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A client with hypothyroidism (myxedema) is receiving levothyroxine (Synthroid), 25 mcg PO daily. Which finding should the nurse recognize as an adverse effect?
- A. Dysuria
- B. Tachycardia
- C. Leg cramps
- D. Blurred vision
Correct Answer: B
Rationale: Levothyroxine is a synthetic form of thyroid hormone used to treat hypothyroidism. An adverse effect of levothyroxine therapy is the development of tachycardia, which is an abnormally rapid heart rate. This is due to the increased metabolic rate resulting from the thyroid hormone replacement. Dysuria (painful urination), leg cramps, and blurred vision are not typically associated with levothyroxine therapy for hypothyroidism.
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A 32 y.o. male patient is admitted to a medical unit with a diagnosis of Guillain-Barre Syndrome. His legs are weak, and he is unable to walk without assistance. Which of the ff. is most likely responsible for this syndrome?
- A. Bacterial infection
- B. High-fat diet
- C. Heredity
- D. Autoimmune reaction
Correct Answer: D
Rationale: Guillain-Barre Syndrome (GBS) is an autoimmune disorder where the body's immune system mistakenly attacks the peripheral nerves. This leads to inflammation that damages the nerves and interrupts their ability to send signals to the brain. In the case of the 32-year-old male patient with weak legs, the autoimmune reaction is most likely responsible for causing muscle weakness and difficulty walking. GBS typically presents with ascending muscle weakness starting in the legs and progressing upwards. It is essential to recognize this condition promptly as it can lead to severe complications such as respiratory failure. Treatment often involves supportive care and interventions to manage the autoimmune response.
The nurse interprets this as?
- A. Respiratory acidosis
- B. Metabolic acidosis
- C. Respiratory alkalosis
- D. Metabolic alkalosis
Correct Answer: C
Rationale: Respiratory alkalosis is a condition where there is a decrease in carbon dioxide levels in the blood due to hyperventilation, leading to an increase in pH. In respiratory alkalosis, the body is expelling too much carbon dioxide, causing the blood to become more alkaline. The nurse's interpretation of the situation as respiratory alkalosis suggests that the patient may be breathing rapidly or deeply, resulting in the elimination of excess carbon dioxide and a shift towards alkalosis.
After cancer chemotherapy, a client experiences nausea and vomiting. The nurse should highest priority to which intervention?
- A. Serving small portions bland food
- B. Encouraging rhythmic breathing exercises
- C. Administering metoclopramide (Reglan) and dexamethasone (Decadron) as prescribed
- D. Withholding fluids for the first 4 to 6 hours after chemotherapy administration
Correct Answer: C
Rationale: Administering metoclopramide (Reglan) and dexamethasone (Decadron) as prescribed should be the highest priority intervention for a client experiencing nausea and vomiting after cancer chemotherapy. Metoclopramide is a commonly used antiemetic medication that helps to reduce nausea and vomiting by enhancing gastric emptying and decreasing nausea. Dexamethasone, a corticosteroid, can also help alleviate inflammation that may contribute to the nausea and vomiting. By administering these medications as prescribed, the nurse can effectively address the client's symptoms and improve their comfort level. The other options, such as serving small portions bland food, encouraging rhythmic breathing exercises, and withholding fluids, are important interventions but should not take precedence over providing the prescribed antiemetic medications to manage the client's post-chemotherapy symptoms.
A client in the terminal stage of cancer is receiving continuous infusion of morphine (Duramorph) for pain management. Which assessment finding suggests that the client is experiencing an adverse effect of this drug?
- A. Voiding of 350mL of concentrated urine in
- B. Irregular heart rate of 82 beats/min
- C. Pupils constricted and equal
- D. Respiratory rate of 8breaths/min
Correct Answer: D
Rationale: The assessment finding that suggests the client is experiencing an adverse effect of morphine (Duramorph) is a respiratory rate of 8 breaths/min. Morphine is a potent opioid analgesic that can cause respiratory depression as a side effect. When the respiratory rate decreases significantly, it indicates the potential for compromised breathing, which could progress to respiratory failure. This is a serious adverse effect that requires immediate attention and evaluation by healthcare providers. The client receiving continuous infusion of morphine should be closely monitored for signs of respiratory depression to prevent life-threatening consequences.
When taking the blood pressure of a client who has AIDS the nurse must;
- A. Wear a mask and gown
- B. Use barrier techniques
- C. Wash the hands thoroughly
Correct Answer: B
Rationale: When taking the blood pressure of a client with AIDS, it is important for the nurse to use barrier techniques to prevent the potential transmission of infection. This includes wearing gloves to protect against exposure to blood or other bodily fluids, using disposable blood pressure cuffs and stethoscopes, and ensuring proper hand hygiene before and after the procedure. Barrier techniques help minimize the risk of cross-contamination and protect both the healthcare provider and the client from potential infections.