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A nurse is educating a patient with multiple sclerosis who has been prescribed baclofen. What guidance should the nurse include in the education? What guidance should the nurse include for baclofen?
- A. Consume the medication on an empty stomach.
- B. Anticipate initial development of diarrhea.
- C. Discontinue the medication immediately if a headache occurs.
- D. Avoid taking antihistamines with this medication.
Correct Answer: D
Rationale: Correct Answer: D - Avoid taking antihistamines with this medication.
Rationale:
1. Baclofen is a muscle relaxant used to treat muscle spasms in conditions like multiple sclerosis.
2. Antihistamines can potentiate sedative effects when taken with baclofen, leading to increased drowsiness and dizziness.
3. Combining baclofen with antihistamines can result in impaired motor function and cognitive abilities.
4. It is important to educate the patient to avoid taking antihistamines while on baclofen to prevent these potential adverse effects.
Summary of Incorrect Choices:
A. Consuming the medication on an empty stomach is not necessary for baclofen.
B. Diarrhea is not a common initial side effect of baclofen.
C. Headache is not a common adverse effect of baclofen that requires immediate discontinuation of the medication.
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A nurse is calculating the total fluid intake for a patient over a 4-hour period. The patient consumed 1 cup of coffee, 4 oz of orange juice, 3 oz of water, 1 cup of flavored gelatin, 1 cup of tea, 5 oz of broth, and 3 oz of water. How many mL of intake should the nurse record on the patient's chart? How many mL of fluid intake should the nurse record?
Correct Answer: 1160
Rationale: The correct answer is 1160 mL. To calculate this, first convert all measurements to mL: 1 cup = 240 mL, 1 oz = 30 mL.
Coffee (240 mL), orange juice (120 mL), water (90 mL), flavored gelatin (240 mL), tea (240 mL), broth (150 mL), water (90 mL).
Adding these up: 240 + 120 + 90 + 240 + 240 + 150 + 90 = 1170 mL.
Therefore, the nurse should record 1160 mL on the patient's chart.
Other choices are incorrect because they do not calculate the total accurately or convert all measurements to mL.
A nurse is instructing a patient who has just been prescribed bumetanide. What should the nurse include in the instructions? What should the nurse include in bumetanide instructions?
- A. Take the prescribed second dose at nighttime.
- B. Limit your fluid intake to no more than 1.5 L a day.
- C. Report any changes in hearing.
- D. Avoid foods high in potassium.
Correct Answer: C
Rationale: The correct answer is C: Report any changes in hearing. Bumetanide is a loop diuretic that can cause ototoxicity, leading to changes in hearing. Instructing the patient to report any changes in hearing is crucial to monitor for potential adverse effects. Choice A is incorrect as bumetanide is usually taken once daily in the morning to prevent nocturia. Choice B is incorrect as the patient may need to increase fluid intake to prevent dehydration. Choice D is incorrect as bumetanide can lead to hypokalemia, so foods high in potassium may be beneficial.
A nurse is caring for a patient who has a new prescription for citalopram. Which of the following instructions should the nurse include? What instructions should the nurse include for citalopram?
- A. Take the medication in the morning.
- B. Report any suicidal thoughts.
- C. Avoid foods high in tyramine.
- D. Take the medication with food.
Correct Answer: B
Rationale: The correct answer is B: Report any suicidal thoughts. This is crucial because citalopram is an antidepressant that can increase the risk of suicidal thoughts, especially in the initial stages of treatment. Monitoring and reporting any such thoughts are essential for the patient's safety.
A: Take the medication in the morning - This is incorrect as citalopram can be taken at any time of the day, depending on individual preference and tolerability.
C: Avoid foods high in tyramine - This is incorrect as tyramine restriction is more relevant for MAOIs, not SSRIs like citalopram.
D: Take the medication with food - This is not a specific requirement for citalopram, as it can be taken with or without food.
A nurse is caring for a patient who is receiving total parenteral nutrition (TPN). Which of the following laboratory values should the nurse monitor? Which lab value should the nurse monitor for TPN?
- A. Serum glucose
- B. Serum calcium
- C. Serum magnesium
- D. Serum sodium
Correct Answer: A
Rationale: The correct answer is A: Serum glucose. When a patient is receiving TPN, monitoring serum glucose levels is crucial as TPN solutions contain high concentrations of glucose. Elevated glucose levels can lead to hyperglycemia, which can result in complications such as osmotic diuresis and hyperosmolar hyperglycemic state. Monitoring glucose levels helps in adjusting TPN infusion rates to maintain a stable blood glucose level.
Incorrect answers:
B: Serum calcium - Calcium levels are not directly affected by TPN and are not typically monitored specifically for patients receiving TPN.
C: Serum magnesium - While magnesium levels may be affected by TPN, glucose monitoring is more critical due to the high glucose content in TPN.
D: Serum sodium - Sodium levels are not directly influenced by TPN and are not typically monitored specifically for patients receiving TPN.
A nurse in an emergency department is caring for a patient who has diabetic ketoacidosis (DKA) and a blood glucose level of 925 mg/dL. What prescription should the nurse anticipate from the provider? What prescription should the nurse anticipate for DKA?
- A. Glucocorticoid medications.
- B. Dextrose 5% in 0.45% sodium chloride.
- C. Oral hypoglycemic medications.
- D. 0.9% sodium chloride IV bolus.
Correct Answer: D
Rationale: The correct answer is D: 0.9% sodium chloride IV bolus. In DKA, the primary concern is severe dehydration and electrolyte imbalances due to high blood glucose levels. 0.9% sodium chloride helps to rehydrate the patient and correct electrolyte imbalances. Glucocorticoids (A) are not typically used in the treatment of DKA. Dextrose 5% in 0.45% sodium chloride (B) would worsen hyperglycemia. Oral hypoglycemic medications (C) are not appropriate for managing acute DKA. Therefore, the nurse should anticipate the prescription of 0.9% sodium chloride IV bolus to address the immediate needs of the patient with DKA.