Nokea
The client admitted to the ED has drowsiness, clammy skin, and slow, shallow breathing. A friend states that the client took multiple oxycodone tablets. Which medication should the nurse plan to administer to this client?
- A. Naloxone
- B. Disulfiram
- C. Flumazenil
- D. Acetylcysteine
Correct Answer: A
Rationale: Naloxone (Narcan) reverses CNS and respiratory depression due to opioid overdose.
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The 4-year-old with meningitis is to receive ceftriaxone 750 mg IVPB over 30 minutes. The pharmacy provided 750 mg in 50 mL D5W to be infused IVPB through a microdrip infusion system (tubing drop factor 60 gtt/min). At what rate, in gtt per min, should the nurse program the IVPB pump?
Correct Answer: 100
Rationale: Volume to be infused is 50 mL over 30 minutes. Calculate mL/min: 50 mL/ 30 min = 1.6667 mL/min. Convert to gtt/min using the drop factor: 1.6667 mL/min x 60 gtt/mL = 100 gtt/min.
The nurse completed teaching for the client who will be receiving TPN at home. Which client statement indicates that further teaching is needed?
- A. My refrigerator is big enough to store several bags of parenteral solution.
- B. I will keep my cellular phone with me at all times to use in an emergency.
- C. I plan to use the main floor bedroom; it'll be best with the infusion pump.
- D. I'll sit at the table to remove the IV catheter cap to attach the IV tubing.
Correct Answer: D
Rationale: A: Several total nutrient solution bags are kept on hand and require refrigeration. B: A telephone is necessary for contacting home health personnel, arranging for supply deliveries, and calling emergency services. C: The TPN is delivered through an infusion pump, which can limit the client's mobility. D: The central catheter lumen is capped with a needleless port. The IV infusion tubing is connected to the insertion site cap and not removed to administer the TPN solution. Caps are changed every 3 to 7 days during dressing changes, with the client in a flat position. An air embolus can occur if the cap is removed while the client is in a sitting position.
A client has chronic respiratory acidosis caused by end-stage chronic obstructive pulmonary disease (COPD). Oxygen is delivered at 1 L/min per nasal cannula. The nurse teaches the family that the reason for this is to avoid respiratory depression, based on which of the following explanations?
- A. COPD clients are stimulated to breathe by hypoxia.
- B. COPD clients depend on a low carbon dioxide level.
- C. COPD clients tend to retain hydrogen ions if they are given high doses of oxygen.
- D. COPD clients thrive on a high oxygen level.
Correct Answer: A
Rationale: COPD clients are compensating for low oxygen and high carbon dioxide levels. Hypoxia is the main stimulus to breathe in persons with chronic hypercapnia. Increasing the level of oxygen decreases the stimulus to breathe.
The best lab test to diagnose disseminated intravascular coagulation (DIC) is:
- A. platelet count
- B. protime (PT)
- C. partial thromboplastin time (PTT)
- D. D-dimer
Correct Answer: D
Rationale: The D-dimer test specifically detects fibrin degradation products, indicating DIC's characteristic clotting and fibrinolysis. Other tests are less specific.
A pregnant Asian client who is experiencing morning sickness wants to take ginger to relieve the nausea. Which of the following responses by the nurse is appropriate?
- A. I will call your physician to see if we can start some ginger.'
- B. We don't use home remedies in this clinic.'
- C. Herbs are not as effective as regular medicines.'
- D. Just eat some dry crackers instead.'
Correct Answer: A
Rationale: This statement reveals cultural sensitivity. Ginger is sometimes used to relieve nausea. The other statements are culturally insensitive and do not show an awareness of herbal pharmacology.