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The nurse notes a medication ordered for a client is advised to use with caution in the elderly due to declining renal function. Which of the following nursing interventions is an example of a precaution?

Administering medications different times during the day

Compare the clients armband with the medication administration record

Closely monitoring the clients BUN and creatine for a decrease from baseline

closely monitoring the clients BUN and creatine for an increase from baseline

Answer and Explanation

The Correct Answer is D

A. Administering medications at different times: timing does not affect renal function monitoring.

B. Comparing the client’s armband with the MAR: this is a safety check, not a precaution for renal function.

C. Monitoring for a decrease in BUN and creatinine: a decrease does not indicate renal impairment.

D. Closely monitoring the client's BUN and creatinine for an increase from baseline: Renal function declines with age, increasing the risk of drug accumulation and toxicity. An increase in BUN (normal: 7-20 mg/dL) and creatinine (normal: 0.6-1.3 mg/dL) indicates worsening kidney function and necessitates medication adjustments.

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Correct Answer is A

Explanation

A. Intravenous: IV administration delivers medication directly into the bloodstream, allowing for the fastest onset of action (within seconds to minutes).

B. Topical patch: Slow absorption, designed for long-term, sustained release.

C. Sublingual: Faster than oral, but slower than IV (absorbed through mucous membranes).

D. Intramuscular: Faster than oral, but slower than IV, as the drug must diffuse into the bloodstream from muscle tissue.

A. Sodium 148 B. Potassium 3.1 C. Sodium 130 D. Potassium 5.7

Correct Answer is D

Explanation

A. Sodium 148: This represents mild hypernatremia, but sodium levels are not the primary concern for cardiac monitoring.

B. Potassium 3.1: This is hypokalemia (low potassium), not hyperkalemia.

C. Sodium 130: This represents hyponatremia, which can cause neurological symptoms, not hyperkalemia.

D. Potassium 5.7: Hyperkalemia is defined as K⁺ >5.0 mEq/L. Levels above 5.5 can cause dangerous cardiac dysrhythmias, requiring ECG monitoring.

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The nurse notes a medication ordered for a client is advised to use with caution in the elderly due to declining renal function. Which of the following nursing interventions is an example of a precaution?

Nursing Test Bank

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