Nokea
A nurse is caring for a client prescribed dextran IV. The nurse would observe the client for which of the following as a possible adverse reaction?
- A. Cyanosis
- B. Wheezing
- C. Hyperlipidemia
- D. Hypercoagulability
Correct Answer: B
Rationale: Dextran administration may result in allergic reactions, which are evidenced by urticaria, hypotension, nausea, vomiting, headache, dyspnea, fever, tightness of the chest, and wheezing.
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After teaching a group of nursing students about electrolyte imbalances, the instructor determines that the teaching was successful when the group identifies which of the following as indicative of hypercalcemia? Select all that apply.
- A. Constipation
- B. Oliguria
- C. Polydipsia
- D. Bone pain
- E. Anorexia
Correct Answer: A,C,D,E
Rationale: Signs and symptoms of hypercalcemia include anorexia, nausea, vomiting, lethargy, bone tenderness or pain, polyuria, polydipsia, constipation, dehydration, muscle weakness and atrophy, stupor, coma, and cardiac arrest.
A client is prescribed bicarbonate. The client's medication history reveals that the client is also taking fluoroquinolones. The nurse would be alert for the development of which of the following due to an interaction of these two drugs?
- A. Respiratory alkalosis
- B. Severe abdominal pain
- C. Increased risk of crystalluria
- D. Renal impairment
Correct Answer: C
Rationale: The nurse should monitor the client's condition for an increased risk of crystalluria as a result of the interaction of fluoroquinolones and bicarbonate.
A physician orders levofloxacin (Levaquin) for a client to treat infection. The order is for levofloxacin (Levaquin) 500 mg/100 mL to be infused over a period of 1 hour. The IV infusion set has a drop factor of 10 drops/mL. The nurse would set the infusion flow rate at
- A. 16 drops/min
- B. 17 drops/min
- C. 18 drops/min
- D. 19 drops/min
Correct Answer: B
Rationale: 100 mL / 1 hour = 100 mL/hr; 100 mL/hr ? 1 hr/60 min = 1.67 mL/min; 1.67 mL/min ? 10 = 16.7 or 17 drops/min.
The use of an infusion pump or controller still requires nursing supervision and frequent monitoring of the IV infusion to monitor for signs of infiltration. Assessment of which of the following at the infusion site would lead the nurse to suspect that infiltration is occurring? Select all that apply.
- A. Edema
- B. Necrosis
- C. Burning
- D. Itching
- E. Redness
Correct Answer: A,E
Rationale: It is important for the nurse to monitor frequently for signs of infiltration while an infusion pump is in use. The signs of infiltration include edema and redness at the infusion site.
A physician orders normal saline for a client to replace lost fluids due to poor oral intake. The order is for 1000 mL normal saline to be infused over a period of 6 hours. If the drop factor is 20 drops/mL, the nurse would set the IV flow rate at
- A. 55 drops/min
- B. 56 drops/min
- C. 57 drops/min
- D. 58 drops/min
Correct Answer: B
Rationale: 1000 mL / 6 hours = 166.7 mL/hr; 166.7 mL/hr ? 1 hr/60 min = 2.8 mL/min; 2.8 mL/min ? 20 = 55.5 or 56 drops/min.