Nokea
The nurse is providing teaching to the client receiving a thiazide diuretic. Which points should the nurse plan to include? Select all that apply.
- A. Take the radial pulse before setting up the medication.
- B. Include fruits such as melons and bananas in the diet.
- C. Report side effects such as muscle cramps, nausea, or a skin rash.
- D. Take the last dose at bedtime when fluids are at the highest level.
- E. Avoid high-fat foods; thiazide diuretics increase cholesterol levels.
Correct Answer: B,C,E
Rationale: A: It is unnecessary for the client to monitor the pulse prior to taking thiazide diuretics. B: Thiazide diuretics can cause hypokalemia, and potassium-rich foods can help maintain potassium levels. C: Muscle cramps are a sign of possible medication side effects of hypokalemia and hypocalcemia. Nausea and rash are also medication side effects. D: A diuretic taken at bedtime can cause nocturia and loss of sleep. The usual timing of the last daily dose of a diuretic is at suppertime. E: Thiazide diuretics can increase serum cholesterol, LDL, and triglyceride levels, so teaching the client to avoid high-fat foods will help maintain cholesterol levels.
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The nurse is educating the client concerning the possible side effects of a newly prescribed traditional antipsychotic medication. Which client statement reflects a need for further education regarding the side effects of this classification of medication?
- A. I need to get up from bed slowly so I will not get dizzy.
- B. The medication can cause constipation, so I need to eat fiber.
- C. I may need a sleeping pill because insomnia is a possible side effect.
- D. I can't risk gaining weight, so I will need to add some exercise to my routine.
Correct Answer: C
Rationale: Drowsiness, not insomnia, is a common side effect of traditional antipsychotics, indicating a need for further teaching.
The client with COPD is prescribed salmeterol diskus inhaler and fluticasone Rotadisk inhaler. Which instruction should the nurse include to prevent the client from developing oropharyngeal candidiasis?
- A. Drink a glass of water before taking your medications.
- B. Rinse your mouth after using your inhaler medications.
- C. Wait at least one minute before taking the next medication.
- D. Close your mouth tightly around the inhaler mouthpiece.
Correct Answer: B
Rationale: A: Drinking fluids before inhaler use may moisten the mouth, but it does not prevent oropharyngeal candidiasis. B: Oropharyngeal candidiasis is a yeast infection that occurs in the mouth due to destruction of the normal flora with the use of a glucocorticoid inhaler (fluticasone [Advair]). The nurse should instruct the client to rinse the mouth after using the glucocorticoid inhaler to prevent its occurrence. C: For best effectiveness, the client should wait 5 minutes between medications, but this has no effect on prevention of oropharyngeal candidiasis. D: This describes the correct technique for using an inhaler but does not reduce the risk of developing oropharyngeal candidiasis.
The nurse is caring for a client who has recently started using a PCA pump for pain management. Which of the following statements indicates a need for additional education.
- A. I will continue to report my pain score during assessments.
- B. I understand that there is a maximum dose in an hour that I can receive regardless of how many times I press the button.
- C. I think this new PCA pump is going to finally get rid of my back pain.
- D. I have more control of when and how much medication I receive.
Correct Answer: C
Rationale: The nurse should assess the client for reasonable versus unreasonable expectations of pain management when using a PCA pump. The patient should not expect the pain to go away completely.
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 6-month-old hospitalized with dehydration is being rehydrated with IV fluids. Which findings should indicate to the nurse that the treatment is having the desired effect? Select all that apply.
- A. Flat fontanelle
- B. Absence of crying
- C. Light yellow urine
- D. Rapid respirations
- E. Moist mucous membranes
Correct Answer: A,C,E
Rationale: A: Flat (rather than depressed) fontanelles indicate good hydration, which is the desired effect of IV rehydration. B: Absence of crying is not related to improved hydration status. C: Light-colored urine indicates good hydration, which is the desired effect of IV rehydration. D: Rapid respirations may indicate dehydration. E: Moist mucous membranes indicate good hydration, which is the desired effect of IV rehydration.