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A patient who is receiving care for osteosarcoma has been experiencing severe pain since being diagnosed. As a result, the patient has been receiving analgesics on both a scheduled and PRN basis. For the past several hours, however, the patients level of consciousness has declined and she is now unresponsive. How should the patients pain control regimen be affected?
- A. The patients pain control regimen should be continued.
- B. The pain control regimen should be placed on hold until the patients level of consciousness improves.
- C. IV analgesics should be withheld and replaced with transdermal analgesics.
- D. The patients analgesic dosages should be reduced by approximately one half. Chapter 36: Immune : HIV/AIDS: stages, testing, complications, assessment; care & Safe Sexual practices
Correct Answer: C
Rationale: The correct answer is C. When a patient's level of consciousness declines and becomes unresponsive, it may indicate a potential overdose of analgesics. To ensure patient safety, IV analgesics should be withheld and replaced with transdermal analgesics, which provide a more controlled and gradual release of medication. This switch helps prevent further overdose and adverse effects. Continuing the current pain control regimen (Choice A) may worsen the situation. Placing the pain control regimen on hold (Choice B) may lead to inadequate pain management. Reducing analgesic dosages (Choice D) may not be sufficient in addressing the overdose issue.
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In providing prenatal care to a pregnant patient, what does the nurse teach the expectant mother?
- A. Calcium intake is especially important in the first trimester.
- B. Protein intake needs to decrease to preserve kidney function.
- C. Folic acid is needed to help prevent birth defects and anemia.
- D. Extra vitamins and minerals should be taken as much as possible.
Correct Answer: C
Rationale: The correct answer is C because folic acid is crucial in preventing neural tube defects and anemia in the developing fetus. The nurse should teach the expectant mother about the importance of taking folic acid supplements before and during pregnancy. Folic acid is essential for proper cell division and growth, reducing the risk of birth defects.
Choice A is incorrect because calcium intake is important throughout pregnancy, not just in the first trimester. Choice B is incorrect as protein intake should be adequate to support maternal and fetal growth, not decreased. Choice D is incorrect as excessive intake of vitamins and minerals can be harmful to the mother and the baby.
In summary, the expectant mother should be educated on the importance of folic acid supplementation to prevent birth defects and anemia, while also ensuring a balanced diet with all essential nutrients.
An oncology patient has begun to experience skin reactions to radiation therapy, prompting the nurse to make the diagnosis Impaired Skin Integrity: erythematous reaction to radiation therapy. What intervention best addresses this nursing diagnosis?
- A. Apply an ice pack or heating pad PRN to relieve pain and pruritis
- B. Avoid skin contact with water whenever possible
- C. Apply phototherapy PRN
- D. Avoid rubbing or scratching the affected area
Correct Answer: D
Rationale: Correct Answer: D - Avoid rubbing or scratching the affected area
Rationale:
1. Rubbing or scratching can further damage the already compromised skin integrity.
2. By avoiding rubbing or scratching, the patient reduces the risk of infection and delayed healing.
3. This intervention promotes skin healing and prevents worsening of the condition.
Summary:
A: Applying ice pack or heating pad may provide temporary relief but does not address the root cause of impaired skin integrity.
B: Avoiding skin contact with water is not necessary and may not directly improve skin integrity.
C: Phototherapy is not indicated for erythematous reactions to radiation therapy and may not address the issue.
A laboratory finding indicatiNveU oRf SDIICN iGs oTnBe .thCatO sMhows
- A. decreased fibrinogen.
- B. increased platelets.
- C. increased hematocrit.
- D. decreased thromboplastin time.
Correct Answer: A
Rationale: The correct answer is A: decreased fibrinogen. In disseminated intravascular coagulation (DIC), there is widespread activation of coagulation leading to consumption of clotting factors like fibrinogen, resulting in decreased levels. Platelets are usually decreased, not increased, in DIC. Hematocrit may be elevated due to hemoconcentration but not directly related to DIC. Thromboplastin time would be prolonged, not decreased, in DIC due to consumption of clotting factors.
A nurse practitioner is assessing a 55-year-old male patient who is complaining of perineal discomfort, burning, urgency, and frequency with urination. The patient states that he has pain with ejaculation. The nurse knows that the patient is exhibiting symptoms of what?
- A. Varicocele
- B. Epididymitis
- C. Prostatitis
- D. Hydrocele
Correct Answer: C
Rationale: The correct answer is C: Prostatitis. The patient's symptoms of perineal discomfort, burning, urgency, frequency with urination, and pain with ejaculation are indicative of prostatitis. Prostatitis is inflammation of the prostate gland, leading to these symptoms. Varicocele (A) is an enlargement of the veins within the scrotum, usually painless. Epididymitis (B) is inflammation of the epididymis, causing scrotal pain and swelling. Hydrocele (D) is a fluid-filled sac around the testicle, typically painless. The patient's symptoms align most closely with prostatitis due to the involvement of the prostate gland and the specific urinary and ejaculatory symptoms experienced.
A patients decline in respiratory and renal function has been attributed to Goodpasture syndrome, which is a type II hypersensitivity reaction. What pathologic process underlies the patients health problem?
- A. Antigens have bound to antibodies and formed inappropriate immune complexes.
- B. The patients body has mistakenly identified a normal constituent of the body as foreign.
- C. Sensitized T cells have caused cell and tissue damage.
- D. Mast cells have released histamines that directly cause cell lysis.
Correct Answer: B
Rationale: The correct answer is B because in Goodpasture syndrome, the patient's immune system mistakenly targets normal constituents of the body, specifically the basement membrane of the kidneys and lungs. This autoimmune response leads to inflammation and damage in these organs, resulting in respiratory and renal dysfunction.
Choice A is incorrect as immune complexes are not the primary mechanism in Goodpasture syndrome. Choice C is incorrect as it refers to T cell-mediated immune responses, which are not the main drivers in this condition. Choice D is incorrect as histamine release and cell lysis are not the main processes involved in Goodpasture syndrome.