Nokea
During treatment of parasitic infections, the primary health care provider orders daily stool specimens be sent to the lab for examination. Which of the following would the nurse document as part of the client's plan of care?
- A. Number of stools produced
- B. Odor of stool
- C. Consistency of stool
- D. Frequency of stool
- E. Color of stool
Correct Answer: A,C,D,E
Rationale: The nurse should record the number, consistency, color, and frequency of stools as part of the client's plan of care. Documenting the odor is not necessary.
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Which of the following would the nurse include in the teaching plan as an adverse reaction for a client receiving antihelminthic therapy?
- A. Hypotension
- B. Drowsiness
- C. Abdominal pain
- D. Hypoglycemia
- E. Nausea
Correct Answer: B,C,E
Rationale: Antihelminthics cause several generalized adverse reactions that the client should be advised of, including drowsiness, dizziness, nausea, vomiting, abdominal pain and cramps, and diarrhea.
A nurse is administering an IV infusion of amphotericin B. The nurse would be alert for which of the following adverse reactions during the first 30 to 60 minutes of the infusion?
- A. Muscle pain
- B. Hypotension
- C. Nausea
- D. Decreased renal function
- E. Chills
Correct Answer: B,C,E
Rationale: When the nurse administers amphotericin B by IV infusion, immediate adverse reactions can occur within 15 to 20 minutes of beginning the infusion, including nausea, vomiting, hypotension, tachypnea, fever, and chills; therefore, it is important for the nurse to carefully monitor the client's temperature, pulse, respirations, and blood pressure during the first 30 to 60 minutes of treatment.
A client who is receiving oral systemic antifungal therapy has a nursing diagnosis of Risk for Ineffective Renal Tissue Perfusion. Which of the following would be least appropriate for the nurse to include in the client's plan of care?
- A. Monitoring urine output hourly
- B. Monitoring serum creatinine levels
- C. Evaluating blood urea nitrogen levels
- D. Premedicating the client with an antihistamine
Correct Answer: D
Rationale: For the nursing diagnosis of ineffective renal tissue perfusion, the nurse would monitor the client's urine output hourly and evaluate serum creatinine and BUN levels frequently. Premedicating the client with an antihistamine would only be appropriate if the client was receiving amphotericin B via IV infusion.
Which of the following would the nurse emphasize when teaching the client and family about measures to prevent reinfection and the transmission of a parasitic infection to others?
- A. Wash hands thoroughly before preparing or eating food.
- B. Disinfect toilets daily.
- C. Bathe daily.
- D. Disinfect the bathtub or shower stall immediately after bathing.
- E. Avoid putting fingers in the mouth or biting fingernails.
Correct Answer: A,B,C,D,E
Rationale: Important measures to include in the teaching plan to prevent reinfection and the transmission of a parasitic infection to others include the following: washing hands thoroughly before preparing or eating food, disinfecting toilets daily, bathing daily (showering is best), disinfecting the bathtub or shower stall immediately after bathing, and avoiding putting fingers in the mouth or biting fingernails.
After teaching a group of nursing students about amphotericin B, the instructor determines that the teaching was successful when the students identify which of the following as true?
- A. The drug is light sensitive.
- B. It can be administered via IM injection.
- C. The drug can cause renal damage.
- D. Amphotericin B is administered in the outpatient setting.
- E. The drug should be used within 8 hours.
Correct Answer: A,C,E
Rationale: Amphotericin B is given only under close supervision in the hospital setting, can cause renal damage, is given IV usually over a period of 6 hours, and should be protected from light and used within 8 hours of reconstitution.