A nurse is preparing to assist with a transesophageal echocardiogram (TEE) procedure for a patient. What action should the nurse prioritize to ensure patient safety during TEE?
- A. Placing the patient in a supine position with arms at their sides
- B. Administering intravenous sedation to the patient before the procedure
- C. Instructing the patient to refrain from eating or drinking for six hours before the procedure
- D. Ensuring the availability of emergency equipment and resuscitation medications
Correct Answer: D
Rationale: Ensuring the availability of emergency equipment and resuscitation medications is crucial to prioritize patient safety during a transesophageal echocardiogram (TEE) procedure. TEE involves inserting a specialized probe (transducer) into the esophagus to obtain detailed images of the heart. While complications during TEE are rare, they can include adverse reactions to sedation, esophageal injury, arrhythmias, or other cardiac events. By having emergency equipment and resuscitation medications readily available, the healthcare team can respond promptly to any unforeseen complications or emergencies that may arise during the procedure, ensuring optimal patient safety. Placing the patient in a supine position, providing sedation, and advising the patient to fast before the procedure are important aspects of the TEE process; however, ensuring emergency preparedness takes precedence in prioritizing patient safety during the procedure.
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Autonomy is the prerogative of the patient to give consent or refusal of treatment with the EXCEPTION of which of the following situations?
- A. Erroneous belief of a head of a church
- B. Negative effect of superstition
- C. Near death
- D. Peer pressure
Correct Answer: A
Rationale: Autonomy refers to the patient's right to make decisions about their own health care, including the ability to give consent or refusal of treatment. This right is based on the patient's own beliefs, values, and preferences. However, in the case of an erroneous belief of a head of a church, it may conflict with the patient's own autonomy and ability to make decisions based on their own beliefs. In such a situation, it is important for healthcare providers to respect the patient's autonomy while also addressing any potential conflicts that may arise from external influences such as the erroneous belief of a head of a church.
A client with congestive heart failure has been receiving digoxin (lanoxin). Which finding indicates that the medication is having a desired effect?
- A. Increased weight
- B. Increased urinary output
- C. Improved appetite
- D. Increased pedal edema
Correct Answer: B
Rationale: Digoxin is a medication commonly used in the treatment of congestive heart failure because it helps to improve cardiac output and reduce heart failure symptoms. One of the desired effects of digoxin is an increase in urinary output. This is because digoxin helps to improve cardiac function, which can lead to better circulation and increased kidney perfusion. As a result, the kidneys are better able to filter and excrete excess fluid, leading to increased urine output. Therefore, an increase in urinary output indicates that the digoxin is having a positive effect in managing the client's congestive heart failure. The other options, such as increased weight, improved appetite, and increased pedal edema, are not indicative of a desired effect of digoxin therapy.
A postpartum client exhibits signs of deep vein thrombosis (DVT), including calf pain, swelling, and warmth. Which nursing action is most appropriate?
- A. Applying warm compresses to the affected calf
- B. Encouraging ambulation to promote circulation
- C. Notifying the healthcare provider immediately
- D. Administering anticoagulant medication as ordered
Correct Answer: C
Rationale: Deep vein thrombosis (DVT) is a serious condition that requires prompt medical intervention. The presence of calf pain, swelling, and warmth in a postpartum client are concerning signs of a potential DVT. By notifying the healthcare provider immediately, appropriate diagnostic tests, such as ultrasound imaging, can be ordered to confirm the diagnosis. Timely treatment with anticoagulant medication can then be initiated to prevent complications such as pulmonary embolism. Applying warm compresses or encouraging ambulation may exacerbate the condition by promoting clot dislodgement, making immediate notification of the healthcare provider the most appropriate nursing action in this situation.
A woman in active labor is receiving intravenous oxytocin for labor augmentation. What nursing intervention is essential to prevent oxytocin-induced uterine hyperstimulation?
- A. Monitor maternal vital signs every 2 hours.
- B. Increase the oxytocin infusion rate gradually.
- C. Administer intravenous fluids rapidly.
- D. Encourage the mother to ambulate regularly.
Correct Answer: B
Rationale: When a woman in active labor is receiving intravenous oxytocin for labor augmentation, it is essential to increase the oxytocin infusion rate gradually to prevent oxytocin-induced uterine hyperstimulation. Uterine hyperstimulation can lead to complications such as fetal distress, uterine rupture, and postpartum hemorrhage. By increasing the oxytocin infusion rate gradually, the uterus has more time to adapt to the medication and reduces the risk of hyperstimulation. It is crucial for the healthcare provider to carefully monitor the woman's response to oxytocin and adjust the infusion rate as needed to ensure safe and effective labor augmentation. Monitoring for signs of uterine hyperstimulation, such as persistent contractions close together or excessive uterine activity, is crucial in preventing complications and ensuring the well-being of both the mother and baby.
A patient with chronic kidney disease presents with progressively worsening anemia and elevated serum phosphate levels. Which medication is commonly prescribed to reduce serum phosphate levels in patients with chronic kidney disease?
- A. Epoetin alfa
- B. Cinacalcet
- C. Sevelamer
- D. Allopurinol
Correct Answer: C
Rationale: Sevelamer is a medication commonly prescribed to reduce serum phosphate levels in patients with chronic kidney disease. Sevelamer is a phosphate binder that works by binding to dietary phosphate in the gut, preventing its absorption into the bloodstream. By reducing serum phosphate levels, sevelamer helps manage complications associated with hyperphosphatemia in chronic kidney disease patients, such as mineral and bone disorders. Other medications like epoetin alfa are used to treat anemia commonly seen in chronic kidney disease patients, while cinacalcet is used to manage secondary hyperparathyroidism. Allopurinol, on the other hand, is used to treat gout by reducing uric acid levels and is not indicated for reducing serum phosphate levels in chronic kidney disease patients.