Exhibits

Review H and P, nurse's notes, laboratory results, flow sheet, and orders.

Click to mark whether the assessment finding represents a therapeutic result of the sodium bicarbonate administered, a non-therapeutic side-effect, or an unrelated finding.

0730

• Admit to the surgical floor
• Dextrose 59% and 0.9% sodium chloride to infuse at 125 ml/hr
• Advance diet as tolerated
• Insulin glargine 12 units subcutaneous every 12 hours
• Ceftriaxone 2 g IV every 24 hours for 3 days, first dose given in surgery
• Insulin lispro 1 unit subcutaneously per 15 carbohydrates
• Insulin lispro sliding scale:

180-240 mg/dL (10-13.3 mmol/L)- 1 unit

241-300 mg/dl. (13.4-16.7 mmol/L)-2 units

300-360 mg/dL (16.7-30 mmol/L)-3 units

over 360 mg/dL (30 mmol/L)-call the physician

• Glucagon 1 syringe subcutaneously for blood glucose less than 60 mg/dL (3.3 mmol/L) and unresponsiveness

It is 1800, and the client has a schedule dose of insulin glargine due. The client has a regular diet tray ordered with 60 carbohydrates. The tray has not yet arrived in the room.

For each nursing action below, click to specify If the action is indicated, contraindicated or non-essential.

The nurse is planning to administer the antiulcer gastrointestinal (GI) agent sucralfate to a client with peptic ulcer disease. Which action should the nurse include in this client's plan of care?

A client receives a new prescription for montelukast. Which information should the nurse include in the client's teaching?

The nurse is administering sodium polystyrene sulfonate to a client in acute kidney injury (AKI). Which laboratory finding indicates that the medication has been effective?

Glucose [Reference Range: 74 to 106 mg/dL (4.1 to 5.9 mmol/L)] Hemoglobin (Hgb) [Reference Range:12-16 g/dL (120-160 g/L)] Potassium (K+) [Reference Range: 3.5 to 5.0 mEq/L (3.5 to 5.0 mmol/L)] Ammonia [Reference Range: Adult: 10 to 80 Mcg/dL (6 to 47 Mcmol/dL)]

A client who received a renal transplant three months ago is readmitted to the acute care unit with signs of graft rejection. While taking the client's history, the nurse determines that the client has been self-administering St. John's Wort, an herbal preparation, on the advice of a friend. Which information is most significant about this finding?

The healthcare provider prescribes the antibiotic tetracycline HCI for an adult client that arrived at an outpatient clinic. Which instruction should the nurse include in the teaching plan for this client?

A young adult female client who is planning to become pregnant asks the nurse if she can continue taking isotretinoin for cystic acne. Which information is most important for the nurse to provide this client?

A client with pneumonia who has an emergent episode of respiratory distress is intubated and transferred to the intensive care unit. The client's chest x-ray shows consolidation in the left lobe, and physical assessment reveals diminished lung sounds. The nurse administers acetylcysteine as prescribed per nebulization via endotracheal tube. Which therapeutic response of this medication should the nurse expect?

When administering medications to a group of clients, which client should the nurse closely monitor for development of acute kidney injury (AKI)?

The client is a 54-year-old male with a history of hypertension and type 2 diabetes. He takes spironolactone 25 mg per day, metformin 500 mg twice a day, and 25 units of insulin glargine.

The nurse is discussing potential drug interactions with captopril.

For each drug, click to indicate whether the drug may increase the effects captopril has on blood pressure, decrease the effects, or have no effect.