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What nursing interventions should you perform when a patient is on Albuterol? (Select all that apply)
- A. Assess lung sounds, pulse, and blood pressure before administering
- B. Monitor for changes in behavior
- C. Observe for paradoxical bronchospasms
- D. Both A and C
Correct Answer: D
Rationale: The correct nursing interventions to perform when a patient is on Albuterol include assessing the patient's lung sounds, pulse, and blood pressure before administering the medication to monitor for cardiovascular side effects like increased heart rate. Additionally, it is crucial to observe for paradoxical bronchospasms, a rare but serious adverse reaction where the medication causes a worsening of bronchospasm instead of relief. Monitoring for changes in behavior is not directly related to Albuterol administration and is not a standard nursing intervention for patients receiving this medication, making choice B incorrect. Therefore, the correct answer is D as it includes the essential nursing actions for patients on Albuterol.
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A healthcare professional is preparing a client's medications. Which of the following actions should the professional take to follow legal practice guidelines? (Select all that apply.)
- A. Maintain skill competency.
- B. Determine the dosage.
- C. Monitor for adverse effects.
- D. Safeguard medications.
Correct Answer: A
Rationale: Maintaining skill competency is a critical aspect of legal practice guidelines for healthcare professionals. It is essential to ensure that healthcare professionals are competent and up-to-date with their skills to provide safe and effective care to patients. While determining the dosage, monitoring for adverse effects, and safeguarding medications are important aspects of medication administration, maintaining skill competency is a fundamental legal responsibility that ensures the delivery of quality care. Determining the dosage and monitoring for adverse effects are clinical responsibilities, while safeguarding medications pertains to proper storage and handling, not specifically related to legal practice guidelines.
A client has a new prescription for Warfarin. Which of the following instructions should the nurse include?
- A. Monitor for signs of bleeding.
- B. Avoid foods high in vitamin K.
- C. Expect to have increased urination.
- D. Take the medication with an antacid.
Correct Answer: A
Rationale: The correct instruction for a client starting Warfarin is to monitor for signs of bleeding. Warfarin is an anticoagulant that increases the risk of bleeding; therefore, it is crucial for the client to watch for any signs of bleeding, such as easy bruising, prolonged bleeding from cuts, blood in urine or stools, or unusual bleeding from gums or nose. If any of these signs occur, the client should promptly report them to their healthcare provider for further evaluation and management. Choices B, C, and D are incorrect because avoiding foods high in vitamin K is related to other medications like Coumadin, increased urination is not a common side effect of Warfarin, and taking Warfarin with an antacid can potentially interfere with its absorption.
What instruction should the nurse give regarding the adverse effect of dry mouth associated with diphenhydramine for a client with poison ivy?
- A. Administer the medication with food.
- B. Chew on sugarless gum or suck on hard, sour candies.
- C. Place a humidifier at your bedside every evening.
- D. Discontinue the medication and notify your provider.
Correct Answer: B
Rationale: The correct instruction for dry mouth associated with diphenhydramine is to chew on sugarless gum or suck on hard, sour candies. These actions stimulate saliva production, providing relief from dry mouth. Administering the medication with food (Choice A) may help reduce stomach upset but won't address dry mouth. Placing a humidifier at the bedside (Choice C) can help with dry air-related issues but won't specifically target dry mouth. Discontinuing the medication (Choice D) without consulting the provider is not recommended and may lead to inadequate treatment of poison ivy.
Which medication is used as a bronchodilator?
- A. Warfarin
- B. Lovastatin
- C. Albuterol
- D. Valproate
Correct Answer: C
Rationale: Albuterol is the correct answer. It is a medication commonly used as a bronchodilator to treat conditions such as asthma. Albuterol works by relaxing the muscles in the airways, allowing better airflow and making breathing easier for individuals with respiratory conditions. Warfarin (Choice A) is an anticoagulant used to prevent blood clots, Lovastatin (Choice B) is a medication used to lower cholesterol levels, and Valproate (Choice D) is used to treat seizures and bipolar disorder. These medications are not bronchodilators and are used for different medical conditions.
A client has a new prescription for Sucralfate. Which of the following instructions should the nurse include?
- A. Take the medication on an empty stomach.
- B. Increase your intake of high-sodium foods.
- C. Take the medication with a full glass of milk.
- D. Expect your stools to be black and tarry.
Correct Answer: A
Rationale: The correct instruction that the nurse should include for a client prescribed Sucralfate is to take the medication on an empty stomach. Sucralfate works by forming a protective barrier over ulcers, which is most effective when the stomach is empty. Taking it with food or other medications may decrease its effectiveness. Instructing the client to take Sucralfate on an empty stomach helps ensure optimal therapeutic benefits. Choices B, C, and D are incorrect because increasing high-sodium foods is not related to Sucralfate therapy, taking the medication with a full glass of milk is not recommended as it may decrease its effectiveness, and the presence of black and tarry stools is not an expected outcome of Sucralfate.