may not provide sufficient coverage for the entire duration when chemotherapy-induced nausea and vomiting can occur. Again, the schedule mentioned in option C is more comprehensive for prevention.
Correct Answer is ["A","B","C","D"]
Explanation
A. "I will avoid foods high in fat." - This is a correct statement. High-fat foods can contribute to the symptoms of GERD.
B. "I will eat small frequent meals and have a snack at bedtime." - This is a correct statement. Eating smaller, more frequent meals and avoiding large meals before bedtime can help manage GERD symptoms.
C. "Orange juice may aggravate my symptoms." - This is a correct statement. Citrus juices, including orange juice, are acidic and can worsen GERD symptoms.
D. "I will wait 2 hours after eating lunch before lying down for a nap." - This is a correct statement. Waiting a few hours after eating before lying down can help prevent stomach contents from refluxing into the esophagus.
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