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A patient in the ICU develops acute kidney injury (AKI) secondary to hypovolemic shock. What intervention should the healthcare team prioritize to manage the patient's renal function?
- A. Administer intravenous fluids to restore circulating volume.
- B. Initiate continuous renal replacement therapy (CRRT) for RRT.
- C. Implement strict dietary restrictions to reduce renal workload.
- D. Recommend nephrotoxic medications for therapeutic purposes.
Correct Answer: A
Rationale: In a patient with acute kidney injury (AKI) secondary to hypovolemic shock, the priority intervention to manage the patient's renal function is to administer intravenous fluids to restore circulating volume. Hypovolemic shock leads to decreased blood flow to the kidneys, resulting in hypoperfusion and ischemic damage to the renal tubules. Prompt correction of hypovolemia with intravenous fluids helps improve renal perfusion and function by increasing blood flow to the kidneys. Adequate fluid resuscitation can potentially prevent further kidney damage and support kidney function recovery. It is crucial to address the underlying cause of AKI (hypovolemia in this case) to prevent complications and improve patient outcomes. Initiating renal replacement therapy or recommending nephrotoxic medications would not be the initial interventions for managing AKI in this scenario.
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When an accurate documentation whether done manually or by electronic by the health care professionals in their Work setting is a component of what quality standards in a health care delivery system?
- A. Patient care standards
- B. Leadership and management
- C. Information management
- D. Human resource management
Correct Answer: C
Rationale: Accurate documentation, whether done manually or electronically by health care professionals, is a critical component of information management in a health care delivery system. Information management involves the collection, storage, processing, and sharing of data to support decision-making and ensure quality care for patients. Properly documented records enable health care providers to have access to relevant information about a patient's medical history, treatment plans, and progress. This helps in delivering effective and coordinated care, reducing medical errors, and improving overall patient outcomes. Moreover, well-kept records are essential for legal and regulatory compliance, billing, quality assessment, and research purposes. Therefore, accurate documentation plays a key role in information management within the healthcare setting.
The nurse plans to educate the entire family about obsessive compulsive disorder. Which of the following plans would be the MOST effective?
- A. The nurse directs resources to help them 1earn about the illness medication to treat it.
- B. The nurse teaches the family about Mrs. Juan's illness and medication and suggests that they educate her disease and the medications to treat it.
- C. The nurse educates the entire famil1v at the same time about the disease and medications to treat it.
- D. The nurse teaches Mrs . Juan about her illness and her mediations and suggests that she teaches her family what she has learned .
Correct Answer: C
Rationale: The most effective plan would be for the nurse to educate the entire family at the same time about the disease and medications to treat it (Option C). This approach ensures that each family member receives the same information and understanding about obsessive compulsive disorder (OCD) and its treatment. By educating the entire family simultaneously, it creates a supportive environment where everyone is on the same page and can provide understanding and assistance to the individual with OCD, in this case, Mrs. Juan. It also allows for open communication and collaboration within the family unit, leading to better management and support for Mrs. Juan in dealing with her illness.
A client is admitted with acute gouty arthritis. Which medication does the nurse anticipate the health care provider may prescribe to prevent and treat an acute attack of gout?
- A. Ibuprofen (Motrin)
- B. Probenecid (Benemid)
- C. Colchicine (Colsalide)
- D. Hydrocortisone (Cortef)
Correct Answer: C
Rationale: Colchicine is a medication commonly prescribed to prevent and treat acute attacks of gout. It works by reducing inflammation caused by the buildup of uric acid crystals in the joints. Colchicine is effective in relieving pain and reducing swelling during gout attacks. It is important to follow the prescribed dosage due to potential side effects such as gastrointestinal upset. Ibuprofen is a nonsteroidal anti-inflammatory drug that can be used for pain relief but is not specific for gout treatment. Probenecid is used for chronic gout by helping the kidneys remove uric acid, not for acute gout attacks. Hydrocortisone is a steroid that may be used in some cases but is not a first-line treatment for acute gouty arthritis.
A postpartum client reports persistent, severe perineal pain despite analgesic medication. On assessment, the nurse observes ecchymosis and swelling of the perineum. Which nursing action is most appropriate?
- A. Applying ice packs to the perineum for pain relief
- B. Encouraging the client to sit on a donut cushion
- C. Notifying the healthcare provider immediately
- D. Administering additional analgesic medication
Correct Answer: C
Rationale: The presence of ecchymosis (bruising) and significant swelling in the perineum despite analgesic medication suggests a potential complication such as a hematoma. A hematoma is a collection of blood that can occur due to trauma or during childbirth. It is important to notify the healthcare provider immediately so that further assessment and interventions, such as drainage of the hematoma, can be initiated promptly to prevent complications and alleviate the client's pain. Applying ice packs or encouraging the client to sit on a donut cushion may provide temporary relief but will not address the underlying issue of a potentially serious hematoma. Administering additional analgesic medication may not be effective in this case if the pain is primarily due to the hematoma. Prompt notification of the healthcare provider is crucial for proper management of this situation.
A postpartum client who experienced a perineal laceration reports pain and discomfort during defecation. What nursing intervention should be prioritized to alleviate symptoms?
- A. Recommending the use of stool softeners or laxatives
- B. Encouraging the client to increase fluid and fiber intake
- C. Providing perineal care using peri-bottles with warm water
- D. Instructing the client on proper positioning for defecation
Correct Answer: A
Rationale: The priority nursing intervention for a postpartum client who experienced a perineal laceration and reports pain and discomfort during defecation is to recommend the use of stool softeners or laxatives. Perineal lacerations can lead to pain and discomfort during bowel movements due to the strain that passing stools may cause on the tender area. Stool softeners or laxatives can help soften the stool, making it easier and less painful for the client to have bowel movements. It is important to alleviate the discomfort and promote bowel regularity to prevent complications such as constipation, which can further exacerbate the pain and delay healing of the perineal laceration.