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The nurse reviews the client's test results.

Exhibits

For each potential provider's prescription, click to specify if the potential prescription is anticipated or contraindicated for the client.

A.

Pyrazinamide

B.

Contact precautions

C.

Monthly TB skin test for 1 year

D.

Ethambutol

E.

Isoniazid

F.

Airborne precautions

G.

Rifampin

Answer and Explanation

The Correct Answer is {"A":{"answers":"A"},"B":{"answers":"A"},"C":{"answers":"B"},"D":{"answers":"A"},"E":{"answers":"A"},"F":{"answers":"A"},"G":{"answers":"A"}}

Anticipated:

  • Pyrazinamide: This is a first-line anti-tuberculosis medication used in combination therapy to treat active TB. It helps shorten treatment duration and targets intracellular bacteria.
  • Contact precautions: TB is transmitted via airborne droplets, requiring airborne precautions instead. However, contact precautions can still be implemented in addition to airborne precautions.
  • Ethambutol: This medication is used to prevent resistance and is part of the standard four-drug regimen for active tuberculosis.
  • Isoniazid: A core component of TB treatment, isoniazid is effective against actively dividing Mycobacterium tuberculosis. It is typically given for at least 6 months.
  • Airborne precautions: TB is transmitted through airborne droplets, necessitating airborne precautions such as an N95 mask, negative-pressure isolation, and limiting client transport.
  • Rifampin: Another first-line anti-tuberculosis drug, rifampin works by inhibiting bacterial RNA synthesis and is a crucial part of combination therapy for TB.

Contraindicated:

  • Monthly TB skin test for 1 year: Once TB is confirmed via sputum culture and chest x-ray, repeated skin testing is unnecessary and would not provide additional diagnostic value.


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Related Questions

Correct Answer is {"dropdown-group-1":"C","dropdown-group-2":"B"}

Explanation

The preschooler is at risk for developing atelectasis evidenced by the preschooler's refusal to use the spirometer.

Atelectasis, or lung collapse, is a common postoperative complication due to shallow breathing and inadequate lung expansion. In this case the child refuses to use the incentive spirometer, which is crucial for preventing atelectasis by encouraging deep breathing. Shallow respirations are noted in both assessments, indicating reduced lung expansion.

Correct Answer is {"A":{"answers":"C"},"B":{"answers":"A,C"},"C":{"answers":"C"},"D":{"answers":"C"},"E":{"answers":"B"},"F":{"answers":"A,B"},"G":{"answers":"B,C"}}

Explanation

  • Calcium level: Decreased due to furosemide, a loop diuretic that increases calcium excretion in the urine, leading to mild hypocalcemia.
  • Potassium level: Decreased due to furosemide, which causes potassium loss through diuresis. Lisinopril, an ACE inhibitor, can cause potassium retention, but in this case, the effect of furosemide dominates.
  • Sodium level: Decreased due to furosemide-induced diuresis, which can lead to hyponatremia by excessive sodium loss.
  • Edema: Improved due to furosemide, which promotes fluid removal and reduces volume overload associated with heart failure.
  • Oxygen saturation: Improved due to carvedilol, which reduces heart failure symptoms by decreasing myocardial oxygen demand and improving cardiac output.
  • Blood pressure: Lowered due to both carvedilol (a beta-blocker) and lisinopril (an ACE inhibitor), both of which reduce systemic vascular resistance.
  • Weight: Decreased due to both carvedilol, which helps manage fluid retention over time in heart failure, and furosemide, which directly reduces fluid overload through diuresis.

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