Nokea
The nurse teaches the client with relapsing-remitting MS about glatiramer. Which information addressed by the client indicates that the nurse's teaching has been effective? Select all that apply.
- A. Keep the medication vial refrigerated until it is to be used.
- B. Glatiramer is given by injection into the subcutaneous tissue.
- C. Rotate injection sites and wait a week before using a site again.
- D. The thigh and abdomen are the best subcutaneous injection sites.
- E. Syringes are washed, air dried, and reused until the needle is dull.
Correct Answer: A,B,C
Rationale: A: Glatiramer is used to delay the progression of MS. To maximize the therapeutic effects of glatiramer, it should be refrigerated and reconstituted correctly. B: Glatiramer is only administered subcutaneously; accidental IV administration must be avoided. C: Injection sites are rotated to prevent skin breakdown or lumps at the injection sites. D: Appropriate subcutaneous injection sites for glatiramer include the thigh, back of the hip, abdomen, and upper arm. E: Used syringes should be placed in a puncture-resistant container for proper disposal. Syringes and needles should not be reused.
You may also like to solve these questions
The child weighing 20 kg is to receive ceftriaxone 2 g IVPB q12h and dexamethasone 3 mg IV-push q6h for 4 days to treat Haemophilus influenzae type b meningitis. The drug reference states that the usual dose of ceftriaxone is 100 mg/kg/dose with a maximum daily dose of 4 g. The recommended dose of dexamethasone for treating H. influenzae type b meningitis is 0.15 mg/kg q6h for 2 to 4 days. Based on the medications prescribed and these findings, which conclusion by the nurse is correct?
- A. The dose of ceftriaxone is too high.
- B. The dose of dexamethasone is too low.
- C. Both medications are safe to administer as prescribed.
- D. The ceftriaxone should be given before the dexamethasone.
Correct Answer: C
Rationale: A: The dose for ceftriaxone is correct (100 mg x 20 kg = 2000 mg; 1000 mg = 1 g; 2000 mg = 2 g). B: The dose of dexamethasone is correct (0.15 mg x 20 kg = 3 mg). C: The doses of ceftriaxone (Rocephin) and dexamethasone (Decadron) are at the recommended doses. D: An IV-push medication takes less time to administer than an IV piggyback (IVPB) medication. The dexamethasone should be administered first.
The hospitalized child who has a blood lead level of 50 mcg/dL is to receive succimer 10 mg/kg oral capsule q8h for 5 days. The child weighs 20 kg. Which intervention by the student nurse should be corrected by the observing nurse?
- A. Prepares to give the total dose of one 100-mg capsule with applesauce
- B. Sprinkles the beads of two 100-mg capsules into pudding for administration
- C. Offers fluids frequently during the shift to increase the child's urine output
- D. Explains to a parent that chelation therapy removes the lead from the blood
Correct Answer: A
Rationale: A: The 20-kg child should receive two capsules of succimer (Chemet), not one. Dose (mg) = 20 kg x 10 mg/kg = 200 mg. B: Succimer capsules can be opened and sprinkled on a small amount of food or in liquid to be swallowed; two 100-mg capsules = 200 mg, which is the correct dose. C: Fluids should be increased to prevent renal damage because succimer is excreted by the kidneys. D: Succimer forms a water-soluble compound with lead, allowing urinary elimination of excessive amounts of lead. Lead is removed from the blood, and theoretically some lead is removed from tissues and organs.
The client taking imipramine is preparing for a summer vacation. Which information should the nurse include when planning client education regarding imipramine? Select all that apply.
- A. Drink additional fluids and add extra fiber to the diet
- B. Stop imipramine if experiencing any unpleasant side effects.
- C. Avoid alcohol, which can cause an additive depressant effect.
- D. Request an “as needed†sleeping pill in the event of insomnia.
- E. Wear sunglasses, protective clothing, and sunscreen while outdoors.
Correct Answer: A,C,E
Rationale: TCAs such as imipramine (Tofranil) may cause constipation, CNS depression when combined with alcohol, and photosensitivity. Increasing fluids and fiber, avoiding alcohol, and using sun protection are appropriate.
The nurse is preparing an educational program on immunizations for parents of children 11 to 12 years of age. To ensure the information presented is accurate for this age group, which immunizations should the nurse plan to address?
- A. Haemophilus influenza, varicella, and human papillomavirus (HPV)
- B. Mumps, measles, and rubella (MMR); pneumococcal (PPSV); and hepatitis A
- C. Diphtheria-tetanus-pertussis (DTaP), meningococcal, and haemophilus influenza
- D. Mumps, measles, and rubella (MMR); diphtheria-tetanus-pertussis (DTaP); and hepatitis B
Correct Answer: C
Rationale: A: Varicella vaccines are administered at 12 to 15 months, with the second dose at 4 to 6 years. B: The first dose of hepatitis A vaccine is administered before 1 year of age, with the second dose 6 months after the first dose. C: The recommended immunization schedule for children 11 to 12 years old includes a DTaP booster and meningococcal and haemophilus influenza vaccines. Others include HPV, PPSV, and hepatitis A series. D: MMR vaccines are administered at 12 to 15 months, with the second dose at 4 to 6 years. A hepatitis B vaccine is administered to all newborns prior to hospital discharge, with the second dose at 1 to 2 months and the third dose at 6 to 18 months.
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.