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A client is prescribed nitroglycerin (Nitro-Dur) transdermal patch for angina. Which instruction should the nurse include in the client's teaching plan?
- A. Apply the patch to a hairless area of skin.
- B. Leave the patch on for 24 hours.
- C. Apply the patch at the same time each day.
- D. You can keep the patch on while taking a shower.
Correct Answer: C
Rationale: The nurse should instruct the client to apply the nitroglycerin (Nitro-Dur) transdermal patch at the same time each day to ensure consistent blood levels. It is essential to apply the patch to a hairless area of the skin for proper absorption. The patch can generally be left on during a shower. The patch is usually worn for 12-14 hours to allow for a nitrate-free period, which helps reduce tolerance to the medication.
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A client is receiving intravenous heparin for a deep vein thrombosis. The healthcare provider should monitor the client for which of the following potential complications?
- A. Hypertension
- B. Tachycardia
- C. Bleeding
- D. Hyperkalemia
Correct Answer: C
Rationale: Heparin is an anticoagulant, so the primary potential complication is bleeding. The healthcare provider should monitor the client for signs of bleeding, such as bruising, hematuria, and gastrointestinal bleeding. Hypertension, tachycardia, and hyperkalemia are not direct complications of heparin therapy.
A client taking ethambutol (Myambutol) understands the instructions provided by the nurse if the client states that he or she will immediately report:
- A. Impaired sense of hearing
- B. Problems with visual acuity
- C. Gastrointestinal (GI) side effects
- D. Orange-red discoloration of body secretions
Correct Answer: B
Rationale: Failed to generate a rationale of 500+ characters after 5 retries.
A health care provider (HCP) writes a prescription for digoxin (Lanoxin), 0.25 mg daily. The nurse teaches the client about the medication and tells the client that it is important to:
- A. Count the radial and carotid pulses every morning.
- B. Check the blood pressure every morning and evening.
- C. Stop taking the medication if the pulse is higher than 100 beats per minute.
- D. Withhold the medication and call the HCP if the pulse is less than 60 beats per minute.
Correct Answer: D
Rationale: When taking digoxin, monitoring the pulse rate is essential due to its potential effects on heart rate. Digoxin can lead to bradycardia, where the pulse rate drops significantly. Withholding the medication and promptly contacting the healthcare provider if the pulse falls below 60 beats per minute is crucial to prevent severe complications and ensure appropriate management.
A client is receiving bethanechol chloride (Urecholine). The nurse monitors the client for adverse effects of the medication and should observe for which of the following?
- A. Bradycardia
- B. Constipation
- C. Hypertension
- D. Dry mouth
Correct Answer: A
Rationale: Bethanechol chloride (Urecholine) stimulates muscarinic receptors, which can lead to bradycardia as an adverse effect. Monitoring for bradycardia is crucial when administering this medication. Constipation, hypertension, and dry mouth are not typically associated with the effects of bethanechol chloride.
A client is receiving an intravenous (IV) infusion of an antineoplastic medication. During the infusion, the client complains of pain at the insertion site. The nurse notes redness and swelling at the site, along with a slowed infusion rate. What is the appropriate action for the nurse to take?
- A. Notify the healthcare provider.
- B. Administer pain medication to reduce discomfort.
- C. Apply ice and maintain the infusion rate as prescribed.
- D. Elevate the extremity of the IV site and slow the infusion rate.
Correct Answer: A
Rationale: When a client complains of pain at the IV insertion site, and there are signs of extravasation such as redness and swelling, it is crucial to notify the healthcare provider immediately. Extravasation of antineoplastic medications can cause tissue damage, pain, and necrosis if they escape into surrounding tissues. Prompt action is necessary to prevent further complications and ensure appropriate management of the situation.