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A nurse cares for a client with pancreatic cancer who is prescribed implanted radioactive iodine seeds. Which actions should the nurse take when caring for this client? (Select all that apply.)
- A. Dispose of linens in a biohazard bag.
- B. Place the client in a private room.
- C. Wear a lead apron when providing client care.
- D. Bundle client care to minimize exposure.
- E. Initiate Transmission-Based Precautions.
Correct Answer: B,C,D
Rationale: The client should be placed in a private room, and dirty linens kept in the client's room until the radiation source is removed. The nurse should wear a lead apron while providing care, ensuring the apron always faces the client. Bundling care minimizes exposure to radiation. Transmission-Based Precautions are not necessary for implanted radioactive iodine seeds.
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A nurse cares for a client who is prescribed 4 mg of calcium gluconate to infuse over 5 hours. The pharmacy provides 2 premixed infusion bags with 2 mg of calcium gluconate in 100 mL of D5W. At what rate should the nurse administer this medication? (Record your answer using a whole number.)
Correct Answer: 40 mL/hr
Rationale: Two bags of 2 mg calcium gluconate in 100 mL D5W each provide a total of 4 mg in 200 mL. To infuse over 5 hours: 200 mL ÷ 5 hr = 40 mL/hr.
A nurse cares for a client with end-stage pancreatic cancer. The client asks, 'Why is this happening to me?' How should the nurse respond?
- A. I don't know. I wish I had an answer for you, but I don't.
- B. It helps to keep a positive attitude for your family right now.
- C. Scientists have not determined why cancer develops in certain people.
- D. I think this is a trial so you can become a better person because of it.
Correct Answer: A
Rationale: The client is not asking the nurse to actually explain why the cancer has occurred. The client may be experiencing feelings of confusion, frustration, distress, and grief related to the diagnosis. The nurse should validate that there is no easy or straightforward answer as to why the client has cancer. Other options do not address the client's emotions or current concerns.
A nurse prepares to discharge a client with chronic pancreatitis. Which question should the nurse ask to ensure safety upon discharge?
- A. Do you have a one- or two-story home?
- B. Can you check your own pulse rate?
- C. Do you prepare your own meals?
- D. Do you have access to alcohol?
Correct Answer: A
Rationale: A client recovering from chronic pancreatitis should be limited to one floor until strength and activity increase. The client will need a bathroom on the same floor for frequent defecation. Assessing pulse rate and preparation of meals is not specific to chronic pancreatitis. Although the client should be encouraged to stop drinking alcohol, assessing alcohol availability is not adequate to assess safety.
A nurse cares for a client who presents with tachycardia and prostration related to biliary colic. Which actions should the nurse take? (Select all that apply.)
- A. Contact the provider immediately.
- B. Lower the head of the client.
- C. Decrease intravenous fluids.
- D. Ask the client to bear down.
- E. Administer prescribed opioids.ã??ã??ã?ª
Correct Answer: A,B
Rationale: Clients who are experiencing biliary colic may present with tachycardia, pallor, diaphoresis, prostration, or other signs of shock. The nurse should stay with the client, lower the client's head, and contact the provider or Rapid Response Team for immediate assistance. Decreasing fluids or administering opioids could worsen the client's condition.
A nurse plans care for a client with acute pancreatitis. Which intervention should the nurse include in this client's plan of care to reduce discomfort?
- A. Administer morphine sulfate intravenously every 4 hours as needed.
- B. Maintain nothing by mouth (NPO) and administer intravenous fluids.
- C. Provide small, frequent feedings with no concentrated sweets.
- D. Place the client in semi-Fowler's position with the head of bed elevated.
Correct Answer: B
Rationale: The client should be kept NPO to reduce GI activity and reduce pancreatic enzyme production. IV fluids should be used to prevent dehydration. The client may need a nasogastric tube. Pain medications should be given around the clock and more frequently than every 4 to 5 hours. A fetal position with legs drawn up to the chest will promote comfort.