A 55-year-old patient with leukemia is being seen in the clinic for complaints of burning pain in the back.

The patient has been diagnosed with shingles.

The nurse would expect which medication classification to be ordered to reduce pain and halt the progression of the disease?

Antibiotic.

Antifungal.

Antiviral.

Anti-inflammatory.

Answer and Explanation

The Correct Answer is C

Choice A rationale

Antibiotics are ineffective against shingles because the disease is caused by a virus, not bacteria. Shingles, or herpes zoster, is a reactivation of the varicella-zoster virus. Antibiotics target and kill bacteria by disrupting their cell walls or inhibiting protein synthesis. Administering an antibiotic would not address the viral cause of the disease and would not reduce the pain or halt its progression.

Choice B rationale

Antifungal medications are not indicated for the treatment of shingles. These drugs are specifically designed to treat infections caused by fungi by targeting the fungal cell wall or membrane. Since shingles is a viral infection, antifungal drugs would have no therapeutic effect on the varicella-zoster virus and would fail to alleviate symptoms or alter the course of the disease.

Choice C rationale

Antiviral medications are the primary treatment for shingles. These drugs, such as acyclovir, valacyclovir, and famciclovir, work by inhibiting viral DNA replication. By interrupting the viral life cycle, they can reduce the severity and duration of the outbreak, lessen the associated pain, and decrease the risk of postherpetic neuralgia. These medications are most effective when initiated within 72 hours of symptom onset.

Choice D rationale

While anti-inflammatory medications may be used to manage the pain associated with shingles, they do not halt the progression of the disease. Nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids can reduce inflammation and provide symptomatic pain relief. However, they do not target the varicella-zoster virus itself. The primary treatment to stop the viral replication and disease progression is an antiviral medication. *.

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Correct Answer is C

Explanation

Choice A rationale

Respiratory alkalosis is characterized by a high pH (above 7.45) and a low PaCO$_2$ (below 35). This is typically caused by hyperventilation, where the patient is blowing off too much carbon dioxide. The patient's ABGs (pH 7.30, PaCO$_2$ 50) show a low pH and a high PaCO$_2$, which is the opposite of respiratory alkalosis.

Choice B rationale

Metabolic acidosis is characterized by a low pH (below 7.35) and a low HCO$_3$ (below 22). While the patient's pH is low (7.30), the HCO$_3$ (26) is within the normal range. The primary imbalance is the elevated PaCO$_2$ (50), indicating a respiratory problem rather than a metabolic one like diabetic ketoacidosis.

Choice C rationale

The patient's ABGs show a low pH (7.30, normal 7.35-7.45), indicating acidosis. The high PaCO$_2$ (50, normal 35-45) indicates a respiratory cause for the acidosis, as carbon dioxide acts as an acid in the blood. The normal HCO$_3$ (26, normal 22-26) suggests that the metabolic system has not yet compensated. This pattern is characteristic of respiratory acidosis caused by hypoventilation.

Choice D rationale

Metabolic alkalosis is characterized by a high pH (above 7.45) and a high HCO$_3$ (above 26). Cushing syndrome can sometimes cause metabolic alkalosis. However, the patient's ABGs (pH 7.30, HCO$_3$ 26) show a low pH and a normal HCO$_3$, which is inconsistent with metabolic alkalosis. .

A. Passage of the ET tube into the esophagus. B. Movement of the ET tube into the right main bronchus. C. Infection of the vocal cords. D. Blockage of the ET tube by the patient's tongue.

Correct Answer is B

Explanation

Choice A rationale

If the endotracheal tube were in the esophagus, there would be no chest wall expansion on either side, and breath sounds would be absent. Instead, abdominal distention would be observed as air enters the stomach. The absence of chest wall expansion on only one side indicates a problem within the respiratory tract, not an esophageal intubation.

Choice B rationale

The right main bronchus is wider, shorter, and more vertical than the left, making it more likely for an endotracheal tube to be advanced too far and enter this bronchus. When the tube is lodged in the right main bronchus, the left lung is not ventilated, leading to the absence of breath sounds and chest wall expansion on the left side, as observed.

Choice C rationale

Vocal cord infection would cause symptoms such as hoarseness, pain, and potentially swelling. It does not typically lead to the absence of unilateral chest wall expansion. The absence of left-sided chest wall expansion is a mechanical ventilation issue related to the tube's position, not an infectious process of the larynx.

Choice D rationale

A blockage of the endotracheal tube by the patient's tongue is anatomically impossible. The endotracheal tube is designed to bypass the oral cavity and extend past the tongue into the trachea. While the tube could become occluded by secretions or kinking, the tongue is not a source of obstruction for an properly placed endotracheal tube.

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A 55-year-old patient with leukemia is being seen in the clinic for complaints of burning pain in the back. The patient has been diagnosed with shingles. The nurse would expect which medication classification to be ordered to reduce pain and halt the progression of the disease?

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A patient has the following arterial blood gasses (ABGs): pH 7.30, PaCO$_2$ 50, HCO$_3$ 26. Which diagnosis do these ABGs correlate with?

Correct Answer is C

Explanation

A nurse in the postanesthesia care unit is assessing a patient who has an endotracheal tube in place and observes the absence of left-sided chest wall expansion upon respiration. Which of the following complications should the nurse suspect?

Correct Answer is B

Explanation

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A 55-year-old patient with leukemia is being seen in the clinic for complaints of burning pain in the back.

The patient has been diagnosed with shingles.

The nurse would expect which medication classification to be ordered to reduce pain and halt the progression of the disease?