Nokea
In planning care for this client, the nurse should anticipate which of the following side effects to contribute to a sense of altered body image?
- A. cushingoid appearance
- B. alopecia
- C. temporary or permanent sterility
- D. pathologic fractures
Correct Answer: D
Rationale: Pathologic fractures are not common to the disease process. Its treatment through osteoporosis is a potential complication of steroid use. Hodgkin's disease most commonly affects young adults (males), is spread through lymphatic channels to contiguous nodes, and also might spread via the hematogenous route to extradal sites (GI, bone marrow, skin, and other organs). A working staging classification is performed for clinical use and care.
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Oral ranitidine 2 mg/kg twice daily is prescribed for the infant weighing 16 lb 8 oz. The medication is supplied as 15 mg/mL. How many milliliters should the nurse instruct the parent to withdraw in the syringe provided with the ranitidine to administer one dose?
Correct Answer: 1
Rationale: Use a proportion formula to calculate the dose. First determine the dose for the child's weight: 16 lb 8 ounces = 16.5 lb/ 2.2 lb/kg = 7.5 kg. Next determine the prescribed dose: 7.5 kg x 2 mg = 15 mg. The medication is supplied in 15 mg per 1 mL. The dose to administer is 1 mL of ranitidine (Zantac).
Trimethoprim-sulfamethoxazole is prescribed for the child who develops a UTI. What information should the nurse address when teaching the parents about administering the medication? Select all that apply.
- A. Weigh the child daily in the morning.
- B. Take the child's temperature once daily.
- C. Encourage the child to drink plenty of fluids.
- D. Administer the medication at the prescribed times.
- E. If a rash occurs, report this immediately to the HCP.
Correct Answer: C,D,E
Rationale: A: Weighing is unnecessary; it is important with medications that affect fluid balance, but not with an antibiotic. B: Monitoring temperature would be important to evaluate the effectiveness of antipyretic medications. C: Fluids should be increased to dilute bacterial toxins and increase urinary output. D: The medication should be given in the exact amount at the times directed to maintain a therapeutic blood level. If the therapeutic blood level falls, organisms can build a resistance to the medication. E: Trimethoprim-sulfamethoxazole (Bactrim) is a sulfonamide antibiotic. A rash can indicate an allergy to sulfonamides.
The client has a new prescription for metoclopramide. The nurse notifies the HCP because the client has a contraindication for metoclopramide use. Which information in the client's medical record most likely prompted the nurse's notification of the HCP?
- A. Use of nasogastric suctioning
- B. History of diabetes mellitus
- C. History of seizure disorders
- D. Chemotherapy treatment for cancer
Correct Answer: C
Rationale: A: The use of NG suctioning alone would not prevent metoclopramide use. Metoclopramide can be administered through the NG tube; the tube is then clamped for an hour after administration until absorption occurs. B: Metoclopramide should be used with caution with DM, but it is not contraindicated. C: The client's history of a seizure disorder would contraindicate the use of metoclopramide. Because metoclopramide (Reglan) blocks dopamine receptors in the chemoreceptor trigger zone of the CNS, it is contraindicated in seizure disorders. D: Metoclopramide is used in the treatment of nausea and vomiting for clients receiving chemotherapy.
The nurse is preparing to care for the 14-month-old newly hospitalized toddler with bacterial gastroenteritis and severe dehydration. Which initial collaborative interventions should the nurse expect to implement? Select all that apply.
- A. IV antibiotic to treat infection
- B. Oral fluids for fluid rehydration
- C. IV fluid therapy for rehydration
- D. Analgesics for pain and discomfort
- E. An antidiarrheal to control diarrhea
- F. Antipyretic for elevated temperature
Correct Answer: A,C,F
Rationale: A: Antibiotics may be prescribed to treat bacterial gastroenteritis to ensure complete recovery. B: Oral fluid rehydration will be initiated later, but not initially, when the toddler presents with severe dehydration. C: The child who presents with severe dehydration needs IV therapy to stabilize the balance of fluids and electrolytes. D: The pain and discomfort the toddler will have are due to fever and cramping from the GI illness; thus, analgesics are usually not prescribed. E: An antidiarrheal medication is contraindicated. F: Fever is often a symptom of gastroenteritis. Ensuring that the fever is controlled will provide some comfort.
A client with asthma develops respiratory acidosis. Based on this diagnosis, what should the nurse expect the client's serum potassium level to be?
- A. normal
- B. elevated
- C. low
- D. unrelated to the pH
Correct Answer: B
Rationale: Hyperkalemia occurs in a state of acidosis because potassium moves from injured cells into the bloodstream.