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A patient admitted to the ICU develops acute pancreatitis with severe abdominal pain and elevated pancreatic enzymes. What intervention should the healthcare team prioritize to manage the patient's pancreatitis?
- A. Administer intravenous fluids to maintain adequate hydration.
- B. Perform an abdominal ultrasound to assess pancreatic morphology.
- C. Implement total parenteral nutrition (TPN) to meet nutritional needs.
- D. Recommend proton pump inhibitors (PPIs) for gastric acid suppression.
Correct Answer: A
Rationale: The priority intervention in managing acute pancreatitis is to administer intravenous fluids to maintain adequate hydration. Acute pancreatitis can lead to significant fluid loss and dehydration due to factors such as vomiting and third-spacing of fluids into the retroperitoneal space. Adequate hydration helps to optimize perfusion to the pancreas, prevent hypovolemic shock, and support overall organ function. This intervention also aids in flushing out inflammatory mediators and preventing complications such as acute kidney injury. Monitoring fluid status and adjusting the rate of intravenous fluid administration based on the patient's response is crucial in the management of acute pancreatitis. While other interventions such as imaging studies, nutritional support, and gastric acid suppression may be important in managing acute pancreatitis, ensuring adequate hydration is the most critical initial step.
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A patient with chronic kidney disease is prescribed erythropoietin-stimulating agents (ESAs) to manage anemia. Which laboratory parameter should be monitored closely during ESA therapy?
- A. Serum potassium
- B. Serum creatinine
- C. Hemoglobin
- D. Platelet count
Correct Answer: C
Rationale: Erythropoietin-stimulating agents (ESAs) are prescribed to manage anemia in patients with chronic kidney disease. Monitoring the hemoglobin level closely during ESA therapy is crucial to ensure that the treatment is effective in increasing red blood cell production without causing excessive elevation. Hemoglobin levels should be checked regularly to adjust the ESA dosage accordingly and prevent risks associated with high hematocrit levels, such as increasing blood viscosity and cardiovascular events. Monitoring serum potassium, creatinine, and platelet count are important in the management of chronic kidney disease for different reasons, but for ESA therapy, monitoring hemoglobin is the most essential parameter.
Nurse Lina is on duty at the ER and has been very busy that morning resulting to the administration of a penicillin injection which is ordered to another patient. With this error, the nurse can be charged of _______.
- A. malpractice
- B. negligence
- C. assault
- D. battery
Correct Answer: B
Rationale: Negligence refers to the failure to act or perform duties according to the standard of care expected from a reasonable person in similar circumstances. In this case, Nurse Lina administering a penicillin injection that was ordered for another patient is a clear instance of negligence. It involves a breach of duty by not verifying the correct patient and medication before administration. While malpractice can also encompass negligence, it typically involves a broader scope of professional misconduct or harm caused by a healthcare provider. Assault and battery involve intentional harmful acts, which are not applicable in this situation.
After the surgical procedure, the nurse assists with transferring the patient to the post-anesthesia care unit (PACU). What information should the nurse provide to the PACU nurse?
- A. Patient's intraoperative vital signs and hemodynamic parameters
- B. Details of the surgical procedure and anesthesia administration
- C. Plan for postoperative pain management and analgesic medications
- D. Documentation of the surgical count and instrument inventory
Correct Answer: A
Rationale: It is important for the nurse to provide the PACU nurse with the patient's intraoperative vital signs and hemodynamic parameters as this information gives insight into the patient's stability during the surgical procedure. The PACU nurse needs this data to monitor the patient's postoperative recovery, assess for any potential complications, and establish appropriate care interventions. Understanding the patient's intraoperative status allows the PACU nurse to provide a seamless continuation of care from the operating room to the post-anesthesia care unit. The details of the surgical procedure and anesthesia administration are also important but are typically conveyed through the surgical and anesthesia records. The plan for postoperative pain management and analgesic medications is essential but can be discussed and adjusted based on the patient's current status in the PACU. Documentation of the surgical count and instrument inventory is crucial for ensuring patient safety but is typically managed by the operating room team and may not be the immediate
A patient with a history of chronic liver disease presents with bruising, petechiae, and mucosal bleeding. Laboratory tests reveal prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) with decreased platelet count. Which of the following conditions is most likely to cause these findings?
- A. Immune thrombocytopenic purpura (ITP)
- B. Disseminated intravascular coagulation (DIC)
- C. Hemophilia A
- D. Von Willebrand disease
Correct Answer: B
Rationale: Disseminated intravascular coagulation (DIC) is a condition characterized by widespread activation of coagulation leading to both thrombosis and hemorrhage. In patients with chronic liver disease, especially in the setting of advanced cirrhosis, DIC can develop due to factors such as decreased synthesis of coagulation factors and impaired clearance of activated clotting factors. The patient in this scenario presents with signs of both abnormal bleeding (bruising, petechiae, mucosal bleeding) and laboratory findings consistent with DIC, including prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT) along with decreased platelet count.
As an epidemiology nurse, Nurse Rona's PRIMARY function and responsibility is to _____.
- A. Assist the epidemiologist in making reports
- B. Implement public health surveillance
- C. Render nursing care to sick residents
- D. Follow up cases and contacts Situation.
Correct Answer: B
Rationale: As an epidemiology nurse, Nurse Rona's primary function and responsibility is to implement public health surveillance. Epidemiology nurses play a crucial role in monitoring and controlling the spread of diseases within communities. This involves conducting surveillance activities to identify patterns of disease occurrence, investigating outbreaks, collecting and analyzing data, and collaborating with various stakeholders to develop strategies for disease prevention and control. While providing nursing care to sick residents is important, the primary focus of an epidemiology nurse is on population-based health issues rather than individual patient care. Additionally, while Nurse Rona may assist epidemiologists in making reports and follow up cases and contacts, her main role is to implement public health surveillance to protect and promote the health of the community as a whole.